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Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss.
Audiol Neurootol 2019; :1-12AN

Abstract

INTRODUCTION

Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD).

METHODS

We included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode.

RESULTS

In both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation.

DISCUSSION/CONCLUSION

Prosthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation.

Authors+Show Affiliations

Department of Otolaryngology, Faculty of Medicine, University of Las Palmas de Gran Canaria, Las Palmas, Spain, ramosorl@idecnet.com.Hearing and Balance Laboratory, University of Las Palmas de Gran Canaria, Las Palmas, Spain.Department of Otolaryngology, and Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain.Department of Otolaryngology, and Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain.Department of Otolaryngology, and Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31801137

Citation

Ramos Macias, Angel, et al. "Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans With Bilateral Vestibulopathy and Sensorineural Hearing Loss." Audiology & Neuro-otology, 2019, pp. 1-12.
Ramos Macias A, Ramos de Miguel A, Rodriguez Montesdeoca I, et al. Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss. Audiol Neurootol. 2019.
Ramos Macias, A., Ramos de Miguel, A., Rodriguez Montesdeoca, I., Borkoski Barreiro, S., & Falcón González, J. C. (2019). Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss. Audiology & Neuro-otology, pp. 1-12. doi:10.1159/000503600.
Ramos Macias A, et al. Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans With Bilateral Vestibulopathy and Sensorineural Hearing Loss. Audiol Neurootol. 2019 Dec 4;1-12. PubMed PMID: 31801137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss. AU - Ramos Macias,Angel, AU - Ramos de Miguel,Angel, AU - Rodriguez Montesdeoca,Isaura, AU - Borkoski Barreiro,Silvia, AU - Falcón González,Juan Carlos, Y1 - 2019/12/04/ PY - 2019/08/07/received PY - 2019/09/16/accepted PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2019/12/5/medline KW - Balance KW - Bilateral vestibulopathy KW - Saccule KW - Utricle KW - Vestibular implant SP - 1 EP - 12 JF - Audiology & neuro-otology JO - Audiol. Neurootol. N2 - INTRODUCTION: Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD). METHODS: We included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode. RESULTS: In both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation. DISCUSSION/CONCLUSION: Prosthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation. SN - 1421-9700 UR - https://www.unboundmedicine.com/medline/citation/31801137/Chronic_Electrical_Stimulation_of_the_Otolith_Organ:_Preliminary_Results_in_Humans_with_Bilateral_Vestibulopathy_and_Sensorineural_Hearing_Loss L2 - https://www.karger.com?DOI=10.1159/000503600 DB - PRIME DP - Unbound Medicine ER -