Cases are idiopathic (unknown cause)
Clinical data
>90%
Optimal treatment
initiation
AAO-HNS Guidelines
14 days
Diagnostic window for
SSNHL
AAO-HNS Definition
72 hrs
New SSNHL cases annually in the U.S.
JAMA Otolaryngol
66,000
Sensorineural (not conductive) confirmed by exam
Documented by audiogram
Occurring within 72 hours
Over 3+ contiguous audiometric frequencies
≥30 dB hearing loss
Diagnostic Criteria (AAO-HNS)
SSNHL is defined as a rapid hearing loss of at least 30 dB over three or more contiguous audiometric frequencies, occurring within 72 hours. Most patients notice it upon waking — one ear suddenly feels "full," muffled, or completely silent. Tinnitus (ringing) and vertigo are common accompanying symptoms.
In more than 90% of cases, no specific cause is identified. Suspected mechanisms include vascular occlusion, viral inflammation, or autoimmune damage to the delicate structures of the inner ear. Without treatment, some hearing may return spontaneously — but the degree of recovery is unpredictable, and permanent hearing loss is common.
What Is Sudden Sensorineural Hearing Loss?
The AAO-HNS guidelines recommend HBOT combined with steroids within 2 weeks of symptom onset for initial therapy, or within 1 month as salvage therapy for patients who haven't responded to steroids alone. Studies show progressively worse outcomes as treatment is delayed beyond 10-14 days.
Why Timing Matters
The inner ear is one of the most metabolically active tissues in the body, yet it has no direct blood supply — it relies entirely on oxygen diffusion from surrounding vessels. When something disrupts that oxygen delivery, cochlear hair cells begin to die within hours.
HBOT dramatically increases the oxygen dissolved in blood plasma, allowing it to reach ischemic cochlear tissue that red blood cells cannot access. This can reduce inflammation, support cellular survival, and create conditions for recovery — but only if treatment begins before irreversible damage occurs.
How HBOT Treats Sudden Hearing Loss
Patient Selection
Source: Chandrasekhar SS, et al. Otolaryngol Head Neck Surg. 2019;161(1_suppl):S1-S45.
- KAS 9a: Clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy within 2 weeks of onset of SSNHL.
- KAS 9b: Clinicians may offer HBOT combined with steroid therapy as salvage therapy within 1 month of onset of SSNHL.
- Studies demonstrate enhanced hearing recovery when HBOT is added to corticosteroids, particularly in patients with severe-to-profound hearing loss (≥60 dB).
- Salvage HBOT after failed steroid therapy shows significant hearing gain compared to no additional treatment.
AAO-HNS Guideline Recommendations
Clinical Evidence for Physicians
The AAO-HNS Clinical Practice Guideline: Sudden Hearing Loss (2019 Update) includes two key action statements supporting HBOT:
MRI recommended to rule out retrocochlear pathology (vestibular schwannoma)
No absolute contraindications to HBOT
Combined with ENT-directed corticosteroid therapy (oral or intratympanic)
Symptom onset within 14 days (initial therapy) or 30 days (salvage)
Audiogram-confirmed SSNHL (≥30 dB, 3+ frequencies, ≤72 hrs onset)
HBOT Eligibility for SSNHL
What Treatment Looks Like
Because SSNHL is time-critical, we prioritize rapid intake and coordination with your ENT. Here's the typical pathway:
SSNHL is an FDA-approved indication for HBOT. Coverage varies by plan, but many insurers cover it when diagnostic criteria are documented. We verify your benefits before beginning treatment.
Is HBOT for sudden hearing loss covered by insurance?
Outcomes vary. Some patients recover fully; others have partial improvement or residual hearing loss. Factors that affect prognosis include severity of initial loss, time to treatment, presence of vertigo, and patient age. We'll discuss realistic expectations based on your audiogram and clinical picture.
Will I get my hearing back?
HBOT may still help as salvage therapy within 1 month of onset, particularly if you haven't responded to steroids alone. Beyond 4-6 weeks, the chance of significant recovery decreases substantially — but we'll give you an honest assessment based on your specific situation.
What if it's been more than 2 weeks since my hearing loss started?
No. HBOT is an adjunct to steroid therapy, not a replacement. The AAO-HNS guidelines recommend HBOT combined with steroids. Your ENT directs the steroid protocol (oral and/or intratympanic), and we provide HBOT alongside that treatment.
Is HBOT used instead of steroids?
We can often begin treatment within 24-48 hours of receiving your referral and audiogram. Because timing is critical, we prioritize SSNHL cases and coordinate directly with your ENT.
How quickly can I start HBOT?
See an ENT or audiologist today — this is urgent. Get an audiogram to confirm the type and severity of hearing loss. If SSNHL is diagnosed, treatment should begin immediately. Don't wait to see if it "gets better on its own."
