Positive pressure therapy for Ménière’s disease.

INTRODUCTION:Ménière's disease is a disorder of the inner ear characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Positive pressure therapy has been used to reduce the intensity and frequency of episodes, but it is not clear whether it is actually effective. METHODS:We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS:We identified five systematic reviews including 22 studies overall, of which five were randomized trials. We concluded positive pressure therapy probably leads to slightly worse hearing and makes little or no difference in the intensity of vertigo. In addition, we are uncertain whether positive pressure therapy improves functionality or decreases vertigo attacks as the certainty of the evidence has been assessed as very low.