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Replacing semicircular canal function with a vestibular implant

Merfeld, Daniel M.a,b; Lewis, Richard F.a,b,c

Current Opinion in Otolaryngology & Head & Neck Surgery:
doi: 10.1097/MOO.0b013e328357630f
HEARING SCIENCE AND VESTIBULAR MEDICINE: Edited by Rodney C. Diaz and Mohamed A. Hamid
Abstract

Purpose of review: To summarize the recent progress in the development of vestibular implants. The review is timely because of the recent advances in the field and because MED-EL has recently announced that they are developing a vestibular implant for clinical applications.

Recent findings: The handicap experienced by patients suffering from bilateral vestibulopathy has a strong negative impact on physical and social functioning that appears to justify a surgical intervention. Two different surgical approaches to insert electrodes to stimulate ampullary neurons have been shown to be viable. The three-dimensional vestibulo-ocular reflex in rhesus monkeys produced with a three-dimensional vestibular implant showed gains that were relatively normal during acute stimulation. Rotation cues provided by an implant interact with otolith cues in a qualitatively normal manner. The brain appears to adapt plastically to the cues provided via artificial electrical stimulation.

Summary: Research to date includes just a few human studies, but available data from both humans and animals support the technological and physiological feasibility of vestibular implants. Although vestibular implant users should not expect normal vestibular function – any more than cochlear implant users should expect normal hearing – data suggest that significant functional improvements are possible.

Author Information

aJenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear Infirmary

bDepartment of Otology and Laryngology

cDepartment of Neurology, Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Daniel M. Merfeld, Jenks Vestibular Physiology Laboratory, MEEI Room 421, 243 Charles Street, Boston, MA 02114, USA. E-mail: dan_merfeld@meei.harvard.edu

© 2012 Lippincott Williams & Wilkins, Inc.