Hyperbaric Oxygen and Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.

Abstract

Sudden sensorineural hearing loss (SSNHL) Remains a significant enigma, despite its profound impacts on affected individuals. Hyperbaric oxygen therapy (HBOT) has gained significant attention as a potential treatment, but its use remains controversial. We aimed to perform a systematic review and meta-analysis assessing the efficacy of HBOT in treating SSNHL. PubMed, EMBASE, CENTRAL, MEDLINE, Google Scholar, Web of Science, and Clinicaltrials.gov were searched through May 7, 2025. Two investigators independently screened articles and extracted data in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A meta-analysis calculated pooled odds ratios (ORs) using a random-effects model. Twenty studies (16 RCTs and four non-randomized prospective studies) were included; in total, these studies investigated 1087 patients receiving HBOT and 600 receiving medical therapy (MT) alone. Ten studies were included in a meta-analysis, which found that patients receiving HBOT in combination with MT had 2.61 higher odds of experiencing hearing recovery than those treated with MT alone (95% CI 1.86-3.68, p < 0.001). Subgroup analyses for HBOT + systemic steroids (SS) vs. SS alone and HBOT + SS + intratympanic steroids (ITS) vs. SS + ITS alone found higher odds of hearing recovery with HBOT (OR 2.54, 95% CI 1.63-3.97, p < 0.001 and OR 2.64, 95% CI 1.39-5.02, p < 0.001, respectively). The combination of HBOT with MT is likely to provide benefit in hearing recovery for individuals with SSNHL. However, ongoing work should seek to standardize treatment protocols and data reporting to allow for more definitive conclusions.