Postauricular versus systemic use of steroids for sudden hearing loss: A systematic review and meta-analysis of randomized controlled trials

作者全名："Deng, H. S.; Hou, Y. W.; Zhang, J. N.; Yang, T."

作者地址："[Deng, H. S.; Hou, Y. W.; Zhang, J. N.] Hanzhong Peoples Hosp, Dept Otolaryngol Head & Neck Surg, Hanzhong, Shaanxi, Peoples R China; [Yang, T.] Chongqing Med Univ, Chongqing, Peoples R China; [Yang, T.] Chinese Acad Sci, Chongqing Inst Green & Intelligent Technol, Chongqing, Peoples R China; [Yang, T.] Univ Chinese Acad Sci, Chongqing Sch, Chongqing, Peoples R China; Chongqing People Hosp, Chongqing, Peoples R China; [Yang, T.] Chongqing Med Univ, Chongqing 400016, Peoples R China"

通信作者："Yang, T (通讯作者)，Chongqing Med Univ, Chongqing 400016, Peoples R China."

来源：MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001046217500064

JCR分区：Q2

影响因子：1.3

年份：2023

卷号：102

期号：32

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结束页：　

文献类型：Review

关键词：meta-analysis; postauricular injection; sudden sensorineural hearing loss; systematic review; systemic therapy

摘要："Background:Sudden sensorineural hearing loss (SSNHL) can be debilitating and is one of the most common otological diseases. Steroids play an important role in its treatment. There are many ways to administer steroids, and the efficacy and safety of different administration routes remain unclear. This meta-analysis aimed to investigate the effect and safety of different types of steroid delivery administration for the treatment of SSNHL. Methods and analysis:We searched the Weipu, Wanfang, Chinese Biomedical Literature, National Knowledge Infrastructure, Web of Science, Embase and PubMed databases for randomized controlled trials (RCTs) on glucocorticoid treatments for SSNHL to compare the efficacy of postauricular injection and systemic steroid administration. Review Manager 5.4 software was used for data synthesis, which included the recovery rate (RR) of reported hearing improvement and change level in pure-tone audiometry (PTA). Subgroup analyses were performed based on different drugs, basic treatment, initial PTA, drug administration methods, onset time, and treatment course. Stata 15.1 software was used for analyses of publication bias and sensitivity. Results:Our meta-analysis included 38 studies involving 3609 patients with SSNHL. In all included studies, the risk difference (RD) using reported improvement as an outcome measure was 0.12 for postauricular injection administration compared with systemic therapy (95% confidence interval [CI] = 0.008, 0.16, P < .00001, I-2 = 59%). When examining PTA changes as an outcome measure (19 studies), the mean difference was 6.06 (95% CI = 3.96, 8.16, P < .00001, I-2 = 70%). The RD for hearing improvement was compared among different factors, and the results showed that postauricular injection is superior to systemic steroid administration. Conclusion:Postauricular injection may be safer and more effective treatment than systemic therapy as a treatment for SSNHL."

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