The Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss Meta-Analysis Might Have a Weight Problem—Reply

Abstract

ment of the orbit. In this case, CT scan revealed a large right supra agger frontal cell and lateralized right middle turbinate, which resulted in obstruction of the right frontal sinus, leading to frontal sinus atelectasis. This produced an attenuation and bowing of the right superior orbital wall into the right frontal sinus.To our knowledge, there is only 1 case of frontal SSS reported in the literature. 6 Our case shared similarities with that of Naik et al, 6 where both patients had an obstructing supra agger frontal cell and recovered well after ESS. The difference was in presentation; the previously reported patient had both enophthalmos and hyperglobus, whereas the present patient had only enophthalmos. This could be owing to earlier diagnosis and treatment before hyperglobus set in. This case highlights that SSS is not exclusively a maxillary sinus disease but in certain anatomical sinus configuration, can lead to frontal SSS. A high index of suspicion, early detection, and intervention can help prevent disease progression.

Avoiding Definitive Conclusions in Meta-analysis of Heterogeneous Studies With Small Sample Sizes

“…A major shortcoming was that most of its overall effects were predominantly driven by the over weighting of Khater et al, an RCT with a total of only 22 participants, resulting in an unconvincing clinical conclusion. In a letter in reply, the authors maintain the validity of their conclusion after excluding Khater et al Their justification was given that the remaining 2 studies were also short of data consistency: the proportion of patients showing a hearing gain of 10 dB or greater was 81.7% (25 of 30 patients) in the control group of Cho et al compared with 28.6% (6 of 21) in the control group of Krajčovičová et al…”