Lai D, Huang Y L, Pu J M, Liu L
Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
Department of Pharmacy, the Affiliated Hospital of Southwest Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 20;31(16):1258-1264. doi: 10.13201/j.issn.1001-1781.2017.16.010.
The aim of this overview is to evaluate the relevant systematic reviews and Meta-analysis that focus on intratympanic steroid intervention as initial therapy for sudden sensorineural hearing loss.The literature search was based on the published systematic reviews and Meta analysis. According to the include and exclude critera, the important data was extracted. Quality assessment was rigorously performed using the 11-item Assessment of Multiple Systematic Reviews (AMSTAR) and main outcome indicators of literature evidence quality were evaluated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Sixteen related systemic reviews and Meta-analysis (6 Chinese literatures and 10 English literatures) published during 2009-2016 were included; AMSTAR score was 4 to 9 points,14 studies was medium quality and 2 was high quality. However, the clinical evidence was controversial and there is no consensus regarding the efficacy of intratympanic steroid therapy for sudden sensorineural hearing loss.As an initial treatment, there is no sufficient high quality evidence to recommend the ITS therapy. There is a need for further systematic reviews that adhere to strict scientific methods.
本综述的目的是评估相关的系统评价和Meta分析,这些研究聚焦于鼓室内注射类固醇作为突发性感音神经性听力损失的初始治疗方法。文献检索基于已发表的系统评价和Meta分析。根据纳入和排除标准,提取重要数据。使用11项多系统评价评估(AMSTAR)严格进行质量评估,并通过推荐分级、评估、制定和评价(GRADE)对文献证据质量的主要结局指标进行评估。纳入了2009年至2016年期间发表的16项相关系统评价和Meta分析(6篇中文文献和10篇英文文献);AMSTAR评分为4至9分,14项研究为中等质量,2项为高质量。然而,临床证据存在争议,对于鼓室内注射类固醇治疗突发性感音神经性听力损失的疗效尚无共识。作为初始治疗,没有足够的高质量证据推荐鼓室内注射类固醇治疗。需要进一步采用严格科学方法进行系统评价。