Sudden for ISSHL. There are up to 20

Sudden sensorineural hearing loss (SSHL) has been defined as an
idiopathic loss of hearing of at least 30 dB over at least three test
frequencies. The disease develops within a timeframe of three days from onset.

The incidence ranges from 5 to 20 per 100.000 persons per year. As it is an
idiopathic disease, the etiological factors contributing towards developing
this disease are still unknown. Although there are various proposed etiologic
factors, such as infections, immunological, toxic, neurological, circulatory
and other disorders. Although viral diseases and circulatory impairment of the
cochlea would seem to be etiological factors of ISSHL, definitive proof is
lacking. 4 None of these factors have evidence supporting its role in the onset of
the disease.

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The assessment of prognosis in ISSHL is even more difficult if we take
on account of the possibility of spontaneous recovery. This phenomenon seems to
occur in 29-78% of patients affected by ISSHL, depending on the shape of the
audiogram at onset of the disease. 3 The spontaneous recovery rate, defined as a hearing
gain of at least 30 dB, typically develops within 2 weeks in 73% of patients

Numerous proposed factors inevitably bring many treatment regimens for
ISSHL. There are up to 20 different types of treatment procedures reported.

Wilson et al., demonstrated that oral steroid therapy had a higher impact on
hearing improvement, in comparison to severe and profound hearing loss.

In clinical practices the more frequent treatment utilised for ISSHL has
been systemic steroid treatment. More recently, IT steroid treatment has been
emerging and becoming more popular with otolaryngologists. This rise has mostly been caused by the high risks of
unfavourable side-effects a systemic approach. These effects can be endocrine
problems, osteoporosis or weight gain 5.  

Hyperbaric oxygen therapy has been common for a longer period of time.

It was first used in the late 1970 by Goto and Vincey in the treatment of ISSHL.

Goto stated that the treatment would
increase perilymph oxygenation. The same was reported by Lamm et al, who
reported that HBO therapy would increase the oxygen tension of the perilymphatic
and improve the microcirculation of the inner ear. In theory, a combination of treatments
should provide a better outcome for patients with sudden sensorineural hearing

This study is a trial to see whether combination of some of the commonly
preferred modalities together yield better results than the traditional