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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neuro-Otology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1471010

Comparative Efficacy of Intratympanic Gentamicin and Intratympanic Corticosteroid in the Treatment of Meniere's Disease: A Systematic Review and Meta-Analysis

Provisionally accepted
Xuanmei Wu Xuanmei Wu 1Jiacheng Shui Jiacheng Shui 2Chengyuan Liu Chengyuan Liu 2Xinyue Wu Xinyue Wu 1Ying Yu Ying Yu 1Hanyu Wang Hanyu Wang 1Yan Cong Yan Cong 1*
  • 1 Beijing University of Chinese Medicine, Beijing, China
  • 2 China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Purpose: We aimed to evaluate the efficacy of gentamicin compared to corticosteroids for the treatment of Meniere's disease. Methods: An extensive search was conducted in PubMed, Embase, and Web of Science until May 2024. For continuous outcomes, pooled effect estimates were determined by calculating the weighted mean difference (WMD), while for binary outcomes, the risk ratio (RR) was used, each accompanied by their respective 95% confidence intervals (CIs). Heterogeneity among the studies was assessed using Cochran’s I2 and Q statistics. Results: A total of 12 studies were selected, involving 694 patients. Our analysis found that the gentamicin group demonstrates superior vertigo control rates compared to the corticosteroid group (RR: 1.36, 95% CI: 1.13 to 1.65, P<0.001). In subgroup analysis, the gentamicin group showed a higher vertigo control rates at 6 months compared to the corticosteroid group (RR: 1.69, 95% CI: 1.28 to 2.24, P<0.001); however, there was no statistically significant difference between the two groups at 12 months (RR: 1.48, 95% CI: 0.88 to 2.49, P=0.14). Regarding changes in pure tone average, the corticosteroid group was superior to the gentamicin group(WMD: 4.41, 95% CI: 3.31 to 5.52, P<0.001). Conclusions: Our study suggests that the intratympanic gentamicin group achieves higher vertigo control rates, whereas the corticosteroid group demonstrates better improvement in pure tone averages. However, the high heterogeneity in vertigo control rates warrants caution. Larger sample-sized randomized controlled trials are needed to further validate these findings.

    Keywords: Intratympanic gentamicin, Intratympanic corticosteroid, Meniere's disease, metaanalysis, Systematic review, efficacy

    Received: 26 Jul 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Wu, Shui, Liu, Wu, Yu, Wang and Cong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yan Cong, Beijing University of Chinese Medicine, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.