Background: Acupuncture as an alternative treatment method is widely used in the treatment of sudden sensorineural hearing loss(SSNHL) in China. We performed a systematic review and meta-analysis to assess the clinical efficacy of acupuncture for the management of SSNHL patients.

Materials and methods: The PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and WanFang databases were searched. Searches were performed on April 27, 2018 and without language and publication year restrictions. We collected and analyzed the randomized controlled trials (RCTs) of acupuncture for the treatment of SSNHL patients to assess its efficacy and safety. The RevMan5.3 software was used for analysis. The fixed-effects model can be applied to calculate the risk ratio (RR) or weighted mean difference (WMD) if the chi-square test shows there was no significance of heterogeneity (p > 0.10, I²<50%). Otherwise, the random effects mode was used.

Results: Twenty randomized controlled trials met our inclusion criteria. The electroacupuncture(EA), manual acupuncture(MA) plus western medicine(WM) and EA plus WM groups lead to significantly better pure tone audiometry(PTA) than WM alone in cured rate (P = 0.01; P < 00,001; P < 0.006, respectively). However, no significant differences were observed between MA and WM (p = 0.27). In terms of total effective rate, all of them showed significant improvement compared to WM alone (MA: P = 0.03; EA: P = 0.01; MA + WM: P < 0.00001; EA + WM: P = 0.04). In addition, no significant difference was found between the MA plus WM and WM alone groups in the improvement of tinnitus (P = 0.37). No trials reported serious adverse events.

Conclusion: Acupuncture could be a valid treatment option for SSNHL, especially for patients who could not be cured by drugs alone. However, the outcome was limited temporarily due to the lack of high-quality research support. High-quality evidence is needed to clarify the future efficacy and safety of acupuncture for SSNHL.