The Next Challenges of Vestibular Implantation in Humans

Joost Johannes Antonius Stultiens*, Richard F. Lewis, James O. Phillips, Anissa Boutabla, Charles C. Della Santina, Rudolf Glueckert, Raymond van de Berg

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Patients with bilateral vestibulopathy suffer from a variety of complaints, leading to a high individual and social burden. Available treatments aim to alleviate the impact of this loss and improve compensatory strategies. Early experiments with electrical stimulation of the vestibular nerve in combination with knowledge gained by cochlear implant research, have inspired the development of a vestibular neuroprosthesis that can provide the missing vestibular input. The feasibility of this concept was first demonstrated in animals and later in humans. Currently, several research groups around the world are investigating prototype vestibular implants, in the form of vestibular implants as well as combined cochlear and vestibular implants. The aim of this review is to convey the presentations and discussions from the identically named symposium that was held during the 2021 MidWinter Meeting of the Association for Research in Otolaryngology, with researchers involved in the development of vestibular implants targeting the ampullary nerves. Substantial advancements in the development have been made. Yet, research and development processes face several challenges to improve this neuroprosthesis. These include, but are not limited to, optimization of the electrical stimulation profile, refining the surgical implantation procedure, preserving residual labyrinthine functions including hearing, as well as gaining regulatory approval and establishing a clinical care infrastructure similar to what exists for cochlear implants. It is believed by the authors that overcoming these challenges will accelerate the development and increase the impact of a clinically applicable vestibular implant.
Original languageEnglish
Pages (from-to)401-412
Number of pages12
JournalJaro-journal of the Association for Research in Otolaryngology
Volume24
Issue number4
Early online date1 Jul 2023
DOIs
Publication statusPublished - Aug 2023

Keywords

  • Vestibulopathy
  • Bilateral vestibulopathy
  • Vestibular implant
  • Vestibular neuroprosthesis
  • Humans
  • SEMICIRCULAR CANAL AFFERENTS
  • QUALITY-OF-LIFE
  • ELECTRICAL-STIMULATION
  • EYE-MOVEMENTS
  • VESTIBULOOCULAR REFLEX
  • DIRECTIONAL PLASTICITY
  • NERVE-STIMULATION
  • RHESUS-MONKEYS
  • ADAPTATION
  • RESPONSES

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