Franz Leonardo, Gallo Chiara, Marioni Gino, de Filippis Cosimo, Lovato Andrea
Department of Neuroscience, Otolaryngology Section, University of Padova, Padova, Italy.
Department of Neuroscience, Audiology Section, University of Padova, Treviso, Italy.
Otolaryngol Head Neck Surg. 2021 Aug;165(2):244-254. doi: 10.1177/0194599820976571. Epub 2020 Nov 24.
Idiopathic sudden sensorineural hearing loss (ISSNHL) is uncommon in children, and its treatment and outcome are debated. We aimed to critically review evidence in the literature about treatment options and functional outcomes of pediatric ISSNHL. Additionally, we performed a meta-analysis of the results of combined systemic-intratympanic steroid therapy versus solely systemic treatment.
A search was run in the PubMed, Scopus, and Google Scholar databases.
Included articles were original ISSNHL case series, written in English, with a population age ranging from 2 to 19 years. Other study types (single case reports, editorials, and reviews) and case series with known etiology of sudden hearing loss were excluded. Descriptive data of patients, treatments, outcomes, and possible prognostic factors were extracted and recorded for every included study.
Twelve articles (7 cohort and 5 case-control studies) met all the selection criteria. Based on only the studies that provided sufficient data about clinical outcome, the pooled overall recovery rate was 67.91% (95% CI, 58.34%-77.48%). No studies showed a significant difference between systemic steroid and combined systemic-intratympanic steroid. The pooled odds ratio for combined systemic-intratympanic steroid versus systemic steroid alone was 0.90 (95% CI, 0.36-2.27) based on a random effects model, ruling out any significant difference between these treatment options.
The results of our meta-analysis did not support combination therapy more than systemic steroid alone. Further prospective clinical trials are necessary to establish evidence-based therapies.
特发性突发性感音神经性听力损失（ISSNHL）在儿童中并不常见，其治疗方法和治疗效果仍存在争议。我们旨在严格审查文献中有关小儿ISSNHL治疗方案和功能预后的证据。此外，我们对全身联合鼓室内注射类固醇疗法与单纯全身治疗的结果进行了荟萃分析。
在PubMed、Scopus和谷歌学术数据库中进行了检索。
纳入的文章为英文撰写的原发性ISSNHL病例系列，研究对象年龄范围为2至19岁。排除其他研究类型（单例报告、社论和综述）以及已知突发性听力损失病因的病例系列。对每项纳入研究的患者描述性数据、治疗方法、治疗效果及可能的预后因素进行提取和记录。
12篇文章（7项队列研究和5项病例对照研究）符合所有入选标准。仅基于提供了足够临床结果数据的研究，汇总的总体恢复率为67.91%（95%CI，58.34%-77.48%）。没有研究显示全身类固醇治疗与全身联合鼓室内注射类固醇治疗之间存在显著差异。基于随机效应模型，全身联合鼓室内注射类固醇与单纯全身类固醇治疗的汇总比值比为0.90（95%CI，0.36-2.27），排除了这些治疗方案之间的任何显著差异。
我们的荟萃分析结果并不支持联合治疗比单纯全身类固醇治疗更具优势。需要进一步开展前瞻性临床试验以确立循证治疗方法。
