Effect of transtympanic low-pressure therapy in patients with unilateral Menière's disease unresponsive to betahistine: a randomised, placebo-controlled, double-blinded, clinical trial

J Laryngol Otol. 2012 Apr;126(4):356-62. doi: 10.1017/S0022215112000102. Epub 2012 Feb 27.

Abstract

Objective: To determine the effect of the Meniett low-pressure generator on the subjective symptoms and audiovestibular disease markers of patients with unilateral Menière's disease unresponsive to betahistine treatment.

Methods: Randomised, placebo-controlled, double-blinded, clinical trial at a tertiary referral centre. After ventilation tube placement, patients were randomised to the active treatment or placebo group. Monitoring comprised audiometry and air caloric testing and a vertigo diary (enabling calculation of vertigo and activity scores, and the number of vertigo days, vertigo-free days and sick days).

Results: Sixty-eight patients completed the study. For the active treatment versus placebo group, the following pre- and post-treatment values, and significances for treatment effect comparisons, were respectively seen: cumulative vertigo scores, 22.47 and 15.97 vs 20.42 and 19.23 (p = 0.048); vertigo days, 6.5 and 4.08 vs 5.94 and 5.52 (p = 0.102); sick days, 3.08 and 0.78 vs 2.87 and 3.45 (p = 0.041); vertigo-free days, 14.47 and 17.61 vs 15.48 and 17.58 (p = 0.362); activity score, 23.61 and 13.42 vs 24.68 and 20.23 (p = 0.078); low-tone hearing threshold, 49.15 and 53.18 dB nHL vs 41.66 and 46.10 dB nHL (p > 0.05); and slow phase velocity in response to caloric stimulation, 18.86 and 18.72 °/second vs 14.97 and 15.95 °/second, (p > 0.05).

Conclusion: Use of the Meniett low-pressure generator improved patients' vertigo but not their hearing or vestibular function. This safe, minimally invasive treatment is recommended as second-line treatment for unilateral Menière's disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry, Pure-Tone
  • Betahistine / therapeutic use
  • Caloric Tests
  • Double-Blind Method
  • Ear Canal
  • Equipment Design
  • Female
  • Histamine Agonists / therapeutic use
  • Humans
  • Male
  • Medical Records
  • Meniere Disease / physiopathology
  • Meniere Disease / therapy*
  • Middle Aged
  • Otolaryngology / instrumentation
  • Otolaryngology / methods*
  • Placebos
  • Pressure*
  • Semicircular Canals / physiopathology
  • Severity of Illness Index
  • Treatment Failure
  • Treatment Outcome
  • Vertigo / physiopathology
  • Vertigo / therapy*
  • Young Adult

Substances

  • Histamine Agonists
  • Placebos
  • Betahistine