Meniett Device
FOR MÉNIÈRE'S DISEASE
Meniett Device for Ménière’s Disease from Medtronic

Meniett Device for Ménière's Disease

Meniett therapy is a safe, simple, and effective treatment for Ménière's disease vertigo symptoms.1-12 Developed and tested in nearly 30 years of research, it helps many patients gain control of their Ménière's disease.1-16

About the Meniett Device for Ménière’s Disease

Managing Ménière's disease can be a significant clinical challenge. Each Ménière's disease patient progresses and responds differently, so the goal is to manage Ménière's disease symptoms at an acceptable level with the most conservative treatment.

Safe, Simple, and Effective

The Meniett® Low-Pressure Pulse Generator device is a safe, simple, and effective treatment for the vertigo symptoms of Ménière's disease.1-12 Many Ménière's disease patients consider dizziness and vertigo the most disabling aspect of the disease.

The Meniett device delivers micropressure therapy and is based on nearly 30 years of clinical research in the US and abroad.1-16 Short- and long-term results have been studied in Ménière's disease patients, including placebo-controlled trials.

AAO-HNS Policy Statement, March 2008

“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.”17

Advantages of Meniett Therapy

  • May help reduce the frequency and intensity of vertigo attacks, helping some patients avoid serious surgical or destructive procedures
  • Safe and minimally invasive Ménière’s disease treatment
  • Developed and tested over nearly 30 years of clinical research1-16
  • Easy for patients to do and puts them in control of their Ménière's disease
  • Portable and convenient therapy just takes a few minutes each day
  • Other Ménière's disease treatments may still be employed, if necessary
  • Full refund within 6 weeks if patient’s Ménière's disease doesn’t respond to Meniett therapy

Disadvantages of Meniett Therapy for Ménière's Disease

  • Slight risk of infection from tympanostomy tube
  • Not reimbursed by all insurance providers
  • Ménière's disease is not responsive to Meniett therapy in a small portion of the population

References

  1. Dornhoffer JL, King D. The effect of the Meniett device in patients with Ménière's disease: long-term results. Otol Neurotol 2008; 29(6):868-74.
  2. Mattox DE, Reichert M. Meniett device for Ménière's disease: use and compliance at 3 to 5 years. Otol Neurotol 2008; 29(1):29-32.
  3. Weining H, Fang L, Bo G, Jinmei Z. Clinical long-term effects of Meniett pulse generator for Ménière's disease. Acta Otolaryngol 2009; 129(8): 819-825.
  4. Barbara M, Monini S, Chiappini I, Filipo R. Meniett therapy may avoid vestibular neurectomy in disabling Ménière's disease. Acta Otolaryngol 2007; 127(11):1136-1141.
  5. Nabi S, Parnes LS. Bilateral Ménière’s disease. Curr Opin Otolaryngol Head Neck Surg 2009; 17:356-362.
  6. Thomsen J, Sass K, Ödkvist L, Arlinger S. Local over-pressure treatment reduces vestibular symptoms in patients with Ménière’s disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol 2005; 26:68-73.
  7. Rajan GP, Din S, Atlas MD. Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience. J Laryngol Otol 2005; 119:391-395.
  8. Densert B, Sass K. Control of symptoms in patients with Ménière’s disease using middle ear applications: A two-year follow-up. Acta Otolaryngol 2001; 121(5):616-621.
  9. Gates GA, Green Jr. JD, Tucci DL, Telian SA. The effects of transtympanic micropressure treatment in people with unilateral Ménière’s disease. Arch of Oto – HNS 2004; 130(6):718-725.
  10. Gates GA, Verrall A, Green Jr. JD, Tucci DL, Telian SA. Meniett clinical trial: long-term follow-up. Arch Otolaryngol Head Neck Surg 2006; 132:1311-1316.
  11. Ödkvist LM, Arlinger S, Billermark E, Densert B, Lindholm S, Wallquist J. Effects of middle ear pressure changes on clinical symptoms in patients with Ménière’s disease: A clinical, multicenter, placebo-controlled study. Acta Otolaryngol Suppl 2000; 543: 99-101.
  12. Densert B, Densert O, Arlinger S, Sass K, Ödkvist LM. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Ménière’s disease: A clinical placebo-controlled study. 1997; Am J Otol 1997; 18:726-733.
  13. Densert B, Densert O. Overpressure in treatment of Ménière’s disease Laryngoscope 1982; 92: 1285-1292.
  14. Densert B. Effects of overpressure on hearing function in Ménière’s disease. Acta Otolaryngol (Stockh) 1987; 103:32-42.
  15. Feijen RA, Segenhout JM, Wit HP, Albers FWJ. Monitoring inner ear pressure changes in normal guinea pigs induced by the Meniett 20. Acta Otolaryngol 2000; 804-809.
  16. Densert B, Sass K, Arlinger S. Short-term effects of induced middle ear pressure changes on the electrocochleogram in Ménière’s disease. Acta Otolaryngol (Stockh) 1995; 115: 732-737.
  17. Committee on Equilibrium of the American Academy of Otolaryngology–Head and Neck Surgery: Micropressure Therapy Policy Statement. March 2008.

How It Developed

Origins of Pressure Therapy for Ménière's Disease

Micropressure therapy for Ménière’s disease is based on nearly 50 years of research into how pressure affects the inner ear. Scientists observed that air pressure changes often caused dizziness in pilots and underwater divers.17,18 If air pressure changes could cause dizziness, they postulated, perhaps pressure changes could relieve the dizziness of Ménière’s disease.

The First Pressure Treatments for Ménière’s Disease

The first Ménière’s disease patients were treated with pressure therapy in 1976. Ménière’s disease patients went into a large hyperbaric pressure chamber and the air pressure was slowly adjusted. This treatment helped their Ménière’s disease symptoms, but was inconvenient and not readily available to many patients.19,20 Because the inner ear constantly produces endolymphatic fluid, pressure therapy has to be repeated regularly. Ménière’s disease patients needed easier, more convenient pressure therapy.

Pressure Therapy That’s Easy and Convenient

Dr. Barbara Densert invented the Meniett device in the 1990s. It received clearance in Europe in 1997 and FDA clearance in 1999 for Ménière’s disease treatment. The Meniett device is a small, portable micropressure device that is easy and convenient for Ménière’s disease patients to use at home, work, or just about anywhere.

If your patient has tried initial medical and/or dietary treatments without success, the AAO-HNS supports the use of micropressure therapy, such as the Meniett device, as a second-level therapy before attempting surgery.21

References

  1. Dornhoffer JL, King D. The effect of the Meniett device in patients with Ménière's disease: long-term results. Otol Neurotol 2008; 29(6): 868-74.
  2. Mattox DE, Reichert M. Meniett device for Ménière's disease: use and compliance at 3 to 5 years. Otol Neurotol 2008; 29(1): 29-32.
  3. Weining H, Fang L, Bo G, Jinmei Z. Clinical long-term effects of Meniett pulse generator for Ménière's disease. Acta Otolaryngol 2009; 129(8): 819-825.
  4. Barbara M, Monini S, Chiappini I, Filipo R. Meniett therapy may avoid vestibular neurectomy in disabling Ménière's disease. Acta Otolaryngol 2007; 127(11): 1136-1141.
  5. Rajan GP, Din S, Atlas MD. Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience. J Laryngol Otol 2005; 119: 391-395.
  6. Thomsen J, Sass K, Ödkvist L, Arlinger S. Local over-pressure treatment reduces vestibular symptoms in patients with Ménière’s disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol 2005; 26: 68-73.
  7. Nabi S, Parnes LS. Bilateral Ménière’s disease. Curr Opin Otolaryngol Head Neck Surg 2009; 17: 356-362.
  8. Gates GA, Green Jr. JD, Tucci DL, Telian SA. The effects of transtympanic micropressure treatment in people with unilateral Ménière’s disease. Arch of Oto – HNS 2004; 130(6): 718-725.
  9. Gates GA, Verrall A, Green Jr. JD, Tucci DL, Telian SA. Meniett clinical trial: long-term follow-up. Arch Otolaryngol Head Neck Surg 2006; 132: 1311-1316.
  10. Densert B, Sass K. Control of symptoms in patients with Ménière’s disease using middle ear applications: two years follow-up. Acta Otolaryngol 2001; 121(5): 616-621.
  11. Ödkvist LM, Arlinger S, Billermark E, Densert B, Lindholm S, Wallquist J. Effects of middle ear pressure changes on clinical symptoms in patients with Ménière’s disease: A clinical, multicenter, placebo-controlled study. Acta Otolaryngol Suppl 2000; 543: 99-101.
  12. Densert B, Densert O, Arlinger S, Sass K, Ödkvist LM. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Ménière’s disease: A clinical placebo-controlled study. 1997; Am J Otol 1997; 18: 726-733.
  13. Densert B, Densert O. Overpressure in treatment of Ménière’s disease. Laryngoscope 1982; 92:1285-1292.
  14. Densert B. Effects of overpressure on hearing function in Ménière’s disease. Acta Otolaryngol (Stockh) 1987; 103:32-42.
  15. Feijen RA, Segenhout JM, Wit HP, Albers FWJ. Monitoring inner ear pressure changes in normal guinea pigs induced by the Meniett 20. Acta Otolaryngol 2000; 804-809.
  16. Densert B, Sass K, Arlinger S. Short-term effects of induced middle ear pressure changes on the electrocochleogram in Ménière’s disease. Acta Otolaryngol (Stockh) 1995; 115: 732-737.
  17. Lundgren CEG. Alternobaric vertigo – a diving hazard. Br Med J. 1965; 2:511-513.
  18. Tjernström Ö. 1974. Alternobaric vertigo. An experimental study in man of vertigo due to atmospheric pressure changes. Thesis, Malmö General Hospital. 1974.
  19. Ingelstedt S, Ivarsson A, Tjernström Ö. Immediate relief of symptoms during acute attacks of Ménière's disease, using a pressure chamber. Acta Otolaryngol 1976; 82(5-6): 368-378.
  20. Younger R, Longridge NS, Mekjavic I. Effect of reduced atmospheric pressure on patients with fluctuating hearing loss due to Ménière’s disease. J Otolaryngol 1984; 13: 76-82.
  21. Committee on Equilibrium of the American Academy of Otolaryngology–Head and Neck Surgery: Micropressure Therapy Policy Statement. March 2008.

How It Works

The Ménière's Disease Ear

Ménière's disease is associated with endolymphatic hydrops, a condition of excess endolymphatic fluid in the cochlea and semicircular canals. The resulting pressure and swelling causes Ménière's disease symptoms of vertigo, tinnitus, hearing loss, and aural fullness.

Meniett Micropressure Therapy for Ménière's Disease

The Meniett device delivers a computer-controlled, complex algorithm of micropressure pulses that are transmitted to the middle ear space and act on the oval and round windows. It's believed that the energy of the Meniett's micropressure pulses causes a displacement of the perilymphatic fluid, which stimulates the flow of endolymphatic fluid and reduces it, thus relieving the symptoms of Ménière's disease.

View an animation of how the Meniett device works.

References

  1. Dornhoffer JL, King D. The effect of the Meniett device in patients with Ménière's disease: long-term results. Otol Neurotol 2008; 29(6): 868-74.
  2. Mattox DE, Reichert M. Meniett device for Ménière's disease: use and compliance at 3 to 5 years. Otol Neurotol 2008; 29(1): 29-32.
  3. Weining H, Fang L, Bo G, Jinmei Z. Clinical long-term effects of Meniett pulse generator for Ménière's disease. Acta Otolaryngol 2009; 129(8): 819-825.
  4. Barbara M, Monini S, Chiappini I, Filipo R. Meniett therapy may avoid vestibular neurectomy in disabling Ménière's disease. Acta Otolaryngol 2007; 127(11): 1136-1141.
  5. Rajan GP, Din S, Atlas MD. Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience. J Laryngol Otol 2005; 119: 391-395.
  6. Thomsen J, Sass K, Ödkvist L, Arlinger S. Local over-pressure treatment reduces vestibular symptoms in patients with Ménière’s disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol 2005; 26: 68-73.
  7. Nabi S, Parnes LS. Bilateral Ménière’s disease. Curr Opin Otolaryngol Head Neck Surg 2009; 17: 356-362.
  8. Gates GA, Green Jr. JD, Tucci DL, Telian SA. The effects of transtympanic micropressure treatment in people with unilateral Ménière’s disease. Arch of Oto – HNS 2004; 130(6): 718-725.
  9. Gates GA, Verrall A, Green Jr. JD, Tucci DL, Telian SA. Meniett clinical trial: long-term follow-up. Arch Otolaryngol Head Neck Surg 2006; 132: 1311-1316.
  10. Densert B, Sass K. Control of symptoms in patients with Ménière’s disease using middle ear applications: two years follow-up. Acta Otolaryngol 2001; 121(5): 616-621.
  11. Ödkvist LM, Arlinger S, Billermark E, Densert B, Lindholm S, Wallquist J. Effects of middle ear pressure changes on clinical symptoms in patients with Ménière’s disease: A clinical, multicenter, placebo-controlled study. Acta Otolaryngol Suppl 2000; 543: 99-101.
  12. Densert B, Densert O, Arlinger S, Sass K, Ödkvist LM. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Ménière’s disease: A clinical placebo-controlled study. 1997; Am J Otol 1997; 18: 726-733.
  13. Densert B, Densert O. Overpressure in treatment of Ménière’s disease. Laryngoscope 1982; 92:1285-1292.
  14. Densert B. Effects of overpressure on hearing function in Ménière’s disease. Acta Otolaryngol (Stockh) 1987; 103:32-42.
  15. Feijen RA, Segenhout JM, Wit HP, Albers FWJ. Monitoring inner ear pressure changes in normal guinea pigs induced by the Meniett 20. Acta Otolaryngol 2000; 804-809.
  16. Densert B, Sass K, Arlinger S. Short-term effects of induced middle ear pressure changes on the electrocochleogram in Ménière’s disease. Acta Otolaryngol (Stockh) 1995; 115: 732-737.

Treatment Plan

Meniett Treatment Plan for Ménière's Disease

The Meniett® device is only indicated for definite Ménière's disease. Meniett therapy is most effective for Ménière's disease patients whose worst symptom is vertigo, which many patients say is the most disabling symptom of Ménière's disease.

Steps in the Treatment Plan

These are the typical steps when prescribing Meniett therapy for Ménière's disease:

  • Physician faxes patient’s Meniett prescription to Medtronic at (866) 463-8726
  • Patient orders Meniett device from our customer service department
  • Physician places tympanostomy tube in patient’s affected ear(s)
  • Physician shows patient how to use Meniett device
  • Patient performs Meniett treatments exactly as prescribed during the 6-week trial period (typically 3 times/day, 5 minutes each time)

Once symptoms improve, your patient should continue Meniett treatments as prescribed until Ménière's disease remission and thereafter, depending on the duration and severity of symptoms.

6-Week Trial Period

Ménière's disease is highly variable. Like many other Ménière's disease treatments, Meniett therapy doesn’t help every Ménière's disease patient. That’s why the first 6 weeks of Meniett therapy is a very important trial period. For most Ménière's disease patients, it takes about 6 weeks to determine if they will respond to Meniett therapy.

During the 6-week trial period, it’s extremely important that patients follow your prescription every day and don’t skip any Meniett treatments. If patients skip treatments, there is no way to know for sure if the device can help their Ménière's disease.

If your Ménière's disease patient responds to Meniett therapy, the dizziness and vertigo attacks will become less frequent or less intense. Patients should continue to follow their Meniett prescription every day. They’ll also need regular follow-up visits with you to monitor their Ménière's disease, check the vent tube for patency, etc.

If Meniett treatments are performed as prescribed for 6 weeks and symptoms do not improve, then your patient’s Ménière's disease may not respond to Meniett therapy. He or she can return the device for a refund, and other Ménière's disease treatments may still be employed.

References

  1. Dornhoffer JL, King D. The effect of the Meniett device in patients with Ménière's disease: long-term results. Otol Neurotol 2008; 29(6):868-74.
  2. Mattox DE, Reichert M. Meniett device for Ménière's disease: use and compliance at 3 to 5 years. Otol Neurotol 2008; 29(1):29-32.
  3. Weining H, Fang L, Bo G, Jinmei Z. Clinical long-term effects of Meniett pulse generator for Ménière's disease. Acta Otolaryngol 2009; 129(8): 819-825.
  4. Barbara M, Monini S, Chiappini I, Filipo R. Meniett therapy may avoid vestibular neurectomy in disabling Ménière's disease. Acta Otolaryngol 2007; 127(11):1136-1141.
  5. Nabi S, Parnes LS. Bilateral Ménière’s disease. Curr Opin Otolaryngol Head Neck Surg 2009; 17:356-362.
  6. Thomsen J, Sass K, Ödkvist L, Arlinger S. Local over-pressure treatment reduces vestibular symptoms in patients with Ménière’s disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol 2005; 26:68-73.
  7. Rajan GP, Din S, Atlas MD. Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience. J Laryngol Otol 2005; 119:391-395.
  8. Densert B, Sass K. Control of symptoms in patients with Ménière’s disease using middle ear applications: A two-year follow-up. Acta Otolaryngol 2001; 121(5):616-621.
  9. Gates GA, Green Jr. JD, Tucci DL, Telian SA. The effects of transtympanic micropressure treatment in people with unilateral Ménière’s disease. Arch of Oto – HNS 2004; 130(6):718-725.
  10. Gates GA, Verrall A, Green Jr. JD, Tucci DL, Telian SA. Meniett clinical trial: long-term follow-up. Arch Otolaryngol Head Neck Surg 2006; 132:1311-1316.
  11. Ödkvist LM, Arlinger S, Billermark E, Densert B, Lindholm S, Wallquist J. Effects of middle ear pressure changes on clinical symptoms in patients with Ménière’s disease: A clinical, multicenter, placebo-controlled study. Acta Otolaryngol Suppl 2000; 543: 99-101.
  12. Densert B, Densert O, Arlinger S, Sass K, Ödkvist LM. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Ménière’s disease: A clinical placebo-controlled study. 1997; Am J Otol 1997; 18:726-733.
  13. Densert B, Densert O. Overpressure in treatment of Ménière’s disease. Laryngoscope 1982; 92:1285-1292.
  14. Densert B. Effects of overpressure on hearing function in Ménière’s disease. Acta Otolaryngol (Stockh) 1987; 103:32-42.
  15. Feijen RA, Segenhout JM, Wit HP, Albers FWJ. Monitoring inner ear pressure changes in normal guinea pigs induced by the Meniett 20. Acta Otolaryngol 2000; 804-809.
  16. Densert B, Sass K, Arlinger S. Short-term effects of induced middle ear pressure changes on the electrocochleogram in Ménière’s disease. Acta Otolaryngol (Stockh) 1995; 115: 732-737.
Last updated: 9 Jan 2013

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(877) 966-3350
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(866) 463-8726