title: Prosthetic implantation of the human vestibular system.
abstract: OBJECTIVE
  A functional vestibular prosthesis can be implanted in human such that electrical stimulation of each semicircular canal produces canal-specific eye movements while preserving vestibular and auditory function.
  
  
  BACKGROUND
  A number of vestibular disorders could be treated with prosthetic stimulation of the vestibular end organs. We have previously demonstrated in rhesus monkeys that a vestibular neurostimulator, based on the Nucleus Freedom cochlear implant, can produce canal-specific electrically evoked eye movements while preserving auditory and vestibular function. An investigational device exemption has been obtained from the FDA to study the feasibility of treating uncontrolled Ménière's disease with the device.
  
  
  METHODS
  The UW/Nucleus vestibular implant was implanted in the perilymphatic space adjacent to the three semicircular canal ampullae of a human subject with uncontrolled Ménière's disease. Preoperative and postoperative vestibular and auditory function was assessed. Electrically evoked eye movements were measured at 2 time points postoperatively.
  
  
  RESULTS
  Implantation of all semicircular canals was technically feasible. Horizontal canal and auditory function were largely, but not totally, lost. Electrode stimulation in 2 of 3 canals resulted in canal-appropriate eye movements. Over time, stimulation thresholds increased.
  
  
  CONCLUSIONS
  Prosthetic implantation of the semicircular canals in humans is technically feasible. Electrical stimulation resulted in canal-specific eye movements, although thresholds increased over time. Preservation of native auditory and vestibular function, previously observed in animals, was not demonstrated in a single subject with advanced Ménière's disease.
authors: *Virginia Merrill Bloedel Hearing Research Center and the Department of Otolaryngology-Head and Neck Surgery; †Washington National Primate Research Center; ‡Department of Physiology and Biophysics; §Department of Speech and Hearing Sciences; and ∥Department of Bioengineering; University of Washington, Seattle, Washington, U.S.A.
authors: Justin S
authors: JS
authors: Golub
authors: Leo
authors: L
authors: Ling
authors: Kaibao
authors: K
authors: Nie
authors: Amy
authors: A
authors: Nowack
authors: Sarah J
authors: SJ
authors: Shepherd
authors: Steven M
authors: SM
authors: Bierer
authors: Elyse
authors: E
authors: Jameyson
authors: Chris R S
authors: CR
authors: Kaneko
authors: James O
authors: JO
authors: Phillips
authors: Jay T
authors: JT
authors: Rubinstein
mesh_terms: D004558:Electric Stimulation; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D019919:Prosthesis Implantation; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology; D012665:Semicircular Canals / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D014722:Vestibule, Labyrinth / Q000503:physiopathology / Q000601:surgery*