scholarly journals Differences in Vestibular-Evoked Myogenic Potential Responses by Using Cochlear Implant and Otolith Organ Direct Stimulation

2021 ◽  
Vol 12 ◽  
Author(s):  
Isaura Rodriguez Montesdeoca ◽  
Angel Ramos de Miguel ◽  
Juan Carlos Falcon González ◽  
Silvia Borkoski Barreiro ◽  
Nicolás Pérez Fernández ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Clinical Effect ◽  
Electrode Array ◽  
Vestibular Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Otolith Organ ◽  
Vestibular Evoked Myogenic Potential ◽  
Direct Stimulation ◽  
Vestibular Implant ◽  
Stimulation Of

Objective: Several studies have demonstrated the possibility to obtain vestibular potentials elicited with electrical stimulation from cochlear and vestibular implants. The objective of this study is to analyze the vestibular-evoked myogenic potentials (VEMPs) obtained from patients implanted with cochlear and vestibulo-cochlear implant.Material and Methods: We compared two groups: in the first group, four cochlear implant (CI) recipients with present acoustic cVEMPs before CI surgery were included. In the second group, three patients with bilaterally absent cVEMPs and bilateral vestibular dysfunction were selected. The latter group received a unilateral cochleo-vestibular implant. We analyze the electrically elicited cVEMPs in all patients after stimulation with cochlear and vestibular electrode array stimulation.Results: We present the results obtained post-operatively in both groups. All patients (100%) with direct electrical vestibular stimulation via the vestibular electrode array had present cVEMPs. The P1 and N1 latencies were 11.33–13.6 ms and 18.3–21 ms, respectively. In CI patients, electrical cVEMPs were present only in one of the four subjects (25%) with cochlear implant (“cross”) stimulation, and P1 and N1 latencies were 9.67 and 16.33, respectively. In these patients, the responses present shorter latencies than those observed acoustically.Conclusions: Electrically evoked cVEMPs can be present after cochlear and vestibular stimulation and suggest stimulation of vestibular elements, although clinical effect must be further studied.

scholarly journals Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 79-90 ◽  
Author(s):  
Angel Ramos Macias ◽  
Angel Ramos de Miguel ◽  
Isaura Rodriguez Montesdeoca ◽  
Silvia Borkoski Barreiro ◽  
Juan Carlos Falcón González
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Otolith Organ ◽  
Bilateral Vestibulopathy ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Introduction: Bilateral 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). Methods: We 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. Results: In 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/Conclusion: Prosthetic 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.

Comparison of Electrically Evoked Whole-Nerve Action Potential and Electrically Evoked Auditory Brainstem Response Thresholds in Nucleus CI24R Cochlear Implant Recipients

2002 ◽  
Vol 13 (08) ◽  
pp. 416-427 ◽  
Author(s):  
Marcia J. Hay-McCutcheon ◽  
Carolyn J. Brown ◽  
Kelly Schmidt Clay ◽  
Keely Seyle
Keyword(s):  
Action Potential ◽  
Cochlear Implant ◽  
Auditory Brainstem Response ◽  
Electrode Array ◽  
Auditory Brainstem ◽  
Electrode Arrays ◽  
Direct Stimulation ◽  
Nerve Action ◽  
Brainstem Response ◽  
Response Thresholds

In this study, differences between electrically evoked whole-nerve action potential (EAP) and electrically evoked auditory brainstem response (EABR) measurements within Nucleus CI24R cochlear implant recipients were evaluated. Precurved modiolus-hugging internal electrode arrays, such as the CI24R, are designed to provide more direct stimulation of neural elements of the modiolus. If the electrode array is closer to the modiolus, electrically evoked and behavioral levels might be lower than were previously recorded for the straight electrode array, the CI24M. EAP and EABR growth functions and behavioral levels were obtained for 10 postlingually deafened adults. Results revealed no significant differences between EAP and EABR threshold levels, and these levels were not significantly lower than those obtained using the CI24M.

scholarly journals Characteristics and clinical use of ocular and cervical vestibular evoked myogenic potentials for evaluating paediatric candidates for cochlear implants

2016 ◽  
Vol 131 (1) ◽  
pp. 56-63 ◽  
Author(s):  
X-D Xu ◽  
J Hu ◽  
Q Zhang ◽  
Y Zhang ◽  
X-T Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cochlear Implant ◽  
Inner Ear ◽  
Temporal Bone ◽  
Cochlear Implants ◽  
Bone Structure ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Ear Malformations

AbstractObjective:This study aimed to define the characteristics and use of ocular and cervical vestibular evoked myogenic potentials for evaluating paediatric cochlear implant candidates.Methods:Ocular and cervical vestibular evoked myogenic potentials of 34 paediatric cochlear implant candidates were analysed. All patients also underwent a routine audiological examination, including computed tomography.Results:In all, 27 patients with normal inner-ear structures had absent or impaired vestibular evoked myogenic potential responses. In paediatric candidates with inner-ear malformations, ocular and cervical vestibular evoked myogenic potentials had lower thresholds and higher amplitudes. Vestibular evoked myogenic potential responses in this cohort were classified into three groups. There was significant concordance between vestibular evoked myogenic potentials and temporal bone computed tomography findings.Conclusion:Ocular and cervical vestibular evoked myogenic potential waveforms were different in paediatric candidates with normal and abnormal inner-ear structures. Therefore, vestibular evoked myogenic potential responses can indicate temporal bone structure.

scholarly journals The Role of BMP Signaling in Osteoclast Regulation

2021 ◽  
Vol 9 (3) ◽  
pp. 24
Author(s):  
Brian Heubel ◽  
Anja Nohe
Keyword(s):  
Bone Formation ◽  
Bone Morphogenetic Proteins ◽  
Bone Diseases ◽  
Bmp Signaling ◽  
Bone Homeostasis ◽  
Direct Stimulation ◽  
Federal Drug Administration ◽  
Bmp Pathway ◽  
Stimulation Of

The osteogenic effects of Bone Morphogenetic Proteins (BMPs) were delineated in 1965 when Urist et al. showed that BMPs could induce ectopic bone formation. In subsequent decades, the effects of BMPs on bone formation and maintenance were established. BMPs induce proliferation in osteoprogenitor cells and increase mineralization activity in osteoblasts. The role of BMPs in bone homeostasis and repair led to the approval of BMP2 by the Federal Drug Administration (FDA) for anterior lumbar interbody fusion (ALIF) to increase the bone formation in the treated area. However, the use of BMP2 for treatment of degenerative bone diseases such as osteoporosis is still uncertain as patients treated with BMP2 results in the stimulation of not only osteoblast mineralization, but also osteoclast absorption, leading to early bone graft subsidence. The increase in absorption activity is the result of direct stimulation of osteoclasts by BMP2 working synergistically with the RANK signaling pathway. The dual effect of BMPs on bone resorption and mineralization highlights the essential role of BMP-signaling in bone homeostasis, making it a putative therapeutic target for diseases like osteoporosis. Before the BMP pathway can be utilized in the treatment of osteoporosis a better understanding of how BMP-signaling regulates osteoclasts must be established.

scholarly journals EEG-based diagnostics of the auditory system using cochlear implant electrodes as sensors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ben Somers ◽  
Christopher J. Long ◽  
Tom Francart
Keyword(s):  
Cochlear Implant ◽  
Auditory Evoked Potentials ◽  
Human Subjects ◽  
Electrode Array ◽  
Brain Regions ◽  
Hearing Impaired ◽  
Brain Responses ◽  
Listening Environments ◽  
Set Up ◽  
Neural Feedback

AbstractThe cochlear implant is one of the most successful medical prostheses, allowing deaf and severely hearing-impaired persons to hear again by electrically stimulating the auditory nerve. A trained audiologist adjusts the stimulation settings for good speech understanding, known as “fitting” the implant. This process is based on subjective feedback from the user, making it time-consuming and challenging, especially in paediatric or communication-impaired populations. Furthermore, fittings only happen during infrequent sessions at a clinic, and therefore cannot take into account variable factors that affect the user’s hearing, such as physiological changes and different listening environments. Objective audiometry, in which brain responses evoked by auditory stimulation are collected and analysed, removes the need for active patient participation. However, recording of brain responses still requires expensive equipment that is cumbersome to use. An elegant solution is to record the neural signals using the implant itself. We demonstrate for the first time the recording of continuous electroencephalographic (EEG) signals from the implanted intracochlear electrode array in human subjects, using auditory evoked potentials originating from different brain regions. This was done using a temporary recording set-up with a percutaneous connector used for research purposes. Furthermore, we show that the response morphologies and amplitudes depend crucially on the recording electrode configuration. The integration of an EEG system into cochlear implants paves the way towards chronic neuro-monitoring of hearing-impaired patients in their everyday environment, and neuro-steered hearing prostheses, which can autonomously adjust their output based on neural feedback.

scholarly journals In-Vitro Study of Speed and Alignment Angle in Cochlear Implant Electrode Array Insertions

2021 ◽  
pp. 1-1
Author(s):  
Philipp Aebischer ◽  
Georgios Mantokoudis ◽  
Stefan Weder ◽  
Lukas Anschutz ◽  
Marco Caversaccio ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
In Vitro Study ◽  
Vitro Study ◽  
Alignment Angle

scholarly journals The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy

2021 ◽  
Vol 11 (9) ◽  
pp. 4144
Author(s):  
Ohad Cohen ◽  
Jean-Yves Sichel ◽  
Chanan Shaul ◽  
Itay Chen ◽  
J. Thomas Roland ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
Cost Effective ◽  
X Rays ◽  
Normal Anatomy ◽  
Electrode Arrays ◽  
Plain Radiographs ◽  
Hearing Function ◽  
Tertiary Center ◽  
Cochlear Implant Surgery

Although malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement. The purpose of this report was to assess the incidence and describe cases in which intraoperative plain radiographs detected a malpositioned array. Intraoperative anti-Stenver’s view plain X-rays are conducted routinely in all CI surgeries in our tertiary center before awakening the patient and breaking the sterile field. Data of patients undergoing 399 CI surgeries were retrospectively analyzed. A total of 355 had normal inner ear and temporal bone anatomy. Patients with intra or extracochlear malpositioned electrode arrays demonstrated in the intraoperative X-ray were described. There were four cases of electrode array malposition out of 355 implantations with normal anatomy (1.1%): two tip fold-overs, one extracochlear placement and one partial insertion. All electrodes were reinserted immediately; repeated radiographs were normal and the patients achieved good hearing function. Intraoperative plain anti-Stenver’s view X-rays are valuable to confirm electrode array location, allowing correction before the conclusion of surgery. These radiographs are cheaper, faster, and emit much less radiation than other imaging options, making them a viable cost-effective tool in patients with normal anatomy.

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