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HNO 2020 Jul 2. Epub 2020 Jul 2.

Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

Necrotizing fasciitis (NF) is a life-threatening, usually bacterial, soft tissue infection that rarely affects the head and neck region. Rapid progression and systemic illness are typical for the disease and complicate diagnosis. Immediate surgical and antimicrobial therapy is required. Read More

Ochsner J 2020 ;20(2):193-196

Retina and Vitreous Specialists New Orleans, Metairie, LA.

With the increasing popularity of facial filler injections, growing numbers of complications have been reported. We present the case of a 60-year-old female with vision changes and keratitis following hyaluronic acid (HA) facial filler injections who completely recovered following hyperbaric oxygen treatment (HBOT). Using HBOT to successfully treat ocular ischemia has been reported, but to our knowledge, our case is the first report of successful HBOT use for ocular ischemia and keratitis following cosmetic facial HA injection. Read More

Int Marit Health 2020 ;71(2):105-108

Department of Neurorehabilitation, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

A professional 55-year-old female experienced diver, who surfaced after the second dive, had a lucid interval before dropping Glasgow Coma Scale (GCS) to 3/15. She was admitted to intensive care unit and commenced on hyperbaric oxygen therapy. Her initial computed tomography of the head was normal but her magnetic resonance imaging of the brain at 48 hours showed extensive bilateral cortical watershed territory infarcts. Read More

BMJ Open 2020 Jun 29;10(6):e031708. Epub 2020 Jun 29.

Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Copenhagen, Rigshospitalet, Denmark.

Introduction: Diabetic foot ulcer represents a major health problem globally. Preliminary studies have indicated that systemic treatment of diabetic foot ulcer patients with hyperbaric oxygen therapy have beneficial effects on wound healing, risk of amputation, glycaemic control, atherosclerosis, inflammatory markers and other clinical and laboratory parameters. This protocol for a systematic review aims at identifying the beneficial and harmful effects of adding hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers. Read More

Zhonghua Shao Shang Za Zhi 2020 Jun;36(6):480-483

Department of Burns and Plastic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China.

To investigate the effect of pedicled thoracodorsal artery perforator (TDAP) flap on the repair of axillary moderate to severe scar contracture deformity. From January 2012 to January 2017, 29 patients with axillary moderate to severe scar contracture deformity were admitted to the the Second Xiangya Hospital of Central South University, including 18 females and 11 males, aged 14-42 years. There were 3 patients with cicatricial contracture deformity of bilateral axillas and 26 patients with cicatricial contracture deformity of unilateral axilla. Read More

Med Hypotheses 2020 Jun 13;144:109990. Epub 2020 Jun 13.

Department of Pharmaceutics, Max Institute of Pharmaceutical Sciences, Khammam, Telangana 507318, India. Electronic address:

Diabetic wound (DW) is a major complication of diabetes mellitus that often ends up with amputation of the concerned organ. The current therapies for DW include glucose regulation, wound debridement, pressure off-loading, surgeries, hyperbaric oxygen therapy, maggot therapy, and so on. However, the majority are not meeting all the prerequisites of DW because of extensive pathology and cost associated with the strategies. Read More

J Cosmet Dermatol 2020 Jun 27. Epub 2020 Jun 27.

Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Background: Mandibular osteomyelitis after filler injection is extremely rare. We reported a case of mandibular osteomyelitis after hyaluronic acid injection.

Patients: A 33-year-old woman received 1ml hyaluronic acid injection on her chin one year ago, after which her chin kept swelling and painful, and gradually ulcerated with pus flowing out. Read More

Aging (Albany NY) 2020 Jun 26;12. Epub 2020 Jun 26.

The Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel.

More than half of community-dwelling individuals sixty years and older express concern about declining cognitive abilities. The current study's aim was to evaluate hyperbaric oxygen therapy (HBOT) effect on cognitive functions in healthy aging adults.A randomized controlled clinical trial randomized 63 healthy adults (>64) either to HBOT(n=33) or control arms(n=30) for three months. Read More

Jt Dis Relat Surg 2020 18;31(2):260-266. Epub 2020 Jun 18.

Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 42080 Meram, Konya, Türkiye.

Objectives: This study aims to investigate the effects of hyperbaric oxygen (HBO) therapy and platelet-rich plasma (PRP) on the regeneration of osteochondral defects of the rats, and the synergistic effect of this combined treatment.

Materials And Methods: This randomized, controlled, and interventional animal study was conducted between May 2014 and August 2014 Osteochondral regeneration was evaluated in four treatment groups (control, PRP, HBO, and HBO+PRP groups) at the 30th day after iatrogenic injury. Thirty-two female Wistar albino rats (weighing 248-305 g) underwent arthrotomy and osteochondral surgery on left knees. Read More

JMIR Res Protoc 2020 Jun 23. Epub 2020 Jun 23.

Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, US.

Background: Background: Hyperbaric oxygen (HBO2) (oxygen at pressures higher than atmospheric) is approved for 14 indications by the Undersea and Hyperbaric Medical Society. HBO2's main effect is to increase oxygen content in plasma and body tissues, which can counteract hypoxia or ischemia. Laboratory studies show that hyperbaric oxygen has effects beyond relieving hypoxia (e. Read More

Acta Cir Bras 2020 22;35(5):e202000503. Epub 2020 Jun 22.

PhD, Associate Professor, Division of Surgery, School of Medicine, UnB, Brasilia-DF, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript preparation and writing; critical revision, final approval.

Purpose: To investigate the effect of hyperbaric oxygen therapy on colonic anastomosis healing with and without ischemia in rats.

Methods: Forty female rats underwent segmental resection of 1 cm of the left colon followed by end-to-end anastomosis. They were randomly assigned to four groups (n=10 each), a sham group; two groups were submitted to Hyperbaric Oxygen therapy (HBOT) with and without induced ischemia and the induced ischemia group without HBOT. Read More

J Pediatr Urol 2020 May 30. Epub 2020 May 30.

Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Int J Environ Res Public Health 2020 Jun 19;17(12). Epub 2020 Jun 19.

DAN Europe Research Department, 64026 Roseto, Italy.

: The "Severe Acute Respiratory Syndrome Coronavirus 2″ (SARS-CoV2) pandemic has led to a worldwide shortage of personal protection devices (PPD) for medical and paramedical personnel. Adaptation of commercially available snorkel masks to serve as full face masks has been proposed. Even not formally approved as PPD, they are publicized on social media as suitable for this use. Read More

Appl Physiol Nutr Metab 2020 Jun 23. Epub 2020 Jun 23.

University of Toronto Department of Anesthesia, 177410, Hyperbaric medicine, Toronto, Ontario, Canada ;

Neuroplasticity and recovery after stroke can be enhanced by a rehabilitation program pertinent to upper limb motor function exercise and mental imagery (EMI) as well as hyperbaric oxygen therapy (HBOT). We assessed the feasibility and safety of the combined approach utilizing both HBOT and EMI, and derived preliminary estimates of its efficacy. In this randomized controlled trial, twenty-seven patients with upper extremity hemiparesis 3-48 months after stroke were randomized to receive either a complementary rehabilitation program HBOT-EMI (intervention group), or EMI alone (control group). Read More

Crit Care Med 2020 Jul;48(7):977-984

Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia.

Objectives: The manipulation of arterial carbon dioxide tension is associated with differential mortality and neurologic injury in intensive care and cardiac arrest patients; however, few studies have investigated this relationship in patients on venoarterial extracorporeal membrane oxygenation. We investigated the association between the initial arterial carbon dioxide tension and change over 24 hours on mortality and neurologic injury in patients undergoing venoarterial extracorporeal membrane oxygenation for cardiac arrest and refractory cardiogenic shock.

Design: Retrospective cohort analysis of adult patients recorded in the international Extracorporeal Life Support Organization Registry. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):299-307

Undersea Hyperb Med 2020 Second Quarter;47(2):297-298

There have been numerous recent inquiries regarding use of hyperbaric oxygen (HBO2) for patients with COVID-19. Questions have been raised pertinent to two possible mechanisms for HBO2 in this clinical context. The UHMS Hyperbaric Oxygen Therapy Committee, UHMS Executive Committee, with collaborative input from multiple senior UHMS members and researchers have drafted this position statement. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):271-295

Clinical Professor, Section of Emergency Medicine, Louisiana State University, University Medical Center, New Orleans, Louisiana U.S.

Sudden sensorineural hearing loss (SSNHL) presents as an abrupt onset of hearing loss; 88% of these presentations are idiopathic (ISSHL). Many mechanisms of injury and etiopathologies have been postulated, but they share a common result - hypoxia of the organ of Corti leading to hair cell-cilia fusion, synaptic, dendritic swelling and sustained depolarization. Of all of the various treatments tried, only corticosteroids and hyperbaric oxygen (HBO2) therapy have shown benefit in randomized controlled trials (RCTs). Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):261-265

Navy Experimental Diving Unit, Panama City Beach, Florida U.S.

Hyperoxic myopia is a phenomenon reported in individuals who have prolonged exposure to an increased partial pressure of oxygen (PO2) and subsequently have a myopic (nearsighted) change in their vision. To date, there are numerous accounts of hyperoxic myopia in dry hyperbaric oxygen treatment patients; however, there have been only three confirmed cases reported in wet divers. This case series adds four confirmed cases of hyperoxic myopia in wet divers using 1. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):241-251

Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York, New York .U.S.

The definition of medication-related osteonecrosis of the jaw (MRONJ) includes a stage 0 presentation where exposed bone, the hallmark of this condition, is absent. Numerous management strategies have been recommended for MRONJ including hyperbaric oxygen (HBO2) therapy. This report describes a 64-year-old woman with stage 0 MRONJ of the bilateral mandible, refractory to clindamycin and local debridement, who was subsequently managed successfully with amoxicillin/clavulanate and HBO2 therapy. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):235-240

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Acute limb ischemia (ALI) as a complication of acute carbon monoxide (CO) poisoning is rare. Several reports have utilized hyperbaric oxygen therapy (HBO2) as an adjunctive therapy for peripheral arterial diseases. However, no study has yet described the use of HBO2 for ALI precipitated by CO poisoning. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):229-234

Rocky Mountain Multiple Sclerosis Clinic, Salt Lake City, Utah.

Introduction: Health care workers are vulnerable to workplace violence, including active shooter incidents. Little is known about how firearms could damage monoplace chamber acrylic and whether a breached pressurized chamber presents additional threat to the patient or bystanders.

Methods: In a remote area where firearm discharge is permitted, we tested the durability of sections of monoplace hyperbaric chamber acrylic under various firearm discharges. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):217-228

Hyperbaric Medicine Centre, Pôle RUSH, Sainte-Marguerite Hospital, Marseille, France.

Introduction: Hyperbaric oxygen (HBO2) therapy is the use of oxygen or gas mixtures at a pressure above atmospheric pressure for therapeutic purposes. This treatment is used in numerous pathological processes. Its main side effect is middle ear barotrauma (MEB), which represents a great concern for iatrogenic HBO2 therapy. Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):181-187

Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai China.

Objectives: To determine whether hyperbaric oxygen (HBO2) therapy be effective to improve hypoxemia for severe COVID-19 pneumonia patients.

Methods: Two male patients ages 57 and 64 years old were treated. Each met at least one of the following criteria: shortness of breath; respiratory rate (RR) ≥30 breaths/minute; finger pulse oxygen saturation (SpO2) ≤93% at rest; and oxygen index (P/F ratio: PaO2/FiO2 ≤300 mmHg). Read More

Undersea Hyperb Med 2020 Second Quarter;47(2):177-179

Medical Director and Division Chief, Hyperbaric Medicine, University of Utah School of Medicine, LDS Hospital, Salt Lake City, UtahU.S.

Recently the internet has been abuzz with new ideas to treat COVID-19, including hyperbaric oxygen (HBO2) therapy, undoubtedly driven by the fact that until recently there have been few therapeutic options for this highly contagious and often lethal infection. . . Read More

Minerva Med 2020 Jun 22. Epub 2020 Jun 22.

Department of Hyperbaric Oxygen Therapy, People's Hospital of Rizhao, Rizhao, China -

Cardiol Young 2020 Jun 23:1-6. Epub 2020 Jun 23.

Department of Pediatrics, Division of Pediatric Emergency, Ege University School of Medicine, Izmir, Turkey.

Objectives: To demonstrate the usefulness of N-Terminal Pro-B-Type natriuretic peptide (NT-proBNP) as an early biomarker of carbon monoxide-induced myocardial injury in children. It also aimed to identify the correlation between NT-proBNP and left ventricular systolic dysfunction findings shown by echocardiography.

Methods: Prospective, observational study conducted at a paediatric emergency department between October 2017 and April 2019 which involved children aged 0-17 years. Read More

Crit Care Med 2020 Jun 16. Epub 2020 Jun 16.

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Objective: To determine the effects of adjunctive therapeutic hypothermia, by comparing hyperbaric oxygen therapy versus hyperbaric oxygen therapy combined with therapeutic hypothermia in acute severe carbon monoxide poisoning.

Design: Retrospective analysis of data from our prospectively collected carbon monoxide poisoning registry.

Setting: A single academic medical center in Wonju, Republic of Korea. Read More

Clin Gastroenterol Hepatol 2020 Jun 18. Epub 2020 Jun 18.

Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburg, PA. Electronic address:

J Ultrasound Med 2020 Jun 20. Epub 2020 Jun 20.

Department of Life Science, National Chung Hsing University, Taichung, Taiwan.

Objectives: We hypothesized that specific endobronchial ultrasound (EBUS) features may differentiate sarcoidosis from other causes of lymphadenopathy.

Methods: We conducted this retrospective observational study from January 2014 to January 2019 to analyze patients with intrathoracic lymphadenopathy who underwent EBUS-guided transbronchial needle aspiration. Ultrasound features, including nodal size, margin, echogenicity, the presence or absence of calcification, a central hilar structure, the coagulation necrosis sign, nodal conglomeration, and the septal vessel sign in the color Doppler mode were recorded and compared between 3 groups. Read More

Otol Neurotol 2020 May 14. Epub 2020 May 14.

Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University & Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, Hunan, China.

Objectives: Sudden sensorineural hearing loss (SSNHL) may occur in post-irradiated nasopharyngeal carcinoma (NPC) survivors with a rare rate. This study was conducted to evaluate the clinical characteristics and prognosis of this population.

Study Design: Retrospective cohort study. Read More

Diving Hyperb Med 2020 Jun;50(2):181-184

Military Institute of Biomedical Research (ERRSO), Toulon, France.

Introduction: We report a case of a diving accident associating both cerebral symptoms and signs of respiratory impairment after two dives. The objective is to describe the process for obtaining the diagnosis.

Case Report: A 52-year-old man experienced mental confusion associated with hypoxaemia after surfacing. Read More

Diving Hyperb Med 2020 Jun;50(2):90-91

Editor - Diving and Hyperbaric Medicine Journal.

J Plast Reconstr Aesthet Surg 2020 May 21. Epub 2020 May 21.

Division of Plastic Surgery, Section of Pediatric Plastic Surgery. Albany Medical Center and Bernard and Millie Duker Children's Hospital at Albany Medical Center. Albany, New York.

Background: Management of pediatric facial defects can be challenging, as reattachment of large composite grafts is usually unsuccessful. Hyperbaric oxygen therapy (HBO) has been researched to augment composite graft survival, but clinical use for this application remains anecdotal. The authors present their successful experience managing select cases with large composite grafts and HBO as an adjunct. Read More

J Drugs Dermatol 2020 Mar;19(3):250-253

Although oxygen is essential for proper wound healing, wounds are often hypoxic with diminished oxygen delivery to the healing tissue. Since oxygenation of the outer layers of skin is almost exclusively provided by the atmosphere, increasing the presence of external oxygen enhances the healing process. Hyperbaric oxygen therapy is beneficial for treating nonhealing wounds, such as diabetic ulcers, and has been used to speed post-treatment recovery following aesthetic procedures; however, it is not suitable for home use. Read More

Alzheimers Dement (N Y) 2020 14;6(1):e12030. Epub 2020 Jun 14.

Center for Clinical Research on Neurological Diseases the First Affiliated Hospital Dalian Medical University Dalian China.

Introduction: It has been reported that environmental factors such as hypoxia could contribute to the pathogenesis of Alzheimer's disease (AD). Therapeutics like hyperbaric oxygen treatment, which improves tissue oxygen supply and ameliorates hypoxic conditions in the brain, may be an alternative therapy for AD and amnestic mild cognitive impairment (aMCI). The present work aims to investigate the potential therapeutic effect of hyperbaric oxygen treatment for AD and aMCI. Read More

Int Med Case Rep J 2020 21;13:211-215. Epub 2020 May 21.

Specialty Retina Centre, Coral Springs, FL, USA.

Objective: To describe a case of central retinal artery occlusion (CRAO) after nasosinal surgery and subject's subsequent response to hyperbaric oxygen therapy (HBOT).

Design: Observational case report.

Results: We describe a subject with diagnosed CRAO after septoplasty, bilateral inferior turbinate reduction and balloon sinuplasty, who was given hyperbaric oxygen treatment after four days of onset of CRAO with an improvement in visual acuity and visual field. Read More

Int J Surg Case Rep 2020 Jun 11;72:233-236. Epub 2020 Jun 11.

Division of Pediatric Otolaryngology, Department of Otolaryngology, Chiang Mai University, Chiang Mai, Thailand. Electronic address:

Introduction: Epidermoid and dermoid cysts in the floor of the mouth are uncommon. A large cyst can lead to functional morbidities including airway, swallowing and speech problems. The treatment of choice is surgical excision. Read More

Med Gas Res 2020 Apr-Jun;10(2):63

Department of Surgery, University of Dundee, Scotland, UK.

Med Gas Res 2020 Apr-Jun;10(2):61-62

Department of Medicine, Section of Emergency and Hyperbaric Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.

JCO Oncol Pract 2020 Jun 15:OP2000058. Epub 2020 Jun 15.

Brooke Army Medical Center, San Antonio, TX.

Audiol Neurootol 2020 Jun 12:1-6. Epub 2020 Jun 12.

Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China,

Objective: To assess the efficacy of the combination of hyperbaric oxygen (HBO) and pharmacological treatment in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and define patients amenable for HBO therapy.

Methods: Prospective, randomized, trial involving 136 cases with unilateral ISSNHL that were randomly divided into 2 groups: the pharmacological treatment (P) group and HBO + pharmacological treatment (HBO+P) group, which received additional HBO for 14 days besides the pharmacological treatments. Pure tone audiometry gain larger than 15 dBHL was defined as success, and the success rate of each group was calculated. Read More

J Wound Care 2020 Jun;29(Sup6):S4-S9

SerenaGroup Research Foundation, Cambridge, MA, US.

Objective: Oxygen plays an integral role in all phases of the wound healing process and tissue oxygenation is a key determinant of wound healing. A comprehensive evaluation of patients with hard-to-heal wounds must include measurement of oxygenation in and around the area of skin breakdown. The current gold standard, transcutaneous oxygen measurement (TCOM), has numerous drawbacks and as a result has fallen into disuse. Read More

United European Gastroenterol J 2020 Jun 12:2050640620934915. Epub 2020 Jun 12.

Department of Anaesthesiology/Hyperbaric Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands.

Background: Metastatic Crohn's disease (CD) is a rare manifestation of CD. It involves inflammatory skin lesions with histopathological findings (granulomas) similar to CD, without connection to the gastrointestinal tract. Hyperbaric oxygen therapy (HBO) has been suggested as a possible treatment option. Read More

Aliment Pharmacol Ther 2020 Jul;52(1):215-216

Department of Anaesthesiology/Hyperbaric Medicine, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands.

Aliment Pharmacol Ther 2020 Jul;52(1):216-217

Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

F1000Res 2019 24;8:737. Epub 2019 May 24.

Reconstructive and Plastic Surgery, CHRU Montpellier, Montpellier, France.

Various international guidelines and recommendations are available for management of diabetic foot infections. We present a review of the guidelines and recommendations for management of these infections. A systematic literature search was conducted through MEDLINE, CENTRAL, EMBASE, LILACS, DARE, and national health bodies. Read More

Clinics (Sao Paulo) 2020 3;75:e1656. Epub 2020 Jun 3.

Department of Endocrinology, Changhai Hospital, the First Affiliated Hospital of the Naval Medical University, Shanghai 200433, China.

Objectives: Mesenchymal stem cells (MSCs) are potentially ideal for type 2 diabetes treatment, owing to their multidirectional differentiation ability and immunomodulatory properties. Here we investigated whether the stem cells from human exfoliated deciduous teeth (SHED) in combination with hyperbaric oxygen (HBO) could treat type 2 diabetic rats, and explored the underlying mechanism.

Methods: SD rats were used to generate a type 2 diabetes model, which received stem cell therapy, HBO therapy, or both together. Read More

PLoS One 2020 8;15(6):e0234419. Epub 2020 Jun 8.

Division of Surgical Oncology, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Background And Objectives: Sarcomas are commonly managed by surgical resection combined with radiotherapy. Sarcoma treatment is frequently complicated by chronic wounds and late radiation tissue injury (LRTI). This study aims to gain insight in the use and results of hyperbaric oxygen therapy (HBOT) for radiation-induced complications following sarcoma treatment. Read More

Acta Otolaryngol 2020 Jun 4:1-5. Epub 2020 Jun 4.

Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Hearing recovery would be different in each sound frequency in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). To analyze frequency-specific efficacy of intratympanic steroid on ISSNHL. Of a total of 381 patients with ISSNHL (hearing threshold ≥40 dB; ≤30 days until treatment), 174 patients (174 ears) received systemic steroid plus hyperbaric oxygen therapy (HBO group), and 207 patients (208 ears) received systemic plus intratympanic steroid (IT group). Read More