Case Report: Positive Pressure Therapy Combined With Endolymphatic sac Surgery in a Patient With Meniere's Disease

Positive pressure therapy (PPT) is applied for medically-intractable vertigo in Meniere's disease (MD); however, it remains unknown whether PPT affects in vivo endolymphatic hydrops (EH). In this case report, we describe a 5-year course of MD in a patient in which EH was repeatedly observed. As the patient experienced recurrent vertigo attacks after endolymphatic sac surgery, he began to use the PPT device additionally and vertiginous episodes decreased in accordance with a decrease in the EH volume. The mechanism of PPT is suggested that the pressure increase in the middle ear inhibits EH development. PPT, if added after surgery, might be more effective to reduce EH volume compared with surgery alone. A larger study group size is required to test these preliminary data concerning EH changes.

Automated summary

This case report describes a 5-year course of MD in a patient where EH was repeatedly observed, and the use of PPT device reduced vertiginous episodes according to a decrease in EH volume, suggesting that PPT may inhibit the development of EH. A larger study group size is needed to further test these preliminary findings on EH changes.