Evidence map›Paper›PMID 33567192›Full record

Trial reportThe New England journal of medicine2021

Posture, Gait, Quality of Life, and Hearing with a Vestibular Implant.

Margaret R Chow, Andrianna I Ayiotis, Desi P Schoo, Yoav Gimmon, Kelly E Lane, Brian J Morris, Mehdi A Rahman, Nicolas S Valentin, Peter J Boutros, Stephen P Bowditch and 6 more

6 registry-linked trialsOpen access · bronzeAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 64 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 1 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02725463 naactive not recruitingnot on this map

First-in-Human Early Feasibility Study of Safety, Tolerability and Efficacy for a Multichannel Vestibular Implant in Individuals With Bilateral Severe-to-Profound Loss of Vestibular Sensation

TypeinterventionalSponsorJohns Hopkins UniversityRan2016 to 2028Enrolled30ConditionsOther Disorders of Vestibular Function, Bilateral, Bilateral Vestibular Deficiency (BVD), Gentamicin Ototoxicity, Labyrinth DiseasesArmsLabyrinth Devices MVI™ Multichannel Vestibular Implant
NCT05674786 narecruitingnot on this mapstarted 2023, after this paper: background citation

Vestibular Implantation to Treat Adult-Onset Bilateral Vestibular Hypofunction

TypeinterventionalSponsorJohns Hopkins UniversityRan2023 to 2027Enrolled8ConditionsOther Disorders of Vestibular Function, Bilateral, Bilateral Vestibular Deficiency (BVD), Gentamicin Ototoxicity, Labyrinth DiseasesArmsLabyrinth Devices MVI™ Multichannel Vestibular Implant System
NCT05676944 narecruitingnot on this mapstarted 2023, after this paper: background citation

Vestibular Implantation in Older Adults

TypeinterventionalSponsorJohns Hopkins UniversityRan2023 to 2028Enrolled15ConditionsOther Disorders of Vestibular Function, Bilateral, Bilateral Vestibular Deficiency (BVD), Gentamicin Ototoxicity, Labyrinth DiseasesArmsLabyrinth Devices MVI™ Multichannel Vestibular Implant System
NCT06500975 narecruitingnot on this mapstarted 2024, after this paper: background citation

Long Term Outcomes After Vestibular Implantation

TypeinterventionalSponsorJohns Hopkins UniversityRan2024 to 2029Enrolled32ConditionsBilateral Vestibular Hypofunction, Bilateral Vestibular Deficiency, Bilateral Vestibulopathy, Gentamicin OtotoxicityArmsLabyrinth Devices MVI™ Multichannel Vestibular Implant System
NCT07627087 narecruitingnot on this mapstarted 2026, after this paper: background citation

Vestibular Implant Tested in Patients With Peripheral Vestibular Damage: Effects on Spatial Orientation, Navigation, and Neuropsychologic Function

TypeinterventionalSponsorMassachusetts Eye and Ear InfirmaryRan2026 to 2029Enrolled20ConditionsVestibular Dysfunction, Bilateral Vestibular Loss, Vestibular ImplantArmsvestibular implant stimulation
NCT07709143 recruitingnot on this mapstarted 2024, after this paper: background citation

The Clinical Trial Protocol: MRI Performance and Risk Factors of Bilateral Vestibular Hypofunction: A Multi-center Cross-sectional Study

TypeobservationalSponsorShanghai 6th People's HospitalRan2024 to 2029Enrolled120ConditionsBilateral Vestibular Hypofunction, Bilateral Vestibulopathy, PresbyvestibulopathyArmsMultimodal Neuroimaging and Vestibular Function Assessment
3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 1 synthesis or guideline pooled it, 130 citations in OpenAlex.

  1. Investigation of Vestibular Dysfunction Requires Renewed Research Enthusiasm.Journal of the Association for Research in Otolaryngology : JARO · 2026
    Pooled it
  2. Trial
  3. [The effectiveness of vestibular rehabilitation in Ménière's disease patients with chronic imbalance].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2022
    Trial
  4. Preserving the Membranous Labyrinth With a Piezoelectric Drill? Exploring Potential for Semicircular Canal Surgery.Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
    Article
  5. Effects of Electrode Position on Vestibular Implant Performance in Rhesus Macaque.Journal of the Association for Research in Otolaryngology : JARO · 2026
    Article
  6. Article
  7. Vestibular implant stimulation can improve self-motion perception.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  8. Robotic keyhole access to the semicircular canals for vestibular implantation: an anatomical feasibility study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  9. Bilateral vestibulopathy - insight in impact on quality of life and economic burden.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  10. Review
  11. Article
  12. Article
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  15. Article
  16. The impact of bilateral vestibulopathy on quality of life: data from the Antwerp University Hospital registry.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  17. Vestibular electrode position stability over time.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
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4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 2 countries.

Margaret R ChowFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.ORCID 0000-0002-4335-0903
Andrianna I AyiotisFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.ORCID 0000-0002-5497-7197
Desi P SchooFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.ORCID 0000-0001-7483-9261
Yoav GimmonFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.ORCID 0000-0001-5979-3269
Kelly E LaneFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Brian J MorrisFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.ORCID 0000-0002-8119-6177
Mehdi A RahmanFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Nicolas S ValentinFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Peter J BoutrosFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Stephen P BowditchFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Bryan K WardFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Daniel Q SunFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Carolina Treviño GuajardoFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Michael C SchubertFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
John P CareyFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Charles C Della SantinaFrom the Departments of Otolaryngology-Head and Neck Surgery (M.R.C., A.I.A., D.P.S., Y.G., K.E.L., B.J.M., P.J.B., S.P.B., B.K.W., D.Q.S., C.T.G., M.C.S., J.P.C., C.C.D.S.) and Biomedical Engineering (M.R.C., A.I.A., B.J.M., P.J.B., C.C.D.S.), Johns Hopkins University School of Medicine, and Labyrinth Devices (M.A.R., N.S.V., C.C.D.S.) - both in Baltimore.
Johns Hopkins University · US

Funding

Training Program in Hearing and BalanceT32DC000023 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI CULLEN, KATHLEEN E · 1989 to 2025
$8.7M
Multichannel Vestibular Prosthesis Pilot Early Feasibility TrialR01DC013536 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI DELLA SANTINA, CHARLES C · 2013 to 2017
$2.4M
HIGH FIELD MRI AND THE LABYRINTH: VESTIBULAR STIMULATION AND NEW IMAGING TECHNIQUESK23DC018302 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI WARD, BRYAN KEVIN · 2021 to 2025
$991k
NIDCD NIH HHS K23 DC018302NIDCD NIH HHS R01 DC013536NIDCD NIH HHS T32 DC000023
6 · The paper itself

Abstract

backgroundBilateral vestibular hypofunction is associated with chronic disequilibrium, postural instability, and unsteady gait owing to failure of vestibular reflexes that stabilize the eyes, head, and body. A vestibular implant may be effective in alleviating symptoms.

methodsPersons who had had ototoxic (7 participants) or idiopathic (1 participant) bilateral vestibular hypofunction for 2 to 23 years underwent unilateral implantation of a prosthesis that electrically stimulates the three semicircular canal branches of the vestibular nerve. Clinical outcomes included the score on the Bruininks-Oseretsky Test of Motor Proficiency balance subtest (range, 0 to 36, with higher scores indicating better balance), time to failure on the modified Romberg test (range, 0 to 30 seconds), score on the Dynamic Gait Index (range, 0 to 24, with higher scores indicating better gait performance), time needed to complete the Timed Up and Go test, gait speed, pure-tone auditory detection thresholds, speech discrimination scores, and quality of life. We compared participants' results at baseline (before implantation) with those at 6 months (8 participants) and at 1 year (6 participants) with the device set in its usual treatment mode (varying stimulus pulse rate and amplitude to represent rotational head motion) and in a placebo mode (holding pulse rate and amplitude constant).

resultsThe median scores at baseline and at 6 months on the Bruininks-Oseretsky test were 17.5 and 21.0, respectively (median within-participant difference, 5.5 points; 95% confidence interval [CI], 0 to 10.0); the median times on the modified Romberg test were 3.6 seconds and 8.3 seconds (difference, 5.1; 95% CI, 1.5 to 27.6); the median scores on the Dynamic Gait Index were 12.5 and 22.5 (difference, 10.5 points; 95% CI, 1.5 to 12.0); the median times on the Timed Up and Go test were 11.0 seconds and 8.7 seconds (difference, 2.3; 95% CI, -1.7 to 5.0); and the median speeds on the gait-speed test were 1.03 m per second and 1.10 m per second (difference, 0.13; 95% CI, -0.25 to 0.30). Placebo-mode testing confirmed that improvements were due to treatment-mode stimulation. Among the 6 participants who were also assessed at 1 year, the median within-participant changes from baseline to 1 year were generally consistent with results at 6 months. Implantation caused ipsilateral hearing loss, with the air-conducted pure-tone average detection threshold at 6 months increasing by 3 to 16 dB in 5 participants and by 74 to 104 dB in 3 participants. Changes in participant-reported disability and quality of life paralleled changes in posture and gait.

conclusionsSix months and 1 year after unilateral implantation of a vestibular prosthesis for bilateral vestibular hypofunction, measures of posture, gait, and quality of life were generally in the direction of improvement from baseline, but hearing was reduced in the ear with the implant in all but 1 participant. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT02725463.).

Indexed as

Implantable NeurostimulatorsQuality of LifeAgedBilateral VestibulopathyDizzinessFemaleGaitGait Disorders, NeurologicHearing LossHumansMaleMiddle AgedPostoperative ComplicationsPostural BalanceProspective StudiesSemicircular Canals

Identifiers

PMID33567192
PMCPMC8477665
OpenAlexW3127924612

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.