Ask an answerable question (PICO)：
While working in the ward, the author observed an increasing number of patients with sudden sensorineural hearing loss, each receiving different treatments, particularly regarding the use of hyperbaric oxygen therapy. This prompted the author to rigorously select and evaluate literature based on evidence to determine whether hyperbaric oxygen therapy can effectively improve hearing outcomes in patients with sudden sensorineural hearing loss.
The Method and Analysis of Literature Review：
The key words set were: Participants:SSNHL; Intervention: Hyperbaric oxygen therapy;Comparison: steroid, and Outcome: Pure tone audiometry. We searched the systematic review (SR),meta-analyses or randomized controlled trial (RCT) published within 5 years and used Bollean logic to search the database in PubMed, Cochrane Library,and Airiti Library. A total of 31 literatures were obtained and we excluded the duplicates and those inconsistent with title content,resulting in the final inclusion of 1 SR and 1 RCT for the literature review.
Critical Appraisal：
Evaluate the effectiveness, importance, and applicability of the tools using the CASP (2021) RCT checklist and the CASP (2018) SR checklist. Evidence levels are assessed according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. The evidence level for this SR literature is Level 1, while the evidence level for RCT literature is Level 2.
Results, Conclusions and Recommendations：
This review evaluates the study by Lei et al. (2021), which includes 2 RCTs and 4 non-RCTs, focusing on the effects of hyperbaric oxygen therapy (HBOT) and intratympanic steroids (ITS) as treatment for patients with sudden sensorineural hearing loss (SSNHL).After analysis, it was found that hyperbaric oxygen therapy showed no significant difference in hearing improvement (RR = 1.09, 95% CI = 0.83–1.42, P = 0.55) or pure tone averages (PTA) changes (MD = 0.55, 95% CI: 1.76–12.86, P = 0.64) for patients with sudden sensorineural hearing loss. Another RCT study by Cavaliere et al. (2022) compared hyperbaric oxygen therapy, oral steroids(OS),and combination of both therapies for treating SSNHL. Showing that, combination of HBOT and OS is a valid treatment for SSNHL both in case of early and late treatment. Combination of HBOT and OS was the choice with the best results in case of treatment started >14 days from symptom onset.
Overall, the effect of hyperbaric oxygen therapy on changes in pure tone audiometry in patients with sudden sensorineural hearing loss remains uncertain and requires further investigation. Future studies should employ more rigorous methods to assess the specific impact of hyperbaric oxygen therapy on pure tone audiometry, including larger sample sizes and longer follow-up periods to determine the durability and clinical significance of the treatment effect.
