Hoffman3
No evidence of efficacy for hyperbaric oxygen in acute hearing loss or tinnitus of long-standing.
Clinical Bottom Line:
1. No evidence of improvement in hearing loss or tinnitus with the administration of hyperbaric oxygen.
2. Pressurization was associated with some benefit in both groups.
Citation/s:1. Hoffmann G, Bohmer D, Desloovere C. Hyperbaric oxygen as a treatment of chronic forms of inner ear hearing loss and tinnitus.In: Wen-ren Li. Proceedings of the Eleventh International Congress of Hyperbaric Medicine, Fuzhou, China. Best Publishing, Flagstaff, Arizona 1993:141-145.
Clinical Scenario:A patient with long-standing hearing loss and tinnitus presented for treatment and we wondered if there was any place for hyperbaric oxygen.
Three-part Question:For patients with hearing loss and/or tinnitus of acute onset, where the loss is of long standing (>6 months), does the application of hyperbaric oxygen, compared to placebo, result in any improvement in hearing loss or tinnitus?
Search Terms:Hyperbaric oxygen, deafness, tinnitus
The Study:Double-blinded randomised controlled trial with intention-to-treat. Patients with a history of sudden onset of inner-ear hearing loss and/or tinnitus lasting at least 6 months.
Control group (N = 22; 22 analysed):Air breathing at 1.5ATA for 45 minutes daily, five days each week for 3 weeks.
Experimental group (N = 22; 22 analysed):100% oxygen breathing at 1.5ATA on the same schedule as controls.
The Evidence:
Outcome |
Time to Outcome |
Control group |
HBO group |
Relative risk reduction |
Absolute risk reduction |
NNT |
|
Improved hearing |
3 weeks |
0.5 |
0.33 |
34% |
0.17 |
6 |
95% CI: |
-23% to 91% |
-0.12 to 0.46 |
NNT2 to INF NNH=9 to INF | |||
|
Improved tinnitus |
3 weeks |
0.41 |
0.18 |
56% |
0.23 |
4 |
95% CI: |
-8% to 100% |
-0.03 to 0.49 |
NNT2 to INF NNH=32 to INF | |||
Comments:
1. Control group was pressurized and breathed an increased PO2. Any benefit may be due to a placebo effect, pressure effect or oxygen effect (equivalent 31.5% oxygen at 1ATA).
2. All patients received a second course of hyperbaric oxygen at 1.5ATA immediately following the trial course, making comparative longer-term follow-up impossible.
3. 15 treatments may have been insufficient in this chronic, well-established condition.
Appraised by:Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital,Sydney; Wednesday, 28 July 1999
Expiry date:June 2022
