Our meta-analysis results indicated that SLIT provided significant symptom relief and reduced the need for medication in pediatric patients. Moreover, the safety of SLIT needs to be confirmed in RCTs with larger samples.

Objectives: In recent decades, intratympanic gentamicin (ITG) has increasingly been used to treat intractable Menière's disease (MD). We performed a meta-analysis of pooled clinical outcomes, exploring whether ITG was effective and safe. Data Sources: Cochrane Library database, Embase, and Medline. Study Selection: We searched scientific and medical databases to March 2018 for articles evaluating clinical outcomes after ITG treatment of intractable MD according to the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) guidelines. Data Extraction: We performed a meta-analysis to evaluate treatment efficacy and safety. Quantitative and descriptive information of included RCTs was obtained. Data Synthesis: We ultimately evaluated 49 of the initially retrieved 1,062 citations (the 49 articles included data from a total of 2,344 MD patients). In almost all studies, patients served as their own controls; “before-and-after” clinical outcomes were reported. The I 2 metric was used to explore heterogeneity. Conclusion: Overall, our results seem to provide the limited evidence about efficacy and toxicity effects of ITG. However, clinical outcomes require further confirmation; many included studies were poorly designed, less than 2 years for reporting results in MD are in the majority of patients. More long-term prospective follow-up, high-quality, large-scale, randomized controlled trials are needed to confirm that ITG is safe and effective when used to treat intractable MD.

Background: Although most of the foreign body, such as a fish bone can be inadvertently dislodged, severious complications range from mild inflammatory changes to abscess formation and viscus perforation can occurs for the delayed visiting time and unaware of the ingestion history. In such cases, surgery treatment is inevitable.Case Presentation: A 55-year-old male presented with pain on swallowing after accidental fish bone ingestion 3 days before. We first attempted to remove the fish bone under flexible endoscopy but failed because nothing was detected except significant soft tissue edema on the left lateral laryngopharynx. After conducting contrast-enhanced computed tomography, a 19.5-mm-long linear hyperdensity lying in the left lateral laryngopharyngeal space encircled by a low-density area with fluid was demonstrated, suggestive of ingested fish bone with infection and mild abscess. Operation was our preferred treatment as the infection improved. CT was conducted agained to clarify the acurate spot of the fish bone right before the operation after 5 days of antibiotherapy, and we detected completely free of fish bone in original position. The patient recovered without complications and was discharged on the 7 th day. Conclusion:Early medication treatment including antibiotics for the infection caused by fish bone ingestion can help with the fish bone dislodgement.