Up to 60 per cent of patients with enlarged vestibular aqueduct syndrome experience sudden hearing loss. This review analyses treatment options and outcomes when sudden hearing loss occurs.

Embase, Ovid MEDLINE and Web of Science databases were the data sources. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO. The number of patients, episodes, treatments, baseline hearing and change in hearing thresholds after intervention and return to baseline were extracted.

The final analysis included 60 episodes of hearing loss from 11 studies, from a search of 1,064 studies. The treatment groups were: 1, no treatment; 2, systemic steroids; 3, salvage hyperbaric oxygen therapy in steroid partial or non-responders. The hearing improvement across the groups was 9.1 per cent, 50 per cent and 89.5 per cent, respectively.

Enlarged vestibular aqueduct patients with sudden hearing loss may first be treated with systemic steroids. Salvage hyperbaric oxygen therapy can be considered in steroid non-responders to improve further chances of recovery.

Tissue injuries that occur after earthquakes are usually traumatic and cause various anatomical damages. Hyperbaric Oxygen Therapy (HBOT) is an increasingly popular treatment modality for such tissue injuries because it has the potential to accelerate the healing process of tissues by providing effective oxygen.

This study aimed to present a retrospective evaluation of the effects and outcomes of HBOT in patients with tissue damage after earthquakes, thus contributing to the development of medical intervention strategies following natural disasters.

This study included 51 patients treated as earthquake victims in the Hyperbaric Oxygen Therapy Unit. Information regarding the earthquake victims was obtained retrospectively and relevant analyses were conducted. Statistical analyses were performed to evaluate the relationship between the Mangled Extremity Severity Score (MESS) and related variables.

Sensory and functional recovery rates were 64.7% and 62.7%, respectively, after HBOT. After treatment, 10 (19.6%) patients had a minor amputation, and 5 (9.8%) patients had a major amputation. As patients’ MESS Scores increased, the rate of amputation did not increase (P < 0.05), but the rate of recovery of sensation and function in the recovered extremities decreased (P < 0.05). No patient died during treatment.

These results suggest that HBOT can protect life and limb in earthquake injuries, but also save numb and non-functioning limbs in severe cases.

This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).

This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.

A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).

Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.

This study evaluated the prognosis of idiopathic sudden sensorineural hearing loss when treated with hyperbaric oxygen therapy and intravenous steroids.

The clinical data for 334 patients with idiopathic sudden sensorineural hearing loss treated by hyperbaric oxygen therapy and intravenous steroids at our hospital were retrospectively reviewed. These data included the initial averaged five-frequency hearing level, patient age, interval between onset of symptoms and treatment, vertigo as a complication, and co-existence of diabetes mellitus.

The overall improvement rate was 69.2 per cent, including better improvement (25.5 per cent), good improvement (21.0 per cent) and fair improvement (22.7 per cent).

Hyperbaric oxygen therapy appears to confer a significant additional therapeutic benefit when used in combination with steroid therapy for idiopathic sudden sensorineural hearing loss. If performed early, hyperbaric oxygen therapy may bring about hearing improvement in many patients who are unresponsive to initial therapy.

Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy.

A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy.

Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment.

Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.

The management of sudden sensorineural hearing loss has not yet been standardised. Hyperbaric oxygen therapy influences recovery from sudden sensorineural hearing loss, but the underlying mechanism is unknown and the appropriate indications and protocols undetermined.

Nineteen patients affected by sudden sensorineural hearing loss were treated after unsuccessful medical therapy, either in an acute or chronic setting. Pure oxygen inhalation at 2.5 atmospheres absolute pressure was administered for 90 minutes, for 30 sessions. Frequency-specific and average pure tone hearing thresholds were determined before and after hyperbaric oxygen therapy. The number of hyperbaric oxygen therapy sessions, the patient's age and any therapeutic delay were considered as quantitative variables possibly influencing outcome. Stepwise multivariate analysis was performed.

Salvage hyperbaric oxygen therapy appeared to improve patients' pure tone hearing thresholds, particularly at low frequencies. Positive results were more likely with increased patient age and reduced delay in receiving hyperbaric oxygen therapy.

Hyperbaric oxygen therapy has a strong scientific rationale, and improves pure tone hearing thresholds in cases of sudden sensorineural hearing loss unresponsive to medical therapy. Further research may be able to identify those patients with sudden sensorineural hearing loss for whom hyperbaric oxygen therapy would be most cost-effective.