Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well unde...Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.展开更多
Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination thera...Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previousstudy, early initiation of the combination therapy was associated with better outcomes. Therefore, weperformed a new analysis to assess the difference in hearing outcome between patients in whomcombination therapy was started within two days, versus after more than two days.Methods: A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relativehearing improvement between first and last audiograms were calculated for all affected frequencies(defined as loss of 20 dB on initial audiogram). We also determined the amount of patients whorecovered to the level of Dutch military requirement, and performed speech discrimination tests.Results: In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5years (IQR 23e29). The median time to initiation of therapy with corticosteroids and HBOT were one andtwo days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on allaffected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB(gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearingimprovement when HBOT was started in 2 days, compared to >2 days.Conclusion: Our analysis shows results in favor of early initiation ( 2 days) of the combination treatmentof HBOT and corticosteroids in patients with AAT.展开更多
Introduction： Hyperbaric oxygen treatment （HBOT） is one of the treatment modalities for retinal artery occlusion （RAO）. HBOT may be beneficial if initiated within 2-12 hours of onset of symptoms. The...Introduction： Hyperbaric oxygen treatment （HBOT） is one of the treatment modalities for retinal artery occlusion （RAO）. HBOT may be beneficial if initiated within 2-12 hours of onset of symptoms. The objective of this study was to evaluate the usefulness of HBOT on the patients who had applied to our center for HBOT with an RAO diagnose. Methods： Sixteen patients were included in this study for a three-year period those were applied HBOT with RAO diagnosis. HBOT sessions of these patients had been started as quick as possible soon after they have arrived. Also, all patients had been started medication by ophthalmologists who sent them. To evaluate the outcome of the treatment the patients were called with telephone and ophthalmology clinic control examinations were obtained. Patients were asked survey questions about their visual ameliorations before and after HBOT. Results： Mean initiation duration of patients to get HBOT was about 28 hours. Only one patient has initiated treatment after 13 days from the event and no visual improvement was recorded. Within this patient, no visual amelioration was recorded for two more patients. Among the other 13 patients, three had 80% and more, three had 50-79% and seven had below 50% visual amelioration. Eleven of 13 patients had peripheral visual field amelioration. Discussion： With the medical treatment, an immediate intervention of HBOT was considered a useful treatment modality for RAO. The visual improvement of the visual fields was considered especially in the peripheral vision rather than central vision.展开更多
基金supported by Beijing Science and Technology Special Fund[grants number 2161100000116067]。
文摘Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.
文摘Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previousstudy, early initiation of the combination therapy was associated with better outcomes. Therefore, weperformed a new analysis to assess the difference in hearing outcome between patients in whomcombination therapy was started within two days, versus after more than two days.Methods: A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relativehearing improvement between first and last audiograms were calculated for all affected frequencies(defined as loss of 20 dB on initial audiogram). We also determined the amount of patients whorecovered to the level of Dutch military requirement, and performed speech discrimination tests.Results: In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5years (IQR 23e29). The median time to initiation of therapy with corticosteroids and HBOT were one andtwo days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on allaffected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB(gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearingimprovement when HBOT was started in 2 days, compared to >2 days.Conclusion: Our analysis shows results in favor of early initiation ( 2 days) of the combination treatmentof HBOT and corticosteroids in patients with AAT.
文摘Introduction： Hyperbaric oxygen treatment （HBOT） is one of the treatment modalities for retinal artery occlusion （RAO）. HBOT may be beneficial if initiated within 2-12 hours of onset of symptoms. The objective of this study was to evaluate the usefulness of HBOT on the patients who had applied to our center for HBOT with an RAO diagnose. Methods： Sixteen patients were included in this study for a three-year period those were applied HBOT with RAO diagnosis. HBOT sessions of these patients had been started as quick as possible soon after they have arrived. Also, all patients had been started medication by ophthalmologists who sent them. To evaluate the outcome of the treatment the patients were called with telephone and ophthalmology clinic control examinations were obtained. Patients were asked survey questions about their visual ameliorations before and after HBOT. Results： Mean initiation duration of patients to get HBOT was about 28 hours. Only one patient has initiated treatment after 13 days from the event and no visual improvement was recorded. Within this patient, no visual amelioration was recorded for two more patients. Among the other 13 patients, three had 80% and more, three had 50-79% and seven had below 50% visual amelioration. Eleven of 13 patients had peripheral visual field amelioration. Discussion： With the medical treatment, an immediate intervention of HBOT was considered a useful treatment modality for RAO. The visual improvement of the visual fields was considered especially in the peripheral vision rather than central vision.
