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THE VESTIBULAR IMPLANT

Under normal circumstances the organ of balance records movements of the head. These movements of the head are converted into electrical signals that are passed on to both equilibrium nerves. These signals are processed inthe brain and in this way movements are observed. This leads to, among others, image stabilisation, balance and spacial orientation.
With people suffering from Usher Syndrome type 1 the organ of balance is not functioning, as a result of which these bodily functions can be disrupted.

The purpose of the vestibular implant is to partly recover the functions of the organs of balance. The implant has been composed of an external part which, just like a cochlear implant, can be magnetically connected with the surgically implanted internal part. This surgery is similar to that of a cochlear implant. The external part includes, among other things, gyroscopes, which observe and measure the movements of the head. Subsequently, a microprocessor converts this information into electrical signals. These electrical signals are passed on through the internal part of the implant to the ends of the equilibrium nerve in the organ of balance.

A team of researchers and physicians in Maastricht and Geneva is conducting pilot studies into an artificial organ of balance and/or vestibular implant for patients whose organs of balance have both failed.

‘We implanted the VI with the first people in 2012’, ENT specialist Raymond van de Berg (Maastricht UMC+) tells us. ‘We are still in the testing phase, but the results are promising. We believe that this will be more widely applicable in the future.’
His colleague Joost Stultiens (research physician Maastricht UMC+) is doing a study into the further development of the implant. He tells us: ‘We found out that we could recover certain functions of the organs of balance of the patients who had undergone surgery. We are now further improving the implant and the implanting technique.’

Recently, the researchers in the Maastricht UMC+ were granted a large subsidy for testing the use of a vestibular implant (VI) in daily life with a number of test persons. This is a major step on the way to the objective to make available the VI to all patients with failing organs of balance on both sides in a few years. Apart from this, people are working on the development of a vestibular and cochlear implant in one, the so-called vestibulo-cochlear implant (VCI).

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BALANCE BELT

The BalanceBelt has been developed for people with failing organs of balance and is meant for maintaining balance. Our brain combines information coming from various systems in order to reach equilibrium/balance. Apart from information coming from the organs of balance in both ears, this also includes information from the eyes and from the rest of the body (such as the muscles and, more specifically, the muscle spindles).
The BalanceBelt strengthens the information coming from the muscle spindles by giving vibration signals when someone is about to loose his balance. The person wearing the belt then automatically corrects his body posture.

The first results of clinical pilot studies in a hospital environment and at home are highly satisfactory. The BalanceBelt can be a help for people suffering from Usher Syndrome type 1, because the information that the brain receives from the eyes decreases in the course of life, so this information from the eyes can less contribute to maintaining balance. This can make a person dependent on other balance systems.
The BalanceBelt strengthens the information coming from the muscle spindles and can thus improve balance.

The BalanceBelt is an aid that not only – literally – keeps people more in balance, but it also gives them enough confidence to pick up daily life again. The balance belt is an idea of Professor Herman Kingma of the Maastricht UMC+ and was developed in cooperation with engineers of the University of Maastricht, the Netherlands. The licence rights are now transferred to the company Elitac BV in Utrecht, the Netherlands, which is specialised in so-called haptic wearables (technology in which communication with the user is established through movement or vibrations).

The objective is to make this aid available to patients through referral by an ENT specialist. It is still to be determined in consultation with the health insurance companies whether the BalanceBelt will be fully or partially covered.

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