Hyperbaric oxygen with steroids was associated with better recovery from sudden hearing loss

Design

Multicentre retrospective cohort

Population

1,309 adults with sudden sensorineural hearing loss at four Shanghai hospitals

Primary outcome

Hearing recovery at end of treatment

Effect

11–20 HBO sessions: partial recovery OR 2.24 (1.43 to 3.50); slight recovery OR 2.21 (1.40 to 3.47)

A retrospective cohort study from four Shanghai hospitals, published in Otolaryngology–Head and Neck Surgery on 1 October, included 1,309 patients with sudden sensorineural hearing loss treated between 2022 and 2024. Of these, 991 received hyperbaric oxygen at 2.2 atmospheres with corticosteroids and 318 received corticosteroids alone.

Patients given 11 to 20 hyperbaric sessions had higher odds of slight recovery (OR 2.21, 95% CI 1.40 to 3.47) and partial recovery (OR 2.24, 1.43 to 3.50) at the end of treatment, but not of complete recovery at that point. Older age, delayed treatment, vertigo and worse initial thresholds predicted poorer outcomes. No serious adverse events occurred.

This is observational: patients were not randomised to hyperbaric oxygen, and those who received it may have differed in severity, timing and access. The 90-day results are reported in a way that is hard to interpret. The consistent message is the one already in guidelines — treat early. Hyperbaric oxygen within two weeks of onset is a reasonable adjunct where it is available, particularly for severe loss; in India, access to hyperbaric chambers is limited to a few centres.

• Start corticosteroids promptly for sudden sensorineural hearing loss; delay predicted worse recovery.
• Consider hyperbaric oxygen as an adjunct within two weeks of onset where a chamber is available, especially for severe loss.
• Record age, vertigo and initial thresholds — each predicted outcome.
• Arrange a follow-up audiogram to document recovery.

Why it matters

It adds a large data set to a treatment many ENT surgeons cannot easily offer, and reinforces that timing matters most.

Don't overread it

Observational and non-randomised; it cannot show that hyperbaric oxygen caused the better recovery.

The statistics, in plain English

An odds ratio of about 2.2 means roughly double the odds of partial recovery, and the intervals exclude 1. But without randomisation, patients who got hyperbaric oxygen may have differed in ways that affect recovery, so this shows association rather than cause.

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