Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP, et al.
The Cochrane database of systematic reviews. Date of publication 2012 Oct 17;volume 10():CD004739.
1. Cochrane Database Syst Rev. 2012 Oct 17;10:CD004739. doi:
10.1002/14651858.CD004739.pub4.
Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus.
Bennett MH(1), Kertesz T, Perleth M, Yeung P, Lehm JP.
Author information:
(1)Department of Anaesthesia, Prince of Wales Hospital, Randwick, Australia.
m.bennett@unsw.edu.au
Update of
Cochrane Database Syst Rev. 2007;(1):CD004739.
BACKGROUND: This is an update of a Cochrane Review first published in The
Cochrane Library in Issue 1, 2005 and previously updated in 2007 and
2009.Idiopathic sudden sensorineural hearing loss (ISSHL) is common and has a
significant effect on quality of life. Hyperbaric oxygen therapy (HBOT) may
improve oxygen supply to the inner ear and result in an improvement in hearing.
OBJECTIVES: To assess the benefits and harms of HBOT for treating ISSHL and/or
tinnitus.
SEARCH METHODS: We searched the Cochrane Ear, Nose and Throat Disorders Group
Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL);
PubMed; EMBASE; Database of Randomised Trials in Hyperbaric Medicine (DORCTHIM);
CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP
and additional sources for published and unpublished trials. The date of the most
recent search was 2 May 2012, following previous searches in 2009, 2007 and 2004.
SELECTION CRITERIA: Randomised studies comparing the effect on ISSHL and tinnitus
of HBOT and alternative therapies.
DATA COLLECTION AND ANALYSIS: Three authors evaluated the quality of trials using
the 'Risk of bias' tool and extracted data from the included trials.
MAIN RESULTS: Seven trials contributed to this review (392 participants). The
studies were small and of generally poor quality. Pooled data from two trials did
not show any significant improvement in the chance of a 50% increase in hearing
threshold on pure-tone average with HBOT (risk ratio (RR) with HBOT 1.53, 95%
confidence interval (CI) 0.85 to 2.78, P = 0.16), but did show a significantly
increased chance of a 25% increase in pure-tone average (RR 1.39, 95% CI 1.05 to
1.84, P = 0.02). There was a 22% greater chance of improvement with HBOT, and the
number needed to treat (NNT) to achieve one extra good outcome was 5 (95% CI 3 to
20). There was also an absolute improvement in average pure-tone audiometric
threshold following HBOT (mean difference (MD) 15.6 dB greater with HBOT, 95% CI
1.5 to 29.8, P = 0.03). The significance of any improvement in tinnitus could not
be assessed.There were no significant improvements in hearing or tinnitus
reported for chronic presentation (six months) of ISSHL and/or tinnitus.
AUTHORS' CONCLUSIONS: For people with acute ISSHL, the application of HBOT
significantly improved hearing, but the clinical significance remains unclear. We
could not assess the effect of HBOT on tinnitus by pooled analysis. In view of
the modest number of patients, methodological shortcomings and poor reporting,
this result should be interpreted cautiously. An appropriately powered trial is
justified to define those patients (if any) who can be expected to derive most
benefit from HBOT.There is no evidence of a beneficial effect of HBOT on chronic
ISSHL or tinnitus and we do not recommend the use of HBOT for this purpose.
DOI: 10.1002/14651858.CD004739.pub4
PMID: 23076907 [Indexed for MEDLINE]
