title: Combined intratympanic and systemic use of steroids for idiopathic sudden sensorineural hearing loss: a meta-analysis.
abstract: The main objective of the meta-analysis was to investigate whether intratympanic steroid injections in combination with systemic steroids would provide an additional advantage over systemic steroid therapy (SST) alone in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The results will provide a meaningful suggestion in clinical therapy of ISSNHL. The electronic database search was based on the database in OVID Medline, Embase and PubMed up to December 15, 2015 with the goal of identifying all available observational studies examining the effects of combination therapy and SST in ISSNHL patients. Observational studies that compared the pure tone average (PTA) improvement and recovery rate between combination therapy and SST group in ISSNHL patients were selected. Finally we have identified eight eligible studies that focused on comparing the combination therapy and SST in ISSNHL from designated researches. In the PTA improvement group, seven studies have been analyzed to compare the pooled mean differences between two therapy modalities and subgroups based on initial hearing loss and treatment delay. In the recovery rate group, six studies were calculated for pooled risk ratios and subgroup analysis was also conducted. Through our meta-analysis, we have reached the conclusion that combination therapy exhibited better outcomes in PTA improvement than SST alone, especially in severe-profound initial hearing loss cases. Combination therapy also showed advantages in recovery rate. Whether time of treatment delay would influence the PTA improvement and recovery rate requires further researches.
authors.affiliation: Department of Biochemistry, Memorial University of Newfoundland, 230 Elizabeth Ave, St. John's, NF, A1B 3X9, Canada.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Princess Margaret Cancer Center, Techna Institute, University Health Network, 101 College Street, Toronto, ON, M5G 1L7, Canada. cyyzld@gmail.com.|Department of Otorhinolaryngology, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, 250012, China. cyyzld@gmail.com.|Key Laboratory of Otolaryngology, Ministry of Health, 44 West Wenhua Road, Jinan, 250012, China. cyyzld@gmail.com.
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D000069555:Injection, Intratympanic; D015233:Models, Statistical; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids
keywords: Combination therapy; Idiopathic sudden sensorineural hearing loss; Intratympanic steroid; Systemic steroid