Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

32 Hyperbaric Oxygenation Therapy KCE Reports 74
3.4.11.2 Summary of the evidence
Sudden deafness is an accepted indication and recommended by EHCM (type 2, level C
recommendation) but is not an accepted indication for UHMS. The rationale of HBOT
is mainly based on the supposed aetiology of the disease, involving hypoxic events in the
cochlear apparatus. HBOT may therefore be able to reverse this hypoxia. 1 It has been
used since the nineteen sixties for this indication with conflicting results.
A Cochrane review from 2007 assessed the available evidence from six RCTs. 21 It
concluded that for people with early presentation of ISSHL, the application of HBOT
significantly improved hearing loss assessed through audiometry at the 25%
improvement level (not at the 50% level), as shown in Figure 16 and Figure 17. The
average improvement in PTA as proportion of baseline was significantly better in the
HBOT group (Figure 18). The clinical significance of the level of improvement remains
unclear (Figure 19). There is no evidence of a beneficial effect of HBOT on chronic
presentation of ISSHL (Figure 20). However, RCTs currently available are too small,
present too many methodological shortcomings and are too poorly reported to draw
solid conclusions.
Figure 16. Acute presentation of ISSHL: greater than 50% return of hearing
as measured by audiometry
Source: Bennett et al. 21