Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss
Sübutlu məlumatların xülasələri
22.09.2014 • Sonuncu dəyişiklik 22.09.2014
Editors
Vasodilators might possibly have limited effect in the treatment of ISSHL, but the evidence is insufficient.
A technology assessment report
carbogen gas in the treatment of sudden sensorineural hearing loss was abstracted in the Health Technology Assessment Database
. Three comparative studies were found with comparisons to heparin infusion and standard care with improvement in hearing as outcome. No statistically significant differences between carbogen gas and either heparin infusion or standard care were found. One study indicates that carbogen may be more effective than anticoagulant therapy in patients with high sloping hearing losses. All studies have potential for bias due to non-randomisation, group differences at baseline, and differences in how the groups were
treated.
A Cochrane review included three trials with 189 participants. One study showed a significant difference in hearing recovery in the vasodilator group (carbogen combined with a course of several other drugs) compared to the control group (a course of several other drugs alone) (76.9% in treatment group and 50% in control group, P < 0.05). Another study only showed a significant improvement (44% versus 13%) in higher frequencies in the vasodilator group (prostaglandin E1 + steroid) compared with the control group (placebo and steroid), no difference having been shown in overall hearing gain. In the third study the vasodilator group (naftidrofuryl and low-molecular weight dextran) showed an 70% improvement only in lower frequencies over the control group (placebo and low-molecular weight dextran, 40%).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and blinding) and by imprecise results (few patients and wide confidence intervals, differences in interventions).
Ədəbiyyat
Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;(4):CD003422.
Health Technology Assessment Database: HTA-20030678. The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.- Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;(4):CD003422.