Postauricular and Intratympanic Glucocorticoid Injection for Sudden Deafness:A Meta-analysis

XIONG Jian; WU Lixiang; ZENG Suyi; LIN Wei; DOU Yanling; FANG Li; ZHANG Jie

doi:10.3969/j.issn.1672-2922.2024.05.020

Abstract：Objective To compare efficacy and safety of postauricular and tympanic glucocorticoid injection in the treatment of sudden deafness.Methods Randomized controlled studies on treatment of sudden deafness involving postauricular or intratympanic glucocorticoid injection published at home and abroad up to September 2022 were retrieved from the CNKI,Wanfang,VIP,Pubmed,Cochrane and EMBASE databases for a meta-analysis.Results A total of 1,723 articles were retrieved and 33 eligible articles,including one published in English,were included in the meta-analysis.The rate of total effectiveness showed no significant difference between postauricular and the intratympanic injections(RR=1.02,95％CI:0.98-1.07,Z=1.20,P=0.23),although the rate of recovery in postauricular injection was higher than in intratympanic injection(RR=1.14,95％CI:1.00-1.29,Z=2.03,P=0.04).Postauricular and the intratympanic injections showed no significant difference regarding rates of total effectiveness in patients with diabetes(RR=1.08,95％CI:0.99-1.17,Z=1.71,P=0.09).For patients with refractory sudden deafness,intratympanic injection showed higher rates of effectiveness than postauricular injection(RR=0.88,95％CI:0.80-0.97,Z=2.56,P=0.01).There was no significant difference in tinnitus improvement between the two approaches(RR=1.11,95％CI:0.95-1.30,Z=1.33,P=0.18).In terms of safety,postauricular injection performed better than intratympanic injection(RR=0.33,95％CI:0.25-0.44,Z=7.57,P＜0.01).Conclusion Postauricular glucocorticoid injection can achieve similar or better therapeutic efficacy than intratympanic injection with better safety.