Sudden Hearing Loss

Benefits from Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is a recognized adjunct for idiopathic sudden sensorineural hearing loss (ISSHL) — also referred to as sudden sensorineural hearing loss (SSNHL) or simply sudden hearing loss (SHL). This condition is defined as a rapid loss of at least 30 dB over three contiguous frequencies within 72 hours and is considered an otologic emergency. By substantially increasing dissolved oxygen delivery to the cochlea, HBOT counteracts inner-ear hypoxia/ischemia and oxidative injury, supporting hair-cell recovery, especially when started early and combined with steroids.

Major guidelines and consensus statements support time sensitive use: the Undersea & Hyperbaric Medical Society (UHMS) lists ISSHL as an approved indication; the European Committee for Hyperbaric Medicine recommends HBOT initiated within 2 weeks of onset (with salvage up to 1 month in severe/profound cases); and the American Academy of Otolaryngology Head & Neck Surgery guideline allows HBOT as initial therapy within 2 weeks and as salvage within 1 month.

Evidence syntheses and large clinical series report that adding HBOT to steroid therapy improves hearing outcomes versus medical therapy alone, with earlier treatment associated with greater recovery. The typical protocol delivers 2.0–2.5 ATA oxygen for about 90 minutes, over 10–20 sessions.

Given this patient’s acute ISSHL and high risk of permanent hearing loss without prompt therapy, urgent access to HBOT is medically necessary. Aligning with the above guidance, approval for treatment now, rather than delaying care, offers the best chance to preserve hearing.