M.bennett at 07:58, 28 September 2021

2021-09-28T07:58:09Z

Gordoben: Imported from Wikispaces

2018-06-17T01:52:01Z

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'''No evidence of improvement in hearing loss or tinnitus with hyperbaric oxygen compared to a regime of hydroxyethyl starch and pentoxifylline.'''


'''Clinical Bottom Line:'''
1. No statistically significant improvement in hearing loss or tinnitus was demonstrated in this trial.
2. There was a trend to more improvement in hearing loss in the hyperbaric group 


**Appraised by:''' Mike Bennett, Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney Thursday, 11 November 1999

**Clinical Scenario:''' A patient with sudden loss of hearing and tinnitus of unknown cause presented for treatment. 
**Three-part Question:''' For patients presenting for treatment of acute hearing loss and or tinnitus, does administration of hyperbaric oxygen, compared to pentoxifylline and hydroxyethyl starch, result in any improvement in either complaint?

**Search Terms:''' Hyperbaric oxygenation, sudden hearing loss, tinnitus

**The Study:'''
Non-blinded randomised controlled trial with intention-to-treat.
Sudden hearing loss with at least 20dB loss in one or more frequencies and /or tinnitus, seen within 2 weeks and without any prior therapy.
Control group (N = 38; 31 analysed): Intravenous hydroxyethyl starch 6% 250mls and pentoxyphylline 300mg daily for ten days.
Experimental group (N = 37; 24 analysed): 100% oxygen at 2.5ATA for 75 minutes daily for 10 days. 

**The Evidence:'''
{|
| '''Non-event outcomes''' || '''Time to outcome''' || '''Control group''' || '''HBO group''' || '''P-value'''
|-
| '''Mean hearing change (dB)''' || ?4 weeks || 10.7 || 15.6 || NS
|-
| '''Tinnitus rating (0 to 10 scale)''' || ?4 weeks || 4.0 || 3.6 || NS
|-
|}
**Comments:'''
1. There may be a significant clinical benefit in hearing recovery with hyperbaric oxygen, however, this trial is of insufficient power to confirm this.
2. The numbers reaching follow-up are unclear.
3. There is no placebo control to establish the rate of spontaneous improvement.

**Expiry date:''' June 2020
**References: '''
1. Schwab B, Flunkert C, Heermann R, Lenarz T. HBO in the therapy of cochlear dysfunctions - first results of a randomized study. Collected manuscripts of XXIV Annual Scientific Meeting of the European Underwater and Baromedical Society, M Gennser, ed. Stockholm 1998; 40-42.

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Schwab - Revision history

M.bennett at 07:58, 28 September 2021

Gordoben: Imported from Wikispaces