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Positive pressure therapy for M eniere's syndrome/disease with a M eniett device: a systematic review of randomised controlled trials
Author(s) -
Syed M.I.,
Rutka J.A.,
Hendry J.,
Browning G.G.
Publication year - 2015
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12344
Subject(s) - medicine , placebo , randomized controlled trial , clinical trial , meta analysis , confidence interval , incidence (geometry) , surgery , alternative medicine , pathology , physics , optics
Background Incidence rates of M eniere's syndrome/disease vary considerably from 157 per 100 000 in the U nited K ingdom to 15 per 100 000 in the U nited S tates. A wide range of treatments are used for the treatment of the condition with no consensus on the most effective intervention. Objectives To assess the effectiveness of the M eniett device in reducing the frequency and severity of vertigo in M eniere's syndrome/disease. Search methods The C ochrane E ar, N ose and T hroat D isorders G roup T rials R egister; the C ochrane C entral R egister of C ontrolled T rials ( CENTRAL ); P ub M ed; EMBASE ; CINAHL ; W eb of S cience; BIOSIS P reviews; C ambridge S cientific abstracts; ICTRP and additional sources for published and unpublished trials were searched. The date of the last search was 13th M ay 2014. Selection criteria Four randomised controlled trials ( RCT s) were identified that compared the efficacy of the M eniett device versus a placebo device in patients with M eniere's ‘disease’ as defined by the AAOO criterion. Data collection and analysis Two review authors independently assessed study eligibility and risk of bias and extracted data. The outcome data were dichotomous for all the included trials. Main results The four RCT s compared 123 patients with the M eniett device against 114 patients with the placebo device from four RCT 's over a follow‐up period of 2 weeks to 4 months. There was a significant overall 61% reduction in the frequency of vertigo in both groups (mean no vertigo days per month of 8–3). However, this reduction was not significantly different between the two groups in any study or on meta‐analysis [mean difference in vertigo‐free days between M eniett and placebo device of 0.77 days over a 1‐month period (95% CI – 0.82, 1.83) P = 0.45]. There were also no substantive data to support a greater reduction in the severity of the vertigo or any other outcome with the M eniett device compared with the placebo device. Authors conclusions No evidence was found to justify the use of the M eniett device in M eniere's syndrome/disease.