Affiliations: [a] Massachusetts Eye and Ear Infirmary, Boston, MA, USA | [b] Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA
Correspondence:
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Corresponding author: Daniel M. Merfeld, Jenks Vestibular Physiology Laboratory, Room 421, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Tel.: +1 617 573 5595; Fax: +1 617 575 5594; E-mail: dan_merfeld@meei.harvard.edu
Abstract: Among other problems, patients with vestibular problems suffer imbalance, spatial disorientation, and blurred vision. These problems lead to varying degrees of disability and can be debilitating. Unfortunately, a large number of patients with vestibular complaints cannot be diagnosed with the clinical tests available today. Nor do we have treatments for all patients that we can diagnose. These clinical problems provide challenges to and opportunities for the field of vestibular research. In this paper, we discuss some new diagnostic and treatment options that could become available for tomorrow's patients. As a new diagnostic, we have begun measuring patient's perceptual direction-detection thresholds. Preliminary results appear encouraging; patients diagnosed with bilateral loss have yaw rotation thresholds almost ten times greater than normals, while patients diagnosed with migraine associated vertigo have roll tilt thresholds well below normal at 0.1 Hz. As a new treatment, we have performed animal studies looking at responses evoked by electrical stimulation provided by a vestibular prosthesis. Results measuring the VOR demonstrate promise and preliminary studies of balance and perception are also encouraging. While electrical stimulation is a standard means of stimulation, optical stimulation is also being investigated as a way to improve prosthetic stimulation specificity.
