[Intratympanic versus systemic steroid treatment for idiopathic sudden hearing loss: a meta-analysis].

OBJECTIVE: To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss. METHODS: An extensive search of the literature was performed in Pubmed and other available database from January, 1980 to November, 2011. After filtering by the criteria of Cochrane Collaboration, a meta-analysis was conducted. RESULTS: Nine studies met the criteria for meta-analysis, for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy, the improvement rate (RR = 1.11,95% CI = 0.96-1.28, P = 0.15) did not show any significance when compared with the patients received systemic therapy. While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR = 1.24, 95% CI = 1.02-1.50, P = 0.03). CONCLUSION: For the initial therapy of idiopathic sudden hearing loss patients without diabetes, systemic steroid treatment still remains the first choice, but for the idiopathic sudden hearing loss patients with diabetes, intratympanic steroid treatment should be used for the initial treatment.