Prosthetic implantation of the human vestibular system
Otology & Neurotology, 2014•journals.lww.com
Background A number of vestibular disorders could be treated with prosthetic stimulation of
the vestibular end organs. We have previously demonstrated in rhesus monkeys that a
vestibular neurostimulator, based on the Nucleus Freedom cochlear implant, can produce
canal-specific electrically evoked eye movements while preserving auditory and vestibular
function. An investigational device exemption has been obtained from the FDA to study the
feasibility of treating uncontrolled Ménière's disease with the device. Methods The …
the vestibular end organs. We have previously demonstrated in rhesus monkeys that a
vestibular neurostimulator, based on the Nucleus Freedom cochlear implant, can produce
canal-specific electrically evoked eye movements while preserving auditory and vestibular
function. An investigational device exemption has been obtained from the FDA to study the
feasibility of treating uncontrolled Ménière's disease with the device. Methods The …
Background
A number of vestibular disorders could be treated with prosthetic stimulation of the vestibular end organs. We have previously demonstrated in rhesus monkeys that a vestibular neurostimulator, based on the Nucleus Freedom cochlear implant, can produce canal-specific electrically evoked eye movements while preserving auditory and vestibular function. An investigational device exemption has been obtained from the FDA to study the feasibility of treating uncontrolled Ménière’s disease with the device.
Methods
The UW/Nucleus vestibular implant was implanted in the perilymphatic space adjacent to the three semicircular canal ampullae of a human subject with uncontrolled Ménière’s disease. Preoperative and postoperative vestibular and auditory function was assessed. Electrically evoked eye movements were measured at 2 time points postoperatively.
Results
Implantation of all semicircular canals was technically feasible. Horizontal canal and auditory function were largely, but not totally, lost. Electrode stimulation in 2 of 3 canals resulted in canal-appropriate eye movements. Over time, stimulation thresholds increased.
Conclusion
Prosthetic implantation of the semicircular canals in humans is technically feasible. Electrical stimulation resulted in canal-specific eye movements, although thresholds increased over time. Preservation of native auditory and vestibular function, previously observed in animals, was not demonstrated in a single subject with advanced Ménière’s disease.
Lippincott Williams & Wilkins