title: Systematic review and meta-analysis of Meniett therapy for Meniere's disease.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis of micropressure treatment for Meniere's disease (MD).
  
  
  METHODS
  Medline, Ovid, Web of Science, and Cochrane Library search of the literature from January 1996 to December 2012.
  
  
  METHODS
  Systematic literature review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria required definitive diagnosis of unilateral MD, treatment with Meniett device, vertigo control results, and hearing results before and after treatment. Randomized controlled trials and other types of case-control studies were included. Improvements in vertigo, American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) functional score, and pure tone average (PTA) were assessed. Funnel plots were used to detect bias and Q test was used to assess for heterogeneity. Random effects model was used for meta-analysis. T test was used to assess for significance.
  
  
  RESULTS
  Of 113 abstracts screened, 18 studies met criteria for review and 12 were used for meta-analysis. Eight studies reported hearing evaluation and the improvement in PTA after Meniett treatment was significant (P = 0.0085). Data could not be combined for AAO-HNS functional score due to heterogeneity. However, there was a trend toward improvement. Of six studies reporting frequency of vertigo, Meniett treatment significantly reduced frequency of vertigo (P = < .0001).
  
  
  CONCLUSIONS
  Much of the data used in the analysis was derived from retrospective or level 4 studies. The average follow-up was only 5 months, and there were low number of patients in the treatment and control groups.
  
  
  CONCLUSIONS
  The Meniett device is a safe, nondestructive treatment for patients' refractory to medical therapy for MD.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital; Henry Ford Health System, Detroit, Michigan, U.S.A.
authors.forename: Syed F
authors.initials: SF
authors.lastname: Ahsan
authors.forename: Robert
authors.initials: R
authors.lastname: Standring
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D001301:Audiometry, Pure-Tone; D005500:Follow-Up Studies; D006801:Humans; D008575:Meniere Disease / Q000175:diagnosis / Q000628:therapy*; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018401:Sample Size; D062086:Transtympanic Micropressure Treatment / Q000295:instrumentation* / Q000379:methods
keywords: Meniere's disease; Meniett device; micropressure treatment; middle ear pressure treatment; vertigo