Hyperbaric oxygen with steroids was linked to better partial recovery in sudden hearing loss

Design

Multicentre retrospective cohort

Population

1,309 adults with sudden sensorineural hearing loss in Shanghai

Primary outcome

Hearing recovery at treatment completion

Effect

11-20 sessions: partial recovery OR 2.24 (95% CI 1.43-3.50); no difference in complete recovery

This retrospective cohort, published in October, drew on four tertiary hospitals in Shanghai with hyperbaric facilities. Of 1,309 adults with sudden sensorineural hearing loss treated in 2022-2024, 991 received hyperbaric oxygen at 2.2 ATA with corticosteroids and 318 received corticosteroids alone.

Patients given 11 to 20 sessions had higher odds of slight recovery (OR 2.21, 95% CI 1.40-3.47) and partial recovery (OR 2.24, 1.43-3.50) at the end of treatment, but not of complete recovery. Older age, delay to treatment, vertigo and a worse initial threshold were independent predictors of poorer recovery. No serious adverse events were reported.

Treatment was not randomised, and patients who were offered and could attend 11-20 sessions may differ from those who were not. The 90-day results are reported in a way that is hard to interpret.

This is supportive but not definitive evidence for hyperbaric oxygen as salvage or adjunct therapy where it is available. Steroids started early remain the standard.

• Hyperbaric oxygen with steroids was linked to about twice the odds of partial recovery.
• No clear effect was seen on complete recovery at the end of treatment.
• Delay, age, vertigo and severe initial loss predicted poorer recovery.
• Start steroids early; consider hyperbaric oxygen as an adjunct where it is available.
• The groups were not randomised, so selection may explain part of the benefit.

Why it matters

Hyperbaric oxygen is increasingly offered for sudden deafness, and this gives a sense of how many sessions the benefit is linked to.

Don't overread it

This retrospective cohort cannot show hyperbaric oxygen causes better recovery.

The statistics, in plain English

An odds ratio of about 2.2 for partial recovery is a sizeable association, and the interval stays above 1. But in a non-randomised comparison, healthier or earlier-presenting patients may have been more likely to receive more sessions.

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