Skip to main content Accessibility help

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

  • R Gürkov (a1), L B Filipe Mingas (a1), T Rader (a2), J Louza (a1), B Olzowy (a1) and E Krause (a1)...



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.


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).


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).


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.


Corresponding author

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:


Hide All
1Thorp, MA, Shehab, ZP, Bance, ML, Rutka, JA. Does evidence-based medicine exist in the treatment of Meniere's disease? A critical review of the last decade of publications. Clin Otolaryngol 2000;25:456–60
2Tjernstrom, O. Effects of middle-ear pressure on the inner ear. Acta Otolaryngol 1977;83:1115
3Densert, B, Densert, O, Erlandsson, B, Sheppard, H. Transmission of complex pressure waves through the perilymphatic fluid in cats. Acta Otolaryngol 1986;102:403–9
4Gates, GA, Green, JD, Tucci, DL, Telian, SA. The effects of transtympanic micropressure treatment in people with unilateral Meniere's disease. Arch Otolaryngol Head Neck Surg 2004;130:718–25
5Kim, HH, Wiet, RJ, Battista, RA. Trends in the diagnosis and the management of Meniere's disease: results of a survey. Otolaryngol Head Neck Surg 2005;132:722–6
6Plontke, SK. Recent aspects in Meniere's disease [in German]. HNO 2007;55:1214
7Westhofen, M. Meniere's disease: evidence and controversies [in German]. HNO 2009;57:446–54
8Zapala, DA, Sholt, KF, Lundy, LB. A comparison of water and air caloric responses and their ability to distinguish between patients with normal and impaired ears. Ear Hear 2008;29:585600
9Densert, B, Densert, O, Arlinger, S, Sass, K, Odkvist, L. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Meniere's disease: a clinical placebo-controlled study. Am J Otol 1997;18:726–33
10Odkvist, LM, Arlinger, S, Billermark, E, Densert, B, Lindholm, S, Wallqvist, J. Effects of middle ear pressure changes on clinical symptoms in patients with Meniere's disease – a clinical multicentre placebo-controlled study. Acta Otolaryngol Suppl 2000;543:99101
11Thomsen, J, Sass, K, Odkvist, T, Arlinger, S. Local overpressure treatment reduces vestibular symptoms in patients with Meniere's disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol 2005;26:6873



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed