학술논문

Intratympanic Treatment in Menièreʼs Disease, Efficacy of Aminoglycosides Versus Corticosteroids in Comparison Studies: A Systematic Review
Document Type
Academic Journal
Source
Otology & Neurotology. Nov 27, 2019
Subject
Language
English
ISSN
1531-7129
Abstract
OBJECTIVE:: To compare the functional outcomes and complications of intratympanic gentamicin (ITG) versus intratympanic corticosteroids (ITC) in Menièreʼs disease. DATA SOURCES:: An electronic search was conducted in the Cochrane Library, PubMed, and Embase databases on February 3, 2019. Articles written in English, Dutch, German, French, or Turkish language were included. STUDY SELECTION:: Study inclusion criteria were: 1) patients diagnosed with definite Menièreʼs disease according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery, 2) treated with ITG or ITC in a comparison study, and 3) reported subjective and objective outcomes concerning Menièreʼs disease. DATA EXTRACTION:: The quality of eligible studies was assessed according to an adjusted version of the Cochrane Risk of Bias tool. The extracted data were study characteristics (study design, publication year, and number of relevant patients), patientʼs characteristics (sex and age), disease characteristics (uni or bilateral and duration of Menièreʼs disease), treatment protocol, and different therapeutic outcomes (vertigo, tinnitus, aural fullness, and hearing loss). DATA SYNTHESIS:: A total of eight articles were included for data extraction and analysis. For subjective outcomes, ITG was slightly favored compared to intratympanic corticosteroids. This was significant only in three studies (p < 0.05). For objective outcomes and complications, no significant differences were seen. CONCLUSIONS:: The result of this systematic review shows some benefit of ITG over ITC for subjective outcomes and no difference regarding objective outcomes or complication rate. However, this superiority of ITG is rather weak. Both interventions can be effectively and safely used in controlling Menièreʼs disease in acute situations.