CONCLUSION: According to this long-term study, the Meniett pulse generator is a safe, effective, and non-destructive therapy that can reduce vertiginous symptoms and associated functional handicap and partly show an improvement of hearing in medically intractable and active Meniere's disease. Moreover, we recommend considering it before attempting any surgical or chemical vestibular ablation procedure. OBJECTIVE: To evaluate the long-term efficacy and safety of transtympanic pressure treatment in the management of recalcitrant vertigo in Meniere's disease. PATIENTS AND METHODS: This was a cross-sectional case study of 22 consecutive patients with medically active and intractable Meniere's disease who opted to try the Meniett pulse generator between July 2005 and March 2008. Eighteen of these patients were followed up for over 24 months. A standard ventilation tube was inserted in the affected ear. The treatment period with the Meniett pulse generator was 2 months in clinic, then the follow-up was a mean of 28 months. Patients indicated on the symptom report card and six-point functional scale the maximum level of vertigo, activity, and stress. Hearing was assessed utilizing pure tone average thresholds (PTAs) and the vestibular caloric test was performed. RESULTS: For 18 patients, the changes on the vertigo visual analog scale (VAS) and six-point functional scale before and after treatment with the Meniett device were statistically significant (p<0.05). No changes in vestibular function were noted. In all, 13 and 10 of 18 patients, respectively, showed a significant PTA increase of 10 dB or more at 2 months and 12 months after treatment with the Meniett device. Nine of 17 patients showed a significant PTA increase of 10 dB or more at 24 months after the treatment. There were no complications during the 28-month follow-up.
CONCLUSION: According to this long-term study, the Meniett pulse generator is a safe, effective, and non-destructive therapy that can reduce vertiginous symptoms and associated functional handicap and partly show an improvement of hearing in medically intractable and active Meniere's disease. Moreover, we recommend considering it before attempting any surgical or chemical vestibular ablation procedure. OBJECTIVE: To evaluate the long-term efficacy and safety of transtympanic pressure treatment in the management of recalcitrant vertigo in Meniere's disease. PATIENTS AND METHODS: This was a cross-sectional case study of 22 consecutive patients with medically active and intractable Meniere's disease who opted to try the Meniett pulse generator between July 2005 and March 2008. Eighteen of these patients were followed up for over 24 months. A standard ventilation tube was inserted in the affected ear. The treatment period with the Meniett pulse generator was 2 months in clinic, then the follow-up was a mean of 28 months. Patients indicated on the symptom report card and six-point functional scale the maximum level of vertigo, activity, and stress. Hearing was assessed utilizing pure tone average thresholds (PTAs) and the vestibular caloric test was performed. RESULTS: For 18 patients, the changes on the vertigo visual analog scale (VAS) and six-point functional scale before and after treatment with the Meniett device were statistically significant (p<0.05). No changes in vestibular function were noted. In all, 13 and 10 of 18 patients, respectively, showed a significant PTA increase of 10 dB or more at 2 months and 12 months after treatment with the Meniett device. Nine of 17 patients showed a significant PTA increase of 10 dB or more at 24 months after the treatment. There were no complications during the 28-month follow-up.