Tinnitus evolution in patients with sudden sensorineural hearing loss treated with hyperbaric oxygen therapy
Introduction: Sudden sensorineural hearing loss presents with tinnitus in up to 90% of cases. Tinnitus constitutes a subjective complaint, therefore hard to quantify and evaluate. Hyperbaric oxygen therapy (HOT) constitutes a valuable adjunctive therapy in patients who are only parcially re...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Portuguese Society of Otolaryngology and Head and Neck Surgery
2023-03-01
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| Series: | Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço |
| Subjects: | |
| Online Access: | https://journalsporl.com/index.php/sporl/article/view/2002 |
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| Summary: | Introduction: Sudden sensorineural hearing loss presents with tinnitus in up to 90% of cases. Tinnitus constitutes a subjective complaint, therefore hard to quantify and evaluate. Hyperbaric oxygen therapy (HOT) constitutes a valuable adjunctive therapy in patients who are only parcially responsive or refractory to corticoid treatment, but the effect it may have on tinnitus remains poorly studied.
Goals: To evaluate HOT effect on tinnitus and audiometric evolution in sudden sensorineural hearing loss with tinnitus, refractory to corticoid treatment.
Methods: This paper presents a prospective non- controlled study that applied Tinnitus Handicap Inventory (THI) before and after treatment with HOT. The study was carried in the Portuguese Navy’s Center for Hyperbaric and Subaquatic Medicine, between May and December, 2018. The Center’s HOT protocol included on average 20 sessions at 2.5 ATM for 90 minutes. The statistic analysis was performed using IBM SPSS Statistics 26 software.
Resuls: 57 patients were included in the study, with ages between 25-78 years (average 51), 50.8% female. The average time between symptom onset and HOT was 34,9 days. We were able to make an inverse correlation between the symptom- treatment window and hearing outcomes (p=0,045). The average hearing outcome was of 17dB. According to Spiegel’s hearing outcome classification, there was complete recovery in 19% of patients, parcial recovery in 23%, slight improvement in 33% and no improvement in 25% of patients. Regarding tinnitus, most patients had a THI classification of grade 3 or 4 before treatment (71%). After treatment, 77% of patients presented a THI score <3. We observed an improvement of THI classification even in patients with no audiometric improvement.
Conclusion: This data concludes that, besides improving hearing outcomes, HOT seems to have a positive effect in improving tinnitus and it’s impact in the patient’s quality of life. Patients should be referred to HOT treatment as soon as possible, since the window between symptom onset and HOT treatment has a significant effect on hearing outcomes.
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| ISSN: | 2184-6499 |