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Hyperbaric Oxygen Therapy For Hearing Loss

Medical information reviewed by: ANDREI BOGDAN, MD, Orthopedics-traumatology doctor
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Discover the hyperbaric medicine center opened in our clinic. Centrokinetic has the top-performing hyperbaric chamber in Bucharest, with multiple medical and anti-aging uses. The Baroks chamber has 5 seats, and operates at a constant pressure of 2.5 atmospheres, being fully automated and having protocols for each condition, and can be used individually for each patient. 

Hyperbaric oxygen therapy - benefits

Patients who use the clinic's hyperbaric therapy services benefit from:

  • The only medically accredited hyperbaric therapy chamber in Bucharest, which operates at 2.5 atmospheres (those for aesthetic use go to 1 atmosphere and have no medical benefits).
  • A safe medical procedure, without irradiation, without pain, without other side effects. 
  • The specialized medical team consists of recovery doctors, orthopedists, rheumatologists, neurologists, and neurosurgeons, meaning a multidisciplinary team specialized in all diseases that can be treated with hyperbaric therapy. 
  • Premium conditions at a fair price. Our clinic is recognized for the conditions offered and for the care of each patient. But we do not need to pay exorbitant prices to have access to quality medical services. At Centrokinetic you can find an affordable and fair price. But note that we do not have a contract with the National Health Insurance House (we do not offer state reimbursed services)

Centrokinetic is keeping contact with prestigious clinics and universities in Belgium, the Netherlands, France, and Greece to constantly update treatments to provide patients with the best medical solutions.

What is hearing loss?

Sudden sensory hearing loss is defined as a hearing loss of at least 30 decibels that occurs on at least three consecutive frequencies and lasts for at least 3 days. A specific etiology is identified only about 10% to 15% of the time, most of which are considered idiopathic. 

Possible etiologies include vascular occlusion, viral infections, labyrinthine membrane ruptures, autoimmune, trauma, toxins, cochlear membrane damage, demyelinating disease, stroke, and schwannoma. Usually, the patient first observes the symptoms on waking and describes a fullness/sound block. They may also have tinnitus, dizziness, or vertigo. There are about 4,000 new cases in the United States each year. The rate of spontaneous recovery is difficult to determine because many patients do not seek medical care, but it has been reported at 25% and 65%. 

In most controlled studies, spontaneous recovery in patients receiving placebo is between 35% and 39%. Hearing loss can lead to social and economic problems and can significantly affect the patient's quality of life. Hearing loss is the most common cause of disability globally and the third leading cause of lost productivity due to disability, according to the World Health Organization (WHO).

Hearing aids are recommended for moderate (41 decibels to 60 decibels) and severe (61 decibels and higher) hearing loss. Over 60 treatment protocols have been described for sudden hearing loss, but most of them are not effective. The three most promising treatments include corticosteroids, vasodilators, and hyperbaric oxygen therapy. Of these, only hyperbaric oxygen has sufficient randomized controlled trials to provide effective results.

Anatomy

The auditory function in the inner ear is maintained by the cochlea, which is known to have a high oxygen demand. Cochlear hypoxia is associated with progressive ossification, fibrosis, neuronal loss, endolymphatic hydrops, and hearing loss. Direct blood supply to the Corti organ is minimal; oxygen must diffuse through perilemma.

The labyrinthine artery (internal auditory artery) is a long and thin branch outside the inferior anterior cerebellar artery (85%) or the basilar artery (15%). It accompanies the vestibulocochlear nerve through the internal acoustic meatus in the inner ear. Animal models of labyrinthine artery occlusion showed progressive degenerative changes, fibrosis, new bone formation, and hearing loss. Any pathology that results in vascular occlusion of this artery can lead to hearing loss.

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Indications 

Hyperbaric oxygen can increase the tension of oxygen in the perilymph and restore hearing in a significant number of patients with sudden hearing loss. Efficacy can depend on many factors, including the degree of oxygenation of the labyrinthine artery and the ability to increase oxygen stress in the perilymph. Many prospective randomized controlled trials have proven their benefits over other treatments. The best results are found when patients are treated within 14 days of the onset of symptoms and with concomitant steroids (systemic or intratympanic). Steroids should be given at an initial dose of 1 mg/kg/day for 2 to 3 weeks unless such treatment is contraindicated. 

The American Academy of Otolaryngology recommends that hyperbaric oxygen be considered a treatment option for up to 3 months after the onset of symptoms and recommends against the routine use of antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants. Patients who have failed to recover with initial steroid treatment can often benefit from a combination of intratympanic steroids and hyperbaric oxygen therapy, even up to ten weeks after the onset of symptoms. 

An otolaryngologist and audiologist should evaluate patients with an audiogram, brain MRI (to rule out retrocochlear pathology), complete autoimmune assessment of vasculitis, and brainstem auditory response. Follow-up audiograms should be performed during (after the first ten sessions) and after (at the end of the 20 sessions) hyperbaric oxygen therapy and at 6 months. Also, patients should be educated about the natural history of the condition, the benefits and risks of interventions, and the limitations of existing evidence on efficacy. Patients should be advised of the possibility of incomplete hearing recovery and the possible benefits of supportive technologies.

Contraindications 

Contraindications for hyperbaric oxygen are relatively few but may include: anxiety, severe congestive heart failure, severe reactive respiratory disease, untreated pneumothorax, and doxorubicin or concomitant bleomycin therapy. Systemic corticosteroids may be contraindicated in patients with psychiatric illness, diabetes, diseases such as peptic ulcer, breastfeeding, and liver disease. For these patients, intra-tympanic steroids may be a better option. 

Equipment

Patients can be treated in a single-seater hyperbaric chamber or in a multiplace chamber.

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What are the effects of oxygen therapy on the body?

  • Decreases inflammation
  • Increases the body's oxygen saturation by 20-30%
  • Increases the body's immunity
  • Increases blood circulation and stimulates the formation of new capillaries
  • Decreases toxins in the body
  • Stimulates the production of new blood cells
  • Increases healing rate

Training 

Patients should be examined for reversible contraindications, such as fever and hypoglycemia before treatment.

Technology 

The treatment pressure for hyperbaric oxygen therapy should be from 2.0 ATA to 2.5 ATA for 60 minutes a day for 10 to 20 treatments, depending on the response. Those who did not show any improvement (10 decibels or less) in the first ten treatments are less likely to benefit from additional treatment. 

Complications

The middle ear barotrauma is the most common complication of hyperbaric oxygen therapy. Its incidence is about 13%, but the vast majority of these cases are resolved without sequelae. The incidence of middle ear barotrauma can be reduced by using slower compression rates, involving ear cleaning techniques and oral decongestants. The O'Neill rating scale showed greater reliability and utility than the Teed scale in determining the degree of barotrauma and recommended treatment options.

Clinical significance

Moderate to severe hearing loss dramatically affects the quality of life of patients and their families and can affect their ability to work in their chosen career. Hearing aids cost between $ 1,500 and $ 3,000 per pair, requiring replacement every 3 to 5 years, and they do not always give the patient perfect hearing. A course of 10 hyperbaric oxygen treatments at an outpatient center ranges from $ 2,000 to $ 5,000. For people with an early onset of sudden hearing loss, the application of hyperbaric oxygen therapy significantly improves the likelihood of positive results. For patients with moderate hearing loss, hyperbaric oxygen improved hearing by an average of 19.3 decibels and for those with severe hearing loss by approximately 37. 7 decibels. 

Improving the results of the healthcare team

Sensory hearing loss is best treated with the help of a multidisciplinary nurse. Over the years, HBOT has been recommended for the treatment of sensory loss, but clinicians should be aware that the data are heterogeneous and there are still some questions about its real benefits. Results based on a series of small studies seem to suggest that some patients with hearing loss have a positive result, but this is not a universal finding. 

IN CASE YOU HAVEN'T ALREADY HEARD ABOUT US

Centrokinetic is the place where you will find clear answers and solutions for your motricity problems. The clinic is dedicated to osteoarticular diseases and is divided into the following specialized departments:

  • Orthopedics , a department composed of an extremely experienced team of orthopedic doctors, led by Dr. Andrei Ioan Bogdan, primary care physician in orthopedics-traumatology, with surgical activity at Medlife Orthopedic Hospital, specialized in sports traumatology and ankle and foot surgery. .
  • Pediatric orthopedics , where children's sports conditions are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and those of the feet (hallux valgus, hallux rigidus, equine larynx, flat valgus, hollow foot).
  • Neurology , which has an ultra-performing department, where consultations, electroencephalograms (EEG) and electromyography (EMG) are performed. 
  • Medical recovery  for adults and  children , department specialized in the recovery of performance athletes, in spinal disorders, in the recovery of children with neurological and traumatic diseases. Our experience is extremely rich, treating over 5000 performance athletes.
  • Medical imaging , the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal disorders, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.

Find the latest news by following the Facebook and YouTube accounts of the Centrokinetic clinic.  

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READ MORE