A comparison of effects of systemic and intratympanic steroid therapies for sudden sensorineural hearing loss:A meta-analysis

Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss(SSNHL) patients.Methods:A comprehensive search of PubMed,Wanfang database and CNKI(China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014.A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration.Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis.The data were extracted and analyzed using the Rev Man 5.3 meta-analysis software.Results:The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies(RR = 1.08,95%CI = 0.99-1.99,P = 0.10),although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies(RR = 1.29,95%CI = 1.00-1.66,P = 0.05).Conclusion:Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL,which may be especially useful for patients in whom systemic steroids are contraindicated.