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Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss:A meta-analysis of randomized,controlled trials

查看全文 作　　者：Ting [1]Yang;Hui [2]Liu;Fangyao [3]Chen;An [2]Li;Zhou [2]Wang;Shuangyuan [1]Yang;Shiyu [2]Yang;Wen [2]Zhang 高影响力作者 机构地区：[1]Xi’an Medical University,China;[2]Department of Otolaryngology,Shaanxi Provincial People’s Hospital,China;[3]Xi’an Jiaotong University,China高影响力机构 出　　处：《Journal of Otology》索引2021年第16卷第3期,共13页高影响力期刊 摘　　要：Background Sudden sensorineural hearing loss(SSNHL)is a common disease in otology,and steroids play an important role in its treatment.Steroids can be administered systemically or locally,and the efficacies of different administration routes remain controversial.Methods We searched the Cochrane,EMBASE,PubMed,Web of Science,CNKI,Wanfang and Weipu databases for randomized controlled trials(RCTs)on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration.The Review Manager 5.4 software was used for synthesis of data:the rate of reported hearing improvement and change in pure-tone audiometry(PTA).Results In all the included studies,when intratympanic administration was compared to systemic therapies,the risk difference(RD)using reported hearing improvement as an outcome measure was 0.08(95%CI:0.01–0.14,I2=45%).Using PTA changes as an outcome measure in 4 studies,the mean difference(MD)was 10.43 dB(95%CI:3.68–17.18,I2=81%).Hearing improvement RD was also compared among different types of steroid,recovery criteria,follow-up times and diagnostic criteria,and showed no significant differences exception for recovery criteria(>10 dB)(RD-0.06,95%CI:0.14-0.2,I2=0%).Conclusion As the initial treatment for SSNHL,topical steroids seem to be superior to systemic steroid administration,especially in patients with contraindications to systemic steroids usage.However,further verification based on high-quality research is needed. 关 键 词：Intratympanic treatment Systemic treatment META-ANALYSIS Sudden sensorineural hearing loss
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