Efficacy of Apheresis in the Remission of Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.

PURPOSE

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.

METHODS

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).

FINDINGS

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).

IMPLICATIONS

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.