A Prosthetic Labyrinth?

Alan Desmond
April 12, 2017

Dr. Charles Della Santina

Last week, I attended a conference at Johns Hopkins in Baltimore, MD. It was described as a ‘Vestibular Master Class”, and I agree that the information and faculty were as good as it gets. There was a fairly international attendance, and many of the top people in the United States and Canada were present. These types of conferences are very helpful, not only for the presented information, but also for the little tidbits you learn from speaking with others with similar or greater experience. 

The most fascinating presentation to me was done by Dr. Charles Della Santina from Hopkins. He presented on the current status of a vestibular prosthesis that is currently in clinical trials. He has implanted three patients so far, with encouraging results. The prosthesis is reminiscent of a cochlear implant, in that energy is converted into electrical impulses that are then delivered to the inner ear. With a cochlear implant, sound waves are converted to electricity, and sent to the cochlea (the hearing part of the inner ear). With the Labyrinth Prosthesis, movement is converted to electricity, and sent to various sensors within the labyrinth.  Electrodes are inserted into the motion sensors in each of the three semi-circular canals, while a motion sensor worn on the head registers movement and converts the movement into electrical impulses.

He showed video of the surgery (Amazing!) and video of patients that could detect motion based on changes in electrical currents sent to the electrodes. When the horizontal canal was stimulated, they would register horizontal movement, measured by the patient moving a light bar in the direction of perceived movement. The same was true of posterior and anterior canal stimulation.

The three patients implanted so far are doing so well that the FDA actually loosened up their requirements so the patients could continue to use the implant, as the original application only allowed temporary use of the implant on a trial basis. One of the patients actually sent Dr. Della Santina video of him running on a treadmill.

For more information, you can get on the Johns Hopkins website. If you are interested in the possibility of participating in the trial, click here for an application.

birdsong hearing benefits
  1. I am an Au.D. My sister has very strange symptoms and I don’t know where to send her. I have sent her to Timothy Hain, MD, who admits he hasn’t seen before what is displayed. She has occasional mild low frequency SNHL (usually the left ear) accompanying by ear fullness for which a conventional ENT prescribed hydrochlorathiazide which provides relief, occasional BPPV down right, occasional horizontal nystagmus (left beating), suspicion of cervical vertigo for which she tries to remediate by keeping her head straight and steady, chronic imbalance, diagnosed fibromyalgia, mild hearing loss which causes disproportionate problems hearing in background noise (yes she has hearing aids–expensive ones), occasional but sometimes serious problems with speech processing, chronic nausea, occasional sense of being “hot”, and frequent burping (she does have a twisted colon) that seems to accompany the nausea which can be incapacitating, absent VEMPs and normal ABR. Mayo is booked out two years for Medicare pts. Where do I send her for an ENT/neurologic work-up? She has everyone stumped and me very sad. We’ll fly anywhere.

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