The vestibular implant: Opinion statement on implantation criteria for research

Raymond van de Berg*, Angel Ramos, Vincent van Rompaey, Alexandre Bisdorff, Angelica Perez-Fornos, Jay T Rubinstein, James O Phillips, Michael Strupp, Charles C Della Santina, Nils Guinand

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)

Abstract

This opinion statement proposes a set of candidacy criteria for vestibular implantation of adult patients with bilateral vestibulopathy (BVP) in a research setting. The criteria include disabling chronic symptoms like postural imbalance, unsteadiness of gait and/or head movement-induced oscillopsia, combined with objective signs of reduced or absent vestibular function in both ears. These signs include abnormal test results recorded during head impulses (video head impulse test or scleral coil technique), bithermal caloric testing and rotatory chair testing (sinusoidal stimulation of 0.1 Hz). Vestibular implant (VI) implantation criteria are not the same as diagnostic criteria for bilateral vestibulopathy. The major difference between VI-implantation criteria and the approved diagnostic criteria for BVP are that all included vestibular tests of semicircular canal function (head impulse test, caloric test, and rotatory chair test) need to show significant impairments of vestibular function in the implantation criteria. For this, a two-step paradigm was developed. First, at least one of the vestibular tests needs to fulfill stringent criteria, close to those for BVP. If this is applicable, then the other vestibular tests have to fulfill a second set of criteria which are less stringent than the original criteria for BVP. If the VI-implantation is intended to excite the utricle and/or saccule (otolith stimulation), responses to cervical and ocular vestibular evoked myogenic potentials must be absent in addition to the above mentioned abnormalities of semicircular canal function. Finally, requirements for safe and potentially effective stimulation should be met, including implanting patients with BVP of peripheral origin only, and assessing possible medical and psychiatric contraindications.

Original languageEnglish
Pages (from-to)213-223
Number of pages11
JournalJournal of Vestibular Research-Equilibrium & Orientation
Volume30
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • Vestibular implant
  • vestibular prosthesis
  • implantation criteria
  • bilateral vestibulopathy
  • bilateral vestibular hypofunction
  • electrical stimulation
  • vestibular system
  • vestibulo-ocular reflex
  • VOR
  • bilateral vestibular loss
  • bilateral vestibular areflexia
  • EVOKED MYOGENIC POTENTIALS
  • BILATERAL VESTIBULOPATHY
  • ELECTRICAL-STIMULATION
  • SEMICIRCULAR CANALS
  • HYPOFUNCTION
  • PROSTHESIS
  • REHABILITATION
  • SENSITIVITY
  • PERFORMANCE
  • DIAGNOSIS

Cite this