M.bennett at 04:59, 5 October 2021

2021-10-05T04:59:48Z

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2018-06-17T01:50:24Z

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'''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.

**Appraised by:''' Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Wednesday, 28 July 1999

**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 || NNT'''2 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 || NNT'''2 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 longer-term follow-up impossible.
3. 15 treatments may have been insufficient in this chronic, well-established condition.

**Expiry date:''' June 2020
**References: '''
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.

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Hoffman3 - Revision history

M.bennett at 04:59, 5 October 2021

Gordoben: Imported from Wikispaces