Objective: To compare the efficacy and safety of postauricular injection (PI) and intratympanic injection (II) of glucocorticoids (GC) in the initial treatment of sudden sensorineural hearing loss (SHL). Methods: Electronic databases retrieval (PubMed, Web of Science, CNKI, VIP, WANFANG) was performed to identify all randomized controlled trials about PI and II of GC in the initial treatment of SHL between 2015 and 2024. Meta-analysis was performed on the studies met the inclusion criteria by RevMan5.4. Results: A total of 971 articles were retrieved, and 23 Chinese articles were included after screening. Meta-analysis found that the total effective rate of PI was significantly higher than that of II (OR=1.37, 95%CI:1.15-1.65, P=0.000 6), with higher recovery of the hearing threshold (SMD=1.24, 95%CI:0.01-2.46, P=0.05) and a lower incidence of adverse reactions and complications (OR=0.20, 95%CI:0.15-0.28, P<0.000 01). Conclusions: Compared with II, PI has a better efficacy and safety. Nonetheless, whatever topical administration of GC that can be regarded as the first choice of initial therapeutic schedules to SHL requires further studied.
目的： 分析比较耳后注射及鼓室注射糖皮质激素初始治疗突发性聋的疗效和安全性。 方法： 检索PubMed、Web of Science、中国知网（CNKI）、维普（VIP）、万方数据（WANFANG）等数据库，收集2015—2024年间发表的有关糖皮质激素耳后注射及鼓室注射初始治疗突发性聋的随机对照研究，采用RevMan5.4对符合纳入标准的文献进行分析，探讨糖皮质激素不同局部给药方式治疗突发性聋的效果和安全性。 结果： 共检索获得文献971篇，经筛选纳入23篇中文文献。Meta分析发现耳后注射总有效率明显高于鼓室注射（OR=1.37，95%CI：1.15~1.65，P=0.000 6）；耳后注射患者听阈恢复值高于鼓室注射（SMD=1.24，95%CI：0.01~2.46，P=0.05）；鼓室注射的不良反应及并发症发生率明显高于耳后注射（OR=0.20，95%CI：0.15~0.28，P<0.000 01）。 结论： 突发性聋患者耳后注射糖皮质激素比鼓室注射糖皮质激素疗效更好、安全性更高，但仍需进一步明确何种局部给药方式可作为突发性聋的首选初始治疗方案。.