Hyperbaric Oxygen Shows Promise as Initial Therapy for Sudden Deafness
NEW YORK (Reuters Health) Mar 29 - In patients with sudden deafness, initial treatment with hyperbaric oxygen (HBO) plus conventional therapy is associated with improved hearing outcomes compared with conventional therapy alone, according to a recent report.
While the exact cause of sudden deafness is unknown, cochlear hypoxia appears to play an important role. In an attempt to improve the hypoxic state, some centers have begun using HBO therapy. The reported success of such an approach has varied, but in most studies, HBO therapy was only pursued after conventional therapy had failed.
Dr. Cagatay Oysu, from Taksim State Hospital in Istanbul, Turkey, and colleagues assessed the hearing outcomes of 50 patients with sudden deafness who were treated at initial presentation with conventional therapy with or without HBO therapy.
Conventional therapy involved treatment with betahistine hydrochloride and prednisone, as well as a daily stellate ganglion block. Patients treated with HBO received a total of 20 sessions over a 13-day period.
The average hearing gain was 17.9 dB higher in patients who received combination therapy compared with those who received only conventional therapy, the authors state in the February issue of Otolaryngology-Head and Neck Surgery.
In the combination therapy group, mean hearing gain was highest in patients younger than 50 years of age. In fact, for patients older than 60 years, the addition of HBO therapy did not offer any hearing gain over conventional therapy.
HBO therapy is strongly recommended for patients younger than 50 years with sudden deafness, the authors state. "For patients between the ages of 50 and 60, the physician should explain to the patient the limited value of HBO therapy and discuss the cost and benefits of the treatment," they add. Given its potential complications and lack of benefit, HBO therapy is not recommended for patients older than 60 years.
Otolaryngol Head Neck Surg 2002;126:121-126.
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