Cekin
No evidence of benefit with hyperbaric oxygen therapy for sudden hearing loss.
- Bottom line
- Statistically non-significant small benefit for those treated with HBOT.
- Citations
Çekin E, Cincik H, Ulubil SA, Gungor A. Effectiveness of hyperbaric oxygen therapy in management of sudden hearing loss. The journal of laryngology and otology 2009; 123: 609-12.
- Three-part clinical question
For patients with sudden hearing loss within 3 days of onset, does the application of hyperbaric oxygen combined with systemic corticosteroid therapy, compared to corticosteroid therapy alone, improve hearing recovery.
- Search Terms
Sudden Hearing Loss, Inner Ear
- The study
Non-blinded randomised controlled trial. Intention to treat not stated.
- The study patients
Males and females aged 18-82 with sudden onset hearing loss either or both ears, within 3 days. Hearing loss defined as loss of at least 30dB in three frequencies within three days of enrolment. EXPERIMENTAL GROUP (n=36), 100% oxygen at 2.5 ATA for 90 minutes, 10 daily sessions over 10 days plus prednisolone 1mg/kg starting dose reducing over three weeks plus famotidine 40mg daily. CONTROL GROUP (n=21) Drugs as above but no HBOT.
- The evidence:
| Outcome | Time to Outcome | Control Group Rate | HBOT Group Rate | Relative Risk Reduction | Absolute Risk Reduction | NNT |
| Improved with treatment* | 10 days | 0.71 | 0.83 | 14% | 0.12 | 8 |
| ^ | 95% CIs: | -13% to 42% | -0.11 to 0.35 | NNT 3 to INF; NNH 9 to INF |
*Complete or ‘moderate’ improvement
- Comments
- Large difference in patient numbers between treatment and control arms is not explained.
- Time period of outcome assessment not defined (possibly at 10 days).
- Reducing dose of prednisolone regimen not stated.
- Average mean audiometry quoted in dB, but how many frequencies affected not described.
- Power calculation is inadequately described – no suggestion what effect they were aiming to confirm.
- 12 years to collect data at a single centre
- Two patients in study group recruited outside the protocol period
- Some discrepancy between text and Table II results.
- Appraised by: D. Smart Monday 1st August 2016
Email : [| dsmart@iinet.net.au]
- Kill or Update by : June 2020
