title: [Intratympanic versus systemic steroid treatment for idiopathic sudden hearing loss: a meta-analysis].
abstract: OBJECTIVE
  To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss.
  
  
  METHODS
  An extensive search of the literature was performed in Pubmed and other available database from January, 1980 to November, 2011. After filtering by the criteria of Cochrane Collaboration, a meta-analysis was conducted.
  
  
  RESULTS
  Nine studies met the criteria for meta-analysis, for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy, the improvement rate (RR = 1.11,95% CI = 0.96-1.28, P = 0.15) did not show any significance when compared with the patients received systemic therapy. While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR = 1.24, 95% CI = 1.02-1.50, P = 0.03).
  
  
  CONCLUSIONS
  For the initial therapy of idiopathic sudden hearing loss patients without diabetes, systemic steroid treatment still remains the first choice, but for the idiopathic sudden hearing loss patients with diabetes, intratympanic steroid treatment should be used for the initial treatment.
authors.affiliation: Department of Otorhinolaryngology, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Xiu-yong
authors.initials: XY
authors.lastname: Ding
authors.forename: Ting-ting
authors.initials: TT
authors.lastname: Cui
authors.forename: Guo-dong
authors.initials: GD
authors.lastname: Feng
authors.forename: Zhi-qiang
authors.initials: ZQ
authors.lastname: Gao
mesh_terms: D000284:Administration, Oral; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D008775:Methylprednisolone; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014432:Tympanic Membrane
chemical_list: D013256:Steroids; D003907:Dexamethasone; D008775:Methylprednisolone