Dear Doctors: My 11-year-old son was diagnosed with sudden sensorineural hearing loss. He’s been treated with steroids and 10 HBOT sessions, with a small increase in hearing. I’m struggling to find any information regarding HBOT for children. Is there literature or experience in similar cases?
Dear Reader: For those who are not familiar, sudden sensorineural hearing loss, or SSHL, is sometimes called sudden deafness. It is a specific diagnosis in which hearing loss has dropped from normal to significantly diminished in three days or less. The word "sensorineural" means the doctor believes the structures of the inner ear and the neural pathways to the brain are involved. This diagnosis requires a loss of a minimum of 30 decibels. This is enough to make everyday conversation difficult to hear. Because high, low and middle registers are affected, the audio of daily life for someone with SSHL sounds like a speaker set on low.
Another important part of your question is about a medical treatment called hyperbaric oxygen therapy (HBOT). An individual breathes pure oxygen for an extended period of time while in a pressurized chamber or room. Because some cases of SSHL can involve impaired blood flow to the structures of the ear, HBOT is sometimes recommended. Treatments typically consist of a set sequence of daily sessions of 90 minutes each. The number of treatments depends on the condition involved.
The reason you have been struggling to find information about the efficacy of this treatment for your son's diagnosis is that, although SSHL can occur at any age, it is rare in children. The majority of cases are seen in adults, often in their late 40s and early 50s. It’s often difficult to identify a clear reason for the condition in patients of any age. Contributing factors can include viral illness, head trauma or a noise injury. Other factors can be autoimmune or vascular diseases, neurological disorders or side effects of certain medications.
When it comes to understanding your son's condition and evaluating future treatments, the available information comes from studies in adults. The limited data that does reference children comes from case studies. These are narratives in which a doctor outlines what happened with a specific patient. Case studies include symptoms, treatment options, decisions made and their outcomes. While useful, they lack the heft of a study with a large sample size.
Data suggest that HBOT can offer modest improvements in cases of SSHL. A small study in Turkey, which looked at 15 children with the condition, saw a wide range of responses. Half reported a complete recovery of hearing, 25% had small to partial recovery and 25% were unchanged. As with your son, they received steroids as well.
It is important to note that, because the study was so small, we should interpret the results with caution. They do not predict how any one child will respond. It is likely your son’s ENT can help put the findings into context, and you can make treatment decisions together.
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