Ting Yang , Hui Liu , Fangyao Chen , An Li , Zhou Wang , Shuangyuan Yang , Shiyu Yang , Wen Zhang
{"title":"鼓室内与全身使用类固醇作为突发性听力损失的一线治疗:随机对照试验的荟萃分析","authors":"Ting Yang , Hui Liu , Fangyao Chen , An Li , Zhou Wang , Shuangyuan Yang , Shiyu Yang , Wen Zhang","doi":"10.1016/j.joto.2021.02.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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, I<sup>2</sup> = 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, I<sup>2</sup> = 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, I<sup>2</sup> = 0%).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":37466,"journal":{"name":"Journal of Otology","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.joto.2021.02.001","citationCount":"4","resultStr":"{\"title\":\"Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss: A meta-analysis of randomized, controlled trials\",\"authors\":\"Ting Yang , Hui Liu , Fangyao Chen , An Li , Zhou Wang , Shuangyuan Yang , Shiyu Yang , Wen Zhang\",\"doi\":\"10.1016/j.joto.2021.02.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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, I<sup>2</sup> = 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, I<sup>2</sup> = 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, I<sup>2</sup> = 0%).</p></div><div><h3>Conclusion</h3><p>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. 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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
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.
期刊介绍：
Journal of Otology is an open access, peer-reviewed journal that publishes research findings from disciplines related to both clinical and basic science aspects of auditory and vestibular system and diseases of the ear. This journal welcomes submissions describing original experimental research that may improve our understanding of the mechanisms underlying problems of basic or clinical significance and treatment of patients with disorders of the auditory and vestibular systems. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines. Journal of Otology welcomes contributions from scholars in all countries and regions across the world.
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