Meta‐analysis for the effect of medical therapy vs. Placebo on recovery of idiopathic sudden hearing loss

Labus, Jakob; Breil, Judith; Stützer, H.; Michel, Olaf

doi:10.1002/lary.21011

Cited by 67 publications

(48 citation statements)

References 21 publications

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“…6 A recent meta-analysis of various medical treatments, including corticosteroids, showed a slight but not statistically significant improvement with medical therapy compared with placebo. 129 …”

Section: Systematic Reviews Of Randomized Controlled Trialsmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

772

361

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Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL.Purpose. The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients.Results. The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals,...

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Section: Systematic Reviews Of Randomized Controlled Trialsmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

772

361

View full text Add to dashboard Cite

show abstract

“…Comparing the total effective rate between the two groups, a significant difference was concluded (v 2 = 6.07, P \ 0.05) In routine practice, the medicine for idiopathic hearing loss is emergent within 1 month [8,10,11], and the lost hearing is hard to recovery after 3 months from onset of ISSNHL. In the current study, we observed the therapeutic effect on ISSNHL patients with duration of onset more than 3 months and comparison of efficacy of oral and intravenous medicine.…”

Section: Discussionmentioning

confidence: 93%

“…Possible causes include infections (especially viruses), autoimmune disease, circulatory problems, and neurological disease, including multiple sclerosis. As a result of the high rate of spontaneous resolution [7,8], multiple potential causes, absence of validated tests for etiological identification, differences in patient demographics, and the existence of multiple factors involved in its genesis, [9] the evaluation of treatment effectiveness is difficult. There was no significant difference in baseline characteristics between the oral and intravenous administration group …”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect on Idiopathic Sudden Sensorineural Hearing Loss with Duration of Onset More Than 3 Months

Wang

Han

Fan

et al. 2012

Indian J Otolaryngol Head Neck Surg

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The purpose of this study was to evaluate the therapeutic efficacy and stability upon idiopathic sudden sensorineural hearing loss (ISSNHL) patients with duration of onset more than 3 months. Twenty-eight patients diagnosed as ISSNHL were treated by intravenous injection and another 26 by oral medication. Pure tone tests were undertaken at pre-therapy, the 3rd, 7th, 10th, 14th day of post-treatment, and 1 and 2 months of follow-up respectively. A total of 54 ISSNHL patients with duration of onset ranged from 3 months to 19 years were concerned. In the group administrated by intravenous injection, the total effective rate was 64.29 % including 2 cases total recovery, 3 excellent and 13 partial recovery. In the oral administration group, there was no recovery or excellence case, and 8 (30.77 %) showed partial recovery. There was significant difference between the two groups in total effective rates (P \ 0.05). The treatment efficacy were stable in both two groups, and the difference in stability was no statistical significance (P = 0.397). There was therapeutic value for ISSNHL duration of onset more than 3 months, especially for patients with mild and moderate hearing loss. The administration by intravenous injection should be the optimization.

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“…The success rate of this treatment strategy is reported to be between 50 and 80% [7,13,14]. However, recent systematic reviews of randomized controlled trials determined that the use of corticosteroids in SSNHL treatment is an issue of some controversy; i.e., these findings are based on conflicting results from multiple studies [1,9,[15][16][17], and other treatment options have not been validated by sufficiently rigorous randomized trials [1].…”

Section: Treatment Modalities For Idiopathic Ssnhlmentioning

confidence: 99%

Neuroplasticity-targeted Intervention for Idiopathic Sudden Sensorineural Hearing Loss: A New Therapeutic Direction

2017

NNR

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Meta‐analysis for the effect of medical therapy vs. Placebo on recovery of idiopathic sudden hearing loss

Cited by 67 publications

References 21 publications

Clinical Practice Guideline

Clinical Practice Guideline

Therapeutic Effect on Idiopathic Sudden Sensorineural Hearing Loss with Duration of Onset More Than 3 Months

Neuroplasticity-targeted Intervention for Idiopathic Sudden Sensorineural Hearing Loss: A New Therapeutic Direction

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