Cekin
No evidence of benefit with hyperbaric oxygen therapy for sudden hearing loss.
Clinical Bottom Line:
- Statistically non-significant small benefit for those treated with HBOT.
Citations:1.Çekin E, Cincik H, Ulubil SA, Gungor A. Effectiveness of hyperbaric oxygen therapy in management of sudden hearing loss. The journal of laryngology and otology 2009; 123: 609-12.
Three-part clinical question:For patients with sudden hearing loss within 3 days of onset, does the application of hyperbaric oxygen combined with systemic corticosteroid therapy, compared to corticosteroid therapy alone, improve hearing recovery.
Search Terms:Sudden Hearing Loss, Inner Ear
The study:Non-blinded randomised controlled trial. Intention to treat not stated.
The study patients:Males and females aged 18-82 with sudden onset hearing loss either or both ears, within 3 days. Hearing loss defined as loss of at least 30dB in three frequencies within three days of enrolment.
Control Group (n=21):Prednisolone 1mg/kg starting dose reducing over three weeks plus famotidine 40mg daily.
HBO Group (n=36):As above plus 100% oxygen at 2.5 ATA for 90 minutes, 10 daily sessions over 10 days.
The evidence:
Outcome |
Time to Outcome |
Control Group |
HBOT Group |
Relative Risk Reduction |
Absolute Risk Reduction |
NNT |
|
Complete or moderate improvement with treatment |
10 days |
0.71 |
0.83 |
14% |
0.12 |
8 |
95% CIs: |
-13% to 42% |
-0.11 to 0.35 |
NNT 3 to INF; NNH 9 to INF | |||
Comments:
1. Large difference in patient numbers between treatment and control arms is not explained.
2, Time period of outcome assessment not defined (possibly at 10 days).
3. Reducing dose of prednisolone regimen not stated.
4. Average mean audiometry quoted in dB, but how many frequencies affected not described.
5. Power calculation is inadequately described – no suggestion what effect they were aiming to confirm.
6. 12 years to collect data at a single centre and two patients recruited outside the protocol period
7. Some discrepancy between text and Table II results.
Appraised by:D. Smart, Monday 1st August 2016dsmart@iinet.net.au
Kill or Update by:June 2022
