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National Guideline Centre (UK). Hearing loss in adults: assessment and management. London: National Institute for Health and Care Excellence (NICE); 2018 Jun. (NICE Guideline, No. 98.)

Cover of Hearing loss in adults

Hearing loss in adults: assessment and management.

Contents

Appendix JGRADE tables

J.1. Urgent and routine referral

J.1.1. Urgent referral

None

J.1.2. Routine referral

None

J.2. MRI

None

J.3. Subgroups

None

J.4. Early versus delayed management of hearing loss

Table 27. Clinical evidence profile: early management group versus delayed management group 1 (PDF, 370K)

Table 28. Clinical evidence profile: early management group versus delayed management group 2 (PDF, 369K)

J.5. Communication difficulties and limitations in function

None

J.6. Management of earwax

J.6.1. Treatment

J.6.1.1. Earwax softeners alone versus no treatment

Table 29. Clinical evidence profile: water ear drops (repeated application) versus no treatment for earwax (PDF, 354K)

Table 30. Clinical evidence profile: sodium bicarbonate ear drops (repeated applications) versus no treatment for earwax (PDF, 359K)

Table 31. Clinical evidence profile: Chlorobutanol ear drops (repeated applications) versus no treatment for earwax (PDF, 354K)

J.6.1.2. Earwax softeners against each other

Table 32. Clinical evidence profile: sodium bicarbonate solution versus water (repeated applications) for earwax (PDF, 359K)

Table 33. Clinical evidence profile: chlorobutanol solution versus water (repeated applications) for earwax (PDF, 354K)

Table 34. Clinical evidence profile: chlorobutanol solution versus sodium bicarbonate solution (repeated applications) for earwax (PDF, 354K)

Table 35. Clinical evidence profile: chlorobutanol (Cerumol) ear drops versus almond oil (repeated applications) for earwax (PDF, 357K)

Table 36. Clinical evidence profile: Hydrogen Peroxide Urea solution ear drops versus Chlorobutanol solution ear drops (repeated applications) (PDF, 360K)

J.6.1.3. Earwax softeners to facilitate immediate irrigation

Table 37. Clinical evidence profile: water ear drops 15 minutes prior tosyringing versus no ear drops prior to syringing for earwax (PDF, 355K)

Table 38. Clinical evidence profile: sodium bicarbonate ear drops 30 minutes prior to syringingversus no ear drops prior to syringing for earwax (PDF, 354K)

Table 39. Clinical evidence profile: hydrogen peroxide urea ear drops 30 minutes prior to syringing versus no ear drops prior to syringing for earwax (PDF, 354K)

Table 40. Clinical evidence profile: olive oil ear drops 30 minutes prior to syringing versus no ear drops prior to syringing for earwax (PDF, 355K)

Table 41. Clinical evidence profile: chlorobutanol solution ear drops 15minutes prior to irrigation versus saline ear drops 15 minutes prior to irrigation for earwax (PDF, 361K)

Table 42. Clinical Evidence Profile: hydrogen peroxide urea solution ear drops (30 minutes prior to syringing versus sodium bicarbonate ear drops 30 minutes prior to syringing for earwax (PDF, 356K)

Table 43. Clinical Evidence Profile: hydrogen peroxide urea solution ear drops 30 minutes prior to syringingversus olive oil ear drops 30 minutes prior to syriging for earwax (PDF, 361K)

Table 44. Clinical Evidence Profile: Docusate solution ear drops (repeated applications) prior to delayed syringing versus Sodium Bicarbonate solution ear drops (repeated applications) prior to delayed syringing for earwax (PDF, 360K)

Table 45. Clinical Evidence Profile: Hydrogen Peroxide Urea solution prior to irrigation versus Sodium Chloride (Saline) prior to irrigation (up to 2x15 minute applications) (PDF, 373K)

J.6.1.4. Earwax softeners to facilitate delayed irrigation

Table 46. Clinical Evidence Profile: olive oil ear drops (repeated applications) prior to delayed syringing versus sodium bicarbonate solution ear drops (repeated applications) prior to delayed syringing for earwax (PDF, 356K)

Table 47. Clinical Evidence Profile: docusate solution ear drops (repeated application) prior to delayed syringing versus oil ear drops (repeated applications) prior to delayed syringing for earwax (PDF, 407K)

Table 48. Clinical Evidence Profile: water (single application) prior to immediate syringing versus oil ear drops (repeated applications) prior to delayed syringing for earwax (PDF, 362K)

Table 49. Clinical Evidence Profile: home syringing kit with ear drops versus ear drops plus irrigation in GP clinic for earwax (PDF, 369K)

Table 50. Clinical Evidence Profile: clinic irrigation following oily ear drops versus oily ear drops alone for earwax (PDF, 355K)

J.6.2. Settings

None

J.7. Sudden sensorineural hearing loss

J.7.1. Treatment

Table 51. Clinical evidence profile: First-line treatment – steroid (oral/IT) versus placebo (oral/IT) [Prednisolone versus placebo] (PDF, 385K)

Table 52. Clinical evidence profile: First-line treatment – steroid (oral/IT) versus steroid (oral) [dexamethasone versus prednisolone] (PDF, 384K)

Table 53. Clinical evidence profile: First-line treatment – steroid (oral) plus steroid (IT) versus steroid (oral/IT) [prednisolone oral plus dexamethasone IT versus placebo oral/IT plus dexamethasone oral/IT] (PDF, 383K)

Table 54. Clinical evidence profile: First-line treatment – steroid (oral/IV) plus antiviral (oral/IV) versus steroid (oral/IV) [prednisolone oral or hydrocortisone IV plus acyclovir or valacyclovir versus prednisolone oral or hydrocortisone IV] (PDF, 383K)

Table 55. Clinical evidence profile: Second-line treatment – steroid versus placebo or no treatment [Prednisolone or dexamethasone versus placebo or no treatment] (PDF, 384K)

J.7.2. Routes of administration

Table 56. Clinical evidence profile: Steroid (IT) versus steroid (oral) [IT prednisolone, methylprednisolone or dexamethasone versus oral prednisolone] (PDF, 401K)

Table 57. Clinical evidence profile: Steroid (IV) versus steroid (oral) [IV methylprednisolone followed by oral prednisolone versus oral prednisolone] (PDF, 375K)

Table 58. Clinical evidence profile: Dual steroid (IT plus oral) versus steroid (oral) [IT dexamethasone or methylprednisolone plus oral prednisolone versus oral prednisolone] (PDF, 383K)

Table 59. Clinical evidence profile: Dual steroid (IT plus oral) versus steroid (IT) [IT dexamethasone plus oral prednisolone versus IT dexamethasone] (PDF, 380K)

Table 60. Clinical evidence summary: Dual steroid (IT plus oral) plus antiviral versus single steroid (oral) plus antiviral [IT dexamethasone plus oral prednisolone plus oral acyclovir versus oral prednisolone plus oral acyclovir] for poor prognosis cases (PDF, 374K)

J.8. Information and support

None

J.9. Decision tools

None

J.10. Assistive listening devices

Table 61. Clinical evidence profile: ALD versus no ALD (PDF, 353K)

J.11. Hearing aids

J.11.1. Hearing aids versus no hearing aids

Table 62. Clinical evidence profile: hearing aids versus no hearing aids for mild to moderate hearing loss in adults (PDF, 516K)

J.11.2. 1 hearing aid versus 2 hearing aids

None

J.12. Hearing aid microphones and noise reduction algorithms

J.12.1. Microphones

Table 63. Clinical evidence profile: directional microphones versus omnidirectional microphones (PDF, 448K)

J.12.2. Noise reduction algorithms

None

J.13. Monitoring and follow-up

None

J.14. Interventions to support the use of hearing aids

Table 64. Clinical evidence profile: self-management support interventions versus control (PDF, 370K)

Table 65. Clinical evidence profile: delivery system design interventions versus control (PDF, 371K)

Table 66. Clinical evidence profile: self-management support and delivery system design interventions versus control (PDF, 397K)

Table 67. Clinical evidence profile: Motivational interviewing versus usual care for first time hearing aid users (PDF, 360K)

Table 68. Clinical evidence profile: Motivational interviewing versus usual care in those reporting use of ≤4hours/day (PDF, 385K)

Table 69. Clinical evidence profile: Motivational engagement versus usual care (PDF, 388K)

Copyright © NICE 2018.

Bookshelf ID: NBK536547

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National Guideline Centre (UK). Hearing loss in adults: assessment and management. London: National Institute for Health and Care Excellence (NICE); 2018 Jun. (NICE Guideline, No. 98.) Appendix J, GRADE tables.
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In this Page

Urgent and routine referral
MRI
Subgroups
Early versus delayed management of hearing loss
Communication difficulties and limitations in function
Management of earwax
Sudden sensorineural hearing loss
Information and support
Decision tools
Assistive listening devices
Hearing aids
Hearing aid microphones and noise reduction algorithms
Monitoring and follow-up
Interventions to support the use of hearing aids

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National Institute for Health and Care Excellence: Guidelines

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