Treatment Of Sudden Hearing Loss With Intratympanic Dexamethasone: A Meta-analysis

Background:Sudden sensorineural hearing loss(SSHL)is one of the common emergencies in otolaryngology.Although systemic steroid therapy(SST)is considered to be one of the standard treatments for SSHL,its clinical application is limited because of the potential side effects.In recent years,it has been found that Intratympanic steroid(ITS)is an effective treatment and has few side effects.However,there is no literature to systematically study and discuss ITS,and there is a lack of unified criteria for the evaluation of side effects of ITS.Objective:The purpose of this study was to investigate the efficacy and safety of intratympanic dexamethasone(ITD)in the treatment of sudden sensorineural hearing loss(SSHL).Methods:Searched PubMed,Ovid,web of science,knowledge network and Wanfang database by computer.To screen and collect the randomized controlled trials(RCTs)of intratympanic dexamethasone(ITD)and systemic steroid therapy(SST)in the treatment of sudden sensorineural hearing loss(SSHL)before December 2018 in China and abroad.The intervention measures of the experimental group must include the ITD,control group without special restrictions.The inclusion and exclusion criteria were strictly formulated,and RevMan5.3 software was used for Metaanalysis of the studies in accordance with the standards.Results:The results of Meta analysis showed that the curative effect of ITD group was significantly higher than that of placebo group,and the curative effect of ITD group was better than that of placebo group.There was significant difference in efficacy between ITD group and SST group,simple ITD group was significantly better than that of SST group.Basic treatment + ITD group compared with basic treatment +SST group,The difference of effectiveness was statistically significant,the curative effect of basic treatment + ITD group was better than that of basic treatment + ITD group,and the curative effect of basic treatment + ITD group was better than that of basic treatment group.The main side effects were 2 cases of tympanic membrane perforation,2 cases of pain and 42 cases of transient vertigo.All the side effects were self-cured.Conclusion:ITD has obvious positive effect in remedial treatment of SSHL;as an auxiliary means of basic treatment of non-hormonal basic therapy,it can greatly improve the efficacy of basic therapy alone;The difference of curative effect between ITD and SST was statistically significant,and the curative effect of ITD was more obvious.Most of the side effects of ITD can be cured,so it is a safe and effective treatment.