Restoring the High-Frequency Dynamic Visual Acuity with a Vestibular Implant Prototype in Humans

Dmitrii Starkov*, Nils Guinand, Florence Lucieer, Maurizio Ranieri, Samuel Cavuscens, Maksim Pleshkov, Jean-Philippe Guyot, Herman Kingma, Stefano Ramat, Angelica Perez-Fornos, Raymond van de Berg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction: The vestibular implant could become a clinically useful device in the near future. This study investigated the feasibility of restoring the high-frequency dynamic visual acuity (DVA) with a vestibular implant, using the functional Head Impulse Test (fHIT). Methods: A 72-year-old female, with bilateral vestibulopathy and fitted with a modified cochlear implant incorporating three vestibular electrodes (MED-EL, Innsbruck, Austria), was available for this study. Electrical stimulation was delivered with the electrode close to the lateral ampullary nerve in the left ear. The high-frequency DVA in the horizontal plane was tested with the fHIT. After training, the patient underwent six trials of fHIT, each with a different setting of the vestibular implant: (1) System OFF before stimulation; (2) System ON, baseline stimulation; (3) System ON, reversed stimulation; (4) System ON, positive stimulation; (5) System OFF, without delay after stimulation offset; and (6) System OFF, 25 min delay after stimulation offset. The percentage of correct fHIT scores for right and left head impulses were compared between trials. Results: Vestibular implant stimulation improved the high-frequency DVA compared to no stimulation. This improvement was significant for "System ON, baseline stimulation" (p = 0.02) and "System ON, positive stimulation" (p <0.001). fHIT scores changed from 19 to 44% (no stimulation) to maximum 75-94% (System ON, positive stimulation). Conclusion: The vestibular implant seems capable of improving the high-frequency DVA. This functional benefit of the vestibular implant illustrates again the feasibility of this device for clinical use in the near future.

Original languageEnglish
Pages (from-to)91-95
Number of pages5
JournalAudiology and Neurotology
Issue number1-2
Publication statusPublished - 2020


  • Vestibular implant
  • Neural prosthesis
  • Bilateral vestibulopathy
  • Functional head impulse test
  • Dynamic visual acuity
  • Vestibular prosthesis

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