Comparing the efficacy of various acupuncture-related therapies for sudden sensorineural hearing loss: a PRISMA-compliant protocol for systematic review and network meta-analysis.

INTRODUCTION: Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that can profoundly impact patients' auditory function and quality of life. While conventional treatments like corticosteroids offer moderate efficacy, a proportion of patients experience persistent deficits, highlighting the need for effective adjunctive therapies. Acupuncture has demonstrated therapeutic potential for SSNHL, but the relative efficacy of various acupuncture-related modalities remains unclear. This protocol outlines a systematic review (SR) and network meta-analysis (NMA) aimed at comprehensively evaluating the comparative efficacy of different acupuncture modalities in treating SSNHL.

METHODS AND ANALYSIS: An extensive literature search across nine databases and five clinical trial registries will be conducted to identify randomised controlled trials investigating acupuncture-related therapies for SSNHL. The primary outcome measure is the change in pure-tone audiometric thresholds. Secondary outcomes include the proportion of recovered patients, tinnitus severity, psychological symptoms and adverse events. Two independent reviewers will perform study selection, data extraction and methodological quality assessment using the Cochrane's risk of bias (V.2.0) tool. A Bayesian NMA will be employed to compare the relative efficacy among multiple acupuncture modalities. The overall quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation methodology.

ETHICS AND DISSEMINATION: As this study will use data from previously published studies, it does not require ethical approval. The findings of this SR and NMA will be disseminated through publication in a peer-reviewed academic journal.

PROSPERO REGISTRATION NUMBER: CRD42024525763.