Local overpressure treatment reduces vestibular symptoms in patients with Ménière's disease : A clinical, randomized, multicenter, double-blind, placebo-controlled study

• Objectives: To evaluate the efficacy of a new device, the Meniett, in the treatment of Ménière'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. Study Design: A clinical, randomized, multicenter, double-blind, placebo-controlled study. A total of 40 patients were included that had active Méniè re'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. Outcome Measures: 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. Conclusion: Local overpressure treatment is a novel treatment that is noninvasive, nondestructive, and safe. It significantly reduces vestibular symptoms in patients with Ménière's disease. The Meniett was cleared by the Food and Drug Administration in 2000.

Nyckelord

Ménière's disease

Noninvasive

Pulsed local overpressure

Vertigo

MEDICINE

MEDICIN

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