- Design
- Multicentre retrospective cohort study
- Population
- 1,309 patients with sudden sensorineural hearing loss (991 with hyperbaric oxygen plus steroids, 318 steroids alone)
- Primary outcome
- Hearing recovery at treatment completion and 90 days
- Effect
- 11 to 20 sessions: slight recovery odds ratio 2.21 (1.40 to 3.47), partial 2.24 (1.43 to 3.50)
Sudden sensorineural hearing loss is an emergency, and whether hyperbaric oxygen adds to corticosteroids — and in what dose — has been uncertain. This multicentre retrospective cohort of 1,309 patients compared hyperbaric oxygen plus corticosteroids (991 patients) with corticosteroids alone (318).
A course of 11 to 20 hyperbaric sessions increased the odds of slight recovery (odds ratio 2.21, 95% CI 1.40 to 3.47) and partial recovery (odds ratio 2.24, 1.43 to 3.50) at treatment completion, and improved complete recovery by 90 days. Benefit was greatest in severe and total losses, and worse outcomes tracked with older age, delayed treatment, vertigo and a higher initial hearing threshold.
The practical direction is to start hyperbaric oxygen early — within two weeks of onset — as a 10-to-20-session course alongside steroids, prioritising more severe losses, where facilities allow. The evidence is retrospective, so it strengthens the case for early combined treatment rather than settling the dose.
- Multicentre retrospective cohort of 1,309 patients with sudden sensorineural hearing loss.
- 11 to 20 hyperbaric sessions raised odds of slight (2.21) and partial (2.24) recovery at completion.
- Complete recovery at 90 days was also improved with that course.
- Benefit was greatest in severe and total hearing loss; start within two weeks of onset.
- Older age, delayed treatment, vertigo and a high initial threshold predicted worse recovery.
Why it matters
It gives a clearer protocol — timing, course length and who benefits most — for an emergency where delayed or absent adjunctive treatment can cost permanent hearing.
Don't overread it
This was retrospective; the apparent benefit may partly reflect selection of who received hyperbaric oxygen, so it supports early combined treatment rather than proving dose.
The statistics, in plain English
Odds ratios above 2 with intervals clear of 1.0 indicate a real association in these data; as a retrospective cohort it cannot exclude that patients offered hyperbaric oxygen differed systematically from those who were not.
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