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.
Keywords: Vestibular neuritis, Steroids, Meta-analysis,
Recovery of function, Caloric tests