Steroids for treatment of sudden sensorineural hearing loss: a meta-analysis of randomized controlled trials

To systematically review the available evidence regarding steroid treatment for sudden sensorineural hearing loss (SSHL) and to update prior analyses when possible.

OVID Medline.

An electronic database search (OVID Medline) was performed with the objective of identifying all randomized controlled trials examining the use of steroids for the treatment of SSHL. The search was limited to English-language publications between January 1980 and June 2013. Reference lists were examined for additional articles.

A total of 15 articles including 1,166 subjects were included in three separate analyses. Three articles (181 subjects) were included in the steroid versus placebo analysis, which resulted in an odds ratio of 1.52 (95% confidence interval [CI]: 0.83-2.77). Six articles (702 subjects) were included in the systemic versus intratympanic steroids analysis, which resulted in an odds ratio of 1.14 (95% CI: 0.82-1.59). Six articles (283 subjects) were included in the salvage treatment analysis, which resulted in an odds ratio of 6.04 (95% CI: 3.26-11.2).

A meta-analysis of randomized controlled trials does not support the use of steroids over placebo in this condition, a finding consistent with previous analyses. Although systemic or intratympanic steroid administration does not have a significant treatment effect, steroids for salvage treatment of patients failing traditional therapy appear to have an effect. However, this result should be interpreted with caution given the poor quality of component trials. Implications for clinical practice and future trial design are discussed.