Systematic Review Of Vasodilators For Sudden Sensorineural Hearing Loss

Objective To evalute the efficacy and safety of vasodilators for sudden sensorineural hearing loss.Methods Based on the principles of EBM,using the methods of systematic reviews,we searched the Cochrane Central Register of Controlled Trials (issue, 3,2009),PubMed(1966 to 2009),EMbase(1974-2009),ISI Proceedings(1997-2009),the China Biological Medicine Datebase,VIP,CNKI,WangFang databases and academics search of Google from establishment to Sep in 2009.Reviewers screeched the studies for eligibility,evaluated the quality and did data extraction.Forms were used to show the characteristics of the studies.Jadad scale and degree of randomization allocation concealment were used to assess the methodological quality of studies ,such as randomization,blind,allocation concealment and following-up.Meta-analysis was performed for the results of homogeneous studies using RevMan 4.2.10 software.If Meta-analysis can't be done,qualitative descriptions were made.For continuous data,we compare outcome measures using the weighted means difference(WMD) or standard mean deviation(SMD) with 95% confidence intervals(CI).For binary data,the relative risks(RR) or odds ratio(OR) was used.After heterogeneity test,date without heterogeneity could be using fixed effect model.Those with heterogeneity could be using randomized effect model.Results Twenty eight randomized control trials met the inclusion criteria.There are many vasodilators in included studies,such as Low-molecular-weight Dextran, Hydroxyethyl-Starch,Prostacyclin,Pentoxifyline,Naftidrofuryl,Danshen,Puerarin,and Ginaton.In this systematic review, 7 studies showed vasodilators was not more effective than placebo.From 14 studies comparing vasodilators with vasodilators, The effect of Puerarin comparing to other vasodilators has statistical significance.The Ginaton was not more effective than other vasodilators .The Low-molecular-weight Dextran plus Danshen was not superior to that of other vasodilators;Both the Short-term efficacy and long-term efficacy of Low-molecular-weight Dextran are not better than Hydroxyethyl Starch;The Naftidrofuryl was not better than other vasodilators. From 9 studies comparing vasodilators with other drugs,Danshen was not better than other therapies; Vasodilators was not better than steroids.There are 8 studies described the side effects,e.g. pruritus, allergic response, high blood, arhythmia,and headache.Conclusion The evidence currently available does not support the use of vasodilators in the treatment of sudden sensorineural hearing loss.It is too week to recommend which vasodilator is better due to low methodological quality,small sample size,and limited number of studies. Expect that there are more multicentre,large sample,and follow-up randomized comtrolled trials in further to provide more reliable evidence of vasodiliators in the treatment of sudden sensorineural hearing loss...