Difference between revisions of "Krajcovicová"
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<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70.<br/> '''Lead author's name and fax: '''Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk</span></span></span></span> | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70.<br/> '''Lead author's name and fax: '''Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk</span></span></span></span> | ||
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<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> | ||
| − | {| class="Table" style="border:solid windowtext | + | {| class="Table" style="border: 1pt solid windowtext; width: 660px;" |
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| style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <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:">Outcome</span></span>'''</span></p> | | style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <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:">Outcome</span></span>'''</span></p> | ||
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| style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <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:">Control group</span></span>'''</span></p> | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <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:">Control group</span></span>'''</span></p> | ||
| style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <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:">HBO group</span></span>'''</span></p> | | style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <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:">HBO group</span></span>'''</span></p> | ||
| − | | style="width: | + | | style="width: 107px; border: 1pt solid windowtext;" width="94" | <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:">Relative risk reduction</span></span>'''</span></p> |
| − | | style="width: | + | | style="width: 90px; border: 1pt solid windowtext;" width="95" | <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:">Absolute risk reduction</span></span>'''</span></p> |
| − | | style="width: | + | | style="width: 79px; border: 1pt solid windowtext;" width="82" | <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:">NNT</span></span>'''</span></p> |
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| rowspan="2" style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <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:">Improvement in ave pure tone hearing threshold (>10dB)</span></span>'''</span></p> | | rowspan="2" style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <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:">Improvement in ave pure tone hearing threshold (>10dB)</span></span>'''</span></p> | ||
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| style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <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:">0.29</span></span></span></p> | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <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:">0.29</span></span></span></p> | ||
| style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <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:">0.62</span></span></span></p> | | style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <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:">0.62</span></span></span></p> | ||
| − | | style="width: | + | | style="width: 107px; border: 1pt solid windowtext;" width="94" | <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:">116%</span></span></span></p> |
| − | | style="width: | + | | style="width: 90px; border: 1pt solid windowtext;" width="95" | <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:">0.33</span></span></span></p> |
| − | | style="width: | + | | style="width: 79px; border: 1pt solid windowtext;" width="82" | <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:">3</span></span></span></p> |
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| colspan="3" style="width:133.2pt; border:solid windowtext 1.0pt" width="180" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p> | | colspan="3" style="width:133.2pt; border:solid windowtext 1.0pt" width="180" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p> | ||
| − | | style="width: | + | | style="width: 107px; border: 1pt solid windowtext;" width="94" | <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:">32% to 199%</span></span></span></p> |
| − | | style="width: | + | | style="width: 90px; border: 1pt solid windowtext;" width="95" | <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:">0.09 to 0.57</span></span></span></p> |
| − | | style="width: | + | | style="width: 79px; border: 1pt solid windowtext;" width="82" | <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:">2 to 11</span></span></span></p> |
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<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.<br/> 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.<br/> 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.</span></span></span></span> | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.<br/> 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.<br/> 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.</span></span></span></span> | ||
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' June 2023</span></span></span></span> |
| − | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:xx-large;">[ | + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Audiovestibular|BACK]]</span></p> |
Latest revision as of 02:05, 30 September 2021
Some evidence of better hearing outcome with hyperbaric oxygen added to a polypharmacy regimen including steroids for idiopathic sudden hearing loss
|
Clinical Bottom Line 1. More individuals improved when HBOT was added to a pharmacological treatment regimen. |
Citation/s:1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70.
Lead author's name and fax: Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk
Three-part Clinical Question:For patients with idiopathic sudden sensorineural hearing loss (ISSNHL), does the addition of hyperbaric oxygen to standard treatment result in any further improvement in hearing?
Search Terms: Sudden hearing loss; steroids; pentoxifylline
The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adults with unilateral ISSNHL (41 to 60dB loss).
Control group (N = 21; 20 analysed): Polypharmacy including steroids intravenously days 1 to 5 then orally to day 15, pentoxifylline and betahistine.
Experimental group (N = 47; 47 analysed): As above plus 100% oxygen breathing at 2.0 ATA for 90 minutes daily for 10 days.
The Evidence:
Outcome |
Time to Outcome |
Control group |
HBO group |
Relative risk reduction |
Absolute risk reduction |
NNT |
Improvement in ave pure tone hearing threshold (>10dB) |
day15? |
0.29 |
0.62 |
116% |
0.33 |
3 |
95% CIs: |
32% to 199% |
0.09 to 0.57 |
2 to 11 | |||
Measure |
Control Group |
HBO Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Mean threshold at mid-frequency 1000-2000 Hz after treatment (dB) |
28.9 |
18.8 |
26.5 |
23.5 |
2.4 |
-260.7 to 265.5 |
|
Mean threshold at high frequencies (4000 to 8000 Hz) after treatment (dB) |
45.1 |
21.6 |
37.5 |
29.6 |
7.6 |
-395.1 to 410.3 |
Comments:
1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.
2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.
3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.
Appraised by:Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021
Kill or Update By: June 2023
