Meniett Therapy for Ménière's Disease: An Updated Meta-analysis.

OBJECTIVE: To re-evaluate the efficacy of Meniett therapy for the treatment of Ménière's disease (MD). DATA SOURCES: PubMed, Embase, Cochrane Library, Clinicaltrials.gov, ChiCTR, and the CNKI database were searched for articles in English and Chinese published before August 31, 2015. STUDY SELECTION: Included in this meta-analysis were studies that dealt with outcomes of Meniett therapy for the treatment of MD, including randomized controlled clinical trials, case-control studies, and prospective or retrospective cohort studies, with sample sizes of ≥ 10 subjects. DATA EXTRACTION: Keywords included endolymphatic hydrops, Ménière's disease, pressure, Meniett, and transtympanic micropressure treatment. DATA SYNTHESIS: Fourteen studies were included, involving a total of 345 MD patients. Data were analyzed using the Meta package in R. Dichotomous outcomes were expressed as risk ratios with 95% confidence intervals, and weighted mean differences with 95% confidence intervals were used to present continuous outcomes. Heterogeneity of the included studies was quantitatively assessed by χ(2) and I tests. Fixed-effects models were used for I(2) <50%; otherwise, random-effects models were used. Funnel plots were constructed to test the publication bias. CONCLUSION: This study showed that Meniett therapy may prevent vertigo attacks and substantially reduce its frequency in MD patients. It may also alleviate the functional deficit. The impact of Meniett therapy on hearing remains uncertain. The optimal effect might maintain for approximately 18 months. This meta-analysis suggested that Meniett therapy may be a useful second-line therapy in the treatment of MD.

[Individualized integrated therapy on patients with vertigo].

OBJECTIVE: To explore the treatment of patients with vertigo by the integrated therapy including the drug, surgery and rehabilitation exercise and to investigate the establishment of individualized integrated therapy on patients with vertigo. METHOD: One hundred and fifty-eight patients with peripheral vestibular vertigo were taken the individualized integrated therapy of vertigo (IITV). In first step of IITV, according to the etiology of vertigo, the therapy protocols were personally designed including drug, surgery or rehabilitation exercise. In second step of IITV, the patients who did not achieve effective treatment were followed-up and status of vestibular compensation and model of sensory organization in stance balance were re-evaluated. Then, the adjusted therapy protocol was designed by using drug, surgery or rehabilitation exercise comprehensively. The outcome assessment methods included the vestibular symptom index (VSI), balance assessment and dizziness handicap inventory (DHI). RESULT: The result of VSI showed that there were significant difference (P < 0.01) between the post-therapy and pre-therapy in the symptoms except the headache. Both results of timed balance test and foam posturography showed that the postural stability was improved after IITV (P < 0.01). The total DHI score improved 15.97 after therapy and there were significant difference (P < 0.01) of total DHI score between the post-therapy and pre-therapy. The total effective rate of IITV was 91.14% in these patients with vertigo. CONCLUSION: To treat patients with vertigo effectively, it was necessary to design the individualized integrated therapy protocol which applied the methods of drug, surgery and rehabilitation exercise comprehensively on the base of etiology of vertigo, status of vestibular compensation and model of sensory organization.