Methods and clinical outcomes in vestibular implantation - A systematic literature review

BackgroundThe vestibular implant is an experimental device that may provide treatment to patients suffering from bilateral vestibulopathy who do not benefit from standard vestibular rehabilitation.ObjectiveThe objective is to identify the various methodology regarding device designs and surgical approaches in addition to assessing subjective and objective vestibular and clinical outcomes in order to evaluate the future and possible limitations of the vestibular implant.MethodsA systematic search of Medline and Embase was conducted according to the PRISMA guidelines using pre-defined inclusion and exclusion criteria. 350 hits were found, which after 2 rounds of screening by 2 independent reviewers resulted in 21 studies eligible for full-text review.ResultsA total of 36 recipients of a vestibular implant across four centres world-wide were identified. Both surgical approach and devices as well as vestibular and functional outcomes varied greatly across centres and from patient to patient, evaluated using a variety of objective and subjective tests.ConclusionSeveral promising results in vestibular implantation were found using both subjective and objective measurements. However, some questions with regards to hearing preservation and long-term, continuous use of the vestibular implant remain to be answered, and more studies are needed to assess the efficacy and cost-utility of the implant.