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Intratympanic steroid injection versus hyperbaric oxygen therapy in refractory sudden sensorineural hearing loss: a meta-analysis

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

The present meta-analysis aims to compare the efficacy of intratympanic steroid (ITS) injection and hyperbaric oxygen (HBO) therapy as salvage treatments for refractory sudden sensorineural hearing loss (SSNHL).

Data sources

Comprehensive searches were performed in PubMed, EMBASE and the Cochrane Library from the date of the database inception to June 2020. All studies reporting the use of salvage ITS and HBO treatments in refractory SSNHL patients were included. Subsequently, the full texts of the eligible studies were evaluated.

Methods

The quality and bias of the studies were assessed using the Newcastle–Ottawa Scale and Cochrane’s risk of bias tools for nonrandomized and randomized studies, respectively. The data were analyzed using Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood, NJ).

Results

Three hundred and fourteen subjects in 3 observational studies and 1 randomized controlled trial met our inclusion criteria. The pooled results demonstrated that there were no significant differences in the mean posttreatment hearing gain between the ITS and HBO groups. The changes in word discrimination and hearing gain at 250, 500, 1000, 2000, 4000 and 8000 Hz were also comparable between the two salvage treatment groups.

Conclusions

The pooled results demonstrated that there were no significant differences in hearing improvements between salvage ITS injection and salvage HBO therapy after failed primary systemic steroid treatment in patients with SSNHL. However, spontaneous recovery could bias the treatment outcomes, and these results should be interpreted with caution. Clinicians may choose these salvage treatments according to personal experience and treatment availability. In cases in which specialized HBO facilities are difficult to access, salvage ITS injection can be provided with comparable responses.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Tz-Ching Kuo

  2. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan

    Wei-Chieh Chao & Yi-Chan Lee

  3. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Chao-Hui Yang

  4. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ming-Shao Tsai & Yao-Te Tsai

  5. College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Wei-Chieh Chao, Chao-Hui Yang, Ming-Shao Tsai & Yi-Chan Lee

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  2. Wei-Chieh Chao
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  3. Chao-Hui Yang
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  4. Ming-Shao Tsai
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Contributions

T-CK: conduct and analysis. W-CC: design and interpretation of data. C-HY: interpretation of data. M-ST: interpretation of data. Y-TT: interpretation of data. Y-CL: design, analysis and interpretation of data.

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Correspondence to Yi-Chan Lee.

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Kuo, TC., Chao, WC., Yang, CH. et al. Intratympanic steroid injection versus hyperbaric oxygen therapy in refractory sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 279, 83–90 (2022). https://doi.org/10.1007/s00405-021-06616-9

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  • DOI: https://doi.org/10.1007/s00405-021-06616-9

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