Difference between revisions of "Topuz"

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==Significant improvement in hearing for people with idiopathic sudden sensorineural hearing loss with the addition of hyperbaric oxygen==
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**Clinical bottom line:'''
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"="">Significant improvement in hearing for people with idiopathic sudden sensorineural hearing loss with the addition of hyperbaric oxygen</span></span>'''</span>
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{|
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| '''1. Significant improvement in hearing in 4 of 5 frequencies'''<br>**2. Some evidence that HBOT is more effective with mild initial loss and in people under 50 years.'''
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">Clinical bottom line:</span></span>'''</span>
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{| class="Table" style="border:undefined"
 
|-
 
|-
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|
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<span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. Significant improvement in hearing in 4 of 5 frequencies</span></span><br/> <span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">2. Some evidence that HBOT is more effective with mild initial loss and in people under 50 years.</span></span></span>
 +
 
|}
 
|}
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**Citation/s:'''Topuz E., Yigit O,Cinar U, Seven H. Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2004, 261: 393-396
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**Lead author's name and fax:''' O Yigit Fax: +90-212-2341121
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----
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**Three-part Clinical Question:''' Does the addition of a hyperbaric oxygen regimen to a standard medical treatment improve the hearing in people with acute idiopathic sudden sensorineural hearing loss (ISSHL).
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**Search Terms:''' hyperbaric oxygenation, idiopathic sudden sensorineural hearing loss, ISSHL, hearing loss
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Citation/s:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1.Topuz E., Yigit O,Cinar U, Seven H. Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2004, 261: 393-396</span></span></span>
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**The Study:'''Non-blinded randomised controlled trial with intention-to-treat.
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**The Study Patients:''' Sudden hearing loss of >30dB in at least 3 continguous pure tone frequencies. Less than 2 weeks since onset of symptoms. All were admitted to hospital.
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Lead author's name and fax:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">O Yigit Fax: +90-212-2341121</span></span></span>
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**Control group''' (N = 21; 21 analysed): Prednisone 1mg/kg/day for 2 weeks, rheomacrodex 500mL/day for 5 days, diazepam 5mg twice a day (? duration), pentoxiphyllin 200mg iv twice a day (? duration).
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**Experimental group''' (N = 30; 30 analysed): As above + hyperbaric oxygen 2.5ATA for 90 minutes twice a day over 5 days then 2.5ATA daily for 15 days.
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Three-part Clinical Question:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Does the addition of a hyperbaric oxygen regimen to a standard medical treatment improve the hearing in people with acute idiopathic sudden sensorineural hearing loss (ISSHL).</span></span></span>
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**The Evidence:'''
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{|
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Search Terms:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">hyperbaric oxygenation, idiopathic sudden sensorineural hearing loss, ISSHL, hearing loss</span></span></span>
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| <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">'''Non-Event Outcomes'''</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">'''Time to outcome'''</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">'''Control group (?sd)'''</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">'''HBOT group (?sd)'''</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">'''P-value'''</span></span>
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 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Study:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Non-blinded randomised controlled trial with intention-to-treat.</span></span></span>
 +
 
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Study Patients:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Sudden hearing loss of >30dB in at least 3 continguous pure tone frequencies. Less than 2 weeks since onset of symptoms. All were admitted to hospital.</span></span></span>
 +
 
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control group (N = 21; 21 analysed):</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Prednisone 1mg/kg/day for 2 weeks, rheomacrodex 500mL/day for 5 days, diazepam 5mg twice a day (? duration), pentoxiphyllin 200mg iv twice a day (? duration).</span></span></span>
 +
 
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Experimental group (N = 30; 30 analysed):</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">As above + hyperbaric oxygen 2.5ATA for 90 minutes twice a day over 5 days then 2.5ATA daily for 15 days.</span></span></span>
 +
 
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Evidence:</span></span>'''</span>
 +
 
 +
{| class="Table" style="border:solid windowtext 1.0pt"
 
|-
 
|-
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| Mean hearing gain all patients (dB) || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">4 weeks</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">17.4dB</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">33.3dB</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">?</span></span>  
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| style="width:210.15pt; border:solid windowtext 1.0pt" width="283" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Non-Event Outcomes</span></span>'''</span></p>
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| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Time to outcome</span></span>'''</span></p>
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| style="width:62.25pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control group (?sd)</span></span>'''</span></p>
 +
| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">HBOT group (?sd)</span></span>'''</span></p>
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| style="width:44.8pt; border:solid windowtext 1.0pt" width="63" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">P-value</span></span>'''</span></p>  
 
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|-
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| Mean hearing gain by initial hearing levels (dB)<br><'''60<br>61-80<br>>'''80 || <span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">4 weeks</span></span> || <span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">22.33 +/-9.311</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">6.18 +/-9.00</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">13.00 +/-6.58</span></span> || <span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">22.53+/-12.68</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">35.45+/-22.09</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">50.70+/-21.54</span></span> || <span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><br></span><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">0.758</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">0.014</span></span><br><span style'''"display: block; text-align: center;"><span style'''"display: block; text-align: center;">0.005</span></span>  
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| style="width:210.15pt; border:solid windowtext 1.0pt" width="283" |
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean hearing gain all patients (dB)</span></span>'''</span>
 +
 
 +
| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">4 weeks</span></span></span></p>  
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| style="width:62.25pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">17.4dB</span></span></span></p>  
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| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">33.3dB</span></span></span></p>  
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| style="width:44.8pt; border:solid windowtext 1.0pt" width="63" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">?</span></span></span></p>  
 
|-
 
|-
 +
| style="width:210.15pt; border:solid windowtext 1.0pt" width="283" |
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean hearing gain by initial hearing levels (dB)<br/> <60<br/> 61-80<br/> >80</span></span>'''</span>
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 +
| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">4 weeks</span></span></span></p>
 +
| style="width:62.25pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><br/> <br/> <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">22.3 +/-9.3<br/> 6.2 +/-9.0<br/> 13.0 +/-6.6</span></span></span></p>
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| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><br/> <br/> <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">22.5+/-12.7<br/> 35.5+/-22.1<br/> 50.7+/-21.5</span></span></span></p>
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| style="width:44.8pt; border:solid windowtext 1.0pt" width="63" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><br/> <br/> <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.76<br/> 0.01<br/> 0.01</span></span></span></p>
 
|}
 
|}
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**Comments:'''
 
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1. There is no "functional" improvement assessment performed.
 
−
2. Intervals given above are not defined (probably standard deviations).
 
−
3. Results given for ‘34 ISSHL out of 30 patients’ in the HBOT group. Meaning not clear.
 
−
4. Only age and sex were considered as possible confounders, no other patient data.
 
−
5. No indication of loss to recruitment or attempt to recruit consecutive patients.
 
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**Appraised by''': Dr Glen Hawkins, Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, NSW, AUSTRALIA; Thursday, 10 March 2005Email: [[mailto:hawkeye@swiftdsl.com.au | hawkeye@swiftdsl.com.au]]
 
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**Kill or Update By:''' June 2020
 
  
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[[File:sumhorsa.gif|center]]
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Comments:</span></span>'''</span>
 +
 
 +
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. There is no "functional" improvement assessment performed.</span></span></span>
 +
 
 +
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">2. Intervals given above are not defined (probably standard deviations).</span></span></span>
 +
 
 +
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">3. Results given for ‘34 ISSHL out of 30 patients’ in the HBOT group. Meaning not clear.</span></span></span>
 +
 
 +
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">4. Only age and sex were considered as possible confounders, no other patient data.</span></span></span>
 +
 
 +
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">5. No indication of loss to recruitment or attempt to recruit consecutive patients.</span></span></span>
 +
 
 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Appraised by:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Dr Glen Hawkins, Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, NSW, AUSTRALIA; Thursday, 10 March 2005 &nbsp;[[mailto:hawkeye@swiftdsl.com.au| <span style="color:blue">hawkeye@swiftdsl.com.au</span>]]</span></span></span>
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 +
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Kill or Update By:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">June 2022</span></span></span>
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* 
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[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
  
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<span style="display: block; text-align: center;"><span style="font-size: 29.9px;">[[Audiovestibular | BACK]]</span></span>
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<span style="display: block; text-align: center;"><span style="font-size: 29.9px;">[[Audiovestibular|BACK]]</span></span>

Latest revision as of 01:08, 30 September 2021

Significant improvement in hearing for people with idiopathic sudden sensorineural hearing loss with the addition of hyperbaric oxygen

Clinical bottom line:

1. Significant improvement in hearing in 4 of 5 frequencies
2. Some evidence that HBOT is more effective with mild initial loss and in people under 50 years.

Citation/s:1.Topuz E., Yigit O,Cinar U, Seven H. Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2004, 261: 393-396

Lead author's name and fax:O Yigit Fax: +90-212-2341121

Three-part Clinical Question:Does the addition of a hyperbaric oxygen regimen to a standard medical treatment improve the hearing in people with acute idiopathic sudden sensorineural hearing loss (ISSHL).

Search Terms:hyperbaric oxygenation, idiopathic sudden sensorineural hearing loss, ISSHL, hearing loss

The Study:Non-blinded randomised controlled trial with intention-to-treat.

The Study Patients:Sudden hearing loss of >30dB in at least 3 continguous pure tone frequencies. Less than 2 weeks since onset of symptoms. All were admitted to hospital.

Control group (N = 21; 21 analysed):Prednisone 1mg/kg/day for 2 weeks, rheomacrodex 500mL/day for 5 days, diazepam 5mg twice a day (? duration), pentoxiphyllin 200mg iv twice a day (? duration).

Experimental group (N = 30; 30 analysed):As above + hyperbaric oxygen 2.5ATA for 90 minutes twice a day over 5 days then 2.5ATA daily for 15 days.

The Evidence:

Non-Event Outcomes

Time to outcome

Control group (?sd)

HBOT group (?sd)

P-value

Mean hearing gain all patients (dB)

4 weeks

17.4dB

33.3dB

?

Mean hearing gain by initial hearing levels (dB)
<60
61-80
>80

4 weeks



22.3 +/-9.3
6.2 +/-9.0
13.0 +/-6.6



22.5+/-12.7
35.5+/-22.1
50.7+/-21.5



0.76
0.01
0.01

Comments:

1. There is no "functional" improvement assessment performed.

2. Intervals given above are not defined (probably standard deviations).

3. Results given for ‘34 ISSHL out of 30 patients’ in the HBOT group. Meaning not clear.

4. Only age and sex were considered as possible confounders, no other patient data.

5. No indication of loss to recruitment or attempt to recruit consecutive patients.

Appraised by:Dr Glen Hawkins, Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, NSW, AUSTRALIA; Thursday, 10 March 2005  [hawkeye@swiftdsl.com.au]

Kill or Update By:June 2022

Sumhorsa.gif

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