Impact of hyperbaric oxygen as initial treatment on idiopathic sudden sensorineural hearing loss prognosis: a propensity scores matching analysis

OBJECTIVE: This study aimed to evaluate the effect of Hyperbaric Oxygen Therapy (HBOT) combined with steroids as initial treatment on the prognosis of patients with Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) by using propensity score matching (PSM) to balance covariates between groups. METHODS: A case-control study design was adopted, including 413 ISSNHL patients admitted to our center from January 2021 to June 2024. Based on treatment protocols, patients were divided into two groups: the therapy group received steroids combined with HBOT (intravenous + intratympanic glucocorticoids + HBOT), while the control group received steroids alone (intravenous + intratympanic glucocorticoids). Audiometric evaluation was performed using pure-tone audiometry. PSM was applied in a 1:1 ratio, yielding 135 matched patients in each group. Clinical characteristics and treatment outcomes were then assessed. RESULTS: Before PSM, significant differences were observed between the therapy and control groups in baseline hearing thresholds, severity of hearing loss, and hearing curve classification. After PSM, all imbalanced covariates were effectively balanced. Prior to matching, the overall hearing recovery rate significantly differed between the two groups (p = 0.02). However, after PSM, no statistically significant difference was found in the overall hearing recovery rate (p = 0.180). CONCLUSION: The addition of Hyperbaric Oxygen Therapy (HBOT) as an initial treatment modality for ISSNHL, when combined with intravenous and intratympanic steroid therapy, does not provide additional improvement in outcomes for patients.