Jaro-Journal of the Association for Research in Otolaryngology最新文献

{"title":"Polygenic Contribution to Sensorineural Hearing Loss Implicates Novel Risk Loci and Convergence with Congenital Hearing Loss Genes.","authors":"Royce E Clifford, Jacquelyn A Johnson, Caroline E Mackey, Elizabeth A Mikita, Allen F Ryan, Adam X Maihofer, Caroline M Nievergelt","doi":"10.1007/s10162-026-01044-0","DOIUrl":"10.1007/s10162-026-01044-0","url":null,"abstract":"<p><strong>Purpose: </strong>Disabling sensorineural hearing loss (SNHL) affects 5% of the global population. While congenital (CHL) and non-congenital sensorineural hearing loss (SNHL) are both strongly heritable, SNHL is a polygenic disorder, consisting of common genetic variants which individually confer small risks, requiring large studies for significance.</p><p><strong>Methods: </strong>We present the first report of a SNHL genome-wide association study (GWAS) from the Million Veteran Program (MVP) (210,240 cases and 265,275 controls), including multi-ancestry analysis, and then combine and contrast this data with a United Kingdom Biobank (UKB) self-reported hearing loss study (87,056 cases and 163,333 controls). We perform functional mapping and annotation, gene prioritization, gene-based and gene-set analysis, and cochlear cell type enrichment, including human single-cell expression data.</p><p><strong>Results: </strong>A total of 108 significant loci are identified, including 54 loci containing novel prioritized genes and/or protein-coding genes and implicating 17 known CHL genes. SNP-based partitioned heritability estimates show a 3.26-fold enrichment of CHL relative to other genes. Substantial genetic overlap is seen between MVP and UKB despite differences in phenotypes, demographics, and environmental exposures.</p><p><strong>Conclusion: </strong>In this multi-ancestry GWAS, we identify 108 loci with 54 novel genes. Despite the enrichment of CHL genes, 97% of the risk for adult-onset SNHL is captured by SNPs outside of monogenic hearing loss genes. Although SNHL in the UKB and MVP were assessed using different phenotypes, genetic signals between the two cohorts are predominantly shared, and locus discovery is boosted through increased sample size in meta-analysis.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"447-463"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Suppressibility of Otoacoustic Emissions and Loudness by Low-Frequency Biasing Tones as a Function of Probe Level.","authors":"Torsten Marquardt, Juan Vizuete, Markus Drexl, Carlos Jurado","doi":"10.1007/s10162-026-01029-z","DOIUrl":"10.1007/s10162-026-01029-z","url":null,"abstract":"<p><strong>Purpose: </strong>Biasing of the cochlear partition by tones below 100 Hz is commonly used to investigate cochlear non-linearity. Their long periodicity allows resolution of the suppression of cochlear responses as the partition is displaced periodically away from its resting position. The purpose of this study was to quantify by how much the biasing tone (BT) level needed to be increased to keep an equal suppression depth in OAE and an equal criterion suppression of loudness while the levels of the response-evoking stimuli were increased.</p><p><strong>Method: </strong>Suppression-period patterns were obtained for the distortion-product and stimulus-frequency otoacoustic emissions (DPOAE: N = 8 ears, SFOAE: N = 6 ears) using a 55-Hz BT, conditions in which the primary frequencies were at least 3 octaves above the BT frequency. A prior search for primary parameters that allowed the highest recording SNR was conducted, including an optimization of the lower primary tone level (L1) for the DPOAE. The BT level was adjusted so that the maximum suppression depth was kept constant at 9 dB for both OAEs, for various primary levels. Also, the BT level required to reach an equal criterion suppression in the loudness of 1- and 2-kHz tone-pip probes was measured psychoacoustically (N = 4) at various probe levels using the same BT.</p><p><strong>Results: </strong>The increase in suppressor level per increase in probe level was similar (~ 0.4 dB/dB) for equal-loudness suppression of the tone pips, 9-dB suppression of the SFOAE, and the 2F1-F2 DPOAE, when the increase in L1 was considered. Average BT levels increased linearly over the whole range of probe levels tested.</p><p><strong>Conclusion: </strong>As the observed iso-suppression rate is broadly consistent with the growth of basilar membrane vibration with increasing stimulus level in the active region of the traveling wave, we conclude that equal suppression of cochlear responses during partition biasing occurs when bias displacement grows in proportion to the probe's traveling wave amplitude in its active region.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"289-300"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural Hearing Loss: Mechanisms, Diagnosis and Treatment Horizons.","authors":"Eleni Genitsaridi, Efstratia Papoutselou, Cherith M Campbell-Bell, Leila Abbas, Rachel Haines, Douglas E H Hartley, Marcelo N Rivolta","doi":"10.1007/s10162-026-01036-0","DOIUrl":"10.1007/s10162-026-01036-0","url":null,"abstract":"<p><p>Neural hearing loss, characterized by dysfunction of the auditory nerve, including the spiral ganglion neurons (SGNs) and/or their synaptic connections, is increasingly recognized as a critical contributor to auditory deficits across diverse conditions, including Auditory Neuropathy Spectrum Disorder (ANSD), presbycusis, and noise-induced hearing loss (NIHL). It is possible that neural hearing loss is underdiagnosed, due to the lack of clinical tools with sufficient sensitivity and specificity to detect poor neural health. Current interventions, such as hearing aids and cochlear implants (CIs), primarily target sensory deficits and offer limited benefit in cases of significant neural compromise. Therapeutically, there is a growing shift towards biologically driven strategies aimed at restoring neural function. Recent developments in novel therapies, including pharmacological, gene-based, neurotrophic, and cell-based approaches, have opened new possibilities demonstrating the potential to protect, repair, and/or replace damaged SGNs, and re-establish auditory pathways. This perspectives article explores the evolving understanding of neural hearing loss, emphasizing its complex pathophysiology and the limitations of current diagnostic and therapeutic approaches, while highlighting how a diverse range of emerging solutions are moving closer to clinical application.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"167-187"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Vestibular Rehabilitation in Vestibular Migraine: A Systematic Review.","authors":"Ioanna Sfakianaki, Christos Nikitas, Dimitrios Kikidis","doi":"10.1007/s10162-026-01042-2","DOIUrl":"10.1007/s10162-026-01042-2","url":null,"abstract":"<p><p>This systematic review evaluates the effectiveness of vestibular rehabilitation (VR) in managing vestibular migraine (VM) symptoms in adults. A systematic search of PubMed, Web of Science, Scopus, ProQuest, ScienceDirect, and CENTRAL was conducted from inception to September 30, 2024. Additional searches included the NIH Clinical Trials Register and WHO ICTRP. Key search terms included: (\"Vestibular migraine\" OR \"migraine-associated vertigo\" OR \"migrainous vertigo\" OR \"migraine-associated dizziness\") AND (\"Vestibular rehabilitation\" OR \"Vestibular exercis*\" OR \"balance rehabilitation\" OR \"balance physiotherapy\" OR \"exercis*\"). Studies were excluded if they were non-English studies, irrelevant topics or unacceptable study types. Eligible studies included adults over 18 years diagnosed with VM based on Barany or Neuhauser criteria, excluding those with severe comorbidities or other causes of vertigo. Comparisons involved VR versus alternative treatments or controls, using outcome measures such as subjective scales (DHI, DGI, HADS) and performance tests. Data on design, sample size, age, sex, interventions, comparators, outcomes, results, and follow-up were extracted. Eleven studies (six prospective, three retrospective, two RCTs) with 977 participants (mean age 48.46) were analyzed. VR interventions included adaptation, substitution, habituation, balance, and gait exercises, delivered home-based, therapist-supervised, or combined. Significant improvements in vertigo, dizziness, imbalance, headache, anxiety, and depression were noted, with ten studies showing better DHI scores. However, high bias risk stemmed from limited randomization, blinding, and self-reported measures. In conclusion, VR proves to be effective for managing dizziness, balance, and psychological outcomes in VM, offering a non-pharmacologic option. Future research should prioritize standardized interventions, larger cohorts, and long-term follow-ups.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"137-166"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Aids: What Works Well and What Can Be Improved.","authors":"Brian C J Moore","doi":"10.1007/s10162-026-01031-5","DOIUrl":"10.1007/s10162-026-01031-5","url":null,"abstract":"<p><p>This paper evaluates the current performance of hearing aids, based on research findings and my experiences with hearing aids. The type of acoustic coupling to the ear is important. The fitting can be \"closed\" (sealing the ear canal), but this can lead to the occlusion effect; the user's own voice sounds too loud or too boomy. Alternatively, the fitting can be open (the eartip has a vent). This alleviates the occlusion effect, but it introduces comb-filtering (heard as perceptual coloration) and leads to little or no gain at low frequencies. Also, the highest frequency at which useful gain can be achieved is often about 5 kHz, which is lower than optimal. While acoustic feedback cancellation systems have improved markedly, they can still introduce artifacts and impair sound quality, especially for music. Hearing aids use multi-channel amplitude compression to compensate for the reduced dynamic range of hearing-impaired people, but they often fail to restore the audibility of soft sounds, especially at high frequencies, and the amount of compression is often limited (and less than indicated by the manufacturers' fitting software), leading to loudness discomfort (and sometimes reduced speech intelligibility) at high sound levels. Also, compression systems introduce cross-modulation, impairing sound quality. Most hearing aids incorporate directional processing and noise-reduction systems intended to improve the ability to understand speech in noisy situations. These systems can be effective with a closed fitting, but much of the benefit is lost with an open fitting because of leakage of background sounds through the vent.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"123-135"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Causes of Post-Surgical Conductive Hearing Loss with Optical Coherence Tomography Vibrometry.","authors":"Xiaojie Yang, David P Morris, Robert B A Adamson","doi":"10.1007/s10162-025-01027-7","DOIUrl":"10.1007/s10162-025-01027-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether optical coherence tomography (OCT) vibrometry can differentiate causes of conductive hearing loss (CHL) following ossiculoplasty, specifically distinguishing among effusion, soft-tissue fixation, and prosthesis disconnection.</p><p><strong>Methods: </strong>We simulated three post-surgical CHL conditions, effusion, soft-tissue fixation, and prosthesis disconnection, in a cadaveric temporal bone model (N = 10 per condition), with a partial ossicular replacement prosthesis (PORP) and cartilage graft implanted via a retrotympanic approach. A custom-built swept-source middle-ear OCT system (λ₀ = 1550 nm, Δλ = 40 nm) was used to capture cross-sectional images and mobility measurements at the umbo and center of the cartilage graft across six stimulus frequencies (500, 750, 1000, 1500, 2000, and 3000 Hz). Mobility values (point velocity normalized to sound pressure) served as input features for a Random Forest classifier. Changes in mobility from baseline were also statistically analyzed.</p><p><strong>Results: </strong>The classifier achieved 90.9% accuracy (40/44 datasets) in differentiating conditions in leave-one-out cross-validation, and 100% when trained on the full dataset. Simulated effusion and soft-tissue fixation were associated with broadband mobility decreases of 17.5 dB and 8.0 dB, respectively, averaged across both locations. Prosthesis disconnection at the stapes and at the tympanic membrane led to low-frequency (500 and 750 Hz) mobility increases of 9.9 dB and 11.1 dB, respectively, averaged across both locations.</p><p><strong>Conclusion: </strong>In a cadaveric model of post-surgical CHL, OCT vibrometry accurately distinguished effusion, soft-tissue fixation, and prosthesis disconnection. The ability to identify the cause of post-surgical CHL highlights OCT vibrometry's potential to assist clinical decision-making in revision surgery.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"249-262"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Histology and Molecular Profiling of Postmortem Human Auditory and Vestibular Organs via a Poly (Methyl Methacrylate)-Based Workflow.","authors":"David Bächinger, Brock Peyton, Jacqueline Neubauer, Anbuselvan Dharmarajan, MengYu Zhu, Jennifer T O'Malley, Venus Kallupurackal, Steven Senese, Alison Brown, Sabina Wunderlin, Susanne Kreutzer, Nora M Weiss, Heiko Richter, Adrian Dalbert, Christof Röösli, Anja Kipar, Zsuzsanna Varga, Brigitte von Rechenberg, Sami S Amr, Andreas H Eckhard","doi":"10.1007/s10162-026-01032-4","DOIUrl":"10.1007/s10162-026-01032-4","url":null,"abstract":"<p><strong>Purpose: </strong>Hearing and balance disorders are among the most prevalent sensory impairments globally, yet their cellular and molecular basis remains poorly understood. This gap stems from the inaccessibility of the inner ear, which is encased in the temporal bone (TB)-the hardest bone in the body-and cannot be biopsied in living patients. Conventional histopathology workflows, particularly the century-old celloidin method, are time-consuming, labor-intensive, and incompatible with modern molecular analyses. We aimed to develop a faster, more versatile histology workflow for human TBs that preserves both morphology and molecular integrity.</p><p><strong>Methods: </strong>We developed a reversible polymethyl methacrylate (rPMMA) embedding protocol for formalin-fixed, calcified TBs using low-temperature resin infiltration (-40 to +4 °C). Precision near-serial sections (10-50 µm) were generated via femtosecond laser microtomy or precision diamond wire sawing. Deacrylation was performed to restore tissue accessibility for histological staining, multiplex immunofluorescence, whole-genome sequencing, and in situ RNA detection (RNAscope™).</p><p><strong>Results: </strong>Compared to the celloidin workflow, our method reduced processing time and costs by over 90% while preserving histomorphology of comparable quality (n = 7 human TBs). It maintained antigenicity for multiplexed immunofluorescence, preserved native tissue-implant interfaces in implant-containing specimens, yielded high-quality DNA suitable for whole-genome sequencing (mean coverage 7.4 × in specimens with postmortem intervals < 24 h), and enabled mRNA detection at single-cell resolution. Celloidin-embedded controls consistently failed to support these molecular assays.</p><p><strong>Conclusion: </strong>This rPMMA-based workflow combines gold-standard histomorphology with full compatibility for advanced molecular analyses. With dramatically reduced time and cost, it offers a new benchmark for integrated, spatially resolved studies of human hearing and balance pathologies.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"273-287"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuronal Representation of Auditory Distance Percepts vs. Cues in Human Auditory Cortex.","authors":"Keerthi Kumar Doreswamy, Jyrki Ahveninen, Samantha Huang, Stephanie Rossi, Norbert Kopčo","doi":"10.1007/s10162-025-01026-8","DOIUrl":"10.1007/s10162-025-01026-8","url":null,"abstract":"<p><strong>Purpose: </strong>Perceiving the sound source distance is important in many everyday activities. For sources near the listener, two dominant intensity-independent cues are available, the direct-to-reverberant energy ratio (DRR) and the interaural level difference (ILD). Previous studies identified the planum temporale (PT) and posterior superior temporal gyrus (pSTG) as auditory cortical areas important for distance processing. However, it is not clear whether the identified areas represent integrated percepts of distance, per se, or the discrete cues based on which it is created. To address this, we combined behavioral and neuroimaging experiments with advanced computational modeling.</p><p><strong>Methods: </strong>We conducted human behavioral (15 participants with 5 self-reported females) and fMRI experiments (15 participants with 5 self-reported females) in a virtual reverberant environment using broadband noise stimuli. The availability and congruency of the DRR and ILD cues were manipulated to identify cortical areas encoding distance cues vs. distance percepts.</p><p><strong>Results: </strong>Behavioral results showed that distance percepts were stronger when both cues were available and congruent, confirming that both cues are used when listeners judge distance. A univariate fMRI analysis identified areas in the PT + pSTG as encoding the DRR cue. An ROI-based multi-voxel pattern analysis (MVPA) over the whole PT + pSTG region found a significant difference between Congruent and Incongruent stimuli, likely representing the distance percept.</p><p><strong>Conclusion: </strong>The PT + pSTG region encodes both the distance cues and percepts. However, while the cue encoding is local, the percepts are encoded in a distributed network.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"301-314"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Diphtheria Toxin-Induced Mouse Model of Auditory Neuropathy: From Cochlear Synaptopathy to Neuronal Degeneration.","authors":"Yanyan Mao, Hengjian Fan, Wenqing Yan, Na Zhang, Wenwen Liu, Yun Xiao, Yuechen Han, Zhaomin Fan, Haibo Wang, Anping Xia, Li Li","doi":"10.1007/s10162-026-01033-3","DOIUrl":"10.1007/s10162-026-01033-3","url":null,"abstract":"<p><strong>Purpose: </strong>Auditory neuropathy (AN) is a hearing disorder that is often overlooked due to its hidden cochlear activity and hearing loss profiles. Diphtheria toxin (DT) is commonly used to induce deafness in conditional gene knockout mouse models, but its ototoxic targets in wild-type animals remain controversial. This study aimed to characterize the pathogenic effects of DT on the cochlea of wild-type mice and establish a reliable model of AN.</p><p><strong>Methods: </strong>Adult CBA/CaJ mice of both sexes (n = 81) were administered by DT for three consecutive days. AN was confirmed by electrophysiological profiles: abnormal auditory brainstem response (ABR) with preserved distortion product otoacoustic emissions (DPOAE), followed by histopathological evaluation of the cochlear auditory pathway.</p><p><strong>Results: </strong>DT induced a characteristic AN-characteristic hearing loss in mice. It initiated with ribbon synapse degeneration in inner hair cells (IHCs) within 24 h, coinciding with a significant reduction in ABR amplitude peak I. By post-injection day 3, extensive damage was observed, including IHC loss, degeneration of type I spiral ganglion neurons (SGNs), and demyelination of their axons. Despite a minimal loss of OHCs (~ 2.1%), OHC function remained intact as evidenced by DPOAE. A progressive degeneration of SGNs and demyelination of axons persisted over the 21-day observation period.</p><p><strong>Conclusion: </strong>Our findings demonstrate that DT selectively targets the IHCs and type I afferent pathway in wild-type mice, resulting in a progressive AN- characteristic pathology. This study establishes a mouse model of AN that can serve as a basis for further investigation into the mechanisms underlying similar pathologies.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"209-224"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Electrode Position on Vestibular Implant Performance in Rhesus Macaque.","authors":"Brian J Morris, Katherine N Mueller, Celia C Fernandez Brillet, Dale C Roberts, Roland Hessler, Kathleen E Cullen, Charles C Della Santina","doi":"10.1007/s10162-025-01020-0","DOIUrl":"10.1007/s10162-025-01020-0","url":null,"abstract":"<p><strong>Purpose: </strong>Vestibular implants that target the three semicircular canal branches of the vestibular nerve can partially restore the 3-dimensional vestibulo-ocular reflex (3D VOR) in individuals disabled by bilateral vestibular hypofunction. A key goal of implant design is optimizing the number, spacing, and placement of stimulating and return electrodes to maximize response strength and selectivity. While computational models provide initial insights, empirical data are essential to validate performance.</p><p><strong>Methods: </strong>We unilaterally implanted stimulating electrodes in each semicircular canal and positioned return electrodes both inside the labyrinth and outside the temporal bone in three female rhesus macaques. Using mixed-effects ANOVA, we quantified how electrode location influenced 3D VOR response magnitude and misalignment.</p><p><strong>Results: </strong>We found that: (1) the deepest stimulating electrode in each canal generally yielded the strongest and most aligned responses; (2) a 600-750 µm difference in electrode position significantly impacted VOR outcomes; (3) return electrodes placed inside the labyrinth produced significantly larger VOR responses than those placed outside the temporal bone when stimulus current is constrained to levels that elicit no sign of facial nerve excitation; and (4) \"near-bipolar\" stimulation-using a return electrode in the same ampulla as the stimulating electrode-yielded better alignment.</p><p><strong>Conclusion: </strong>Although including multiple stimulating electrodes per canal may lower the risk of missing the target, a VI limited to one deep stimulating electrode per canal and one common return electrode can suffice if array design and surgical technique ensure placement near the crista ampullaris. Unused stimulator channels could be repurposed in designs intended to stimulate the utricle, saccule and/or cochlea. Moreover, spatial selectivity is improved by placing return electrodes within the labyrinth or ampullae, rather than outside the temporal bone. VIs that use a single common return electrode shared by all stimulation channels could achieve better performance in the future by incorporating multiple independent return electrode channels to permit near-bipolar stimulation.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"225-247"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}