Moreno-Herraiz Nerea, Saz-Lara Alicia, Cavero-Redondo Iván, Lever-Megina Carla Geovanna, Martínez-Cifuentes Óscar, Otero-Luis Iris
CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain.
CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain.
Clin Ther. 2025 Apr;47(4):307-315. doi: 10.1016/j.clinthera.2024.12.016. Epub 2025 Jan 24.
Sudden sensorineural hearing loss (SSHL) is an abrupt hearing loss, often of unknown cause. Apheresis is a treatment option aimed at improving blood hemorheology by removing pathogenic blood components. There are currently no previous meta-analyses on its efficacy. Therefore, the aim of this study was to evaluate the efficacy of apheresis in achieving total, complete, and partial remission of SSHL, as well as remission outcomes based on the type of apheresis used.
A systematic search was performed in PubMed, Scopus, Web of Science, and the Cochrane Library until March 2024. Random-effects models were used to calculate pooled estimates of treatment success rates (TSR) and their respective 95% CI to analyze the efficacy of apheresis in the remission of SSHL. Subgroup analyses were performed by type of apheresis (HELP-apheresis and rheopheresis).
The systematic review included 12 studies (10 in the meta-analysis) involving 786 adults with SSHL. The effect of apheresis showed significant total remission (TSR: 0.55; 95% CI: 0.47, 0.64), complete remission (TSR: 0.21; 95% CI: 0.11, 0.30), and partial remission (TSR: 0.43; 95% CI: 0.37, 0.48). Subgroup analysis revealed significant remission rates for HELP-apheresis (TSR: 0.58; 95% CI: 0.52, 0.64) and rheopheresis (TSR: 0.51; 95% CI: 0.30, 0.72).
These findings support apheresis as an equally or more effective treatment for SSHL, particularly in cases where corticosteroid therapy fails. However, due to the unknown etiology of SSHL, further clinical trials with larger, diverse populations are essential to confirm these results.
突发性感音神经性听力损失（SSHL）是一种突发性听力损失，通常病因不明。血液成分分离术是一种旨在通过去除致病性血液成分来改善血液流变学的治疗选择。目前尚无关于其疗效的荟萃分析。因此，本研究的目的是评估血液成分分离术在实现SSHL完全缓解、彻底缓解和部分缓解方面的疗效，以及基于所用血液成分分离术类型的缓解结果。
截至2024年3月，在PubMed、Scopus、科学网和考克兰图书馆进行了系统检索。采用随机效应模型计算治疗成功率（TSR）的合并估计值及其各自的95%置信区间，以分析血液成分分离术在SSHL缓解中的疗效。按血液成分分离术类型（HELP-血液成分分离术和血液稀释疗法）进行亚组分析。
系统评价纳入了12项研究（荟萃分析中10项），涉及786例成年SSHL患者。血液成分分离术的效果显示出显著的完全缓解（TSR：0.55；95%置信区间：0.47，0.64）、彻底缓解（TSR：0.21；95%置信区间：0.11，0.30）和部分缓解（TSR：0.43；95%置信区间：0.37，0.48）。亚组分析显示HELP-血液成分分离术（TSR：0.58；95%置信区间：0.52，0.64）和血液稀释疗法（TSR：0.51；95%置信区间：0.30，0.72）的缓解率显著。
这些发现支持血液成分分离术作为SSHL同等有效或更有效的治疗方法，特别是在皮质类固醇治疗失败的情况下。然而，由于SSHL的病因不明，进一步开展更大规模、多样化人群的临床试验对于证实这些结果至关重要。
