ANS031 - Electrically Evoked Vestibulo-ocular Reflex in a Patient with a 23-year History of Bilateral Vestibular Hypofunction
Sunday, May 1, 2022
10:13 AM – 10:20 AM CT
Location: Landmark A
Desi P. Schoo, MD
Andrianna I. Ayiotis, BS
Margaret R. Chow, PhD
Kelly E. Lane
Celia Fernandez Brillet, BS
John P. Carey, MD
Charles C. Della Santina, MD PhD
Fellow Johns Hopkins University School of Medicine BALTIMORE, Maryland
Objective: To characterize the early eye movement responses to vestibular stimulation in a patient implanted with an investigational vestibular implant 23 years after onset of ototoxic bilateral vestibular hypofunction (BVH).
Study Design: Case Report
Setting: Tertiary care center as part of a first-in-human clinical trial.
Patients: 1
Interventions: Unilateral vestibular implantation with an investigational multichannel vestibular implant in a 55-year-old male with a well documented 23-year history of aminoglycoside induced bilateral vestibular hypofunction.
Main Outcome Measures: Electrically evoked vestibulo-ocular reflexes (eeVOR).
Results: Three-dimensional video-oculography during canal specific stimulation shows eeVOR elicited eye movements that approximately aligned with each semicircular canal stimulated. The magnitude of the eeVOR response increased withincreasing stimulus pulse frequency and current amplitude. Response alignment and magnitude were similar to those observed for patients who underwent vestibular implantation less than ten years after BVH onset.
Conclusions: Vestibular implantation and electrical stimulation of the semicircular canal afferent nerves can drive canalspecific eye movement responses in a patient with >20 years of vestibular loss.
*Professional Practice Gap & Educational Need: Limited understanding of the use of vestibular implants in patients with long-term bilateral vestibular hypofunction.
*Learning Objective:Improved understanding of which patients may benefit from a vestibular implant.
*Desired Result: Demonstrate that vestibular implantation and stimulation can drive canal-specific eye movements in patients with a prolonged duration of vestibular loss.
*Level of Evidence - V
*Indicate IRB or IACUC: Johns Hopkins School of Medicine IRB: NA_00051349