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Intratympanic Corticosteroid Injection As a First-Line Treatment of the Patients With Idiopathic Sudden Sensorineural Hearing Loss Compared to Systemic Steroid: A Systematic Review and Meta-Analysis Publisher Pubmed



Mirsalehi M1 ; Ghajarzadeh M2 ; Farhadi M1 ; Akbarnejad Z1 ; Ahmadi S3 ; Salem MM4
Authors
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Authors Affiliations
  1. 1. ENT and Head & Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Neurosurgery Department, Hazrat Rasoul Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  4. 4. ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Source: American Journal of Otolaryngology - Head and Neck Medicine and Surgery Published:2022


Abstract

Objectives: The current study aimed to investigate if there is a difference in the use of intratympanic steroid therapy (IST), compared to systemic steroid treatment (SST), as an initial treatment for patients with sudden sensorineural hearing loss (SSNHL) by a meta-analysis design performed on the mean pure-tone average (PTA) improvement and the complete recovery rate. Methods: A systematic literature review was performed on randomized controlled trials published from 1990 to August 2020 in some databases including PubMed/MEDLINE, Scopus, Embase, Web of Science, Cochrane library/CENTRAL, Ovid, ProQuest, Google Scholar, and clinical trials.gov. The primary outcomes of interest were pure-tone average improvement and complete recovery rates. Results: Six eligible studies with 496 patients (250 patients in the IST group and 246 subjects in the SST group) were included in this study. The pooled standardized mean difference of the PTAs was estimated as 0.07 (95% CI = −0.10 to 0.25; I2 = 0.0%, P = 0.668), and the pooled odds ratio of complete recovery rate was obtained as 1.00 (95% CI = 0.66 to 0.151; I2 = 31.6, P = 0.199). Moreover, the pooled standardized mean difference of pure-tone average for the intratympanic steroid treatment group compared to the patients with oral steroid treatment was 0.07 (95% CI = −0.12 to 0.26; I2 = 0.0%, P = 0.526). Conclusions: The current study demonstrated that the effect of intratympanic injection of corticosteroid, as a first-line treatment, is not statistically different from the systemic route in improving the hearing outcomes among patients with SSNHL. © 2022 Elsevier Inc.
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