meniere's

Cochlear implant could help wearers find balance

For those who have never suffered from a bout of vertigo, the condition might evoke thoughts of Alfred Hitchock and a dizzying fear of heights. Those people would be misguided.

Imagine instead that, for anywhere from 20 seconds to 2 minutes, you are both falling and spinning, and yet you are also lying perfectly still in bed. It is not only nauseating and terrifying, but the disconnect is also completely frustrating.

Millions of people around the world are thought to suffer from one of a number of balance disorders, some of which are still poorly understood (do the problems stem from the ear, brain, or some combination of the two?). However, a new device could help those who suffer from one such problem, called Meniere's disease, avoid symptoms the moment an attack begins.

The implantable device consists of a cochlear implant and a processor with new software and electrode arrays designed by University of Washington researchers who specialize in head and neck surgery, signal processing, brainstem physiology, and vestibular neural coding.

It has been designed specifically to treat Meniere's disease--which affects an estimated 615,000 people in the U.S., typically between ages 40 and 60 and which typically affects one ear--because the disease is well understood. (The attacks result from rupturing of the inner-ear membrane, causing a sensation of spinning in the direction of the failing ear.)

The most common way for those with Meniere's to fight the symptoms of a vertigo attack is to lie very still for hours or, in severe cases, to elect for surgery that essentially shuts off that ear altogether, permanently affecting hearing and balance.

"We have a variety of existing treatments for Meniere's disease, and any time there's a variety it's because none of them are optimal," says Dr. Jay Rubinstein at UW's Department of Otolaryngology-Head and Neck Surgery, who himself has never experienced vertigo--"other than from drinking too much in college"--but who for years has seen first-hand how debilitating it can be. "In theory this is potentially an optimal therapy that could really change how we treat Meniere's."

The device, implanted last week in a 56-year-old patient who is the first of 10 to be involved in the first clinical trials, is essentially an override, Rubinstein explains. "It doesn't change what's happening in the ear, but it eliminates the symptoms while replacing the function of that ear until it recovers."… Read more