Treatment of sudden sensorineural hearing loss II. A meta-analysis

Objective: To pool and meta-analyze the results of all randomized controlled trials (RCTs) on treatment of sudden sensorineural hearing loss (SSHL). Data Sources: A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). Study Selection: Prospective RCTs on the treatment of patients diagnosed as having sudden sensorineural hearing loss. Data Extraction: A meta-analysis using the random effects model was conducted when data existed for 2 or more studies. Odds ratios (ORs), 95% confidence intervals (CIs), and tests for heterogeneity were reported. Data Synthesis: Twenty RCTs were identified, of which 5 met inclusion criteria for meta-analysis. Pooling of data from 2 RCTs that compared steroids with placebo showed no difference between treatment groups (OR, 2.47; 95% CI, 0.89-6.84; P=.08). No difference existed between patients treated with antiviral plus steroid therapy vs placebo plus steroid therapy (OR, 0.92; 95% CI, 0.29-2.92: P=.88). Finally, there was no difference between subjects treated with steroids vs subjects treated with any other active treatment (OR, 1.27; 95% CI, 0.64-2.55; P=.50). Conclusions: Despite the traditional practice in North America of treating of SSHL with systemic steroids, a metaanalysis revealed no evidence of benefit of steroids over placebo. There was also no difference in the addition of antiviral therapy to systemic steroids, nor was there difference between systemic steroids and other active treatment.