Control of symptoms in patients with Meniere's disease using middle ear pressure applications: two years follow-up.

The effects of middle ear pressure pulses were studied in 37 patients with a diagnosis of definite Meniere's disease and active vestibular symptoms, 31 of whom had failed to respond to medical treatment including diuretics prior to pressure treatment. The number of vertigo spells during the 6 months prior to treatment and for 6, 18 and 24 months after the start of treatment were evaluated. The functionality level scores were three or worse according to the American Academy of Otolaryngology--Head and Neck Surgery (AAO-HNS) criteria. The results of the study were as follows: 19 patients experienced freedom from vertigo spells; 15 patients reported a significant decrease in the frequency of vertigo spells; and 3 patients did not respond to pressure treatment and were subjected to gentamicin injections, I of whom consequently became deaf in the affected ear. No patient became worse in connection with pressure treatment. With the exception of the three patients who did not respond to pressure treatment, all patients reported an improvement in functionality of at least two levels according to the AAO-HNS functionality scale. No side effects or adverse events were observed during the 2 years of pressure treatment. Overall, the results indicate that pressure treatment provides efficient control of symptoms in patients with intractable forms of Ménière's disease without producing any adverse effects on the inner ear.