J Int Adv Otol. 2026 Oct 12;22(5):1-6. doi: 10.65717/iao.2026.252388.
ABSTRACT
BACKGROUND: To evaluate the clinical efficacy and safety of hyperbaric oxygen therapy (HBOT) combined with systemic corticosteroids in patients with idiopathic sudden sensorineural hearing loss (ISSNHL), with particular focus on treatment timing, predictors of hearing recovery, and the impact of comorbidities.
METHODS: This retrospective observational cohort study was conducted at a tertiary referral center (AOU "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy). A total of 332 adult patients with ISSNHL treated between 2014 and 2024 were included. All patients received combined therapy with systemic corticosteroids (oral prednisone 1 mg/kg/day, tapered over 10-15 days) and HBOT (2.4 atmospheres absolute, 90 minutes per session; median of 10 sessions). Audiometric outcomes were assessed using pure-tone average (PTA). Treatment response was defined as a ≥30% improvement in PTA compared with baseline. Multivariate logistic regression was performed to identify independent predictors of hearing improvement. Safety outcomes were also recorded.
RESULTS: Mean baseline PTA was 61.3 ± 21.5 dB HL, improving to 44.6 ± 22.7 dB HL after treatment, with a mean hearing gain of 16.7 ± 14.2 dB HL (P < .001). Overall, 151 patients (43.5%) met the response criteria. Responders presented with significantly higher baseline PTA compared with nonresponders (67.6 vs. 56.8 dB HL, P < .001) and more frequently reported tinnitus (64.2% vs. 51.5%, P = .014). Median time to treatment initiation was 15 days (interquartile range: 7-30). Multivariate analysis identified shorter time to treatment (odds ratio [OR]: 0.95, 95% CI: 0.92-0.98), presence of tinnitus (OR: 1.79, 95% CI: 1.15-2.80), and higher baseline PTA (OR: 1.03, 95% CI: 1.01-1.05) as independent predictors of hearing improvement. Common comorbidities, including hypertension, diabetes, and cardiovascular disease, were not significantly associated with treatment response. No serious adverse events related to HBOT were observed.
CONCLUSION: Hyperbaric oxygen therapy combined with systemic corticosteroids was associated with improved audiometric outcomes in patients with ISSNHL, particularly when initiated early. Shorter time to treatment, greater baseline hearing loss, and the presence of tinnitus emerged as independent predictors of hearing recovery. Overall, these findings suggest an association between early HBOT use and improved audiometric outcomes and support its consideration as an adjunctive component of multimodal treatment strategies for ISSNHL.
PMID:42867355 | DOI:10.65717/iao.2026.252388