Dexamethasone eardrop with grommet placement vs intratympanic steroid injection for sudden sensorineural hearing loss: A randomized prospective clinical trial

Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

“…We assumed that there was a similar protocol in the rest of the studies, unless otherwise reported. In another two articles on trans‐TyT groups, Kosyakov et al and Chang et al 14,46 reported a total of 51 ears in which the intubation time of TyT in the TM was significantly higher than in the other articles (180 and 402 days, respectively). In the latter, the TyT even remained in place until spontaneous extrusion or at the request of the patient.…”

“…Another 9 papers on trans-TyT delivered steroids and 12 papers on transtympanic delivered steroids were not included because they did not contain descriptions of the main outcome measure or detailed treatment description, respectively. Two articles 13,14 with two cohorts were identified using the trans-TyT searching methods, and were included in the systematic review. All of these refinements of the search analysis yielded 11 studies on trans-TyT delivered steroids (302 ears) and 9 studies on transtympanic delivered steroids (516 ears) for final analysis (Figure 1).…”

Letter to the Editor Regarding “Tympanic Membrane Perforation After Intratympanic Steroid Injection: A Systematic Review and Meta‐analysis” by Kim et al

“…This 16-month difference resulted in the noninclusion of 2 articles for a total of 139 ears, which are equivalent to 35% and 46% of the total number of ears included for the pooled analyses, respectively. 3,4…”

“…Differences in search strategy might lead to differences in the selection of articles suitable for inclusion for pooled analysis, demonstrating the impact of the data search strategy on final drawn conclusions. Searching period: Their meta‐analysis searched for articles up to July 2019 while our search included those published up to November 2020. This 16‐month difference resulted in the noninclusion of 2 articles for a total of 139 ears, which are equivalent to 35% and 46% of the total number of ears included for the pooled analyses, respectively 3,4 Inclusion by outcome: It is critical to realize that only articles stating that “no IRTMP was documented at the end of follow‐up period” are eligible for inclusion for the pooled analysis. Definition of perforation: A post‐ITAoS tympanic membrane perforation (TMP) can still heal spontaneously, unless there is a chronic persistent TMP with a “contact inhibition zone.” 5 A persistent perforation, therefore, should be diagnosed as such only at the end of the follow‐up period.…”

“…This 16-month difference resulted in the noninclusion of 2 articles for a total of 139 ears, which are equivalent to 35% and 46% of the total number of ears included for the pooled analyses, respectively. 3,4 Inclusion by outcome: It is critical to realize that only articles stating that ''no IRTMP was documented at the end of follow-up period'' are eligible for inclusion for the pooled analysis. Definition of perforation: A post-ITAoS tympanic membrane perforation (TMP) can still heal spontaneously, unless there is a chronic persistent TMP with a ''contact inhibition zone.''…”