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dc.contributor.authorLai, Dan
dc.contributor.authorZhao, Fei
dc.contributor.authorJalal, Nasim
dc.contributor.authorZheng, Yun
dc.date.accessioned2017-12-14T13:38:23Z
dc.date.available2017-12-14T13:38:23Z
dc.date.issued2017-12-01
dc.identifier.citationLai, D., Zhao, F., Jalal, N. and Zheng, Y. (2017) Intratympanic glucocorticosteroid therapy for idiopathic sudden hearing loss: Meta-analysis of randomized controlled trials. Medicine, 96(50), p.e8955.en_US
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964 (ESSN)
dc.identifier.urihttp://hdl.handle.net/10369/9195
dc.descriptionThis article was published in Medicine in December 2017 available open access at http://dx.doi.org/10.1097/MD.0000000000008955en_US
dc.description.abstractBackground and objective: Glucocorticoids are the standard treatment for idiopathic sudden sensorineural hearing loss (ISSNHL), but whether intratympanic or systemic therapy is superior remains controversial. Previous meta-analyses of this question have omitted key clinical trials or included observational studies. Methods: English-language randomized controlled trials in OVIDSP, PUBMED, EMBASE, CINAHL and the Cochrane Library comparing intratympanic vs. systemic glucocorticoid therapy for ISSNHL were meta-analyzed using RevMan 5.3. The primary outcome of interest was improvement in pure tone average (PTA) threshold. Results: Six trials involving 248 patients receiving intratympanic steroids and 236 receiving systemic steroids were meta-analyzed. PTA thresholds were similar between the two groups at 3 months after therapy initiation (mean difference, 0.24; 95%CI -2.43 to 2.91, P=.86; I2= 54%, P=.07, random-effects model). PTA thresholds were also similar at 6 months (mean difference, 4.69, 95%CI -5.84 to 15.22, P =.38), although the results showed extremely high heterogeneity (I2= 98%). Sensitivity analysis indicated that a single trial containing 250 patients provided the strongest evidence for equivalence between the two types of therapy. Rates of recovery within 3 months (defined as PTA improvement >10 dB) were similar between the two types of therapy(OR 0.92, 95%CI 0.59 to 1.43, P=.70), with no significant heterogeneity in the pooled data (I2=1%, P=.40). Conclusion: Intratympanic and systemic steroids therapies appear to show similar short-term efficacy for restoring hearing in patients with ISSNHL. Intratympanic therapy may reduce systemic side effects associated with steroid use.en_US
dc.language.isoenen_US
dc.publisherLippincott, Williams and Wilkins
dc.relation.ispartofseriesMedicine;
dc.subjectIdiopathic sudden sensorineural hearing loss; intratympanic steroid treatment; initial treatment; systemic steroids; meta-analysisen_US
dc.titleIntratympanic glucocorticosteroid therapy for idiopathic sudden hearing loss: meta-analysis of randomized controlled trialsen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1097/MD.0000000000008955
dcterms.dateAccepted2017-11-09
rioxxterms.versionVoRen_US
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
dc.refexceptionOA compliant


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