Hyperbaric Oxygen Therapy

Thank you!

What pressure do you usually go to? Do you take any precautions to avoid barotrauma or issues due to the noise?

Can you please explain? HBOT seems to have significant research behind it.
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
 

Attachments

  • Temitope 2021 HBOT for Paients With SSHL.pdf
    520.3 KB · Views: 27
  • Imsuwansri 2012 HBO for SSHL after Failure from Corticosteoid.pdf
    1 MB · Views: 20
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!
 
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.
No, every time when there is damage in the cochlea (organ of Corti), HBOT can work. But be quick. Every hour counts!
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.
 
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.
 
... 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?
 
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.
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?
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.
 
Higher pressures seem to be correlated to having more side effects regarding HBOT.
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?
 
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?
Results: After 1–5 HBO sessions, patients (N = 102) showed an improvement in 45 (44.1%) of the patients (p < 0.000). Also, improvements were found with patients showing different grades of ISSHL: 11 (26.8%) with slight-moderate, 11 (40.7%) with severe, and 23 (67.6%) with profound ISSHL. Significant treatment effects were found at different affected frequencies, especially the low frequency range. After 6–10 HBO sessions, patients (N = 46) showed similar treatment effects as after 1–5 HBO sessions, but no additional improvement. Moreover, patients who received HBO treatment within 12 days showed improvement effects 6.484 times greater (p < 0.000) compared with those who received treatment after 13 days. (4)

Conclusions: The improvement of HBO therapy on ISSHL was significant after 1–5 sessions, with larger improvements for those suffering more serious symptoms. Further adding more HBO treatment sessions to 6–10, no further improvement was found. Patients starting HBO therapy within 12 days of ISSHL showed 6.484 times greater improvements compared with those starting HBO therapy later.
 
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.
Do you use HBOT for tinnitus or hyperacusis? Has it helped your overall health?
 
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?
 
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
 
How long after acoustic trauma can I undergo HBOT, and can it help with hearing loss?
Dear @LulaLula,

As a general rule, it's best to undergo HBOT as soon as possible after noise trauma. Research by Körpinar et al. concluded that the earlier, the better. There's also a YouTube video by Dr. Jason Sonners where he states the same—early treatment is preferable, although he has seen healing occur even in later stages. Personally, I wouldn't expect significant results after three months (the acute phase).

All the best!

Kind regards,
Jan van Dam
 

Attachments

  • Körpinar 2011 Factors influencing the outcome of idiopathic sudden sensorineural hearing loss ...pdf
    224.4 KB · Views: 3
Dear @LulaLula,

As a general rule, it's best to undergo HBOT as soon as possible after noise trauma. Research by Körpinar et al. concluded that the earlier, the better. There's also a YouTube video by Dr. Jason Sonners where he states the same—early treatment is preferable, although he has seen healing occur even in later stages. Personally, I wouldn't expect significant results after three months (the acute phase).

All the best!

Kind regards,
Jan van Dam
Okay, thanks for the help. My main issues are fullness and tinnitus. I think I'll give it a try; it feels like I need to do something to improve the situation.
 
Yes, that's possible, but I've seen a scientific paper (I don't remember the authors) that concluded it's not effective. According to Dr. Jason Sonners, you should use at least 2.0 ATA.
Okay, thanks. I think I might be able to reach 7-8 sessions in a week, maybe about 4 months after the acoustic trauma. I'm debating whether or not I should go through with it.
 
Okay, thanks. I think I might be able to reach 7-8 sessions in a week, maybe about 4 months after the acoustic trauma. I'm debating whether or not I should go through with it.
Dear @LulaLula,

I understand your struggle, and I hope the attached article provides some guidance. I had my first sessions of HBOT in 1996, starting 77 days after an acoustic trauma when I was 32 years old. It wasn't a complete cure, but I'd say it helped by about 40%.

My hypothesis is that age may play a role in treatment outcomes. I've read that the results tend to be significantly better for people under 50.

Wishing you all the best.

Regards,
Jan
 

Attachments

  • Chin 2022 Idiopathic Sudden Sensorineural Hearing Loss Is Hyperbaric Oxygen Treatment the Soon...pdf
    1.2 MB · Views: 0
I did 10 HBOT sessions after each of my two COVID-19 infections. In both cases, I experienced hearing loss and developed tinnitus the first time, which worsened after the second infection. The HBOT did help a little with my hearing, which I was grateful for, but unfortunately, it didn't help my tinnitus.

The doctors who worked with me initially said the ideal window for starting treatment is within two weeks of the hearing loss. I've read at least one study suggesting some benefit might still be possible up to six months after hearing loss, but the effectiveness drops significantly over time. I haven't seen any research indicating that HBOT significantly affects tinnitus.

If you do decide to try it, use a tank that fills with oxygen rather than a mask, as masks are generally less effective at delivering therapeutic levels of oxygen. (My doctor for this treatment round mentioned that an effective HBOT mask should look like something out of Top Gun and fully seal around the face; otherwise, it's not doing much.)
 
I did 10 HBOT sessions after each of my two COVID-19 infections. In both cases, I experienced hearing loss and developed tinnitus the first time, which worsened after the second infection. The HBOT did help a little with my hearing, which I was grateful for, but unfortunately, it didn't help my tinnitus.

The doctors who worked with me initially said the ideal window for starting treatment is within two weeks of the hearing loss. I've read at least one study suggesting some benefit might still be possible up to six months after hearing loss, but the effectiveness drops significantly over time. I haven't seen any research indicating that HBOT significantly affects tinnitus.

If you do decide to try it, use a tank that fills with oxygen rather than a mask, as masks are generally less effective at delivering therapeutic levels of oxygen. (My doctor for this treatment round mentioned that an effective HBOT mask should look like something out of Top Gun and fully seal around the face; otherwise, it's not doing much.)
Okay, thanks for the feedback. Were there any complications?
 
Okay, thanks for the feedback. Were there any complications?

If you do decide to try it, use a tank that fills with oxygen rather than a mask, as masks are generally less effective at delivering therapeutic levels of oxygen. (My doctor for this treatment round mentioned that an effective HBOT mask should look like something out of Top Gun and fully seal around the face; otherwise, it's not doing much.)
A chamber filled entirely with 100 percent oxygen would be much more dangerous. One spark…

In a professional multiplace chamber, patients typically use an oxygen mask to breathe pure oxygen. The chamber itself is ventilated, keeping the overall oxygen concentration below 23 percent for safety. In a monoplace chamber, which can be used at home, a non-rebreather mask with a reservoir is often used. Oxygen is supplied by an oxygen concentrator, which typically provides 93 to 96 percent oxygen.

And yes, it's true—the masks used for HBOT in a professional multiplace chamber do look a bit like something out of Top Gun...
 
Okay, thanks for the feedback. Were there any complications?
I didn't experience any complications. My tinnitus is highly reactive, so I had a temporary spike after each session because of the noise in the chamber. However, this subsided by the end of each day.
A chamber filled entirely with 100 percent oxygen would be much more dangerous. One spark…

In a professional multiplace chamber, patients typically use an oxygen mask to breathe pure oxygen. The chamber itself is ventilated, keeping the overall oxygen concentration below 23 percent for safety. In a monoplace chamber, which can be used at home, a non-rebreather mask with a reservoir is often used. Oxygen is supplied by an oxygen concentrator, which typically provides 93 to 96 percent oxygen.

And yes, it's true—the masks used for HBOT in a professional multiplace chamber do look a bit like something out of Top Gun...
You're right that a pure oxygen environment can be potentially dangerous if you're not grounded before and during treatment. That's why I recommend that anyone considering HBOT have it done at a hospital or a professional medical clinic staffed with licensed doctors and nurse practitioners trained in this therapy. Before I was placed in the chamber, I was cleared of static and connected to a grounding strap, which I wore throughout the treatment to prevent any possibility of a spark. When used correctly, these chambers are very safe and highly effective at delivering pure oxygen. That's why my hospital, as well as institutions like Mass General and the Mayo Clinic, offer them for HBOT treatments.
 

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