Effects of middle ear pressure changes on clinical symptoms in patients with Meniere's disease - a clinical multicentre placebo-controlled study

Different medical and surgical methods hate been tried in attempting to red uce endolymphatic pressure in Meniere's disease. pressure treatment has a r ole on the treatment staircase, after pharmacological treatment and before destructive methods. Pressure chamber treatment has shown that some patient s respond well to the treatment with diminishing inner ear symptoms and als o some hearing improvement. Earlier studies have shown that electrocochlear measurements improve after local pressure treatment in the car. The presen t study was a prospective randomized placebo controlled. multicentre clinic al trial. 56 patients with active Meniere's disease, age 20 - 65 years, wit h a hearing loss of 20-65 dB PTA participated. A total of 31 patients compl eted 2 weeks use with an active apparatus (Meniett) and 25 patients complet ed the 2 weeks with the placebo gadget. Both machines were produced by Pasc al medical, Halmstad, Sweden. Two weeks before the start of treatment a gro mmet was placed in the tympanic membrane. A significant improvement concern ing frequency and intensity of vertigo, dizziness, aural pressure and tinni tus was reported by the active group on the visual analogue scales (VAS) qu estionnaire. In the placebo group no change was the most common finding, fo llowed by worsening of the symptoms and a few improvements. The function in professional and family life improved during active treatment and did not during placebo treatment. Pure-tone audiometry did not improve after placeb o treatment. but improved at the frequencies 500 Hz and 1,000 Hz after acti ve treatment. The study showed an improvement in the inner car symptoms aft er Meniett treatment. The mechanism may be explained by the influence on th e round window membrane pressure receptors or an endolymphatic flow out thr ough the pressure release points, such as the endolymphatic duct and sac, t hus activating the longitudinal flow. Other mechanisms are also possible.