| Background:IT offers an attractive alternative to systematic steroids treatment for treating ISSHL. However, the results vary across studies. The objective of this article is to pool and meta-analyze the results of all RCT on IT of ISSHL.Methods:Medline and Embase were searched for RCTs with no restriction of language. Tow reviewers extracted the data independently.Result:142 articles identified in initial search through strategies,8 met inclusion criteria for meta-analysis. Of these 8 trials,4 were primary treatment and the rest were salvage treatment. In the primary treatment,2 compared IT with OT,1 compared IT+OT with OT, and 1 compared IT, IT+OT and OT, which was considered as 2 RCTs (IT vs OT and IT+OT vs OT). Pooling of data from 3 trials that compared IT with OT in primary treatment showed patients benefit slightly more from IT but no statistically significant difference existed (RR=1.22,95% CI 0.98-1.52,p= 0.071). However, by pooling of data from 4 trials, IT had a much better outcome in the salvage treatment than the control groups (systematic treatment without steroids, placebo treatment and no any further treatment), and there was significant difference (RR 8.73,95% CI 2.46-30.92,p= 0.001). There were considerable heterogeneity (χ2= 4.45, d.f.= 1, p= 0.035, I2= 77.5%) in 2 trials that comparedA IT+OT with OT, than the meta-analysis was quitted in this subgroup. In all 8 trials containing 243 subjects treated with intratympanic management, only 2 subjects occurred perforation and were treated with surgery successfully.Conclusion:IT is a good alternative choice to system steroids treatment and worthy of performance in clinic for the patients who could not tolerate the systematic steroids treatment, or especially failed in this treatment. Besides it is rather safe to perform in clinic. |
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