'Complementary ENT': a systematic review of commonly used supplements.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials and clinical studies
PubMed 17125579 · doi:10.1017/S002221510600449X
What was done
The authors conducted a systematic review of English and foreign-language literature assessing in vivo human clinical studies of complementary supplements in otolaryngology. The review focused on spirulina, Ginkgo biloba, Vertigoheel, and nutritional supplements (cod liver oil, multivitamins, and pineapple enzyme/bromelain). Animal studies, in vitro research, case reports, and other alternative medicine modalities were excluded.
What was found
A formal meta-analysis could not be performed due to a lack of common outcome measures. For spirulina, three studies (one double-blind RCT for allergic rhinitis and two non-randomized mucosal immunity studies) showed positive effects. For Ginkgo biloba in tinnitus, a 2004 Cochrane review and a subsequent double-blind RCT found no evidence of benefit. For Vertigoheel in vertigo, two double-blind RCTs and an existing meta-analysis of four clinical trials found it equally effective compared with betahistine, G. biloba, or dimenhydrinate. For multivitamins and cod liver oil, two small pediatric pilot studies noted positive responses in chronic sinusitis and otitis media. For bromelain in acute sinusitis, one randomized multicenter trial of 116 children reported faster recovery with bromelain monotherapy compared with standard therapy alone or combination treatment.
Why it matters
This review highlights that Ginkgo biloba lacks efficacy for tinnitus while identifying preliminary evidence supporting spirulina, Vertigoheel, and bromelain for specific ENT indications.
Limits
Heterogeneous outcome measures prevented quantitative pooling across studies. Many included interventions rely on small sample sizes, pilot studies, or non-randomized designs, and the total participant count across all included studies was not reported in the abstract.
Cited by
- supports Systematic reviews and meta-analyses show that dietary supplements do not provide a statistically significant therapeutic benefit for general tinnitus.