Dauman - Revision history

M.bennett at 05:58, 28 September 2021

2021-09-28T05:58:02Z

Gordoben: Imported from Wikispaces

2018-06-17T01:48:47Z

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'''No evidence that twice daily hyperbaric oxygen administration improves outcome in sudden hearing loss when compared to a once daily regime.'''


'''Clinical Bottom Line:'''
1. Neither once nor twice daily hyperbaric oxygen to a total of ten treatments seemed associated with improvement in outcome.
2. The efficacy of hyperbaric versus placebo (or other elements of treatment) was not tested.

**Appraised by:''' Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Friday, 16 July 1999

**Clinical Scenario:''' A patient with sudden hearing loss presented for treatment. We wondered if a once or twice daily regimen of hyperbaric oxygen would be the more effective.
**Three-part Question:''' In patients with sudden hearing loss, does the administration of steroids, naftidrofuryl, normovolaemic haemodilution and once daily hyperbaric oxygen, compared to a similar regime but using twice daily hyperbaric oxygen, result in any improved outcome?
Search Terms: Hyperbaric oxygenation; hearing loss, sudden; naftidrofuryl.

**The Study:'''
Non-blinded randomised controlled trial with intention-to-treat.
Patients with sudden hearing loss of not more than 8 days duration. 
Control group (N = 20; 20 analysed): Normovolaemic haemoldilution, steroids and administration of 100% oxygen at 2.2ATA for 90 minutes daily for ten days. Naftidrofuryl 400mg IVI was given during and immediately after the hyperbaric exposure.
Experimental group (N = 20; 20 analysed): As above, but hyperbaric oxygen was repeated twice daily for 5 days, with the naftidrofuryl infusion continued until finishing the second treatment each day.

**The Evidence:'''
Quantitatively difficult to determine without full article translation. Authors state: "The efficiency and side effects were similar in the two groups…" 

**Comments:'''
1. No placebo comparison group and authors feel the spontaneous rate of recovery is not clear, therefore we do not know if either arm is efficacious. 
2. It appears one group received much of the drug naftidrofuryl orally, therefore other elements of the treatment were not identical between groups.
3. Only the abstract is available in English- a full translation is awaited.
4. No quantitative analysis of outcomes seems to have been reported.

**Expiry date:''' June 2020
**References: '''
1. Dauman R, Poisot D, Cros AM, Zennaro O, Bertrand B, Duclos JY, Esteben D, Milacic M, Boudey Ch, Bebear JP. Sudden hearing loss: comparative randomized study of two modalities of hyperbaric oxygen therapy in association with naftidrofuryl. Revue de Laryngologie 1993; 114:53-58.

[[File:sumhorsa.gif|center]]

[[Audiovestibular | BACK]]

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-<span style="border-color: windowtext; border-style: solid; border-width: 1.5pt; display: block; padding: 1pt 4pt;">
+'''<span style="font-size:18.0pt"><span style="line-height:107%">No evidence that twice daily hyperbaric oxygen administration improves outcome in sudden hearing loss when compared to a once daily regimen.</span></span>'''
-**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Clinical Scenario:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> A patient with sudden hearing loss presented for treatment. We wondered if a once or twice daily regimen of hyperbaric oxygen would be the more effective.</span>
+'''<span style="font-size:14.0pt"><span style="line-height:107%">Clinical Bottom Line:</span></span>'''
-**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">The Study:</span>'''
+<span style="font-size:14.0pt"><span style="line-height:107%">1. Neither once nor twice daily hyperbaric oxygen to a total of ten treatments seemed associated with improvement in outcome.</span></span>
-**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">The Evidence:</span>'''
+<span style="font-size:14.0pt"><span style="line-height:107%">2. The efficacy of hyperbaric versus placebo (or other elements of treatment) was not tested.</span></span>
-**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Comments:</span>'''
+----
-**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Expiry date:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> June 2020</span>
+'''<span style="font-size:12.0pt"><span style="line-height:107%">References:</span></span>'''<span style="font-size:12.0pt"><span style="line-height:107%">1. Dauman R, Poisot D, Cros AM, Zennaro O, Bertrand B, Duclos JY, Esteben D, Milacic M, Boudey Ch, Bebear JP. Sudden hearing loss: comparative randomized study of two modalities of hyperbaric oxygen therapy in association with naftidrofuryl. Revue de Laryngologie 1993; 114:53-58.</span></span>
-[[File:sumhorsa.gif|center]]
+'''<span style="font-size:12.0pt"><span style="line-height:107%">Clinical Scenario:</span></span>'''<span style="font-size:12.0pt"><span style="line-height:107%">A patient with sudden hearing loss presented for treatment. We wondered if a once or twice daily regimen of hyperbaric oxygen would be the more effective.</span></span>
-<span style="display: block; text-align: center;"><span style="font-size: 29.9px;">[[Audiovestibular  |  BACK]]</span></span>
+'''<span style="font-size:12.0pt"><span style="line-height:107%">Three-part Question:</span></span>'''<span style="font-size:12.0pt"><span style="line-height:107%">In patients with sudden hearing loss, does the administration of steroids, naftidrofuryl, normovolaemic haemodilution and once daily hyperbaric oxygen, compared to a similar regime but using twice daily hyperbaric oxygen, result in any improved outcome?</span></span>