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Related Experiment Video

Updated: Jan 24, 2026

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
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Electrical Vestibular Co-stimulation by Lateral Wall Cochlear Implant Electrode Arrays.

Laura Fröhlich1, Julia K Mollet1, Ahmed Salha1

  • 1Department of Otorhinolaryngology, University Hospital Bonn, University of Bonn, Bonn, Germany.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|January 23, 2026
PubMed
Summary

Electrical stimulation via cochlear implant (CI) electrodes can activate the vestibular system, causing vestibular co-stimulation. This occurs more frequently with basal electrodes and may happen before sounds are audible, impacting daily CI use.

Keywords:
Co-stimulationCochlear implantElectrical stimulationLateral wall electrodesVEMPVestibular

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Area of Science:

  • Neuroscience
  • Audiology
  • Otolaryngology

Background:

  • Cochlear implants (CIs) can potentially stimulate the vestibular system.
  • Understanding vestibular responses to electrical stimulation is crucial for CI users.

Purpose of the Study:

  • To analyze cervical and ocular vestibular-evoked myogenic potentials (e-cVEMPs and e-oVEMPs) using straight lateral wall CI electrodes.
  • To evaluate response characteristics (numbers, amplitudes, latencies, thresholds) based on electrode position.

Main Methods:

  • Recorded e-cVEMPs and e-oVEMPs in adult CI patients using electric pulse trains.
  • Stimulated with electrodes at apical (E3), medial (E6), and basal (E10, E11) positions.
  • Recorded VEMPs via bone-conducted vibration (BCV) as a reference.

Main Results:

  • e-VEMPs were measured in 95% of participants; BCV-VEMPs in 60%.
  • Basal electrode stimulation showed higher response rates and comparable amplitudes to BCV-VEMPs.
  • e-VEMP thresholds were within clinical fitting levels for basal electrodes.

Conclusions:

  • Straight lateral wall CI electrodes demonstrate vestibular co-stimulation in most patients (95%).
  • Basal electrodes are more likely to induce vestibular co-stimulation than apical or medial ones.
  • Vestibular co-stimulation can occur before electric stimuli are audible, potentially during daily CI use.