Intratympanic steroid as salvage therapy for sudden sensorineural hearing loss: an overview of systematic reviews and meta-analyses.

Objective: To re-evaluate the published systematic reviews and meta-analyses on the efficacy and safety of intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss (SSNHL).

Methods: Systematic reviews and meta-analyses related to intratympanic steroid therapy for SSNHL were identified by searching both English and Chinese language databases, including OVID, The Cochrane Library, PubMed, Web of Science, Embase, CBM, WanFang, CNKI, and CSTJ. For each included study, the AMSTAR 2 appraisal tool was used to assess methodological quality, the PRISMA statement evaluated reporting quality, and the GRADE system was applied to assess the strength of evidence for primary study outcomes.

Results: A total of 16 studies that met the inclusion criteria were included in the analysis. The AMSTAR 2 evaluation identified 2 studies as having low credibility and 14 as having very low credibility. The PRISMA statement ratings for the studies ranged from 10 to 23 (mean score: 17.6), with 4 studies classified as high quality, 8 as medium quality, and 4 as low quality. The GRADE assessment included 53 outcome indicators, with 2 considered as having intermediate evidence, 12 as low-level evidence, and 39 as very low-level evidence.

Conclusion: Based on the AMSTAR 2, PRISMA, and GRADE evaluations, this study provides evidence in favor of intratympanic steroid therapy as a salvage treatment for sudden deafness. However, the systematic reviews and meta-analyses included in this study generally exhibit low methodological quality and inconsistent reporting. Future clinical trials and systematic reviews/meta-analyses should aim to improve the quality of their design, execution, and reporting to provide more reliable evidence that can guide clinical decision-making.