Hearing Loss After Vestibular Implantation in Sand Rats With Normal Hearing.

Abstract

Bilateral vestibular failure is a debilitating condition that may lead to oscillopia and adversely affect quality of life. Researchers have suggested that vestibular function might be restored with implantation of an external mechanical stimulation device. However, it is essential that such a device must not interfere with normal hearing. To evaluate the effect of vestibular implant insertion on hearing in a sand rat model with normal hearing. The study was conducted in a tertiary medical center in accord with the guidelines of the Rabin Medical Center Animal Care and Use Committee. The experiment was performed in 6 adult, 6-month-old, fat sand rats (Psammomys obesus), which have a unique aural anatomy that permits access to the inner ear. The study dates were March 2013 to March 2014. The sand rats were anesthetized and electrodes were implanted unilaterally (in 6 sand rats) or bilaterally (in 2 sand rats) in all 3 semicircular canals (lateral, then posterior, and then superior) by fenestration of the respective ampullas. To measure air and bone conduction thresholds, auditory nerve brainstem evoked responses to alternating polarity clicks and 1-kHz tone bursts were tested before surgery, at each operative stage, and after surgery. Air or bone conduction threshold shifts after implantation of a vestibular implant electrode array in each semicircular canal. After unilateral implantation of the vestibular implant, sand rats showed a sideways head tilt, whereas after bilateral implantation, sand rats ran around in circles and were unable to stand still or walk on a treadmill. On statistical analysis, statistically significant differences from preoperative values were obtained across all stages of surgery for air conduction thresholds. The largest and statistically significant air conduction shift for 1-kHz stimuli (mean [SD, 13.7 [2.8] dB; P < .004) as well as for clicks (12.5 [2.1] dB; P < .002) was found for the superior canal electrode insertion. For the posterior canal, the air conduction thresholds to 1-kHz stimuli and to clicks shifted significantly after electrode insertion (mean [SD], 7.5 [2.3] dB; P < .01 and 7.5 [0.9] dB; P < .001). For the lateral canal, only the threshold to clicks changed significantly (mean [SD], 5.5 [1.7] dB; P < .02). Bone conduction thresholds did not change significantly after vestibular electrode insertion. Implantation of a vestibular device is associated with mild to moderate conductive hearing loss in fat sand rats with normal hearing, especially when the device is placed in the posterior and superior semicircular canals. Bilateral implantation is associated with major vestibular pathologic results. Further studies are needed in animals with cochlear or vestibular disorders before it can be definitively concluded that vestibular implantation carries only a minor risk to hearing.