Local overpressure treatment reduces vestibular symptoms in patients with Meniere's disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study.
OBJECTIVE
To evaluate the efficacy of a new device, the Meniett, in the treatment of Meniere's disease. The device delivers pressure pulses to the middle ear through a ventilating tube in the tympanic membrane at a frequency of 6 Hz for 0.6 second. After rising to a pressure level of 1.2 kPa, the pressure oscillates between 0.4 and 1.2 kPa. It is believed that the pressure changes are conveyed to the inner ear, inducing a transport of fluids via the pressure outlets and thus reducing the endolymphatic hydrops.


METHODS
A clinical, randomized, multicenter, double-blind, placebo-controlled study. A total of 40 patients were included that had active Meniere's disease according to American Academy of Otolaryngology-Head and Neck Surgery criteria, aged between 20 and 65 years, with a history of at least eight attacks during the past year. After insertion of the ventilation tube, the patients should have had attacks of vertigo for 2 months before entering the study.


METHODS
Primary study endpoints were change in frequency of vertigo, change of functionality profile, and change in patient perception of vertigo (visual analogue scale); secondary endpoints were perception of tinnitus, aural pressure, and hearing, as well as an audiologic evaluation of hearing before and after the treatment period.


RESULTS
The functionality level improved statistically significantly in the active group compared with the placebo group (p=0.0014), as did the visual analogue scale evaluation of vertigo (p=0.005). There was a trend toward a reduction of the frequency of vertiginous attacks that was not significant (p=0.090). With regard to the secondary endpoints, there was no statistical difference between active and placebo groups.


CONCLUSIONS
Local overpressure treatment is a novel treatment that is noninvasive, nondestructive, and safe. It significantly reduces vestibular symptoms in patients with Meniere's disease. The Meniett was cleared by the Food and Drug Administration in 2000.
Thomsen
Jens
J
Department of Otolaryngology/Head & Neck Surgery, Gentofte University Hospital, Hellerup, Denmark. jetho@gentoftehosp.kbhamt.dk
Sass
Kornel
K
Odkvist
Lars
L
Arlinger
Stig
S
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004711:Endolymphatic Duct / Q000503:physiopathology; D018159:Endolymphatic Hydrops / Q000503:physiopathology / Q000628:therapy*; D004712:Endolymphatic Sac / Q000503:physiopathology; D004867:Equipment Design; D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D008297:Male; D008575:Meniere Disease / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D010147:Pain Measurement; D010498:Perilymph / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D016896:Treatment Outcome