Effectiveness of Steroid Treatment for Sudden Sensorineural Hearing Loss: A Meta-analysis of Randomized Controlled Trials

Background: The best way to administer steroids for sudden sensorineural hearing loss (SSHL) is still unclear. The present study was aimed at estimating the efficacy of steroids by intratympanic, systemic, and combined therapy (CT) routes. Methods: A systematic literature search was performed from 1...

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Bibliographic Details
Published in:The Annals of pharmacotherapy 2020-10, Vol.54 (10), p.949-957
Main Authors: Li, Jinfei, Ding, Lei
Format: Article
Language:English
Subjects:
Administration, Oral
Dexamethasone - administration & dosage
Dexamethasone - therapeutic use
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Glucocorticoids - administration & dosage
Glucocorticoids - therapeutic use
Hearing Loss, Sensorineural - drug therapy
Hearing Loss, Sudden - drug therapy
Humans
Injection, Intratympanic
Male
Methylprednisolone - administration & dosage
Methylprednisolone - therapeutic use
Middle Aged
Prednisone - administration & dosage
Prednisone - therapeutic use
Randomized Controlled Trials as Topic
Treatment Outcome
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Summary:Background: The best way to administer steroids for sudden sensorineural hearing loss (SSHL) is still unclear. The present study was aimed at estimating the efficacy of steroids by intratympanic, systemic, and combined therapy (CT) routes. Methods: A systematic literature search was performed from 1950 to October 2019 for randomized controlled trials comparing the use of intratympanic, systemic, and combined steroid therapy for SSHL. The outcomes of recovery rate and pure tone average (PTA) improvement were assessed by random-effects and fixed-effects meta-analysis. Results: A total of 20 articles identified from 7 countries were eligible for analysis. Although no significant difference in recovery rate was observed between intratympanic steroid therapy (IST) and systemic steroid therapy (SST), IST did demonstrate better hearing improvement, as evidenced by a higher PTA than SST. Compared with SST, CT comprising IST and SST had significant recovery rate improvement. Patients treated with CT had a significantly higher PTA than those treated with SST. Through subgroup analysis based on the equivalent dose of prednisone, it was shown that CT led to a significantly higher PTA than SST only in the high-dose CT versus high-dose SST groups and moderate-dose CT versus high-dose SST groups. Conclusion: Moderate and high dose of CT could accelerate hearing improvement in SSHL.
ISSN:1060-0280
1542-6270
DOI:10.1177/1060028020908067