1st Department of Otorhinolaryngology-Head and Neck Surgery, ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Otol Neurotol. 2010 Feb;31(2):183-9. doi: 10.1097/MAO.0b013e3181ca843d.
To systematically review and meta-analyze the results of all randomized controlled trials comparing corticosteroids with placebo for the treatment of patients with vestibular neuritis.
An electronic search was performed in MEDLINE, EMBASE, Cochrane Library, and CENTRAL databases, and then extensive hand-searching was performed for the identification of relevant studies. No time and language limitations were applied.
Prospective randomized controlled trials comparing corticosteroids with placebo for the treatment of patients with vestibular neuritis.
Odds ratios (ORs), weighted mean differences (WMD), 95% confidence intervals (CIs), and tests for heterogeneity were reported.
Four studies were eventually identified and systematically reviewed. Meta-analysis was feasible for 3 studies. Regarding the recovery of clinical symptoms, the proportion of patients with clinical recovery at 1 month after the initiation of therapy did not differ significantly between the corticosteroids and placebo groups (OR, 1.45; 95% CI, 0.26-8.01; p = 0.67). The proportion of patients with caloric complete recovery was significantly different between the corticosteroids and placebo groups both at 1 (OR, 12.64; 95% CI, 2.6-61.52; p = 0.002; heterogeneity, p = 0.53; fixed effects model) and 12 months (OR, 3.35; 95% CI, 1.45-7.76; p = 0.005; heterogeneity, p = 0.03; random effects model) after the initiation of therapy. The caloric extent of canal paresis at 12 months after the initiation of therapy seemed to differ significantly between patients who received corticosteroids and those who received placebo (WMD, -12.15; 95% CI, -19.85 to -4.46; p < 0.05; heterogeneity, p < 0.05; random effects model).
The present systematic review and meta-analysis, based on the currently available evidence, suggests that corticosteroids improve only the caloric extent and recovery of canal paresis of patients with vestibular neuritis. At present, clinical recovery does not seem be better in patients receiving corticosteroids.
系统回顾和荟萃分析比较皮质类固醇与安慰剂治疗前庭神经炎患者的所有随机对照试验的结果。
在 MEDLINE、EMBASE、Cochrane 图书馆和 CENTRAL 数据库中进行电子检索，并进行广泛的手工检索以确定相关研究。未应用时间和语言限制。
比较皮质类固醇与安慰剂治疗前庭神经炎患者的前瞻性随机对照试验。
报告了比值比（ORs）、加权均数差（WMD）、95%置信区间（CIs）和异质性检验。
最终确定了 4 项研究并进行了系统评价。3 项研究可进行荟萃分析。关于临床症状的恢复，治疗开始后 1 个月时，皮质类固醇组和安慰剂组患者的临床康复比例无显著差异（OR，1.45；95%CI，0.26-8.01；p = 0.67）。皮质类固醇组和安慰剂组患者在治疗开始后 1 个月（OR，12.64；95%CI，2.6-61.52；p = 0.002；异质性，p = 0.53；固定效应模型）和 12 个月（OR，3.35；95%CI，1.45-7.76；p = 0.005；异质性，p = 0.03；随机效应模型）时，热量完全恢复的比例有显著差异。治疗开始后 12 个月，接受皮质类固醇治疗的患者和接受安慰剂治疗的患者之间的管腔麻痹热量程度似乎有显著差异（WMD，-12.15；95%CI，-19.85 至-4.46；p < 0.05；异质性，p < 0.05；随机效应模型）。
基于目前的证据，本系统回顾和荟萃分析表明，皮质类固醇仅改善前庭神经炎患者的热量程度和管腔麻痹的恢复。目前，接受皮质类固醇治疗的患者的临床康复似乎没有改善。
