Severe bilateral vestibular loss (BVL), regardless of etiology, often is accompanied by significant, chronic symptoms of general imbalance, instability, and blurred vision (oscillopsia) with head movement. These symptoms necessitate lifestyle changes, and possible discontinuation of certain everyday activities. Furthermore, patients become reliant on visual and somatosensory cues to maintain balance.
This creates significant functional impairment when walking in dimly lit environments, traversing uneven surfaces, driving, and jogging. Unlike unilateral vestibular impairments, the vestibular ocular reflex (VOR) in BLV patients cannot be salvaged by the contributions of the still functioning side by the process of compensation. However, there is new hope for BVL patients as an ongoing clinical trial is promising partial, long-term restoration of VOR gain in subjects fit with a unilateral vestibular implant.
The multichannel implant was developed by a team of researchers at Johns Hopkins School of Medicine and is like a cochlear implant in that an internal electrode array is surgically placed, and an external processor is magnetically coupled. Three electrodes are placed to stimulate the cupulae of each semicircular canal (lateral, posterior, and anterior). The study reports that four human subjects with ototoxic BVL have been tracked between 350–812 days of continuous use of the device.
All subjects have shown growth and at least partial restoration of VOR gain in all three vectors associated with semicircular canals stimulated. Additionally, subjects currently enrolled report reduction of chronic symptoms and are resuming activities they were previously unable to perform. While initial results are promising more subjects are needed to enroll in the ongoing clinical trial before the device becomes a viable option for BVL patients.
Boutros PJ, Schoo, DP, Rahman M, et al. (2019) Continuous vestibular implant stimulation partially restores eye-stabilizing reflexes. JCI Insight. 4(22): e128397.
During the COVID-19 pandemic, the American Academy of Audiology (2020) provided audiologists with guidance regarding the use of telehealth services. In October 2021, the Academy released a position statement titled The Use of Telehealth for the Delivery of Audiological Services. Members can access this statement here. While the COVID-19 pandemic may have expanded telehealth services,…
Attention Deficit Hyperactivity Disorder (ADHD) affects approximately five percent of the pediatric population. Up to 50 percent of children with ADHD also exhibit motor control and balance issues in addition to the more commonly seen symptoms of hyperactivity, impulsivity and inattention. Fidgeting, poor motor planning, increased postural sway, and difficulty sitting still may be related…
At the end of September 2022, the Centers for Disease Control and Prevention (CDC) released data overviewing rates of death resulting from unintentional falls between the years of 1999–2020 by adults 65 years and older (Garnett et al, 2022). The report showed that death rates have increased, with the largest increase seen by those aged…