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Idiopathic sudden sensorineural hearing loss

Hearing loss is considered as the most quiet sounds that people can hear with their better ear which is are between 25 and 40db (decibels). Moderate hearing loss between 40 and 70db and severe hearing loss between 70 and 95db.

Idiopathic sudden sensorineural hearing loss (ISSHL) is defined as the sensorineural hearing loss of a minimum of 30 decibels in at least 3 frequencies for 3 days or more. (ie. unexplained unilateral sensorineural hearing loss with onset over a period of less than 72 hours) has an estimated incidence between 5 and 20 per 100,000 persons per year. This is likely to be an underestimate, since many recover quickly and never seek medical help. Up to 65% resolve spontaneously.

The outer ear - has 3 sections:

The pinna or auricle: This is part of the ear on the outside of our heads. The part we usually are referring to when we say ear. It helps to gather sound and vibrations so we can hear more sounds.

The ear canal: This is a tube that helps sound to travel further inside our ear and to get to the next stage of hearing.

The eardrum: This is a thin sheet that vibrates when the sound hits it. Your eardrum is very sensitive and fragile. It’s never a good idea to put anything in your ear, even something that seems safe and soft can damage your eardrum.

The middle ear: Is filled mostly with air and has 3 bones in it. Your ear has little bones called ossicles that help you hear. They are called the hammer (malleus), anvil (incus) and stirrup (stapes). They amplify the sound or make it louder. The middle ear helps to transfer sounds from the air to fluid inside the next stage, or inner ear. The stirrup is the smallest bone in the body.

The inner ear: Is filled with fluid and has hearing organ called the cochlea. This organ helps to take the vibrations and translate them into electrical signals for the nerve to send to the brain. It actually uses little hairs that vibrate with the sound waves  in the fluid. Then you “hear” it.

The inner ear also has fluid filled tubes that help with your balance.

Symptoms of ISSHL

  • Sudden hearing loss
  • Tinnitus
  • A sensation of fullness in the ear
  • Vertigo

Reasons for Hyberbaric Oxygen Therapy

The cause of ISSHL is unclear but it is thought HBO helps with vascular occlusion, viral infections, membrance breaks, trauma, abnormal tissue growth, cochlear membrane damage.


For people with acute ISSHL the application of Hyperbaric Oxygen significantly improved hearing.

Multiple controlled studies have also demonstrated a greater degree of hearing improvement when patients receive early intervention in conjunction with hyperbaric oxygen  and oral steroids

This condition requires ENT and audiology assessment to determine severity and potential cause if ISSHL then are referred.

Criteria for referral

  • Must have a hearing loss greater than 41 decibels.
  • To be referred within 14 days of symptoms - Later presentation might improve but best evidence supports the use of hyperbaric oxygen therapy within 2 weeks of symptom onset


Treated with 100% oxygen for 90 minutes daily. 

The patient will have 10-20 treatments and then reviewed after 20 treatments.


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