Combination of hyperbaric oxygen therapy and steroid therapy effective in people with sudden hearing loss: Study
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Japan: A recent study published in Otology & Neurotology has found an enhanced recovery rate with the combination of hyperbaric oxygen therapy (HBOT) and steroids in patients with sudden hearing loss, especially in severe cases.
Inflammatory markers, including the platelet–lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) were found to be valuable predictors of treatment outcomes, with lower PLR (cutoff at 146.67) and lower NLR (cutoff at 2.43) values linked to improved recovery rates.
Shinya Ohira, Department of Otolaryngology, Shonan Kamakura General Hospital, Okamoto, Kamakura-shi, Kanagawa, Japan, and colleagues aimed to evaluate the therapeutic effect of hyperbaric oxygen therapy combined with steroid therapy for treating sudden hearing loss. They also examined the index associated with excellent therapeutic effect.
For this purpose, the researchers included 109 patients with sudden hearing loss. Patients were categorized into the HBOT combination group (59 sides) treated with HBOT and steroid therapy and the HBOT noncombination group (50 sides) involving only steroid therapy.
The recovery rate of each group was compared by the severity of hearing loss. Blood samples were evaluated and inflammatory markers, such as PLR and NLR, were calculated and compared by severity. The usefulness of inflammatory markers for predicting recovery rate was evaluated, and calculated cutoff values were also evaluated.
The study led to the following findings:
· The HBOT combination group exhibited a higher overall recovery rate than the HBOT noncombination group, particularly in severe cases.
· There was no significant difference in the severity of hearing loss based on various inflammatory markers.
· NLR and PLR are useful for predicting the effect in patients treated with concomitant HBOT.
· By setting 2.43 and 146.67 as cutoff values for NLR and PLR, respectively, lower values resulted in better recovery rates.
"The use of hyperbaric oxygen therapy is effective for severe cases and early blood flow disorders with low PLR and NLR and less inflammation," the researchers wrote.
"When determining treatment, not only should the hearing loss severity be considered, but the PLR and NLR should also be evaluated and examined based on the cutoff values," they concluded.
Reference:
Ohira, Shinya∗,†; Komori, Manabu‡; Tsuna, Yukari∗,†; Nakamura, Mitsuto∗,†; Yamaguchi, Yusei∗,†; Matsuura, Kentaro∗,†; Osafune, Hiroshi∗,†; Wada, Kota†. Indications of Effective Hyperbaric Oxygen Therapy Combined With Steroid Therapy for Sudden Hearing Loss. Otology & Neurotology 44(10):p 983-987, December 2023. | DOI: 10.1097/MAO.0000000000004035
