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

Published online by Cambridge University Press:  27 February 2012

R Gürkov ,
L B Filipe Mingas ,
T Rader ,
J Louza ,
B Olzowy  and
E Krause
R Gürkov*
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
L B Filipe Mingas
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
T Rader
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Johann Wolfgang Goethe University of Frankfurt, Germany
J Louza
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
B Olzowy
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
E Krause
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
*
Address for correspondence: Dr Robert Gürkov, Dept of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilians University Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany Fax: +49 89 70956869 E-mail: Robert.Guerkov@med.uni-muenchen.de
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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.

Keywords

Menière's DiseasePressure TherapyBetahistineVertigo
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 356 - 362
Copyright
Copyright © JLO (1984) Limited 2012

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