M.bennett at 05:45, 30 September 2021

2021-09-30T05:45:11Z

Gordoben: Imported from Wikispaces

2018-06-17T01:56:24Z

Imported from Wikispaces

New page

'''No evidence of benefit with hyperbaric oxygen therapy for sudden hearing loss.'''

**Bottom line'''
# Statistically non-significant small benefit for those treated with HBOT. 

**Citations'''
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. 
EXPERIMENTAL GROUP (n=36), 100% oxygen at 2.5 ATA for 90 minutes, 10 daily sessions over 10 days plus prednisolone 1mg/kg starting dose reducing over three weeks plus famotidine 40mg daily. 
CONTROL GROUP (n=21) Drugs as above but no HBOT.

**The evidence:'''

{|
| '''Outcome''' || '''Time to Outcome''' || '''Control Group Rate''' || '''HBOT Group Rate''' || '''Relative Risk Reduction''' || '''Absolute Risk Reduction''' || '''NNT'''
|-
| '''Improved 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
|-
|}
*Complete or ‘moderate’ improvement

**Comments'''
# Large difference in patient numbers between treatment and control arms is not explained. 
# Time period of outcome assessment not defined (possibly at 10 days).
# Reducing dose of prednisolone regimen not stated.
# Average mean audiometry quoted in dB, but how many frequencies affected not described.
# Power calculation is inadequately described – no suggestion what effect they were aiming to confirm.
# 12 years to collect data at a single centre
# Two patients in study group recruited outside the protocol period
# Some discrepancy between text and Table II results. 

**Appraised by''': D. Smart Monday 1st August 2016
Email : [[mailto:dsmart@iinet.net.au | dsmart@iinet.net.au]]

**Kill or Update by :''' June 2020

[[File:sumhorsa.gif|center]]

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Cekin - Revision history

M.bennett at 05:45, 30 September 2021

Gordoben: Imported from Wikispaces