Sialakis Christos, Iliadis Christos, Frantzana Aikaterini, Ouzounakis Petros, Kourkouta Lambrini
Department of Otolaryngology, General Hospital "Agios Dimitrios-G. Gennimatas", Thessaloniki, GRC.
Department of Nuclear Medicine, Private Diagnostic Health Center, Thessaloniki, GRC.
Cureus. 2022 Mar 6;14(3):e22887. doi: 10.7759/cureus.22887. eCollection 2022 Mar.
Idiopathic sudden sensorineural hearing loss (ISSHL) is a common condition characterized by hearing threshold reduction, most often of unknown causes. The patient experiences a sudden reduction of the hearing threshold in one or both ears. Steroids are the mainstream of the treatment. This study aims to investigate the effectiveness of intratympanic steroid administration compared with systemic administration and the combination of the two steroid treatments in the hearing recovery of patients with idiopathic sudden sensorineural hearing loss. We searched electronic databases such as PubMed, ScienceDirect, CINAHL, Cochrane (Central), Ovid, and Medline from August 31, 2021, to November 31, 2021, and from February 5 to 10, 2022. We included 12 randomized controlled trials (RCTs) and performed a meta-analysis comparing the efficiency in the hearing recovery of intratympanic versus systemic steroid treatment, systemic versus combined, and intratympanic versus combined steroid treatment. The results of the intratympanic versus systemic steroid therapy comparison showed no actual difference in efficiency and no statistical significance (odds ratio: 1.07 (Mantel-Haenszel (M-H), fixed, 95% confidence interval (CI): 0.76-1.51)). Systemic steroid treatment was inferior to combined steroid treatment and was the only outcome with statistical significance (odds ratio: 0.55 (M-H, fixed, 95% CI: 0.38-0.80)). Intratympanic steroid treatment was inferior to combined steroid treatment, although the results were not statistically significant (odds ratio: 0.65 (M-H, fixed, 95% CI: 0.37-1.16)). In conclusion, systemic steroid therapy was inferior to combined steroid therapy. The comparison of intratympanic with systemic therapy and intratympanic with combined therapy showed no statistical significance. Further research is needed with more RCTs, and side effects should be considered.
特发性突发性感音神经性听力损失（ISSHL）是一种常见病症，其特征为听力阈值降低，病因大多不明。患者会出现单耳或双耳听力阈值突然下降。类固醇是治疗的主流方法。本研究旨在探讨鼓室内注射类固醇与全身给药以及两种类固醇治疗方法联合使用相比，对特发性突发性感音神经性听力损失患者听力恢复的有效性。我们检索了电子数据库，如PubMed、ScienceDirect、CINAHL、Cochrane（Central）、Ovid和Medline，检索时间为2021年8月31日至2021年11月31日以及2022年2月5日至10日。我们纳入了12项随机对照试验（RCT），并进行了荟萃分析，比较鼓室内注射与全身类固醇治疗、全身与联合治疗以及鼓室内注射与联合类固醇治疗在听力恢复方面的效率。鼓室内注射与全身类固醇治疗比较的结果显示，效率上无实际差异且无统计学意义（优势比：1.07（曼特尔 - 亨泽尔（M - H），固定效应，95%置信区间（CI）：0.76 - 1.51））。全身类固醇治疗不如联合类固醇治疗，且是唯一具有统计学意义的结果（优势比：0.55（M - H，固定效应，95% CI：0.38 - 0.80））。鼓室内注射类固醇治疗不如联合类固醇治疗，尽管结果无统计学意义（优势比：0.65（M - H，固定效应，95% CI：0.37 - 1.16））。总之，全身类固醇治疗不如联合类固醇治疗。鼓室内注射与全身治疗以及鼓室内注射与联合治疗的比较均无统计学意义。需要更多的随机对照试验进行进一步研究，同时应考虑副作用。
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