• Angel Ramos Macias, Angel Ramos de Miguel, Isaura Rodriguez Montesdeoca, Silvia Borkoski Barreiro, and Juan Carlos Falcón González.
• Department of Otolaryngology, Faculty of Medicine, University of Las Palmas de Gran Canaria, Las Palmas, Spain, ramosorl@idecnet.com.
• Audiol. Neurootol. 2020 Jan 1; 25 (1-2): 79-90.

IntroductionBilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD).MethodsWe included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode.ResultsIn both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation.Discussion/ConclusionProsthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation.© 2019 The Author(s) Published by S. Karger AG, Basel.

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