Hyperbaric Oxygen Therapy

Discussion in 'Treatments' started by joe, Jan 18, 2012.

    1. mick

      mick Member Benefactor

      Location:
      USA
      Tinnitus Since:
      11/2012
      Izis,

      It would be interesting if you could show whether you recovered some of your hearing loss. Any plans to have another audiogram in the near future to compare to the pre-HBOT one?
       
    2. izis

      izis Member

      Tinnitus Since:
      09/2012
      Most definitely, will get one done sooner or later!
       
    3. Deep
      Balanced

      Deep Member

      yes that would be interesting.
       
    4. Goofy
      Goofy

      Goofy Member

      Location:
      US
      Tinnitus Since:
      01/2013

      I am glad that HBOT lowered your T level. I hope you continue to improve.
       
    5. dan26
      Frustrated

      dan26 Member

      Location:
      NJ
      Tinnitus Since:
      1981
      Cause of Tinnitus:
      complete loss of hearing. motorcycle accident
      i have had moderate to severe t for over 30 years after a bad motorcycle accident. head injuries, facial injuries. total loss of hearing. its affected every aspect of my life. i would try anything and maybe this might help. Gonna read up about this.
       
    6. izis

      izis Member

      Tinnitus Since:
      09/2012
      good luck, wish you all the best.
       
    7. tencount
      Surrender

      tencount Member

      Tinnitus Since:
      2013
      I did 14 sessions of HBOT at about 5 weeks into my onset. Each week the base t sound reduced by 10%. and at about 1.5 weeks after the treatment it reduced by an additional 40% and changed the tone of my tinnitus to a more pleasant light seashell sound.

      If you have the resources to do HBOT, I HIGHLY recommend it. The difference from how i'm feeling pre HBOT to post HBOT is tremendous.
       
    8. Louise

      Louise Member Benefactor

      Location:
      Yorkshire, UK
      Tinnitus Since:
      29/06/2012 worsened Jan 2017 & Dec 2017
      Cause of Tinnitus:
      Noise exposure
      That's good news tencount. HBO is the only treatment we have that has shown any evidence as to its efficacy. I'm glad someone has posted to tell us a success story. Could you tell us what depth you went to and for how long please? Thanks.
       
    9. tencount
      Surrender

      tencount Member

      Tinnitus Since:
      2013
      • Like Like x 1
    10. Jade
      Lucky

      Jade Member Benefactor

      Location:
      Sunshine Coast, Australia
      Tinnitus Since:
      08/07/2013
      Cause of Tinnitus:
      Genetics, Beats by Dre, Work
      @tencount,
      Hello :) just wondering where you done this HBO & what was the cost like involved? If it was in Australia? Very interested

      Thank you
       
    11. Louise

      Louise Member Benefactor

      Location:
      Yorkshire, UK
      Tinnitus Since:
      29/06/2012 worsened Jan 2017 & Dec 2017
      Cause of Tinnitus:
      Noise exposure
      Wow, you are brave going in there (I have claustrophobia). Would you be able to email them and find out the depth for us? I was told to "go as deep as possible for as long as possible".
       
    12. Pete

      Pete Member

      Tinnitus Since:
      07/2013
      Hi all! I'm new here - developed tinnitus due to sudden noise exposure (clubbing) just over a month ago. I've been reading this thread with great interest.

      My doctor initially thought it was due to ear wax build up so I had my ears syringed last week. Unfortunately my right ear is still ringing so I'm worried it's something more serious. I plan to go see my doctor tomorrow, hoping for an ENT referral but realise there is normally quite a waiting list.

      I have looked into HBOT treatment and my local MS centre has a chamber which goes to depths of 24ft - do you think this would be sufficient to see any benefits?

      Also my ears, particuarly my right are quite painful/sensitive and I seem to have developed a mild but reasonably constant headache. Last night I had to use earplugs on the tube as it was way too loud for me. Do people experience pain with tinnitus or could this be something else? Should I wait for the pain to (hopefully) subside before going any further with HBOT?

      I hope you can offer me some advice - am going crazy at the moment and don't feel like myself :(
       
    13. Louise

      Louise Member Benefactor

      Location:
      Yorkshire, UK
      Tinnitus Since:
      29/06/2012 worsened Jan 2017 & Dec 2017
      Cause of Tinnitus:
      Noise exposure
      Hi Pete,

      Commiserations on your tinnitus. I too got it from noise exposure on a night out.

      The answers to your questions are:
      Yes, 24ft is deep enough to see benefits, do an hour minimum. The rule with HBO is that you have to do 20 sessions consecutively. So every day (excluding Sundays as they aren't open). The idea is to get the oxygen to the area of damage to promote healing. You can only do this in the first few weeks so I'd get going if I were you. The thing that you need to be able to do is 'clear' your ears, so you need to be able to do the Valsalva Manoeuvre. You will do a trial session first with just you in the tank and if you experience any pain as you 'dive' then they will stop the dive.

      I must reiterate that you only have a limited amount of time after onset for this treatment to have a chance of working.

      The pain you are experiencing could possibly be from the attention that you are giving your ears now. It can alo be from the Tensor Tympani muscle tightening to protect you from noise. Your ears have had a big shock.

      It sounds like you also have Hyperacusis, where noise is too loud, this very often accompanies tinnitus.

      Good Luck Pete, I hope the HBO works for you.
       
    14. LadyDi
      Busy

      LadyDi Member Benefactor

      Location:
      Florida, USA
      Tinnitus Since:
      06/2013
      Cause of Tinnitus:
      Barotrauma/airplane
      Hey, quick question here:

      I now am considering HBO. I found a good facility, connected to a hospital, that can do it for about $250 a session. Single chamber. Here is my question: The airplane flight and barotrauma that I "think" caused my T was May 8. I started having serious symptoms about a month later. So that now puts me about three to four months out of the beginning of all this.

      Is there any point of trying it at this point? Any thoughts on if it would work in a barotrauma situation? Sure wish one of my docs would have mentioned it to me along the way over the past few months.
       
    15. Markku
      Inspired

      Markku Founder Staff Podcast Patron Benefactor Hall of Fame Advocate

      Tinnitus Since:
      04/2010
      Cause of Tinnitus:
      Syringing
      I refer to one of my earlier posts...

      "If the onset of affliction was longer than 3 months up to several years, no hearing improvement can be expected in the majority of patients (fig. 3); however, one third of the cases reported an intensity decrease of tinnitus, 60-62% reported no change and 4-7% noticed a temporary intensity increase (fig. 4)."
      https://www.tinnitustalk.com/threads/hyperbaric-oxygen-therapy.211/page-7#post-9834

      Also check this: https://www.tinnitustalk.com/threads/hyperbaric-oxygen-therapy.211/#post-1057

      In one of the study I referenced 6 patients out of 20 had a reduction of tinnitus after being administered HBO - even though their tinnitus had lasted longer than 1 year.

      But these sample sizes are small, and the study results seem to differ quite a lot.

      In Finland they don't suggest HBO at all to patients who've had it longer than few months. It is already sometime ago when I asked about this from a renowned Finnish tinnitus specialist and he said that in his years of experience the best results have been seen with patients that have had tinnitus only days or a maximum of a couple of weeks before the HBO was started.

      Not sure how barotrauma affects this.

      Be advised of the following though:
      Use of a hyperbaric chamber. Patients undergoing hyperbaric oxygen therapy must learn to equalize in order to avoid barotrauma.[24] Some patients may be at greater risk of otic barotrauma than others.[24]

      Also check this: http://www.ncbi.nlm.nih.gov/pubmed/19105143

      So if you think barotrauma caused your tinnitus, be extra careful with the HBO and remember to equalize properly.
       
      • Like Like x 1
    16. LadyDi
      Busy

      LadyDi Member Benefactor

      Location:
      Florida, USA
      Tinnitus Since:
      06/2013
      Cause of Tinnitus:
      Barotrauma/airplane
      Good advice as always, Markku. Thanks. Given that I did have eustachian tube dysfunction, might not be worth the risk of aggravating the T even more. I was only considering it because I am right on the edge of the time-frame of when there is no reason to try at all.
       
      • Like Like x 1
    17. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      Hi LadyDi,

      Markku's comments and links are great. Like you, I have ETD and chose not to use HBOT because I feared the therapy would further damage my ears. Barotrauma from ETD actually caused my tinnitus.
       
      • Like Like x 1
    18. LadyDi
      Busy

      LadyDi Member Benefactor

      Location:
      Florida, USA
      Tinnitus Since:
      06/2013
      Cause of Tinnitus:
      Barotrauma/airplane
      Thanks for being the voice of reason, Jazz. I found myself feeling all gloomy and anxious today after researching HBOT, thinking: Dang, I have missed out, this could have cured me. In retrospect, it probably would have been more likely to harm me.

      Did you get your T because of a plane trip? I now have been to four specialists and none of them can definitely tell me that yes, it was barotrauma from a transatlantic flight. But I came home with one blocked tube, severe ear pain and what felt like trapped fluid in my ear. So I pretty much believe that's how it happened. Not that it matters... Have given up on the hunt for the cause, moving on with focusing on management.
       
    19. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      I also thought I had missed being cured. I found out about HBOT on TT about five months into my tinnitus. At that point, research suggests HBOT becomes much less effective. Being ever hopeful, however, I continued my research when I discovered about barotrauma as a risk factor from HBOT. This is especially for people with Eustachian tube dysfunction.

      Regarding barotrauma and air travel, I've never done research specifically on this topic, but it does make sense. And I have read that the "pressure equalizer" ear plugs sold at drugstores do not prevent ear trauma. Scuba divers are also at risk for barotrauma.

      My own ETD dates back two years ago when a severe cold ruptured both of my ear drums. After I recovered, my Eustachian tubes began popping sporadically. This popping drove me crazy; I thought it was the worst thing. Little did I know! Long story short, I constantly had pressure in my ears--along with the popping--and would occasionally perform the valsalva maneuver to relieve them. Late last August, my allergies were raging and so were my ears--and so I gently popped them. I felt a rush of air then I heard a symbol sound for a half second in my left ear. That symbol sound was apparently the air backfiring into my cochlea, causing damage and giving me permanent tinnitus. I now tell people to never, ever pop their ears. There's probably one-in-a-million chance of getting tinnitus from ear popping, but you never know. I certainly regret my ear popping days, though I had no idea it could give me tinnitus. I never had heard about tinnitus prior to getting it.

      Well, I'm sorry for rambling. But I am obsessed about warning people with ETD not to pop their ears.

      It's great you're focusing on tinnitus management. You need to feel some control over your noise, and it will come. Having a positive attitude and keeping your life filled with sounds to distract your from the tinnitus will definitely help.

      Your tinnitus, however, is still very new; it might go away on its own. Just protect your ears when you are in noisy situations (like the movies), and always carry ear plugs in case you get stuck in a fire alarm!

      Equally important, you might try Auris Medical's latest clinical trial. I thought they were beginning it in August. But it looks like the date has been moved to December, 2013. That will be too far away for you since Auris wants the trauma to have occured within a three-month window. Perhaps, you could find an ENT, and he could procure the medicine? In addition, have you tried intratympanic steroid injections or taken prednisone? Getting the inflammation under control early may prevent additional damage. It's something to consider if you haven't already tried these therapies.

      Here's the clinical trial link:

      http://clinicaltrials.gov/ct2/show/NCT01803646?term=am+101&rank=3

      Whether or not you participate, nearly everyone with tinnitus improves within the first year and many habitutate within a year or two. At that time, the tinnitus sound either goes away completely (unless you search for it) or the noise becomes a non issue that you can ignore.
       
      • Like Like x 1
    20. Marton

      Marton Member

      Tinnitus Since:
      03/2013
      Hi everyone!
      I did 12 sessions of this after 5 months of the start of my tinnitus...I think it went a bit quieter, but still there. Now my doctor suggests to do 12 more sessions. Do you guys think it worths it?Can it still improve after 12 sessions? its very expensive here so Im not sure I wanna do any more...
       
    21. Dhaval
      Buzzed

      Dhaval Member

      Tinnitus Since:
      4 months
      Yes I have done 14... and going to do 20 at least. There shouldn't be any problem. Just out of curiosity do you feel like your hearing has dulled too?
       
    22. Valentin

      Valentin Member

      Location:
      Thailand
      Tinnitus Since:
      17/08/2013
      hi,

      i have an acoustic trauma since 17/08/2013 due to noise exposure in a club, i woke up with tinnitus in both ears while right ear had a higher pitch than the left ear.

      I ran to see the ENT who prescribed me 4*4 5MG prednisolone, 2*2 12mg betahistine,2*2 vimatin b1(100mg) b6(5mg) b12 (65mg), deanxit(flupentixol 0.5mg + melitracen 10mg) and valium it needed to sleep but this doesn't help.


      i took the first medication less than 15 hours after the initial exposure.

      Audigram 8khz showed no audio loss, however i noticed music at home wasn't feeling the same as it was before this trauma and i had difficulties to separate voices from noise.

      10 days after the inital treatment, music now sounds as good as before and i can follow a conversation with ambient noise aswell.

      it's been 13 days and the tinnitus seems to have disappeared in the right ear(i can barely hear like distant crickets or wind noise) the left ear still has the tinnitus but at a lower volume.

      however i have hard time to sleep as the tinnitus seems to become stronger when i'm sleeping and wakes me up....

      i'm considering doing 10 sessions of HBOT, i'll have to pay by myself 1300 euros for these but i think it's the last thing to do before it's too late.

      to those who had HBOT treatment, where you giving vasodilatator or other medications prior the HBOT?

      i'm going to see my ENT later today and explain my plan to her.

      kind regards,

      Valentin
       
      • Like Like x 1
    23. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      @Valentin I am so glad you got treatment so early. And so far, your treatment protocol looks like your ENT is covering all the bases. I'd definitely also try HBOT, for your injury is still healing. May I ask what country are you from? I don't believe there's any ENTs in the US who would try so many treatments for tinnitus. Even when the tinnitus is new, most ENTs tell people to "live with it."

      And so many people--myself included--end up with chronic tinnitus because they don't get treatment in time--even if they go to the doctor right away--which I did!

      Anyway, I just googled "tinnitus treatment protocol," and it looks like it's minimal. Most treatments consist of sound therapy and hearing aids--if there's also hearing loss. It looks like the US government is evaluating tinnitus treatments for effectiveness. This will be interesting to follow. Here's the link: http://effectivehealthcare.ahrq.gov...orts/?productid=811&pageaction=displayproduct

      I'm also curious if you were offered intratympanic steroid injections? I know several steroids can be delivered this way, and it causes less side effects. I wish some one had offered me steriods--either oral or intratympanic.

      Please keep us posted on your progress!
       
    24. Valentin

      Valentin Member

      Location:
      Thailand
      Tinnitus Since:
      17/08/2013
      i'm currently living in thailand, hopefully a friend of mine is working at the Hyperbaric chamber few kms from where i live so the price is really down to the minimum, normally a session is 900 usd for divers......

      i have not been offered intra tympanic injections, never heard of it, i need to google that :)
       
    25. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      @Valentin

      Here is one link to a favorable study. The researchers tested the injections for sudden SNHL with severe tinnitus. (http://audiologyresearch.org/index.php/audio/article/download/audiores.2012.e2/66)

      There's a discussion on steroids and steroid injections on Tinnitus Talk which you should look it. (https://www.tinnitustalk.com/threads/corticosteroid-injections-steroids-prednisone.348/)

      I'd like to see more studies comparing the two treatments because oral steroids do have many side effects, even if taken for a few days.
       
    26. Mike Ryan

      Mike Ryan Member

      I'm a hyprebaric oxygen chamber operator/technician at a small facility in Boston MA USA that was created 7 years ago by 2 families with children who needed HBOT.

      We see a few client-patients with Tinnitus, but I, personally, have not seen enough folks come through our facility and continue with HBOT for the recommended number of 15-20 'sessions' to give any real evidence that HBOT helps. I have seen and heard others talk about the positive results, but I, personaly, have not seen enough people with Tinnitus come through our doors and stick with it.

      The problem is two-fold: lack of advice from doctors knowledgeable about HBOT, and the perceived cost issue associated with HBOT.

      The advice piece has the affect of discouraging client-patients from trying HBOT in the first place. And, this lack of advice is mainly due to a lack of medical trials, which is due to a lack of incentive by hospitals to further test the effect of HBOT on Tinnitus, all of which discouraging folks from trying HBOT, let alone sticking with it for the 15-20 recommended sessions.

      The cost piece also discourages people from trying HBOT, and sticking with HBOT. But, the costs, like any product or service, vary according to the market. Right now, there are two sets of players - hospitals, and independents. If you go to a hospital and ask for a quote on cost, the hospital will give an inflated price based on what the hospital expects to be reimbursed through insurance. In the US, insurance can't be used for things like Tinnitus. So, the average person gets an incorrect answer from the hospital - a very inflated number. Independent facilities are the best source for this question. So, if you're hearing that costs are high, you need to compare apples to apples.

      I can give my perspective, and offer our facility in Boston as a destination for anyone visiting the Boston area, and talk to the cost issue. In general, costs range around the US from $60/hour to $200/hour. Some more, some less. We're on the low side at my facility, because we're not associated with a hospital, and we do a lot with families to lower costs for folks, without jeopardizing safety.

      To distill what HBOT is, I want to take a step back and simply state it. It's is simply putting a body in a chamber, pressurizing the chamber with air or oxygen, and then having the HBOT user breathe oxygen. That's it. Very simple. But, in any study you read (whether it's for Lyme, CP, rheumatoid arthritis, autism...), you'll always see a few standard things: safety/risks, depth, frequency (aka protocol), and the study's number of participants. The key to digesting these studies (along with anecdotal evidence and testimonials) is understanding where HBOT is in the field, and the rigor of the study.

      Risks: In general, risks involve the risks associated with handling oxygen, and barotrauma (pressuring the ears, like you'd experience in an airplane). These risks would be brought up in any study. They have to be mentioned. Safety is the foremost concern of any facility, and if you don't feel safe, leave the facility.

      Frequency of sessions vs. total hours: Studies will 'recommend,' or the reader will perceive that the recommendation is for 5 days/week or 7 days/week, etc. The thing to keep in mind when reading these is that the frequency is a byproduct of the study, not the design of the study. For example, when you see "5 days per week", that really means that the study brought together the participants (doctors, nurses, technicians, patients) over a period of time so that the study could be conducted and documented as efficiently as possible. They happened to meet 5 days a week, to get the study done and the staff back to their normal work. So, I would not necessarily interpret the frequency as a major component in the determination of protocol. In other words, the cumulative number of HBOT hours that a person gets under her belt is better (more important) than the frequency. In general, for the conditions I see, my experience is that the number of surprises (or improvements/changes) that occur over time is compacted if the total sessions is compacted, and those surprises are more spread out if the total number of sessions are spread out.

      HBOT is simple, but that's the problem today in getting it understood by the medical community. No one company owns a patent on oxygen, so it's not promoted by any one company, and, thus, no one really has any incentive to talk about its benefits in the medical community, so it gets overlooked while patients are persuaded to take drugs.

      HBOT is not well known by the general medical community, and it's not taught in medical school, because it's not tested. But, it is well known by the hyperbaric medical community and is being invested in by the hyperbaric medical community. Ten years ago, it was non-existent, and today you have hyperbaric chambers in ambulances.

      For anyone who explores HBOT for any condition, I always try to remain neutral, because there's so much information available and it can be interpreted differently by differnt folks. Some are hell-bent against HBOT, because they think HBOT is too expensive etc., or they heard something negative about it on the cost or the experience front.

      If you have questions like, "Should I invest in it?," "Is it dangerous?," "Will it cause ear trauma?," I can certainly help.

      HBOT is safe, available outside of the hospital system to qualified client-patients, is relatively inexpensive, and is less risky than prescribed medications.
       
    27. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      @Mike Ryan Thanks for the information and for opening up a dialogue on HBOT. It is an underutilized treatment for all the reasons you cite, e.g., doctors' don't understand the therapy, insurance companies won't reimburse it, etc. In Germany, HBOT is a first-line treatment for acute tinnitus. There are studies supporting HBOT for acute noise-induced hearing loss (see, eg., http://www.ncbi.nlm.nih.gov/pubmed/23111896), but I don't believe this therapy is effective for chronic tinnitus. I do see, however, you've addressed many of these issues in your post. And I'm sure most people do not perform the recommended number of sessions. It would be beneficial, however, if people knew that the costs are not necessarily so prohibitive. How to advertise this?

      I also note you write about the risks of HBOT, namely barotrauma. Are some people more susceptible to this than others? Is there a screening test to insure your ears will equalize correctly? I'm interested because my tinnitus came from a barotrauma, and I've been diagnosed with ETD. These facts, I assume, would render me high risk for HBOT.

      Any information would be appreciated!
       
    28. Valentin

      Valentin Member

      Location:
      Thailand
      Tinnitus Since:
      17/08/2013
      Hi,

      so far i did 5 sessions 45ft 1h40M, as i said before i noticed a decrease in the noise before starting the treatment however not permanent, sometime the tinnitus ringing is almost gone and i just hear like wind noise sometime it's the only the ringing.

      One thing i noticed is the tinnitus seems to stay stable even at night, the first 10 days it was waking me up with sirens, crickets like noise, nowadays i can almost sleep 6 hours at night which is better.

      i can't really say the first 5 sessions have proven to be helpful so far but i'm glad someone operating HBOT joined the discussion.

      My ENT decrease the prednisolone to 2*5MG morning and 2*5MG evening for 5 days then starting tomorrow 1*5MG morning and 1*5Mg evening then stop it completely, i'm still under 1*24MG betahistine morning and 1*24MG betahistine evening.

      we are going to do a sunday break so i should have the last 4 sessions next week.

      any recommandations ?

      thanks,

      Val
       
    29. daman558
      Haunting

      daman558 Member

      Location:
      USA
      Tinnitus Since:
      05/2013
      Hey all,just wanted to say that after suffeing from tinnitus for 3.5 months now ive decided to give HBOT a go. i have a history of eustachian tube dysfunction as well and was wondering exactly how much damage could barotrauma do to ears? also, would it be sudden or would i have time to abort the treatment before any damage was done? like would you feel a pain before it happened or would it just go bam, out of nowhere? i have been very on the fence about this but i dont think i can afford to wait as i have seen that once this becomes chronic at 6 months you have no hope with HBOT. I will keep you all posted on my experiences with it. in addition i will be fasting, quitting smoking, and hitting the supplements hardcore. i feel like this is the last chance i have to try and get over this.
       
    30. daman558
      Haunting

      daman558 Member

      Location:
      USA
      Tinnitus Since:
      05/2013
      Hi lady di,just wanted to mention that the information i read online states that you will only be diving 30ft. in terms of pressure which equals ascending 10000 ft in an airplane. which is not that high. i have had bad etd. fluid in the ears for 2 months, and recently climbed a 3000 ft mountain no problem. it might be worth asking if you can bring an earpopper device into the chamber to help prevent barotrauma and help pop your ears. i know i will be taking mine if i can. i only bring this up because if you are still under 6 months of t there seems to be enough of a chance of improvement for one to try. you could always tell them to let you out if you feel pain as well.
       

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