Last week we posted an anecdotal report specific to the potential benefits of a low-salt diet for a diagnosis of Ménière’s disease. A couple of years ago, I reviewed several proposed treatments for Ménière’s disease, but did not cover the Meniett device. The manufacturer, Medtronic, describes the Meniett as a “Low-Pressure Pulse Generator device.” The idea behind the Meniett is that pressure applied against the round and/or oval window may alter fluid dynamics within the labyrinth and reduce the frequency and severity of Ménière’s attacks.
In March of 2008, the American Academy of Otolaryngology-Head and Neck Surgery issued a policy statement as follows: “We find that there is convincing and well-controlled medical evidence to support the use of micropressure therapy (such as the Meniett device) in certain cases of Ménière’s disease. Micropressure therapy is best used as a second level therapy when medical treatment has failed.”
Medtronic’s website states: “Ménière’s disease is not responsive to Meniett therapy in a small portion of the population.” I am always curious about the evidence behind statements such as “certain cases” and “small portion of the population.” Let’s look at some recent hard data on the subject.
A recent report published in Clinical Otolaryngology reviewed four independent studies that examined the responses of Ménière’s patients to Meniett therapy versus a placebo device. The studies followed up with patients at two weeks to four months following treatment. Both groups showed a significant improvement in symptoms, but there was no difference between the patients using the Meniett device compared to those using a placebo device. Like most treatments for Ménière’s disease, some patients respond immediately and dramatically to some treatments, but there is no treatment that works for everyone. As a result, physicians often employ the “treatment ladder” approach, which we will discuss next week.