Seth Schwartz, MD, MPH, chair of the AAO’s Guidelines Task Force, discussed the guideline that clinicians “may offer hyperbaric oxygen therapy,” in which pure oxygen is delivered at a higher-than-usual pressure. While the treatment is not approved for SSNHL in the United States, international literature shows some possible promise. A Cochrane Review, for example, found improvement in acute idiopathic SSNHL but with the clinical significance unclear and no benefit in chronic idiopathic SSNHL.
Explore This IssueNovember 2014
“I’ve had more and more patients come into my clinic since the guidelines came out asking about this therapy,” said Dr. Schwartz, “and I think there’s a lot of uncertainty about who exactly we should recommend it to and how we should handle it. And we’re currently trying to come up with a protocol at our hospital.”
Afterward, Dr. Chandrasekhar emphasized how important it is to talk to patients about the options with this disorder. “This is one entity where you need to spend the time to educate the patient,” she said, “because there’s a reasonable chance they’re going to get better if you do nothing. If you do nothing and they don’t get better, there’s a reasonable chance that injecting with steroids at that point, if you don’t wait too long, will work.”
In her experience, she said, patients almost never opt for no treatment, usually because they’ve already had a “no treatment” period while they waited before seeing a physician.