Table 1. Summary of evidence for ITC timing strategies.

Strategy	Comparator	Effect estimate	Evidence grade
Primary monotherapy	Systemic steroids	PTA diff: 2.0 dB (NS) OR: 0.94 (0.61-1.44)	Moderate (B) Non-inferior
Combined therapy	Systemic alone	OR: 2.50 (1.95-3.21) PTA: +13 dB	Moderate-high (B+) superior
Salvage therapy	No treatment/placebo	OR: 6.04 (3.26-11.2) Response: 44% vs. 11% NNT ≈3	High (A) Strongly recommended

CI: Confidence interval, NNT: Number needed to treat, NS: Not significant, OR: Odds ratio, PTA: Pure tone average