No
evidence that twice daily hyperbaric oxygen administration improves outcome in
sudden hearing loss when compared to a once daily regime.
Clinical Bottom Line:
1.
Neither once nor twice daily hyperbaric oxygen to a total of ten treatments
seemed associated with improvement in outcome.
2.
The efficacy of hyperbaric versus placebo (or other elements of treatment) was
not tested.
Appraised
by: Mike Bennett, Dept. of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Friday, 16 July 1999
Clinical
Scenario: A patient with sudden hearing
loss presented for treatment. We wondered if a once or twice daily regimen of
hyperbaric oxygen would be the more effective.
Three-part
Question: In patients with sudden hearing
loss, does the administration of steroids, naftidrofuryl, normovolaemic
haemodilution and once daily hyperbaric oxygen, compared to a similar regime but
using twice daily hyperbaric oxygen, result in any improved outcome?
Search Terms: Hyperbaric
oxygenation; hearing loss, sudden; naftidrofuryl.
The
Study:
Non-blinded randomised
controlled trial with intention-to-treat.
Patients with sudden hearing
loss of not more than 8 days duration.
Control group (N = 20; 20
analysed): Normovolaemic haemoldilution, steroids and administration of 100%
oxygen at 2.2ATA for 90 minutes daily for ten days. Naftidrofuryl 400mg IVI was
given during and immediately after the hyperbaric exposure.
Experimental group (N = 20; 20
analysed): As above, but hyperbaric oxygen was repeated twice daily for 5 days,
with the naftidrofuryl infusion continued until finishing the second treatment
each day.
The
Evidence:
Quantitatively difficult to
determine without full article translation. Authors state: "The efficiency
and side effects were similar in the two groups…"
Comments:
1. No placebo comparison group
and authors feel the spontaneous rate of recovery is not clear, therefore we do
not know if either arm is efficacious.
2. It appears one group received
much of the drug naftidrofuryl orally, therefore other elements of the treatment
were not identical between groups.
3. Only the abstract is
available in English- a full translation is awaited.
4. No quantitative analysis of
outcomes seems to have been reported.
Expiry date: July 2002
References:
1. Dauman R, Poisot D, Cros AM,
Zennaro O, Bertrand B, Duclos JY, Esteben D, Milacic M, Boudey Ch, Bebear JP.
Sudden hearing loss: comparative randomized study of two modalities of
hyperbaric oxygen therapy in association with naftidrofuryl. Revue de
Laryngologie 1993; 114:53-58.
