Sudden Deafness on One Ear

Idiopathic Sudden Sensorineural Hearing Loss (SSHL)

Sudden deafness, most frequently experienced in one ear without any apparent cause, is called idiopathic sudden sensorineural hearing loss (SSHL) by doctors.

Degree of hearing loss does vary, although often the condition progresses to a complete loss of hearing in the given ear within 72h.

Normally a significant loss of hearing is required for any person to notice this and if you do notice it, time is of the essence: see a doctor as soon as possible, whether they be your GP, local A&E or your local / private Ear-Nose-Throat (ENT) specialist.

Idiopathic Sudden Sensorineural Hearing Loss (SSHL)

Important

Be wary of ‘wellness’ and bogus HBOT (Mild HBOT) Centres offering treatment at lower pressures in non-medically certified chambers. All research into the benefits of HBOT for this and other condition relies on therapy pressures of 2.4 ATA and proven therapy protocols in a safe environment.

Standard Treatment Regime

100% Medical Oxygen – Therapy pressure: 2.4 ATA –
90 mins duration (with air-breaks)

Hyperbaric oxygen therapy (HBOT) has been a recognised indication since October 2011 by the Undersea & Hyperbaric Medical Society (UHMS).

In the over 10 years since, several studies have shown that HBOT is beneficial in SSHL, however once again this is time-critical:

Download Research Notes

Determining the Recovery Rate of Hearing Thresholds Across Audiometric Frequencies with Use of HBOT

Within 7 Days
Best results are achieved if HBOT is started within the first 7 days following hearing loss, obviously in conjunction with ENT treatment, which most often includes steroids administered orally and/or through your ear drum (tympanic membrane) into your middle ear.
8 - 14 Days
Between 8-14 days considerable improvement is still possible.
Over 14 Days
Potential for expected improvement nosedives after 14 days from onset and beyond 28 days the risks (however modest) of HBOT outweigh the hoped benefits and therefore HBOT is no longer indicated.

Treatment

The standard protocol for HBOT in SSHL is ten treatments (one per day on weekdays, i.e., two weeks) of 100% medical oxygen at 2.5 ATA for 90 mins, followed by a hearing test. If the average between the initial audiogram and the 10-day one shows improvement, then a further 10 treatments are recommended.

There is no evidence for continuing HBOT beyond 20 sessions. Obviously if the 10-day hearing test shows minimal to no improvement then unfortunately there is no benefit in continuing treatment.

We fully appreciate that some patients may feel they have improved, despite their audiogram showing no evidence of this, however our approach is evidence-based, and we do go to lengths to explain this both at the outset and throughout the HBOT sessions.

Questions

As the clock starts ticking when the hearing loss occurs, feel free to call us as soon as you are aware that you (may) have SSHL and we will look to answer your questions as fully as possible and if we feel that you may benefit from adding HBOT to your ongoing treatment will offer to assess you as a matter of urgency.

Funding

At present NHS England does not fund HBOT for SSHL, however we do offer treatment on a private care basis for self payers.

Evidence

Recent studies comparing improvement in patients treated with steroids alone versus those receiving HBOT in addition, have demonstrated significantly greater hearing gain in the steroid + HBOT group, especially in those patients with severe to profound hearing loss initially.

LeGros TL, Murphy-Lavoie H. HBO2 for sudden sensorineural hearing loss. Undersea Hyperb Med. 2020 Second-Quarter;47(2):271-295. doi: 10.22462/04.06.2020.14. PMID: 32574445.

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