Abstract | BACKGROUND: It is generally accepted that intratympanic injection provides an effective approach to manage severe vertigo in Ménière's disease. Although there are several medications available, that which is the most effective is still subject to debate. OBJECTIVE: METHODS: PubMed, EMBASE, CINAHL and CENTRAL were searched. Only randomised controlled trials that compared the effectiveness of medications used for intratympanic injection to treat Ménière's disease with each other or a placebo were included. The primary outcome assessed was the effectiveness of medication in the management of vertigo symptoms. The effectiveness was expressed in terms of risk ratio (RR) with a 95% credible interval (CrI) for individual studies analysed. Network meta-analyses were performed by Stata version 15.0 using the network package. RESULTS: Nine studies involving 314 patients treated with five different medications were included in the present analysis. A number of injections given varied from 1 to 10 and the follow-up time from 3 to 28 months. When compared to each other or to a placebo, Gentamicin was found to be the most efficacious medication, followed by Methylprednisolone, Latanoprost, Dexamethasone and Ganciclovir in order of effectiveness. However, no significant difference in efficacy was found between Gentamicin and Methylprednisolone when outcomes from studies with a follow-up time equal to or more than 24 months were analysed. It was not possible to conduct subgroup and sensitivity analysis because of the limited number of studies that were included. CONCLUSION:
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Authors | Zuwei Cao, Fengjuan Yue, Wei Huang, Deepak Rajenderkumar, Fei Zhao |
Journal | Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
(Clin Otolaryngol)
Vol. 44
Issue 4
Pg. 619-627
(07 2019)
ISSN: 1749-4486 [Electronic] England |
PMID | 31025490
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Copyright | © 2019 John Wiley & Sons Ltd. |
Chemical References |
- Gentamicins
- Latanoprost
- Dexamethasone
- Ganciclovir
- Methylprednisolone
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Topics |
- Dexamethasone
(administration & dosage)
- Ganciclovir
(administration & dosage)
- Gentamicins
(administration & dosage)
- Humans
- Injection, Intratympanic
- Latanoprost
(administration & dosage)
- Meniere Disease
(drug therapy)
- Methylprednisolone
(administration & dosage)
- Randomized Controlled Trials as Topic
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