COVID hearing loss reversal? Any ideas?

While the MoA of HBOT is a bit obscure you definitely get more arterial oxygen in, even up to a point where hemoglobin is no longer required as a carrier:

“Administering 100% oxygen at 1 ATA increases the blood oxygen level to 2.0 mL per dL; at 3 ATA, the blood dissolved oxygen level is 6.0 mL/dL, which can support resting tissues without any contribution from hemoglobin.”

https://www.nature.com/articles/s41598-024-53978-12

@Neville said:

What specific situations are you looking to improve?

Human speech. Especially in noisy situations or if the person is soft-spoken.

The consonants are playing tricks with my ear, P & T, M & N, S & F, and so on.

Left ear isn’t as bad, but isn’t good either.

While gigging, my duo partner, best friend, and wife (same person) will try to field any questions. I slide the tv connector in the Phonak app to the ambient sound side, but with room noise, and people drinking alcohol, it’s pretty useless.

I guess I could go out as a carnival side-show, “Hear the deaf musician play music” (Just kidding)

@RobHooft said:

I imagine such chambers sit idle most of the time and could easily be repurposed for SHL, as discussed here.

In that case of being idle - I think it is only bureaucratic - organizational and regulatory problems.

@user490 said:

Greater oxygen availability for inhalation does not translate to end tissues on a one to one basis?

@RobHooft aswered perfectly as I wanted I would add (for simplicity, do not pay attention to the “CO” parameter, which is cardiac output):

So, assuming healthy patient, 100% saturation from 21% atmospheric oxygen, and 150 g per litre (15 g/dl) hemoglobin, and 100 mgHg oxygen partial pressure in arterial blood, we have:

1,39×150 = 208,5 g of oxygen per litre of blood carried only by hemoglobin

PLUS

0.003×100×10= 3 g oxygen dissolved in arterial blood

but with 100% inhaled oxygen 1.0 ATA, we have 3×5 = 15 ml per litre of arterial blood.

In 2.5 ATA:

2.5×15 = 37.5 g of oxygen per litre of arterial blood.

@BobbyBoomer said:

I slide the tv connector in the Phonak app to the ambient sound side, but with room noise, and people drinking alcohol, it’s pretty useless.

There’s no point in moving the slider. For talking, you should change program from TV Connector to Speech in Noise or even Speech in Loud Noise, assuming you have Phonak Lumity.

@Neville said:

So your next step is probably to determine whether or not you are getting appropriate high frequency gain and, if not, why not and can you do something to get it.

My audi thinks she has the high frequency gain set for my hearing loss, without cranking it up high enough to be dangerous.

It’s definitely the high frequencies that I’m missing.

Since COVID, I also notice that extremely high frequencies, like the highest octave of my flute sound out of tune. I can’t fully determine their pitch.

On the other end of the spectrum, on songs where the bass comes in first, they sound flat (lower in pitch) until the midrange rhythm instruments like piano or guitar come in, then the bass notes correct themselves That’s really weird.

My audi says I could go with an cochlea implant, but they aren’t good enough for music yet. I need very high pitch resolution.

So I’m 80 years young now, still gigging (it’s the most fun I can have with my clothes on), and I have no intention of giving up playing music as long as I still can do it.

My first gig was when I was in middle school. I toured the country and opened concerts for stars when their hits were #1 on Billboard. Almost had that record deal myself, but manager and record company coudn’t agree on terms. I’ve played cruise ships. Ever woman I’ve ever had intimate relationships with were introduced to me via my saxophone, including the best one, who is also a musician, and I ended up marrying. What I’m saying is, musician is not what I do, musician is what I AM.

I’ve always protected my hearing, so it wasn’t from high volume, at least I can go through life without saying, “I wish I listened and used those ear plugs.” But that doesn’t change my situation.

In the lyrics of Mick Jagger, ♫ “What a drag it is getting old” ♫

But it beats the alternative.

I don’t know your audiogram, but the more closed fitting, the better isolation from noise. cShells with no vents have the best isolation from noise, but they should be from deep silicone impression (at least 5mm past 2nd bend of ear canal) to decrease the potential occlusion effect.

You can have another pair of cShells with no vent just for gigs. Another benefit is it can protect from noise exposure A BIT (don’t overestimate it compared to professional noise protection)

@BobbyBoomer said:

My audi thinks she has the high frequency gain set for my hearing loss, without cranking it up high enough to be dangerous.

Thinks because she has measured it on ear?

@BobbyBoomer said:

Since COVID, I also notice that extremely high frequencies, like the highest octave of my flute sound out of tune. I can’t fully determine their pitch.

Yes, just a pretty normal consequence of advanced hearing loss unfortunately. The cochlear outter hair cells, which are what tends to be lost with age and noise damage, function to sharpen the motion of the basilar membrane which results in fewer inner hair cells being activated and a more specific perception. And then additionally when things are louder, activation on really spreads out. I think I’ve said elsewhere, you can kind of imagine this analogously to playing a piano with your elbows versus your fingers–you can no longer hit one note at a time, you have to hit a batch of notes. So pitch gets thrown off, and speech clarity declines.

@BobbyBoomer said:

My audi says I could go with an cochlea implant, but they aren’t good enough for music yet. I need very high pitch resolution.

I’m. . . suspicious of this. Obviously the resolution is poorer and that will have negative consequences, but then on the other hand the brain is a really fabulous thing. When someone gets a cochlear implant the brain needs to learn how to map the new signal onto the pre-existing structure of speech perception in order to eventually make speech sound more familiar, but then it DOES make speech sound more familiar completely in spite of the actual resolution of the device. To do this, users spend hours rehab-ing speech. What if, instead of spending three hours a day working on speech perception the person spent 3 hours a day working on music perception and re-training the ear? I suspect that we can actually get quite a bit further with music perception through a CI than we currently do, and I’ve also heard users say that they have started to get music back eventually, although much more slowly than speech. I think musicians sometimes fail to think about the hours and decades they’ve spent training their ears, that it just feels “natural” when in reality it is highly, highly trained. The idea of having to do that all OVER again is certainly overwhelming, and the experience will absolutely be different. I would like to hope that there is something interesting and joyful in the new experience, too.

Recently a meta-analysis of clinical studies on SSNHL was published. They conclude that:

“Combined systemic and intratympanic corticosteroid therapy generally yields better hearing recovery and speech discrimination outcomes than systemic monotherapy in patients with severe or profound SSNHL.”

doi: 10.1016/j.bjorl.2026.101849

A very interesting clinical trial began a couple of months ago in France.

They are examining if a combination of aspirin and folic acid can improve SSNHL

Study Overview

• Condition: Sudden Sensorineural Hearing Loss (SSNHL)

• Interventions: Aspirin and Folic Acid

• Purpose: Evaluating the effects of combining aspirin and folic acid for patients experiencing sudden hearing loss.

• ClinicalTrials.gov3

I’ve bookmarked this for further reading (I have an appointment in a few minutes).

Thank you.

OK, got back and read it, it looks hopeful.