Acute acoustic trauma requires urgent treatment within 72 h for optimal outcomes: results from the Dutch armed forces

Hyperbaric oxygen therapy (HBOT) is an established treatment for acute acoustic trauma (AAT), with early intervention believed to improve hearing recovery. Evidence suggests that initiating HBOT within seven days of AAT onset results in superior hearing outcomes compared to later treatment. Linear regression models have estimated hearing improvements of approximately 24% and 14% for early (≤ 7 days) and late (> 7 days) treatment groups, respectively. In reanalyzing our own data using a similar model, we found that initiating HBOT within three days led to even greater recovery, with estimated improvements of 65% in the early (≤ 3 days) group and 43% in the late (> 3 days) group. While our results suggest a more pronounced benefit with earlier intervention, the lower R² values indicate greater variability in treatment response. Given that studies on idiopathic sudden sensorineural hearing loss (ISSHL) also support early treatment for optimal outcomes, we propose that HBOT for AAT should be initiated within three days for maximal benefit. Further investigation into this critical therapeutic window is warranted. If corroborating evidence supports a three-day threshold over seven days, it may be justified to consider both AAT and ISSHL as medical emergencies requiring immediate HBOT initiation.