Rhee TM, Hwang D, Lee JS, Park J, Lee JM, et al.
JAMA otolaryngology-- head & neck surgery. Date of publication 2018 Sep 27;volume ():.
1. JAMA Otolaryngol Head Neck Surg. 2018 Sep 27. doi: 10.1001/jamaoto.2018.2133.
[Epub ahead of print]
Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic
Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis.
Rhee TM(1)(2), Hwang D(2), Lee JS(3), Park J(2), Lee JM(4).
Author information:
(1)Department of Undersea and Hyperbaric Medicine, Maritime Medical Research
Center, National Maritime Medical Center, Changwon, Republic of Korea.
(2)Department of Internal Medicine, Seoul National University Hospital, Seoul,
Republic of Korea.
(3)Department of Laboratory Medicine, Hallym University Sacred Heart Hospital,
Anyang, Republic of Korea.
(4)Department of Internal Medicine and Cardiovascular Center, Heart Vascular
Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, Republic of Korea.
Importance: Sudden sensorineural hearing loss (SSNHL) causes substantial disease
burden for both individuals and socioeconomic aspects. The benefit of hyperbaric
oxygen therapy (HBOT) in addition to standard medical therapy (MT) for idiopathic
SSNHL has been unclear.
Objective: To perform a systematic review and meta-analysis to compare HBOT + MT
with MT alone as a treatment for patients with SSNHL.
Data Sources: PubMed, Embase, and the Cochrane Database of Systematic Reviews
were systematically searched up to February 2018.
Study Selection: Randomized clinical trials and nonrandomized studies comparing
HBOT + MT with MT alone for SSNHL treatment.
Data Extraction and Synthesis: Two investigators independently screened the
eligible studies, established data, and assessed quality and risk of bias. A
systematic review and meta-analysis using random-effects models was conducted.
Main Outcomes and Measures: The primary outcome was complete hearing recovery,
and secondary outcomes were any hearing recovery and absolute hearing gain.
Results: Three randomized clinical trials and 16 nonrandomized studies comparing
outcomes after HBOT + MT vs MT alone in 2401 patients with SSNHL (mean age, 45.4
years; 55.3% female) were included. Pooled odds ratios (ORs) for complete hearing
recovery and any hearing recovery were significantly higher in the HBOT + MT
group than in the MT alone group (complete hearing recovery OR, 1.61; 95% CI,
1.05-2.44 and any hearing recovery OR, 1.43; 95% CI, 1.20-1.67). Absolute hearing
gain was also significantly greater in the HBOT + MT group than in the MT alone
group. The benefit of HBOT was greater in groups with severe to profound hearing
loss at baseline, HBOT as a salvage treatment, and a total HBOT duration of at
least 1200 minutes.
Conclusions and Relevance: The addition of HBOT to standard MT is a reasonable
treatment option for SSNHL, particularly for those patients with severe to
profound hearing loss at baseline and those who undergo HBOT as a salvage
treatment with a prolonged duration. Optimal criteria for patient selection and a
standardized regimen for HBOT should be applied in routine practice, with future
trials to investigate maximal treatment benefit.
DOI: 10.1001/jamaoto.2018.2133
PMID: 30267033
