{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:33:56Z","timestamp":1792020836420,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It is generally accepted that intratympanic injection provides an effective approach to manage severe vertigo in M\u00e9ni\u00e8re's disease. Although there are several medications available, that which is the most effective is still subject to debate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness and safety of the different medications used in the treatment of M\u00e9ni\u00e8re's disease by intratympanic injection using a network meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, EMBASE, CINAHL and CENTRAL were searched. Only randomised controlled trials that compared the effectiveness of medications used for intratympanic injection to treat M\u00e9ni\u00e8re's disease with each other or a placebo were included. The primary outcome assessed was the effectiveness of medication in the management of vertigo symptoms. The effectiveness was expressed in terms of risk ratio (RR) with a 95% credible interval (CrI) for individual studies analysed. Network meta\u2010analyses were performed by Stata version 15.0 using the network package.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies involving 314 patients treated with five different medications were included in the present analysis. A number of injections given varied from 1 to 10 and the follow\u2010up time from 3 to 28\u00a0months. When compared to each other or to a placebo, Gentamicin was found to be the most efficacious medication, followed by Methylprednisolone, Latanoprost, Dexamethasone and Ganciclovir in order of effectiveness. However, no significant difference in efficacy was found between Gentamicin and Methylprednisolone when outcomes from studies with a follow\u2010up time equal to or more than 24\u00a0months were analysed. It was not possible to conduct subgroup and sensitivity analysis because of the limited number of studies that were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>All medications are more effective than a placebo in the treatment of M\u00e9ni\u00e8re's disease by intratympanic injection. According to the SUCRA, Gentamicin ranked the most effective, with Gentamicin and Methylprednisolone equally effective in the long\u2010term effect. When the potential risk of hearing loss induced by Gentamicin is taken into consideration, Methylprednisolone may be the best choice for the treatment of M\u00e9ni\u00e8re's disease by intratympanic injection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13350","type":"journal-article","created":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T08:23:28Z","timestamp":1556267008000},"page":"619-627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Different medications for the treatment of M\u00e9ni\u00e8re's disease by intratympanic injection: A systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3082-9197","authenticated-orcid":false,"given":"Zuwei","family":"Cao","sequence":"first","affiliation":[{"name":"Center for Rehabilitative Auditory Research Guizhou Provincial People's Hospital Guiyang China"},{"name":"Centre for Speech and Language Therapy and Hearing Sciences, Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjuan","family":"Yue","sequence":"additional","affiliation":[{"name":"Medical Examination Center Guizhou Provincial People's Hospital Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Rehabilitative Auditory Research Guizhou Provincial People's Hospital Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Rajenderkumar","sequence":"additional","affiliation":[{"name":"Department of Audiovestibular Medicine University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0936-4447","authenticated-orcid":false,"given":"Fei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Centre for Speech and Language Therapy and Hearing Sciences, Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff UK"},{"name":"Department of Hearing and Speech Science, Xinhua College Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199905000-00013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100147449"},{"issue":"3","key":"e_1_2_9_4_1","first-page":"1165","article-title":"Incidence and prevalence of Meniere's disease in Sagamihara City, Kanagawa\u2010ken","volume":"1","author":"Tokumasu K","year":"1983","journal-title":"Pract Otol (Kyoto)"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1979.tb01875.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198408000-00020"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1978.00790020041009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000041"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001270"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32836463bc"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000041"},{"issue":"1","key":"e_1_2_9_12_1","first-page":"35","article-title":"On genetic and environmental factors in meniere's disease","volume":"15","author":"Morrison AW","year":"1994","journal-title":"Am J Otol"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510008960X"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348946707600311"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489209100779"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100130567"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200309000-00002"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2017.09.014"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.28"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2004.06.002"},{"issue":"7","key":"e_1_2_9_21_1","first-page":"CD008514","article-title":"Intratympanic steroids for Meniere's disease or syndrome","volume":"7","author":"Phillips JS","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"e_1_2_9_22_1","first-page":"CD008234","article-title":"Intratympanic gentamicin for M\u00e9ni\u00e8re's disease or syndrome","volume":"3","author":"Pullens B","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001227"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318263d35d"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70102-8"},{"key":"e_1_2_9_26_1","unstructured":"HigginsJ GreenS.Cochrane handbook for systematic reviews of interventions Version 5.1. 0. The Cochrane Collaboration. Confidence intervals.2011."},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1044"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076654"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.016"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1501500403"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480410016621"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480701762458"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-15-328"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811429432"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31461-1"},{"issue":"95","key":"e_1_2_9_36_1","first-page":"341","article-title":"Methylprednisolone versus dexamethasone for control of vertigo in patients with definite Meniere's disease","volume":"29","author":"Masoumi E","year":"2017","journal-title":"Iranian J Otorhinolaryngol"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.05.043"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000111044"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.05.010"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61161-7"},{"key":"e_1_2_9_41_1","first-page":"208","article-title":"Transtympanic treatment for Meniere's disease with gentamicin sulfate","author":"Lange G","year":"1981","journal-title":"Meniere's Disease"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200407000-00023"},{"issue":"3","key":"e_1_2_9_43_1","first-page":"554","article-title":"Meta\u2010analysis of intratympanic gentamicin","volume":"26","author":"Longridge NS","year":"2005","journal-title":"Otol Neurotol"},{"issue":"2","key":"e_1_2_9_44_1","first-page":"96","article-title":"Efficacy of intratympanic gentamicin and dexamethasone in the treatment of intractable Meniere's disease","volume":"31","author":"Wang Q","year":"2017","journal-title":"Lin chuang er bi yan hou tou jing wai ke za zhi= J Clinical Otorhinolaryngol Head Neck Surgery"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcoa.13350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13350","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:25:23Z","timestamp":1694370323000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,23]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1111\/coa.13350"],"URL":"https:\/\/doi.org\/10.1111\/coa.13350","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,23]]},"assertion":[{"value":"2019-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}