The Need for Vestibular Implants in a Tertiary Referral Ear, Nose, and Throat Center and Its Relation to Hearing Status.

Abstract

Patients with bilateral vestibulopathy (BVP) are at increased risk of falling and have poor quality of life. Several research groups are currently developing and investigating vestibular implants to treat BVP. The goal was to identify how many patients can be considered eligible for vestibular implantation. The objective vestibular implantation criteria for research were applied to the results of the caloric irrigation test, the sinusoidal harmonic acceleration test, the video head impulse test, and the cervical and ocular vestibular evoked myogenic potential tests. Vestibular implant eligibility was situated between 3.6% and 15.7% (semicircular canal implant: 3.6%; otolith implant: 15.7%; combined implant: 4.8%). Only 16 out of the 29 patients (55%) eligible for a vestibular implant had bilateral severe-to-profound hearing loss. The remaining 45% (13/29) thus have better hearing in at least 1 ear. Vestibular implant eligibility in an ear, nose, and throat department was situated between 3.6% and 15.7%, depending on the type of implant that was considered. In addition, the data showed that 45% of the eligible patients had normal-to-moderate hearing in at least 1 ear. In other words, only recruiting patients with (bilateral) severe-to-profound hearing loss for vestibular implantation leads to the systematic exclusion of about half of the candidates. Structure-preserving surgical techniques are thus a major future challenge in the field of vestibular implantation.