The treatment of idiopathic sudden sensorineural hearing loss (SSNHL) continues to be a substantial clinical challenge, in part because of the heterogeneity of the patient population and in part because of the difficulty of studying a disorder with no known causes and no defined, proven, or widely accepted course of clinical intervention. We read with interest the systematic review and meta-analysis by Joshua and colleagues on hyperbaric oxygen therapy (HBOT) for patients with SSNHL. Rhee and colleagues published a review of the same topic i n 2019; however, their conclusions were criticized for significant heterogeneity of the pooled studies, which introduced potentially unsurmountable bias.
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