title: Long-term effects of the Meniett device in Ménière's disease: the Western Australian experience.
abstract: OBJECTIVE
  Transtympanic pressure has been shown to influence endolymphatic hydrops. As endolymphatic hydrops plays a key role in Ménière's disease, a few studies, undertaken by the inventors, manufacturers and associates of the Meniett device, have demonstrated positive short-term effects of transtympanic pressure treatment via the Meniett device in medically intractable Ménière's disease. The aim of our study was to independently investigate the long-term efficacy and safety of transtympanic pressure treatment in the management of recalcitrant vertigo in Ménière's disease.
  
  
  METHODS
  Cross-sectional case study.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Eighteen patients with Ménière's disease, suffering from medically intractable symptoms. All patients in the study had Ménière's disease according to the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head & Neck Surgery.
  
  
  METHODS
  Outcome and severity of symptoms were assessed, using the six-point functional scale and the vertigo visual analogue scale (VAS), as recommended by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head & Neck Surgery. Changes of pure tone average thresholds and vestibular calorics before and during treatment with the Meniett device were recorded. The mean follow-up time was 18 months.
  
  
  RESULTS
  Twelve out of 18 patients showed significant improvement in the functional score and in the VAS. Five patients displayed an audiometric improvement, out of which three patients showed a pertaining significant hearing gain of more than 10 dB; the remainder had stable hearing levels. Of six patients without any improvement, four had previous invasive surgery for their Ménière's disease and two had previous vestibular ablation with gentamicin. No changes in vestibular function were noted. There were no complications during the treatment with the Meniett device.
  
  
  CONCLUSIONS
  According to this independent study, the Meniett device seems to be a minimally invasive, non-destructive treatment tool, which can reduce vertigo and associated functional handicap in Ménière's disease. These effects are maintained up to 18 months after treatment so far. Previous surgical or chemical vestibular ablation procedures may adversely influence the effect of the Meniett device.
authors.affiliation: Lions Ear and Hearing Institute, Sir Charles Gairdner Hospital, University of Western Australia, Australia. guneshrajan@hotmail.com
authors.forename: Gunesh P
authors.initials: GP
authors.lastname: Rajan
authors.forename: Sobani
authors.initials: S
authors.lastname: Din
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Atlas
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D011312:Pressure; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000601:surgery