Intratympanic steroid intervention as initial therapy for sudden sensorineural hearing loss: a systematic review of reviews
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摘要: 目的：对鼓室内激素初始治疗突发性聋的Meta分析或系统评价进行再评价研究。方法：计算机检索国内外相关数据库，收集鼓室内激素初始治疗突发性聋的Meta分析或系统评价，按照纳入、排除标准筛选文献，提取出重要数据。采用AMSTAR法对其进行方法学质量评价，应用GRADE评估工具对文献的主要结局指标进行证据质量分级。结果：共纳入16个相关的系统评价或Meta分析，其中中文6篇、英文10篇，文献发表时间2009-2016年；AMSTAR评分为4~9分，14个研究为中等质量，2个研究为高质量。鼓室内激素初始治疗突发性聋的疗效不肯定。主要为两种结论：一是认为其疗效与全身激素治疗相当；二是认为鼓室内激素初始治疗突发性聋的疗效优于全身应用，部分学者推荐作为一线治疗。结论：当前鼓室内激素初始治疗突发性聋的系统评价的方法学质量水平多处于中等，结论的证据水平不高，对患者其他重要的结局指标的关注度不足。因此，更多的高质量的研究是我们的目标。Abstract: Objective: The aim of this overview is to evaluate the relevant systematic reviews and Meta-analyses that focus on intratympanic steroid intervention as initial therapy for sudden sensorineural hearing loss.Method: The literature search was based on the published systematic reviews and Meta-analyses.According to the include and exclude critera,the important data was extracted.Quality assessment was rigorously performed using the 11-item Assessment of Multiple Systematic Reviews(AMSTAR) and main outcome indicators of literature evidence quality were evaluated by Grading of Recommendations,Assessment,Development and Evaluation(GRADE).Result: Sixteen related systemic reviews and Meta-analyses(6 Chinese literatures and 10 English literatures) published during 2009-2016 were included;AMSTAR score was 4 to 9 points,14 studies was medium quality and 2 was high quality.However,the clinical evidence was controversial and there is no consensus regarding the efficacy of intratympanic steroid therapy for sudden sensorineural hearing loss.Conclusion: As an initial treatment, there is no sufficient high-quality evidence to recommend the ITS therapy.There is a need for further systematic reviews that adhere to strict scientific methods.
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Key words:
- hearing loss, sudden /
- tympanum /
- hormones /
- initial treatment /
- Meta-analysis
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