Krajcovicová
Some evidence of better hearing outcome with hyperbaric oxygen added to a polypharmacy regimen including steroids for idiopathic sudden hearing loss
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Clinical Bottom Line 1. More individuals improved when HBOT was added to a pharmacological treatment regimen. |
Citation/s:1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70.
Lead author's name and fax: Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk
Three-part Clinical Question:For patients with idiopathic sudden sensorineural hearing loss (ISSNHL), does the addition of hyperbaric oxygen to standard treatment result in any further improvement in hearing?
Search Terms: Sudden hearing loss; steroids; pentoxifylline
The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adults with unilateral ISSNHL (41 to 60dB loss).
Control group (N = 21; 20 analysed): Polypharmacy including steroids intravenously days 1 to 5 then orally to day 15, pentoxifylline and betahistine.
Experimental group (N = 47; 47 analysed): As above plus 100% oxygen breathing at 2.0 ATA for 90 minutes daily for 10 days.
The Evidence:
Outcome |
Time to Outcome |
Control group |
HBO group |
Relative risk reduction |
Absolute risk reduction |
NNT |
Improvement in ave pure tone hearing threshold (>10dB) |
day15? |
0.29 |
0.62 |
116% |
0.33 |
3 |
95% CIs: |
32% to 199% |
0.09 to 0.57 |
2 to 11 | |||
Measure |
Control Group |
HBO Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Mean threshold at mid-frequency 1000-2000 Hz after treatment (dB) |
28.9 |
18.8 |
26.5 |
23.5 |
2.4 |
-260.7 to 265.5 |
|
Mean threshold at high frequencies (4000 to 8000 Hz) after treatment (dB) |
45.1 |
21.6 |
37.5 |
29.6 |
7.6 |
-395.1 to 410.3 |
Comments:
1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.
2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.
3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.
Appraised by:Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021
Kill or Update By: June 2023
