Perez Fornos Angelica, Cavuscens Samuel, Ranieri Maurizio, van de Berg Raymond, Stokroos Robert, Kingma Herman, Guyot Jean-Philippe, Guinand Nils
Department of Clinical Neurosciences, Service of Otorhinolaryngology, Head and Neck Surgery, University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands.
J Vestib Res. 2017;27(1):51-61. doi: 10.3233/VES-170604.
The primary goal of the vestibular implant is to restore the vestibular function in patients with a disabling bilateral vestibular loss for whom there is currently no available treatment. The prototype developed by our team is a hybrid system consisting of a modified cochlear implant incorporating additional vestibular electrodes. Therefore, in addition of delivering sound information it is also capable of delivering motion information to the central nervous system using electrical stimulation. To date, thirteen patients have been implanted with such vestibular implant prototypes. For ethical reasons, only deaf ears were implanted and all patients experienced a clinical benefit from the hearing rehabilitation. The recent demonstration of partial restoration of the vestibulo-ocular and the vestibulo-collic reflexes in implanted patients suggests that gaze stabilization and postural control, fundamental functions of the balance system, can be artificially restored using a vestibular implant. This allows us to glimpse a useful clinical application in a near future. In parallel, we show how the vestibular implant provides a unique opportunity to explore the integration of the vestibular sensory input into the multisensory, multimodal balance system in humans, since it is able to selectively stimulate the vestibular system.
前庭植入物的主要目标是恢复双侧前庭功能丧失且目前尚无有效治疗方法的患者的前庭功能。我们团队开发的原型是一种混合系统，由一个包含额外前庭电极的改良型人工耳蜗组成。因此，除了传递声音信息外，它还能够通过电刺激将运动信息传递给中枢神经系统。迄今为止，已有13名患者植入了这种前庭植入物原型。出于伦理原因，仅对失聪耳朵进行了植入，所有患者都从听力康复中获得了临床益处。最近在植入患者中部分恢复前庭眼反射和前庭脊髓反射的研究表明，使用前庭植入物可以人工恢复平衡系统的基本功能——凝视稳定和姿势控制。这让我们看到在不久的将来可能会有有用的临床应用。同时，我们展示了前庭植入物如何提供一个独特的机会来探索前庭感觉输入在人类多感官、多模式平衡系统中的整合，因为它能够选择性地刺激前庭系统。
