GM Meniett 201 X Middle ear overpressure treatment is one of the therapeutic methods for the patients with intractable Meniere's disease (MD). Based on the Japanese Clinical Guidelines for Meniere's Disease in 2011, when the medical treatment is not effective to improve vertiginous attacks in MD patients, the middle ear overpressure treatment is recommended before surgical and/or vestibular deafferentation treatment. There are two types of middle ear overpressure treatment; the transtympanic

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... brane massage (TMM) device and the Meniett device. In the middle ear overpressure treatment with the Meniett system, the tympanic membrane ventilation tube is indispensable, but it is unnecessary when treating with the TMM device. Most of the MD patients prefer the TMM device because it is less invasive. In this study, we presented a case in which the TMM device was not effective to cure the vertiginous attacks. On the other hand, the Meniett device was effective, suggesting that this might demonstrate a new idea of a step-wise procedure for middle ear overpressure treatment.