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The Vestibular System

The Vestibular System

The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.

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Electrical Vestibular Stimulation in Humans: A Narrative Review.

Morgana Sluydts¹, Ian Curthoys², Robby Vanspauwen³

¹European Institute for Otorhinolaryngology, GZA Hospitals Antwerp, Wilrijk, Belgium, morgana.sluydts@gza.be.

Audiology & Neuro-Otology

|September 19, 2019

Summary

Electrical vestibular stimulation (EVS) offers new hope for bilateral vestibulopathy patients. Three promising EVS methods—co-stimulation with cochlear implants, vestibular implants, and galvanic vestibular stimulation—are under investigation.

Keywords:

Electrical stimulation Galvanic vestibular stimulation Humans Vestibular co-stimulation Vestibular implant

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Area of Science:

Neuroscience
Biomedical Engineering
Otolaryngology

Background:

Bilateral vestibulopathy treatments like medication and surgery are often insufficient.
Research is exploring electrical vestibular stimulation (EVS) to restore vestibular function.
Three EVS approaches are under investigation: cochlear implant (CI) co-stimulation, vestibular implant (VI), and galvanic vestibular stimulation (GVS).

Purpose of the Study:

To investigate the potential of EVS in restoring vestibular function for patients with bilateral vestibulopathy.
To compare the efficacy and applicability of CI co-stimulation, VI, and GVS.
To determine the most suitable EVS approach for different patient profiles.

Main Methods:

Vestibular co-stimulation using existing cochlear implants.
Development and testing of vestibular implant (VI) prototypes.
Application of galvanic vestibular stimulation (GVS) using surface electrodes.

Main Results:

CI activation can stimulate vestibular structures, suggesting potential for co-stimulation.
VI prototypes have demonstrated feasibility and the ability to activate vestibular reflexes.
GVS, while unspecific, is a non-invasive stimulation method.
All investigated EVS methods show promising results in activating vestibular reflexes.

Conclusions:

EVS approaches, including CI co-stimulation, VI, and GVS, show promise for treating bilateral vestibulopathy.
Further research is needed to establish consensus on the ideal EVS method for specific patient groups.
Multiple EVS strategies may be beneficial due to the diverse needs of patients with vestibular dysfunction.