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Audiol Neurootol. 2019 Oct 29:1-5. doi: 10.1159/000503677. [Epub ahead of print]

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

Author information

1
Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands, dmitrii.n.starkov@gmail.com.
2
Faculty of Physics, Tomsk State Research University, Tomsk, Russian Federation, dmitrii.n.starkov@gmail.com.
3
Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
4
Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands.
5
Faculty of Physics, Tomsk State Research University, Tomsk, Russian Federation.
6
Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

Abstract

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.

KEYWORDS:

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

PMID:
31661687
DOI:
10.1159/000503677
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