Efektivitas Waktu Pemberian Steroid Intratimpani sebagai Salvage Therapy pada Idiopathic Sudden Sensorineural Hearing Loss setelah Kegagalan Terapi Sistemik: Systematic Literature Review
DOI:
https://doi.org/10.58344/locus.v5i7.5786Keywords:
Idiopathic Sudden Sensorineural Hearing Loss, Steroid Intratimpani, salvage therapy, Hearing Recovery, Waktu Inisiasi TerapiAbstract
Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) merupakan gangguan pendengaran sensorineural yang terjadi secara mendadak dan dapat menyebabkan penurunan pendengaran permanen apabila tidak ditangani secara tepat. Steroid intratimpani sering digunakan sebagai salvage therapy pada pasien yang belum menunjukkan perbaikan pendengaran optimal setelah terapi steroid sistemik. Namun, pengaruh waktu pemberian steroid intratimpani terhadap hearing recovery masih menunjukkan hasil yang bervariasi. Penelitian ini bertujuan untuk meninjau secara sistematis efektivitas waktu pemberian steroid intratimpani sebagai salvage therapy terhadap hearing recovery pada pasien ISSNHL setelah kegagalan terapi sistemik. Systematic literature review dilakukan melalui pencarian pada database jurnal nasional dan internasional, yaitu Garuda, PubMed, dan ScienceDirect. Penelitian yang sesuai dengan kriteria inklusi dan dipublikasikan pada Januari 2020–Desember 2025. Kualitas penelitian dinilai menggunakan Study Quality Assessment Tools untuk studi observasional dan penilaian deskriptif untuk studi intervensi. Metode pelaporan penelitian menggunakan pedoman PRISMA. Sebanyak 162 artikel ilmiah diperoleh dari database Garuda (n = 36), ScienceDirect (n = 108), dan PubMed (n = 18). Sebanyak 133 artikel penelitian dieksklusi, 29 artikel menjalani skrining full text, dan 8 artikel penelitian memenuhi kriteria inklusi untuk dianalisis. Hasil review menunjukkan bahwa waktu pemberian steroid intratimpani yang lebih dini cenderung berhubungan dengan hearing recovery yang lebih baik, sedangkan keterlambatan salvage therapy cenderung berhubungan dengan outcome yang lebih buruk. Faktor yang paling konsisten berhubungan dengan hearing recovery adalah waktu inisiasi terapi, meskipun terdapat heterogenitas antarpenelitian dalam hal desain studi, definisi outcome, kategori waktu inisiasi, dan protokol pemberian terapi.
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