Ahsan Syed F, Standring Robert, Wang Yun
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital; Henry Ford Health System, Detroit, Michigan, U.S.A.
Laryngoscope. 2015 Jan;125(1):203-8. doi: 10.1002/lary.24773. Epub 2014 Jun 10.
OBJECTIVES/HYPOTHESIS: To perform a systematic review and meta-analysis of micropressure treatment for Meniere's disease (MD).
Medline, Ovid, Web of Science, and Cochrane Library search of the literature from January 1996 to December 2012.
Systematic literature review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria required definitive diagnosis of unilateral MD, treatment with Meniett device, vertigo control results, and hearing results before and after treatment. Randomized controlled trials and other types of case-control studies were included. Improvements in vertigo, American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) functional score, and pure tone average (PTA) were assessed. Funnel plots were used to detect bias and Q test was used to assess for heterogeneity. Random effects model was used for meta-analysis. T test was used to assess for significance.
Of 113 abstracts screened, 18 studies met criteria for review and 12 were used for meta-analysis. Eight studies reported hearing evaluation and the improvement in PTA after Meniett treatment was significant (P = 0.0085). Data could not be combined for AAO-HNS functional score due to heterogeneity. However, there was a trend toward improvement. Of six studies reporting frequency of vertigo, Meniett treatment significantly reduced frequency of vertigo (P = < .0001).
Much of the data used in the analysis was derived from retrospective or level 4 studies. The average follow-up was only 5 months, and there were low number of patients in the treatment and control groups.
The Meniett device is a safe, nondestructive treatment for patients' refractory to medical therapy for MD.
目的/假设：对梅尼埃病（MD）的微压治疗进行系统评价和荟萃分析。
检索1996年1月至2012年12月期间Medline、Ovid、科学网和考科蓝图书馆的文献。
遵循系统评价和荟萃分析的首选报告项目指南进行系统文献综述。纳入标准要求明确诊断为单侧MD、使用美尼埃特装置治疗、眩晕控制结果以及治疗前后的听力结果。纳入随机对照试验和其他类型的病例对照研究。评估眩晕、美国耳鼻咽喉头颈外科学会（AAO-HNS）功能评分和纯音平均听阈（PTA）的改善情况。采用漏斗图检测偏倚，采用Q检验评估异质性。采用随机效应模型进行荟萃分析。采用t检验评估显著性。
在筛选的113篇摘要中，18项研究符合综述标准，12项用于荟萃分析。8项研究报告了听力评估，美尼埃特治疗后PTA的改善显著（P = 0.0085）。由于异质性，无法合并AAO-HNS功能评分的数据。然而，有改善的趋势。在6项报告眩晕发作频率的研究中，美尼埃特治疗显著降低了眩晕发作频率（P = <.0001）。
分析中使用的大部分数据来自回顾性研究或4级研究。平均随访时间仅为5个月，治疗组和对照组的患者数量较少。
美尼埃特装置对于药物治疗难治的MD患者是一种安全、无创的治疗方法。
