Sudden sensorineural hearing loss is a common presentation to ENT departments with a significant difference in management both at a local and regional level. The authors seek to clarify the role of hyperbaric oxygen therapy in combination with oral and intratympanic steroids with combination steroid therapy alone in patients with poor prognostic feature. They report no overall difference in pure tone audiometry and word discrimination scores in 58 patients. However, there was a small but significant improvement in low frequency hearing at three months follow-up. The authors argued that this marginal improvement may bring the patients’ hearing to a level which is aidable with conventional hearing aids. This paper is a good attempt to define a role for a resource and time intensive treatment. However, this method is always going to be limited to centres with access to hyperbaric oxygen therapy, particularly in countries with a public health system