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Improvement in the inner ear symptoms of patients with Meniere's disease after treatment using low-frequency vibration: A preliminary report
Jing Zou1, Rishunzi Peng1, Guiliang Zheng1, Qing Zhang1, Esko Toppila2, Hongliang Zheng3, Ilmari Pyykkö4
1Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China. Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland.
2Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland.
3Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
4Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland.

Article ID: 100005ZJZO042015
doi:10.5348/O04-2015-5-OA-2

Address correspondence to:
Jing Zou
MD, PhD, Professor, Department of Otolaryngology-Head and Neck Surgery
Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University
Changhai Road #168, Shanghai 200433
China

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How to cite this article
Zou J, Peng R, Zheng G, Zhang Q, Toppila E, Zheng H, Pyykkö I. Improvement in the inner ear symptoms of patients with Meniere's disease after treatment using low-frequency vibration: A preliminary report. Edorium J Otolaryngol 2015;2:5–13.


Abstract
Aims: To evaluate the efficacy of controlling the inner ear symptoms for the duration of 7 – 19 months specifically the vertigo in patients with Meniere's disease (MD) using a novel therapy that delivers low-frequency vibrations to the inner ear through the mastoid process.
Methods: The system is composed of vibrational power generator that was driven by the centrifugal force of the rotating weight, and a head holder that couples the vibrator to the temporal bone skin. 14 MD patients were exposed for 30 min to vibrations at a fundamental frequency of 100 Hz at an intensity of 70.6 m/s2 and consisting of a cluster of harmonic waves ranging from 148 to 1120 Hz. The cervical vestibular evoked myogenic potentials (cVEMPs) were measured in the MD patients before and at 30 min post-vibration treatment. Gadolinium-enhanced MRI scan was used to detect potential endolymphatic hydrops in MD patients. The complaints in MD patients were followed for 7–19 months.
Results: Twelve out of 14 patients felt comfortable within 24 h after exposure to the low-frequency vibration except that 2 patients did not show any benefit. The vertigo were significantly controlled by the novel therapy (p<0.01, Wilcoxon signed ranks test). There was insignificant improvement in hearing function after the treatment. The tinnitus and ear fullness were significantly improved after exposure to the low-frequency vibration. The side difference in the amplitudes of cVEMP (contralateral side minus ipsilateral side) became smaller at 30 min posr-vibration than that before vibration (p<0.05, Wilcoxon signed ranks test).
Conclusion: The novel low-frequency vibration therapy was effective in controlling vertigo, tinnitus, and ear fullness of patients with MD.

Keywords: Vibration, Meniere's disease, Vertigo, Therapy, Low-frequency

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Author Contributions:
Jing Zou – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rishunzi Peng – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guiliang Zheng – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Qing Zhang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Esko Toppila – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Hongliang Zheng – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ilmari Pyykkö – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Jing Zou et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Jing Zou is Professor in Department of Otolaryngology-Head & Neck Surgery at Changhai Hospital, Second Military Medical University, Changhai, China, and Head of Hearing and Balance Research Unit at School of Medicine, University of Tampere, Tampere, Finland. He earned the undergraduate degree Bachelor's Degree and Master's Degree from, Third Military Medical University, Chongqing, China and Doctor's Degree from, Department of Otolaryngology-Head & Neck Surgery, National Key Discipline, Chinese PLA General Hospital, Beijing, China and did post, doc at Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden. His research interests include Inner ear Disease, Inner ear imaging, and Nanomedicine. Was involved in 4 EU projects and 5 national projects. He has published 92 research papers in national and international academic journals and authored 4 books and holds 4 patents. First visualized endolymphatic hydrops in vivo in animal model using MRI and perilymphatic and endolymphatic spaces separately in human, which have significantly changed the clinical practice of Otology globally. Have a strong background in nanomedicine. Also involved in CBCT and micro CT imaging.



Rishunzi Peng is a Candidate of Master's Degree in is Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.



Guiliang Zheng is Attending Physician in Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China. He earned Doctor's Degree from, Department of Otolaryngology-Head & Neck Surgery, National Key Discipline, Chinese PLA General Hospital, Beijing, China. His research focuses on noise-induced hearing loss.



Ms. Qing Zhang is a Technician in charge. She earned Bachelor's Degree in Medicine from, Second Military Medical University Shanghai, China.



Esko Toppila is Associate Professor in Finnish Institute of Occupational Health, Helsinki, Finland. He was associate professor in Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland. He earned the PhD in Physics in University of Helsinki. He is an expert in hearing protection and vibration directive. He has been involved in several EU and national projects that mainly focus on noise, vibration, aging, nanomedicine.



Hongliang Zheng is Professor in Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China. He earned Bachelor's Degree, Master's Degree, and Doctor's Degree from, Department of Otolaryngology-Head & Neck Surgery, Changhai Hospital, Second Military Medical University Shanghai, China. His research focuses on vocal cord disorders and head & neck cancers.



Ilmari Pyykkö is Professor Emeritus in Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland. He earned the MD and PhD in University of Helsinki. Previous positions: Professor, University of Helsinki (1990-1195), Professor and head, Karolinska Institutet, Stockholm (1995-2002). Several EU-grants and national grants. Main clinical and research topics: Working on clinical Oto-Neurology and Otology. Main research interest: Vestibular testing, inner ear disorders, artificial intelligence in assessing hearing loss and dizziness, computer based peer support system, genetic aspect of hearing loss, falls in elderly, nanotechnology based targeted drug and gene delivery. Published about 500 papers in the topic.