Micropressure therapy for refractory Meniere's disease

• aims to reduce endolymph pressure in the inner ear by administering low-pressure air pulses through the tympanic membrane onto the round window membrane, with the aim of stimulating the flow of endolymphatic fluid:
  • with the patient under local or general anaesthesia, a grommet (ventilation tube) is inserted into the tympanic membrane of the affected ear
  • a few weeks later, after checking for patency of the grommet by the Valsalva manoeuvre, a hand-held air pressure generator forms an airtight seal in the outer ear. The device administers computer-controlled micropressure pulses across the tympanic membrane
  • three 60-second pulses are administered per treatment, with rest periods (usually less than 1 minute) between each pulse. Micropressure therapy is administered by the patient at home, usually 3 times per day
  • treatment is normally continued for 4-6 weeks, but it can be used for longer

NICE suggest that "there is some evidence of efficacy, but it is based on limited numbers of patients. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit or research..."

Reference:

• 1) NICE (April 2012). Micropressure therapy for refractory Ménière's disease