Meniett therapy: rescue treatment in severe drug-resistant Ménière's disease?

Area of Science:

• Otolaryngology
• Neurology
• Vestibular Disorders

Background:

• Ménière's disease (MD) is a chronic inner ear disorder characterized by episodic vertigo, hearing loss, tinnitus, and aural fullness.
• Drug-resistant MD often necessitates destructive treatments like intratympanic gentamicin (ITG) injections.
• Meniett therapy, a non-invasive treatment, aims to manage MD symptoms.

Purpose of the Study:

• To evaluate the efficacy of Meniett therapy in patients with severe, drug-resistant Ménière's disease.
• To assess Meniett therapy's value as an alternative to intratympanic gentamicin (ITG) or destructive procedures.

Main Methods:

• Twelve patients with drug-resistant MD, referred for ITG, underwent a 2-month Meniett therapy trial.
• Standardized staging systems evaluated symptoms, functional levels, and hearing.
• Disease-specific quality-of-life measures were assessed pre- and post-therapy, with long-term follow-up (mean 37 months).

Main Results:

• A significant reduction in vertigo spells was observed (median 10.0 to 3.0 per month, p=0.02).
• No significant improvements were noted in hearing status, tinnitus, functional level, or dizziness handicap.
• Long-term follow-up showed only 2 patients preferred Meniett therapy, with 6 requiring ablative surgery.

Conclusions:

• Meniett therapy provides temporary vertigo symptom relief in severe, drug-resistant Ménière's disease.
• It is unlikely to be a beneficial long-term treatment option for patients otherwise indicated for destructive procedures.
• Further research may explore Meniett therapy's role in specific MD patient subgroups.