Therapeutic Effect of Steroids on Vestibular Neuritis: Systematic Review
and Meta-analysis
Abstract
Objectives: The present meta-analysis sought to assess further evidence
for the efficacy of steroids in vestibular neuritis (VN). Methods: The
PubMed, EMBASE and Cochrane Library databases were searched through
August 30, 2019. The main outcome measures were 1) complete caloric
recovery, 2) improvement of canal paresis (CP) in caloric testing, and
3) dizziness handicap inventory. The follow-up times were divided into
short, mid, and long-term. The main outcome measures were 1) complete
caloric recovery, 2) improvement of canal paresis (CP) in caloric
testing, and 3) dizziness handicap inventory. Results: Among 276 records
identified, 5 studies (n = 253) were included in the analysis. The
therapeutic effect of steroid on VN was confirmed (Hedges’g = 0.172,
95% CI 0.048 to 0.295, p = .006). This effect was statistically
significant on long-term follow-up (Hedges’g = 0.496, 95% CI 0.285 to
0.708, p < .0001). The therapeutic effect of steroids on VN
was better than that of non-steroid treatment (Hedges’g = 0.299, 95% CI
0.107 to 0.490, p = .002). However, this effect was obscured by
combination of other treatments. The therapeutic effect of steroids on
VN was statistically significant regarding complete caloric recovery and
improvement in CP (Hedges’g = 0.364, 95% CI 0.181 to 0.547, p
< 0.0001; Hedges’g = 0.592, 95% CI 0.315 to 0.5869, p
< .0001) Conclusions: The results suggest that corticosteroids
are effective at VN recovery, especially in long-term follow-up. More
data are required before recommendations can be made regarding
management in patients on corticosteroids.