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OBJECTIVES: Transtympanic pressure has been shown to influence endolymphatic hydrops. As endolymphatic hydrops plays a key role in M'eni`eretextquoterights 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 M'eni`eretextquoterights 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 M'eni`eretextquoterights disease.

DESIGN: Cross-sectional case study.

SETTING: Tertiary referral centre.

PARTICIPANTS: Eighteen patients with M'eni`eretextquoterights disease, suffering from medically intractable symptoms. All patients in the study had M'eni`eretextquoterights disease according to the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head & Neck Surgery.

MAIN OUTCOME MEASUREMENTS: 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 M'eni`eretextquoterights 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.

CONCLUSION: 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 M'eni`eretextquoterights 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.