No
evidence of improvement in hearing loss or tinnitus with hyperbaric oxygen
compared to a regime of hydroxyethyl starch and pentoxifylline.
Clinical Bottom Line:
1.
No statistically significant improvement in hearing loss or tinnitus was
demonstrated in this trial.
2.
There was a trend to more improvement in hearing loss in the hyperbaric group
Appraised
by: Mike Bennett, Department of Diving and
Hyperbaric Medicine, Prince of Wales Hospital, Sydney Thursday, 11 November 1999
Clinical
Scenario: A patient with sudden loss of
hearing and tinnitus of unknown cause presented for treatment.
Three-part
Question: For patients presenting for
treatment of acute hearing loss and or tinnitus, does administration of
hyperbaric oxygen, compared to pentoxifylline and hydroxyethyl starch, result in
any improvement in either complaint?
Search
Terms: Hyperbaric oxygenation, sudden
hearing loss, tinnitus
The
Study:
Non-blinded randomised
controlled trial with intention-to-treat.
Sudden hearing loss with at
least 20dB loss in one or more frequencies and /or tinnitus, seen within 2 weeks
and without any prior therapy.
Control group (N = 38; 31
analysed): Intravenous hydroxyethyl starch 6% 250mls and pentoxyphylline 300mg
daily for ten days.
Experimental group (N = 37; 24
analysed): 100% oxygen at 2.5ATA for 75 minutes daily for 10 days.
The
Evidence:
Non-Event
Outcomes
Time to outcome
Control group
HBO group P-value
Hearing
improvement
in (dB)
?4 weeks
10.7
15.6
NS
tinnitus
(VAS 0-10)
?4 weeks
4.0
3.6
NS
Comments:
1. There may be a significant
clinical benefit in hearing recovery with hyperbaric oxygen, however, this trial
is of insufficient power to confirm this.
2. The numbers reaching
follow-up are unclear.
3. There is no placebo control
to establish the rate of spontaneous improvement.
Expiry
date:
July
2002
References:
