Hoffman1

Hyperbaric oxygen administration improved hearing for patients with sudden hearing loss who had shown no improvement with standard therapy for two weeks.

Clinical Bottom Line:

1. Significantly more patients with sudden hearing loss had an improvement in hearing of 10 dB or more following hyperbaric oxygen.

2. There was apparent improvement in tinnitus, significance not tested.

---

Citations:1. Hoffmann G, Bohmer D, Desloovere C. Hyperbaric oxygenation as a treatment for sudden deafness and acute tinnitus. In: Wen-ren Li, pres. Proceedings of the Eleventh International Congress on Hyperbaric Medicine, Fuzhou, China. Best Publishing, Flagstaff, Arizona 1993:146-152.

2. Hoffman G. Hyperbaric oxygenation as a treatment of chronic forms of inner ear hearing loss and tinnitus.In: Wen-ren Li, Proceedings of the Eleventh International Congress on Hyperbaric Medicine, Fuzhou. Best Publishing, Flagstaff, Arizona 1993:141-145.

Clinical Scenario:A patient with a recent history of sudden hearing loss presents for treatment. We wondered if hyperbaric oxygen administration would improve hearing loss or tinnitus.

Three-part Question:For patients with sudden hearing loss, with or without tinnitus, does the addition of hyperbaric oxygen to a standard treatment protocol, result in any improvement in hearing or tinnitus?

Search Terms:Hyperbaric oxygen, hearing loss, tinnitus

The Study:Non-blinded randomised controlled trial with intention-to-treat. Patients with a history of sudden hearing loss, with or without tinnitus, and showing no improvement with a 14 day course of standard treatment including haemodilution with hydroxyethyl starch, pentoxifylline and cortisone.

Control group (N = 10; 10 analysed):No treatment.

Experimental group (N = 10; 10 analysed):100% oxygen at 1.5ATA for 45 minutes daily, five days each week for two to four weeks (10-20 sessions).

The Evidence:

Outcome	Time to Outcome	Control group	HBO group	Relative risk reduction	Absolute risk reduction	NNT
Hearing improved by 10dB or more	3 months	0	0.30	INF	0.30	3
	95% CI:				0.02 to 0.58	2 to 63
Tinnitus improved (subjective)	3 months	0.3	0.60	0.50	0.30	3
	95%CI:			-0.39 to 100	-0.17 to 0.72	NNT 9 to INF NNH1 to INF
Non-event outcomes	Time to outcome	Control group
Mean hearing change (dB)	3 months	-0.7
Tinnitus rating (0 to 10 scale)	3 months	5.6

 

Non-event outcomes	Time to outcome	Control group	HBO group	P-value
Mean hearing change (dB)	3 months	-0.7	7.5	Not given
Tinnitus rating (0 to 10 scale)	3 months	5.6	2.7	Not given

 

Comments:

1. Small, unblinded study.

2. No statistical analysis of results made.

3. The proportion of patients with tinnitus is not known. No details given on the nature of the subjective tinnitus scale, therefore the importance or otherwise of this finding is unknown.

 

Appraised by:Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales HospitalSydney; Monday, 19 July 1999

Expiry date:June 2022

 

 

BACK