2019 年 78 巻 4 号 p. 274-281
We occasionally encounter patients with refractory endolymphatic hydrops, including Ménière's disease, who manifest recurrent attacks of vertigo despite medical treatment. The guideline for the treatment of Ménière's disease recommends transtympanic positive-pressure therapy for refractory cases with failure of conservative therapy, before surgery is considered. Overseas, micropressure treatment using the Meniett® low-pressure pulse generator has been reported to be effective for reducing the symptoms of this disease. On the other hand, the tympanic membrane massage device (hereinafter referred to as the non-invasive pressure pulse generator) has been used for patients with otitis media with effusion. Unlike the Meniett® device, it can deliver intermittent pressure to the middle ear without tympanostomy tube insertion and is associated with fewer adverse events. Multicenter studies have been carried out in Japan to determine whether the non-invasive pressure pulse generator is of therapeutic benefit against Ménière's disease.
The present study was focused on the efficacy of the non-invasive pressure pulse generator for refractory Ménière's disease.
A total of 19 adults with Ménière's disease were included in the study. Treatment with the non-invasive pressure pulse generator was self-administered 3 times daily for 4 months.
The patients reported a significant decrease in the number of vertigo attacks after the first month of treatment. Of the total, 64% reported a significant reduction in the number of vertigo attacks for 12 months after the treatment.
Our results suggest that transtympanic positive-pressure therapy using a non-invasive pressure pulse generator is effective for alleviating the symptoms of Ménière's disease.