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Title: The vestibular implant: Opinion statement on implantation criteria for research
Authors: van de Berg, Raymond
Ramos Macías, Ángel Manuel 
van Rompaey, Vincent
Bisdorff, Alexandre
Perez-Fornos, Angelica
Rubinstein, Jay T.
Phillips, James O.
Strupp, Michael
Della Santina, Charles C.
Guinand, Nils
UNESCO Clasification: 32 Ciencias médicas
3314 Tecnología médica
Keywords: VOR
Vestibular implant
Bilateral vestibular areflexia
Bilateral vestibular hypofunction
Bilateral vestibular loss, et al
Issue Date: 2020
Journal: Journal of Vestibular Research: Equilibrium and Orientation 
Abstract: This opinion statement proposes a set of candidacy criteria for vestibular implantation of adult patients with bilateral vestibulopathy (BVP) in a research setting. The criteria include disabling chronic symptoms like postural imbalance, unsteadiness of gait and/or head movement-induced oscillopsia, combined with objective signs of reduced or absent vestibular function in both ears. These signs include abnormal test results recorded during head impulses (video head impulse test or scleral coil technique), bithermal caloric testing and rotatory chair testing (sinusoidal stimulation of 0.1 Hz). Vestibular implant (VI) implantation criteria are not the same as diagnostic criteria for bilateral vestibulopathy. The major difference between VI-implantation criteria and the approved diagnostic criteria for BVP are that all included vestibular tests of semicircular canal function (head impulse test, caloric test, and rotatory chair test) need to show significant impairments of vestibular function in the implantation criteria. For this, a two-step paradigm was developed. First, at least one of the vestibular tests needs to fulfill stringent criteria, close to those for BVP. If this is applicable, then the other vestibular tests have to fulfill a second set of criteria which are less stringent than the original criteria for BVP. If the VI-implantation is intended to excite the utricle and/or saccule (otolith stimulation), responses to cervical and ocular vestibular evoked myogenic potentials must be absent in addition to the above mentioned abnormalities of semicircular canal function. Finally, requirements for safe and potentially effective stimulation should be met, including implanting patients with BVP of peripheral origin only, and assessing possible medical and psychiatric contraindications.
ISSN: 0957-4271
DOI: 10.3233/VES-200701
Source: Journal of Vestibular Research: Equilibrium and Orientation [ISSN 0957-4271], v. 30(3), p. 213-223 (Julio 2020)
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