Ramos de Miguel Angel, Falcon Gonzalez Juan Carlos, Ramos Macias Angel
Department of Ear Nose and Throat, Las Palmas University, Las Palmas, Spain.
J Int Adv Otol. 2017 Aug;13(2):154-161. doi: 10.5152/iao.2017.4216.
Electrical stimulation of the utricular and saccular portions of the vestibular nerve improves stability in patients suffering from vestibular dysfunction. The main objective of this study was to evaluate a new technique, vestibular response telemetry (VRT), for measuring the electrically evoked vestibular compound action potential (saccular and utricular) after stimulating the otolith organ (saccular and utricular) in adults. This study used evidence that the otolith organ can be electrically stimulated in order to develop a new vestibular implant design to improve the sensation of gravitoinertial acceleration.
Four adult patients were evaluated by using a variety of measurement procedures with novel VRT software. VRT values were obtained by stimulating with three full-band Nucleus CI24RE (ST) electrodes. Specific stimuli were used. Simultaneously, electrical ocular vestibular evoked myogenic potentials (eoVEMPs) were recorded in the contralateral side.
Electrically evoked compound action potentials were obtained in 10 of the 12 electrodes tested, and eoVEMPs were recorded when VRT was present. In addition to the validation of this technique, a set of default clinical test parameters was established. The VRT response morphology consisted of a biphasic waveform with an initial negative peak (N1) followed by a positive peak (P1), and latencies were typically 400 μs for N1 and 800 μs for P1. The consequences for the development of a vestibular implant for the improvement of gravitoinertial acceleration sensation are also presented.
The VRT measurement technique has been shown to be a useful tool to record neural response on the otolith organ, and thus it is a convenient tool to evaluate whether the implanted electrodes provide a neural response or not. This can be used for the early development of vestibular implants to improve gravitoinertial acceleration sensation.
对前庭神经的椭圆囊和球囊部分进行电刺激可改善前庭功能障碍患者的稳定性。本研究的主要目的是评估一种新技术——前庭反应遥测（VRT），用于测量成人在刺激耳石器官（椭圆囊和球囊）后诱发的前庭复合动作电位（椭圆囊和球囊）。本研究利用耳石器官可被电刺激这一证据，开发一种新的前庭植入物设计，以改善重力惯性加速度的感知。
使用新颖的VRT软件，通过多种测量程序对4名成年患者进行评估。使用三个全频段Nucleus CI24RE（ST）电极进行刺激，从而获得VRT值。采用了特定的刺激方式。同时，在对侧记录电眼震诱发肌源性电位（eoVEMP）。
在测试的12个电极中，有10个获得了电诱发复合动作电位，并且在出现VRT时记录到了eoVEMP。除了对该技术进行验证外，还建立了一组默认的临床测试参数。VRT反应形态由双相波形组成，初始为负向峰值（N1），随后为正向峰值（P1），N1的潜伏期通常为400微秒，P1为800微秒。还介绍了开发用于改善重力惯性加速度感知的前庭植入物的相关成果。
VRT测量技术已被证明是记录耳石器官神经反应的有用工具，因此是评估植入电极是否提供神经反应的便捷工具。这可用于前庭植入物的早期开发，以改善重力惯性加速度感知。
