BACKGROUND Hearing loss is one of the leading causes of disability in Canada and worldwide, with more than one million Canadians enduring a hearing-related disability. Meniere's disease (MD) is a chronic condition of the inner ear, manifesting as a triad of disabling symptoms, including attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), and tinnitus. Impacts on quality of life are severe, particularly with respect to restrictions in social participation and physical activity, fatigue, and reduced capacity to work. Anxiety and other psychological disorders may result from the restrictions imposed on life, the constant uncertainty of vertigo attacks, and fluctuating SNHL, with neuroses and depression affecting 40 to 60% of sufferers of intractable MD. There is a need to establish the benefits of previously studied interventions with greater certainty. The planned systematic review and meta-analyses/network meta-analyses (NMAs) will assess the relative effects of competing pharmacologic and surgical interventions for management of MD in adults. METHODS An experienced medical information specialist in consultation with the review team will develop the electronic search strategies. We will search various databases including MEDLINE, Embase, and the Cochrane Library with no date or language restrictions for published literature, and key clinical trial registries for in-progress and completed trials. Screening of the literature will be performed by two reviewers independently using pre-specified eligibility criteria, and quality of the included studies will be assessed using the Cochrane Risk of Bias tool. We will resolve disagreements through consensus or third-party adjudication. When applicable, meta-analyses and NMAs will be pursued to compare interventions in terms of their effects on outcomes, including frequency and severity of vertigo, occurrence and intensity of tinnitus, changes in hearing and speech recognition, quality of life, and harms. Separate analyses exploring the effects of pharmacologic and surgical approaches will be performed. DISCUSSION Our planned systematic review will provide informative evaluations of existing treatments for management of Meniere's disease. The findings will inform practitioners as to the relative benefits and harms of the existing competing interventions for MD, offer optimal clinical treatment strategies, identify evidence gaps, and determine promising therapies for evaluation in future trials. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019119129.

中文翻译：

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梅尼埃病患者的药物和手术治疗：系统评价和荟萃分析方案。

背景技术听力损失是加拿大和全世界残疾的主要原因之一，超过一百万加拿大人患有与听力相关的残疾。梅尼埃病 (MD) 是一种慢性内耳疾病，表现为三联症致残症状，包括眩晕发作、波动性感音神经性听力损失 (SNHL) 和耳鸣。对生活质量的影响非常严重，特别是社会参与和体力活动受到限制、疲劳和工作能力下降。焦虑和其他心理障碍可能是由于生活受到的限制、眩晕发作的持续不确定性以及 SNHL 的波动而引起的，神经症和抑郁症影响着 40% 至 60% 的顽固性 MD 患者。有必要更确定地确定先前研究的干预措施的益处。计划进行的系统评价和荟萃分析/网络荟萃分析（NMA）将评估竞争性药物和手术干预措施对成人MD治疗的相对影响。方法 经验丰富的医疗信息专家与审查小组协商后将制定电子检索策略。我们将检索各种数据库，包括 MEDLINE、Embase 和 Cochrane 图书馆，对已发表的文献没有日期或语言限制，并对正在进行和已完成的试验进行关键临床试验注册。文献筛选将由两名评审员使用预先指定的资格标准独立进行，纳入研究的质量将使用 Cochrane 偏倚风险工具进行评估。我们将通过协商一致或第三方裁决来解决分歧。在适用的情况下，将采用荟萃分析和 NMA 来比较干预措施对结果的影响，包括眩晕的频率和严重程度、耳鸣的发生和强度、听力和言语识别的变化、生活质量和危害。将进行单独的分析，探讨药物和手术方法的影响。讨论 我们计划的系统评价将为梅尼埃病的现有治疗方法提供信息丰富的评估。研究结果将使从业者了解MD现有竞争性干预措施的相对益处和危害，提供最佳的临床治疗策略，找出证据差距，并确定有希望的疗法以在未来的试验中进行评估。系统审查注册 PROSPERO CRD42019119129。