Hyperbaric Oxygen Therapy

Hi Bill, I think nobody knows the real answer about how soon the therapy will be ineffective as the lesions are different in each person its impossible to give only one answer.

But in neurological lesions of the inner ear, we have plenty of them here in Chile because of the divers work hunting fish about 40m deep, the neurologist said that the inner ear lesions are the most difficult lesions to treat in his experience and require many more sessions that other neurological issues.

He said sometime 40 sessions or 60, this is for inner ear barotrauma that cause vertigo. He gives them during the week and lets the patient rest during the weekend.

Individual chambers is a matter of privacy and costs. Don´t worry about that. But it's important to know the pressure that the chamber is using. The medical community is using in general 2.0 ATAs at 100% Fio2.

I think the critical issue is the number of sessions, it's very expensive in the U.S, here is less, but 40 or 60 sessions will sure be expensive, so in this case the government is helping the divers that suffer the accident.

But I have no experience yet with a large number of sessions for tinnitus. Hope this helps.

 

It will help many people here who are considering this treatment.
Thank you!

Too bad I only got to have 5 sessions...

 

I'm now 2 months and a half in, and even if not as severe as in the beginning, I still have ETD issues, can't properly equalize with Valsalva and doctors have discouraged me to fly/take the channel tunnel.

I contacted a doctor at a clinic in London doing HBOT explaining my case and he suggested I try it ASAP, even with my ETD issues.

But well, that's his business, of course he wants me to come and pay for a few sessions.

I don't know what to do. If I don't try HBOT, I'll probably regret it forever. But if it makes me worse, I don't think I could take that...

 

@Bill Bauer you might be knowledgeable about this

 

For what it is worth, my ears didn't have any trouble adjusting to the change in pressure inside of the HBOT chamber...

 

I'm just having a series of HBOT sessions (I know it usually helps only for acute cases, but still I decided to give it a try), I had one in the morning today.

In my case it wasn't even loud and I had absolutely no problems with ear pressure, all was fine.

I encourage you to give it a try, you're still acute so there is a big chance for improvement.

If you don't try and your tinnitus stays you may regret it forever, like I do. At my onset nobody advised me I can have HBOT and now I suffer daily struggling to keep my sanity everyday (mine was induced at the rock concert like yours).

Of course there's habituation which works for some of us, but there are also unlucky ones which never fully habituate nor get used to it (even after 2.5 years I'm not fully habituated).

 

Thanks, my GP told me again this afternoon that he fears barotrauma if I try HBOT with my pressure problems.

This is an impossible choice

 

Hi Joe, I'm in the UK and that's pretty cheap. I live around Tilgate (Crawley) and would love to be treated with this.

Where is it you go?

 

Anybody know of a way to find a good, cheap HBOT clinic in the US? I'm located in the South-Central US and wanted to look into it, but all of the clinics that I could find are connected to hospitals and charge $1000+ per session.

 

All, I recently had 20 Hyperbaric Oxygen treatments (1.5 hours per treatment at 2.5 ATA) for my hearing loss. Thank God I was pre-approved by my insurance and that I hit my deductible for the year. After totaling up all of the claims associated with the treatment, the grand total was: $35,894. I just wanted to pass this along for those of you considering HBOT.

 

@ChiGuy : did your hearing loss and / or your tinnitus improve ?

 

@Frédéric No improvement on hearing loss. Slight improvement with tinnitus. The biggest improvement was with aural fullness. My left ear always seemed clogged. It opened up after the third treatment.

 

Already a good news for you !

 

I tried it 1 month (since I didn't know about this earlier) after my tinnitus started (due to loud sound) and after 8 one hour session there were no results.

 

My experience with hyperbaric oxygen therapy
I was treated with hyperbaric oxygen therapy, all 2.5 ATA, 90 minutes, two times: in 1996 and 1999. And I am now currently treated.

In 1996 got 17 treatments (daily, also on saturday and sunday). After 4 treatments I experienced a significant reduction. In total tinnitus loudness went down with 30-40%. Treatment was 10 weeks after an acoustic trauma (very loud music during 5 hours).
In 1999 treatment was within 5 weeks after onset. 10 treatments (during workdays). I didn't experience a reduction within the treatment period. But tinnitus loudness reduced slowly afterwards.

And now again (2017) I get 15 treatments again. 7 weeks after onset caused by loud music (2 hours of 95 dB). I is hard for me to assess the correct reduction. Sometimes I think it is 50%, but there are also times that I think traeatment produced maybe 10-20%. I had 11 treatments, and 4 to go. Normaly treatment takes place during workdays, 5 times a week. No treatments during the weekends. But the last 5 treatments are not in succession. 2, 3 of 4 days between the treatments.

My questions
Is time between treatments good?
During the nineties it was normal to get hbo treatments in succession, nowadays no treatment during the weekend. My hypothesis is that rest between treatments is actually good. What is your opinion about that? Is there any scientific research backing this?

How many treatments?
How many treatments are necessary? 10? 15? 20? More?

 

Just wanted to share my experience with HBOT. I found a clinic in the Northeast USA that was able to get me in quickly and for relatively cheap. My T is in both ears, the left from a noise exposure on 8/26, the right from a noise exposure on 9/19. My right ear also has some fullness and a little TTTS, as well as a bit of occasional pain and a weird ringing that seems to accompany certain sounds. I had 6 total sessions starting on 10/10, as this was all I had time for.

After the first session, I noticed immediate improvement in the right ear. No more fullness and T wasn't noticable. After the 2nd or 3rd, I noticed the right ear ringing again, but only when I put it down on a pillow. This cleared up again after the next session. After the 5th session, things were good with the right ear. Left ear was still ringing as before so I went back for one last session. My ears equalized normally on the "decent", but when being brought back up, I couldn't feel my right ear pop. It wasn't hurting or anything, but when I got out, all of my original symptoms we're back. Really wish I would have kept it at 5.

I'm now looking into seeing if I can find a clinic a little closer to get into for one more to see if it will clear up again. Both ears popped fine on the flight back home, so I'm not sure what happened... Starting to wonder if the whole thing wasn't just placebo or what.

 

Dear Theater Ringing, thank you for your experience. Your HBO treatment was 45 days after onset of the first noise induced hearing loss. In a paper I read for best results treatment has to be within 40 days. Did you do a hearing test? Before and after? With a hearing test you can assess the effect of the treatment more objective way.

 

Hello, Jan64. Yes, I had a hearing test after both exposures at my ENT. Both were within the range that showed no detectable hearing loss, but I believe that I have with high-frequency or hidden hearing loss. Since my right ear trauma was within the 6 week period, that is what led me to try this. I did not have plans to have another hearing test done due to the positive results of the last two.

I do seem to have developed some stronger hyperacusis in both ears, but I am assuming this to be because of my use of earplugs as I was in the city.

 

From the research I have been looking at, HBOT seems to have some promising results to treat sever sudden hearing loss that does not resolve using the standard steroid treatment therapy. That's not the same as a treatment for tinnitus, it's a treatment for the hearing loss, but since the two are often related, figured I would post these here. In my case, I'm hoping it will help with the hearing loss that hit me almost 3 weeks ago, since the steroids have not had much impact.

https://www.ncbi.nlm.nih.gov/pubmed/28423374

https://www.ncbi.nlm.nih.gov/pubmed/28555597

https://www.ncbi.nlm.nih.gov/pubmed/27917721

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012987/

Note that the last paper claims that the treatment needs to start within a few weeks of the hearing loss, and goes on to say "There is no evidence of a beneficial effect of HBOT on chronic ISSHL or tinnitus and we do not recommend the use of HBOT for this purpose."

Most of the papers do agree that there is benefit for treatment of acute hearing loss (vs chronic).

 

35K, and they say healthcare in Europe is expensive....
Could it also be that your ears are under muscular tension and therefore feel full / clogged or was it some sore of fluid feeling inside the ear?

 

Where did you get HBOT treatments in the Netherlands? Since Rotterdam Erasmus MC doesn't believe it will work. I can't believe it's being done in NL as there "is no indication it will work" they said. I have found some pressure chambers but they are not aware of any beneficial effects for T so eventually the risk and bill came for me. As per Antwerp hospital advice (which have their own pressure chamber) they didn't think it was of any help during my onset in 2014.

Prime Minister Michel of Belgium recently had a gun exploding right near his ear and also had HBOT therapy if I read the news article correctly:

http://www.standaard.be/cnt/dmf20170530_02903782

In the article is described that only cortisone therapy is "scientifically proven" as HBOT cannot be easily measured. Note: Rotterdam and Ghent ENT's also didn't believe in cortisone therapy when I asked them, so opinions differ per ENT and hospital unfortunately.

 

Got HBOT treatments at Instituut voor Hyperbere Geneeskunde (Institute for Hyperbaric Oxygen), see www.ivhg.nl in the Netherlands. They own 5 treatment centers with 12 person Haux Hyperbaric Oxygen rooms, and are located in Hoogeveen, Waalwijk, Arnhem, Rotterdam and Maarssen. Treatment is 'off label' (not approved by Zorginstituut Nederland) and they give no garantee. It costs €182,50 per session, and is not covered by insurance. The duration of one treatment is 2 hours and is at 2.5 ATA. You need a reference ('verwijzing') from your ENT doctor or GP. Treatments are done safe and very professional. Let me know if you need more information.

 

Well there goes, if you don't get a reference then you are bust. And I did discuss HBOT with my GP back in the onset days of my T and he thought it didn't help. He even thought going to a Belgian hospital was nonsense. "T was T, and nothing could be done about it boy". I looked into going to Geldrop (https://www.davincikliniek.nl/) but the receptionist did not know if it would work. Oh and my ENT wasn't willing to refer me at all.

On the NVVS (Dutch Tinnitus forum) there are other patients which had HBOT with little to no results. The early onset (acute phase) seems to be an absolute requirement for this to work.

 

Unfortuanately the general opinion about HBOT is negative... See my pm to you regarding an excellent ENT in the Netherlands for future references ('verwijzingen')...

 

I guess it depends what you mean exactly. There are many studies that show that HBOT is effective in treating sudden hearing loss when started fairly quickly (<14 days) after onset and in combination with standard steroid treatments. If the tinnitus is a result of the hearing loss, then tinnitus should reduce with improvement in hearing loss.

Here is one reference, but there are many if you search on pubmed that come to a similar conclusion regarding hearing recovery:
http://www.hsj.gr/medicine/the-clin...neural-hearing-loss-and-tinnitus.php?aid=8303

Another: http://www.hbotnova.com/resources/sudden_hearing_loss/2004_topuz.pdf

I posted a few others before - there are many and are easy to find.

I just started HBOT to see if it will help with my sudden onset single sided profound hearing loss (accompanied by tinnitus). Unfortunately, I did not start the treatment until day 20, but am really hopeful I will see gains. I will post my experience and results to the forum. I am in the US, and my insurance is covering the treatment 100%, otherwise it would be prohibitively expensive.

 

The problems are multiple: HBOT can also give other problems such as barotrauma. You need to get a proper referral. It's expensive and probably not covered by insurance. Nobody knows how many treatments you need at what ATA pressure. Nobody knows exactly if it will help as papers in fact are for and against.

Too bad they cannot test this on mice so we have some proper scientific double placebo tested results.

 

The problem with a possible baro trauma is in my eyes very small. You have to clear your ears properly, but almost everybody can do that. And if not tubes can be placed.

In the UK you can get HBOT really cheap: http://mstherapybristol.org.uk/oxygen.html You have to become a member. Membership costs 30 pounds a year. Treatment: 20 pounds per treatment. So for 430 pounds you get 20 treatments. They offer 2 ATA. You can contact them by: info@mstherapybristol.org.uk Just send an e-mail. Manager is mrs. Dora Pasantes. She is a kind lady!

The problem of how many treatments can be solved when we get more experience... And the pressure: 2.5 ATA is oké for tinnitus (there is a paper on 2.2. and 2.5 ATA and no difference in success was detected), you will be in the chamber with other patients with other problems. I 've heard that above 2.5 ATA (e.g. 3 ATA) problems with oxygen poisening can occur.

 

It's not small. Read this study.

RESULTS: The observed MEB (middle ear barotrauma) incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test), and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol (P=0.028, exact one-sided Mann-Whitney type test).​

 

Baro trauma... indeed not very small...
13.6% https://www.ncbi.nlm.nih.gov/pubmed/20737927
8% https://www.ncbi.nlm.nih.gov/pubmed/8932942