Vestibular implant improves Posture, Gait, Quality of Life:
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Vestibular implantation in patients with bilateral vestibular hypofunction may improve gait, posture, and quality of life suggests a recent study. But may lead to a reduced hearing in the ear with the implant.

Persons who had had ototoxic (7 participants) or idiopathic (1 participant) bilateral vestibular hypofunction for 2 to 23 years underwent unilateral implantation of a prosthesis that electrically stimulates the three semicircular canal branches of the vestibular nerve.

Clinical outcomes included the score on the Bruininks–Oseretsky Test of Motor Proficiency balance subtest, time to failure on the modified Romberg test, score on the Dynamic Gait Index, and quality of life. They compared participants’ results at baseline with those at 6 months and at 1 year with the device set in its usual treatment mode and in a placebo mode.

--The median scores at baseline and at 6 months on the Bruininks–Oseretsky test were 17.5 and 21.0, respectively; the median times on the modified Romberg test were 3.6 seconds and 8.3 seconds; the median scores on the Dynamic Gait Index were 12.5 and 22.5,

--The median times on the Timed Up and Go test were 11.0 seconds and 8.7 seconds, and the median speeds on the gait-speed test were 1.03 m per second and 1.10 m per second.

--Placebo-mode testing confirmed that improvements were due to treatment-mode stimulation.

--Among the 6 participants who were also assessed at 1 year, changes were generally consistent with results at 6 months.

--Implantation caused ipsilateral hearing loss, with the air-conducted pure-tone average detection threshold at 6 months increasing by 3 to 16 dB in 5 participants and by 74 to 104 dB in 3 participants.

--Changes in participant-reported disability and quality of life paralleled changes in posture and gait.

Conclusively, 6 months and 1 year after unilateral implantation of a vestibular prosthesis for bilateral vestibular hypofunction, measures of posture, gait, and quality of life were generally in the direction of improvement from baseline, but the hearing was reduced in the ear with the implant.

The New England Journal of Medicine
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2020457
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