Combination Therapy and Single-Modality Treatment for Acute Low-Tone Hearing Loss: A Meta-Analysis with Trial...

Area of Science:

• Otolaryngology
• Clinical Medicine
• Pharmacology

Background:

• Acute low-tone hearing loss (ALHL) is a common sensorineural hearing impairment affecting low frequencies.
• Optimal initial medication strategies for ALHL remain debated, with potential benefits of combination therapy yet to be established.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of combined steroid and diuretic therapy versus single-modality treatments for ALHL.
• To conduct a trial sequential analysis (TSA) to confirm the statistical significance of treatment outcomes.

Main Methods:

• A systematic review and meta-analysis of studies published up to December 31, 2021, from major databases (PubMed, Cochrane Library, Embase, Scopus, Web of Science).
• Inclusion criteria focused on patients diagnosed with ALHL.
• Five studies comprising 433 patients were analyzed, including comparisons of combination therapy with steroid-only and diuretic-only treatments.

Main Results:

• Combination therapy showed no statistically significant benefit compared to steroid monotherapy (OR, 1.15; 95% CI, 0.51 to 2.59; p = 0.74).
• Combination therapy also did not demonstrate significant advantages over diuretic monotherapy (OR, 1.73; 95% CI, 0.93 to 3.23; p = 0.09).
• Trial sequential analysis confirmed conclusive nonsignificant results for combination therapy.

Conclusions:

• Combined steroid and diuretic treatment for ALHL does not offer significant benefits over single-drug approaches.
• Initiating ALHL treatment with either steroids or diuretics alone is suggested to avoid unnecessary risks and potential adverse effects.