News | 1 August 2019

Clinical trial examines everyday use of vestibular implant

Funding should expedite treatment for patients with balance disorders

The vestibular implant is one step closer to being introduced, thanks to funding amounting to more than €700,000 from the Netherlands Organisation for Health Research and Development (ZonMw), Health Holland and the Heinsius Houbolt Fund. The funding will enable researchers at Maastricht UMC+ to implant an artificial version of the miniscule organ in eight patients who have a severe balance disorder. This will be the first time that patients with a vestibular implant will simulate everyday life in a controlled environment. The aim of the trial is to make the treatment available to patients sooner.

Micro-CT scan of the human inner ear. Individual nerves are shown in yellow, bone and membrane structures in blue (Copyright: Maastricht UMC+)Micro-CT scan of the human inner ear. Individual nerves are shown in yellow, bone and membrane structures in blue (Copyright: Maastricht UMC+)The vestibular system lies deep in the petrosal bone, behind the ear (one on each side), where it brings stability to the world around us. People whose vestibular system fails on both sides become disoriented, dizzy and/or uncomfortable every time they move their head. They constantly lose their balance and their everyday lives are therefore severely limited. No less than three quarters of such patients are unfit for work, for example. Until now, neither surgery or medication offered relief, but the vestibular implant is set to change all that.

Everyday use
The vestibular implant is a small medical aid that takes over the function of the "real" organ. For a start, it registers the patient's movements and transmits the signals to the brain to determine their physical orientation and maintain balance. Since the first prototype was developed in 2012, surgeons at Maastricht UMC+ and the University Hospital of Geneva have implanted the artificial vestibular system in thirteen patients. So far, the implants have only been tested in a clinical research setting. "Now it's time to let patients test the implant in everyday life," say ENT specialist Dr Raymond van de Berg and colleague Marc van Hoof.

Quality of life
The funding makes it possible to give eight patients with bilateral failure of the vestibular system a vestibular implant. Patients will be admitted to a rehabilitation centre after surgery, where the everyday use, functioning and safety of the implant can be analysed. The trial will also give the researchers an opportunity to examine the patients' personal wishes and requirements and whether it is possible to increase and improve the amount and quality of information sent from the implant to the brain. "The ultimate goal is to help patients achieve a better balance, both literally and figuratively, so that their quality of life improves and they can participate more fully in society," says Van de Berg.

There are an estimated 500,000 patients with balance disorders in Europe. A vestibular implant could help hundreds of patients in the Netherlands. The study is entitled "VertiGO!" and has been made possible by Health Holland, the Hoormij Foundation, 'De negende van' Foundation, the Usher Syndrome Foundation and external partners such as the University of Geneva, manufacturer MED-EL, the Heinsius Houbolt Fund, the Apeldoorns Duizeligheidscentrum, Leiden University Medical Centre and Radboud University Medical Centre.