Hyperbaric Oxygen Therapy

Dear Michael,

I have my own chamber now, it goes to 2.0 ATA. According to the attached articles, that is enough... I am used to hyperbaric oxygen therapy and can clear my ears well. Unless I have a bad cold, then it is difficult. I have no issues with the noise, I use earplugs (ACS26) and earmuffs (Peltor X4). I also do have a silencer in the chamber.

See Temitobe (2021) about the number of sessions: "Hence, we recommend a minimum of 900 minutes of 2.0 ATA HBOT delivered either by 10 sessions of 90 minutes or 15 sessions of 60 minutes for the treatment of patients with SSNHL."

Kind regards,
Jan

 

I developed tinnitus and hyperacusis 4 weeks ago after noise trauma. I have no hearing loss, although I feel that I hear less well in noisy environments.

Is HBOT something that could still be considered? Talking to my ENT, they said that they would only consider it if you have hearing loss, not just tinnitus and hyperacusis.

I want to get further opinions. Thanks!

 

Let's put this in perspective:

Oxygen = free radicals.
Pressure = barotrauma.
Together = potential for mechanical impaction / fistula, and even MORE free radicals.

Oh and oxygen is a stimulant, so nerves will fire even more (more radical formation).

HBOT makes a lot of sense if you're having a stroke, or sudden hearing loss. Tinnitus is highly unlikely to be a stroke or hemorrhage because you'd absolutely lose hearing too. The opposite, you making it a LOT worse is more likely (free radicals are the main source of damage in noise trauma, and you want to add more!!??)

If you woke up and couldn't hear, possibly after COVID-19, I'd agree 100% - do what you must. This isn't that.

I'm biased because HBOT for me was a horror show. 100% oxygen at 2.5 ATM, wearing earplugs (snug fitting).

If you do it, use VENTED (for the love of God) earplugs at least, and only do 3, MAYBE 4 sessions; if there's no improvement, it's likely a dead end. Don't do longer than 1.5 hours and not deeper than 2ish atmospheres.

I think HBOT has no place in tinnitus treatments and I wish I never found the journal even suggesting it in the slightest.

And that tank during decompression is definitely not quiet. Oh and prepare to spend a small fortune on a guess. All that money on AMC calls would've been better spent for me.

Steroids worked better for me (and even that was a dice roll).

Risk:benefit is dogshit when it comes to HBOT.

I think this is dangerous garbage advice that only applies if you're at least moderately convinced a stroke in the ear is a possibility or the bends. Your advice also fails to consider it is quite LOUD in there and snug unvented earplugs are a no-no under pressure (regardless of how well you can equalize) unless you want to toy with going deaf.

Given how loud HBOT is, I'm not surprised if your improvement is residual inhibition that would be no different than listening to white noise!

There's no evidence suggesting a lack of O2 occurs as the problem in sound exposure. More so over production of free radicals from excessive O2 (a backup in the electron transport chain) in the IHC nerves or mechanical damage to the hair cells. That's why NAC (glutathione production, free radical scavenger) and steroids, even Lasix, have been a suggestion for noise rescue. Even Betahistine is a safer suggestion for tinnitus w/o hearing loss when compared to a previous audiogram.

If you had an ear stroke, it'd likely be one-sided sudden loss; you won't just have some tinnitus, I'd imagine you'd lose a good chunk of hearing completely (it's why sudden hearing loss guidelines of 30 dB exists; even losing 10 dB is at least evidence for it) and have pure tone / ringing screeching tinnitus and it wouldn't get better with any time until HBOT and anti-clot meds. In that case your window of opportunity for treatment would be a couple of days at most.

A clot that is so small that it only hits enough cells to cause some minor single sided tinnitus (single sided is more likely) will probably dissolve on its own.

Using HBOT for no hearing loss at all, just bilateral tinnitus, after a metabolic insult, is frankly insane.

 

I understand that you had a bad experience with HBOT. How soon did you notice that you had barotrauma? Did you have pain?

I started HBOT 4 days ago and have the feeling that my ears are blocked and do not depressurise as they should, so I wanted to hear your experience.

 

In the beginning of HBOT, clearing of the ears can be a struggle. Especially when you have a cold... You could use Xylometazoline (get it at your local drugstore, e.g., in the Netherlands: Etos, Kruidvat).

 

I have two centers nearby. One does 2.0 ATA and floods the chamber with 100% oxygen. The other does 2.4 ATA but delivers a 97% oxygen mix via a mask.

Anyone know which of these would be the more effective route?

 

The one with 2.4 ATA and providing 97% oxygen via a mask is the better choice. With a mask you get benefit from the "hypoxia-hyperoxia" paradox. Stem cells are stimulated by that paradox. See also Dr. Shai Efrati of the Aviv Clinic.

Above that, 100% oxygen can be more dangerous.

2.4 ATA --> higher pressure, with inner ear problems pressure is relevant (see YouTube of Dr. Jason Sonners of HBOT USA, search on YouTube for his name and "hearing"), but 2.0 ATA will also work.

Best is to get the treatment as soon as possible. Every hour counts!

I think combining HBOT with LLLT afterwards will also be of benefit (see Konftec 660 nm, 50 mW or others).

All the best!

Kind regards,
Jan

 

Neither. I've not seen any evidence or recommendations for HBOT.

 

In the United States practitioners commonly recommend HBOT at 2 atmospheres for acoustic trauma and ear injuries. Prednisone and HBOT in America is pretty much the current standard protocol for damage to the auditory system.

I was too afraid of the possible side effects after my injury from reading too much online and also due to adverse side effects I had from the high dose of steroids.

Looking back now, I probably should have done the treatment considering how essential oxygen is for healing numerous biological processes.

Higher pressures seem to be correlated to having more side effects regarding HBOT. This is why you do not see many HBOT-at-home devices that will go up to 2 atmospheres.

 

Dear Ryan,

Lower pressures correlate with less side effects. 2.0 ATA seems to be safer than 2.4 ATA. Dr. Sonners of HBOT USA (see his YouTube channel) says pressures need to typically be 2.0 ATA, 2.2 - 2.4 ATA... not very clear. But I have read two papers where they used 2.0 ATA and reached good results.

I use 2.0 ATA in my chamber. But I have also undergone more than 250 sessions in a 2.4 ATA chamber. I do not feel or experience any difference between the two.

Kind regards,
Jan

 

I am currently midway through a 15-day course of 2.5 ATA HBOT.

During the treatments I occasionally feel some pain or ache deep inside the ear with tinnitus. My tinnitus also seems to get much louder on some days after the treatment.

Has anyone else experienced anything like this?

 

Dear @withintention, not the "pain or ache deep inside the ear with tinnitus", but I also experience the tinnitus being louder after HBOT. In the beginning it was quite scary, but it is temporary. In my situation the spike lasts about 2 days. I have undergone more than 300 HBOT sessions, and every time I have experienced this...

I hope HBOT will help you!

Kind regards,
Jan

 

I found an interesting paper stressing the importance of starting HBOT within 12 days after onset:

Idiopathic Sudden Sensorineural Hearing Loss: Is Hyperbaric Oxygen Treatment the Sooner and Longer, the Better?

 

Do you use HBOT for tinnitus or hyperacusis? Has it helped your overall health?

 

Only for tinnitus. My overall health is very good, I actually do not know whether my overall health benefited.

Kind regards,
Jan

 

Has anyone ever had myopia from HBOT? After my last run of 13 sessions over 15 days at 2.5 ATA, my distance vision has degraded significantly. I just had an eye exam and my nearsightedness prescription has doubled.

It happened basically overnight a couple days after my last treatment. I've read that this is a rare but known side effect and that it is normally temporary.

Has anyone else experienced this?

 

It is not that rare, but normally not after 13 HBOT sessions. In a letter sent by the hyperbaric center, they state it will reverse within 3 month. I went from -3,5 D to -5,5 D after 80 sessions.

I hope your myopia will reverse...

Kind regards,
Jan