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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuro-Otology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1520554
This article is part of the Research Topic Artificial stimulation of the vestibular labyrinth: galvanic, magnetic, vibration, sound, and prostheses View all 4 articles

Enhancing Balance and Auditory Function in Bilateral Vestibulopathy through Otolithic Vestibular Stimulation: Insights from a Pilot Study on cochlea-vestibular implant efficacy

Provisionally accepted
Angel Ramos De Miguel Angel Ramos De Miguel 1Morgana Sluydts Morgana Sluydts 2Juan Carlos Falcón-González Juan Carlos Falcón-González 3Raquel Manrique-Huarte Raquel Manrique-Huarte 4ISAURA RODRIGUEZ MONTESDEOCA ISAURA RODRIGUEZ MONTESDEOCA 3Andrzej J ZAROWSKI Andrzej J ZAROWSKI 2Maurizio Barbara Maurizio Barbara 5Manuel Jesus Manrique Rodriguez Manuel Jesus Manrique Rodriguez 4Silvia Borkoski Barreiro Silvia Borkoski Barreiro 3Joan Lorente Joan Lorente 4Marc Leblanc Marc Leblanc 2Antonin Rambault Antonin Rambault 6Erika Van Baelen Erika Van Baelen 6Carl Van Himbeeck Carl Van Himbeeck 6Alicia Huarte Alicia Huarte 4Angel Ramos-macias Angel Ramos-macias 3*
  • 1 University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
  • 2 GZA, Antwerp, Antwerp, Belgium
  • 3 Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain
  • 4 University Clinic of Navarra, Pamplona, Navarre, Spain
  • 5 Sapienza University of Rome, Rome, Lazio, Italy
  • 6 Cochlear Technology Center Belgium, Mechelen, Belgium

The final, formatted version of the article will be published soon.

    This study evaluates the efficacy of cochleovestibular implants (CVI) in improving auditory and vestibular function in patients with bilateral vestibulopathy and severe-to-profound hearing loss. Significant improvements were observed in both hearing and balance outcomes, underscoring the therapeutic potential of otolithic stimulation. Pure-tone audiometry scores improved from a preoperative mean of 78 dB HL to 34 dB HL at three months and 36 dB HL at nine months postimplantation, accompanied by notable gains in speech recognition in silence. Vestibular assessments demonstrated enhanced dynamic gait and postural stability, with the Dynamic Gait Index (p < 0.05) in 9 out of 10 participants postoperatively, reaching normal levels in most cases. Posturography results indicated substantial gains in stability, with Sensory Organization Test (SOT) scores improving from a preoperative average of 33% to 68% postoperatively with the CVI activated (p < 0.05). Perceived disability, as measured by the Dizziness Handicap Inventory, showed marked reductions in emotional and functional impacts. Residual balance improvements after device deactivation suggest adaptive neural changes, while placebo-controlled testing confirmed participants could distinguish cochlearonly from cochleovestibular stimulation. These findings highlight the CVI's capacity to restore auditory and vestibular function, offering a promising intervention for patients with bilateral vestibular dysfunction. Future research will optimize device design and stimulation parameters to enhance outcomes further.

    Keywords: Bilateral vestibular dysfunction, Otolithic implants, Cochleovestibular implant, Dynamic gait index, balance improvement, Vestibular Rehabilitation

    Received: 31 Oct 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Ramos De Miguel, Sluydts, Falcón-González, Manrique-Huarte, RODRIGUEZ MONTESDEOCA, ZAROWSKI, Barbara, Manrique Rodriguez, Borkoski Barreiro, Lorente, Leblanc, Rambault, Van Baelen, Van Himbeeck, Huarte and Ramos-macias. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Angel Ramos-macias, Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.