Therapeutic effect of steroids on vestibular neuritis: Systematic review and meta-analysis

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 30 August 2019. The main outcome measure was dizziness handicap inventory (DHI) and secondary outcomes included complete caloric recovery and improvement of canal paresis (CP). The follow-up times were divided into short, mid and long-term. 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 0.05–0.30, p =.006). Although there was no significant difference between steroids and control in the DHI score (Hedges’ g = −0.323, 95% CI −0.533 to −0.113, p <.01), significant effect was seen on complete caloric recovery and improvement in CP (Hedges’ g = 0.364, 95% CI 0.18–0.55, p <.0001; Hedges’ g = 0.592, 95% CI 0.32–0.59, p <.0001). Conclusions: The results suggest that corticosteroids have an effect on the results of caloric tests for VN recovery, especially in long-term follow-up. However, in terms of dizziness handicap, we did not find any evidence of positive effect on corticosteroid. More data are required before recommendations can be made regarding management in patients on corticosteroids.