Some of the most interesting observations are that pressure-related activities such as yawning and swallowing are associated with beneficial effects while others, such as coughing, lifting weights and low-frequency sound are usually associated with worsening of symptoms. However, there are components of these observations which would be applicable to non-Meniere's individuals, such as an increase in fullness with flying and driving and a decrease in fullness with swallowing. It is therefore somewhat difficult to separate out which components are part of the normal ear response, and which are specific to ears with Meniere's symptoms. Future studies and perhaps more highly targeted surveys will be required to isolate the different components.
One factor to come out of this survey, is that swallowing, either from chewing gum or eating candy, may help some patients with their symptoms, particularly fullness. Although the majority will not benefit from this activity and it should certainly not be touted as a cure in any form, it seems a simple and inexpensive solution which may provide benefit to some. If in doubt you should check with your physician. The only contraindication to trying this would be during the course of a vestibular attack. Although it has not been proven, some have suggested that the endolymphatic space may have a fistula at this time and mechanically-induced movements of the fluid could theoretically make the situation worse. To my knowledge, there are no data on this issue but a cautious approach would be advised.
Another area of interest is the fact that the symptoms of some individuals are made worse and of others are made better by many of the activities covered by the survey. There are a number of possible explanations for such a phenomenon. The simplest is to consider the working parts of the ear as a flexible membrane between two compartments. As an analogy, consider a piece of thin polyethylene taped across the window of a room. To work properly, the polyethylene must be loose and able to move backwards and forwards in response to small pressure changes. In the situation where the room pressure is low, and the plastic is bowed inwards, then it won't move with small pressure changes. Similarly, when the room presure is high, the plastic is bowed outwards and it again will not move with small pressure changes. Now consider that all you know is that the plastic is tight and is not working properly. Do you increase or decrease pressure in the room to fix the problem? The point is that in some cases decreasing pressure will help, while in other cases, increasing pressure will help. My hope is that by characterizing the different variations of Meniere's disease, it may be possible to find treatments which are effective in a specific group of patients, but which may be ineffective, or even make the situation worse in others. Meniere's is such a complex disease that I doubt there will be a single treatment which is effective for all patients. As scientists, we have to be able to deal with the variations and treat patients by their individual symptoms.
An important factors that I think is often overlooked with regard to therapies, is the fact that Meniere's symptoms fluctuate. When hearing sometimes improves but then gets worse, when tinnitus may be very severe at times but declines temporarily, when fullness gets better for a while or when the vertigo is not so bad one day - all these things mean that with the right treatment the ear can be returned towards normal function again. Contrast this with noise-induced deafness, in which the sensory hair cells of the ear are permanently lost. Regenerating these lost cells is far more of a challenge than returning normal function to the ear of a Meniere's patient. The fact that there are times when function may be good, gives hope that "all we have to do" is to find out how to keep the ear in this "good" state. Of course, this is by no means a trivial task, but the fact that function of the ear can be improved by some manipulations gives hope that it should eventually be possible to determine what is necessary to extend the good periods indefinitely. This should be a goal of our research.
There are limitations to this survey, some of which we were aware of at the outset. We realize that using the Internet to "sample" the Meniere's population distorted the sample towards younger patients. For this reason, we specifically elected not to quantify how many or what proportion of Meniere's patients were mechanically sensitive. Such a number could have been misleading, as mechanically non-sensitive patients would have been less interested in the survey and less likely to respond. We therefore cannot make any claims with regard to what proportion of Meniere's patients are mechanically-sensitive. Rather, the survey was intended to document the characteristics of sensitivity in those patients who had noticed the phenomenon. It clearly accomplished this goal .