Noise-Induced Hearing Loss Treatment: Systematic Review and Meta-analysis
| Autor: | Mostafa M Ahmed, Rhonda J. Allard, Carlos R. Esquivel |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Future studies Hearing loss business.industry Hearing Loss Sensorineural Public Health Environmental and Occupational Health General Medicine medicine.disease Pure tone average Treatment Outcome Hearing Loss Noise-Induced Internal medicine Meta-analysis medicine Humans Acoustic trauma Statistical analysis Steroids Prospective Studies medicine.symptom business Prospective cohort study Noise-induced hearing loss Retrospective Studies |
| Zdroj: | Military medicine. 187(5-6) |
| ISSN: | 1930-613X |
| Popis: | Objective To determine the efficacy of steroid and hyperbaric oxygen therapy (HBOT) in the setting of acute noise-induced hearing loss. Methods Systematic review and meta-analysis of noise-induced hearing loss treatment studies that reported on patients who (1) reported individual frequencies up to 8,000 Hz with mean and SDs; (2) were treated only with steroids ± HBOT; and (3) sustained acute acoustic trauma. The Newcastle-Ottawa Scale was used to assess risk of bias across cohorts. Data sources were Embase, Web of Science, Cochrane Databases (via Ovid EBM Reviews), and PubMed. Results Four studies were of retrospective cohorts and one of a prospective cohort. Only one study examined blast acoustic trauma, and the remaining four examined gunfire acoustic trauma. This meta-analysis used a random-effects model for pure tone average (PTA) (0.5, 1, and 2 kHz) and “high-frequency” PTA (HPTA) (4, 6, and 8 kHz) for the five studies included. Steroid therapy demonstrated a 6.55-dB (95% CI, 0.08-13.17 dB) PTA (n = 55) improvement and a 9.02-dB (95% CI, 1.45-16.59 dB) HPTA (n = 71) improvement. Steroid with HBOT demonstrated a 7.00-dB (95% CI, 0.84-13.17 dB) PTA (n = 133) improvement and a 12.41-dB (95% CI, 3.97-20.86 dB) HPTA (n = 150) improvement. According to our statistical analysis of the pooled studies’ heterogeneity, there was moderate inconsistency in the cross-study results of both treatment groups. Conclusion Steroids with or without HBOT appear to improve both low and high hearing thresholds following acoustic trauma. Future studies will require inclusion of control groups, precise definition of acoustic trauma intensity and duration, and genetic polymorphisms. |
| Databáze: | OpenAIRE |
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