Systematic review and meta-analysis of Meniett therapy for Meniere's disease

Abstract

Objectives/hypothesis: To perform a systematic review and meta-analysis of micropressure treatment for Meniere's disease (MD).

Data sources: Medline, Ovid, Web of Science, and Cochrane Library search of the literature from January 1996 to December 2012.

Review methods: Systematic literature review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria required definitive diagnosis of unilateral MD, treatment with Meniett device, vertigo control results, and hearing results before and after treatment. Randomized controlled trials and other types of case-control studies were included. Improvements in vertigo, American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) functional score, and pure tone average (PTA) were assessed. Funnel plots were used to detect bias and Q test was used to assess for heterogeneity. Random effects model was used for meta-analysis. T test was used to assess for significance.

Results: Of 113 abstracts screened, 18 studies met criteria for review and 12 were used for meta-analysis. Eight studies reported hearing evaluation and the improvement in PTA after Meniett treatment was significant (P = 0.0085). Data could not be combined for AAO-HNS functional score due to heterogeneity. However, there was a trend toward improvement. Of six studies reporting frequency of vertigo, Meniett treatment significantly reduced frequency of vertigo (P = < .0001).

Limitations: Much of the data used in the analysis was derived from retrospective or level 4 studies. The average follow-up was only 5 months, and there were low number of patients in the treatment and control groups.

Conclusion: The Meniett device is a safe, nondestructive treatment for patients' refractory to medical therapy for MD.

Keywords: Meniere's disease; Meniett device; micropressure treatment; middle ear pressure treatment; vertigo.