TürkçeLoss of balance is a common health problem, particularly among older individuals. Research conducted in recent years shows that significant advances have been made in the diagnosis and treatment of balance disorders. These developments aim to improve patients’ quality of life.
The development of vestibular rehabilitation techniques, virtual reality-based balance exercises, and biofeedback methods offers promising results. These methods help retrain the balance centers.
Implantable balance prostheses and advanced imaging techniques are opening new horizons in the treatment of balance problems. Thanks to these technologies, early detection of the condition and personalized treatment plans are becoming possible.
In the future, genetic research, neurological rehabilitation, and artificial intelligence-assisted devices are expected to be used more extensively in the treatment of balance loss. These developments will provide significant advantages in controlling balance problems.
VESTIBULAR IMPLANT STUDIES IN BILATERAL VESTIBULAR LOSS
We visit hospitals for various health problems. Sometimes these are related to our kidneys, sometimes our heart, and sometimes balance disorders…..
Regardless of the complaint with which we seek medical care, physicians may tell us after their examinations that one of our organs is not functioning properly. The same applies to our balance organ. Previous illnesses and medications used may cause various functional impairments in the inner ear. In light of audiological and vestibular examinations, it may be stated that “our balance organs are not functioning sufficiently.” These functional impairments that may occur in the ear can sometimes present as hearing loss and sometimes as loss of balance.
Particularly when Meniere’s disease affects both ears, when chemotherapeutic drugs are used for diseases such as cancer, when nerve cells are damaged due to diabetes, or when the inner ear completely loses its function following viral or bacterial infections….
With current technologies, various vestibular rehabilitation methods and rehabilitation exercises can be applied to stimulate the inner ear. However, these exercises may not be sufficient in some cases. In such situations, the exercises change direction and aim to increase the function of other sensory organs involved in the balance mechanism and develop various alternative strategies to compensate for the existing loss of balance.
HOW DOES REDUCED BALANCE FUNCTION AFFECT INDIVIDUALS?
There is at least one person around you who says, “I have vertigo.” All of these individuals relive those moments while describing the condition and speak about it with horror. Some individuals even experience persistently high anxiety levels because they feel unbalanced for a long time after attacks. They are not unjustified. There is nothing pleasant about feeling unbalanced. Not being sure of the ground beneath your feet, being unable to enter crowded places, being unable to remain in shopping malls, becoming afraid to go outside alone….
When balance disorders are not fully investigated and are not treated and rehabilitated regularly and under controlled conditions, they seriously and negatively affect the person’s quality of life. In some cases, no response may be obtained despite treatment and rehabilitation services.
Even when there is complete loss of inner ear function, the basic approach is to try all therapy methods and direct the individual particularly toward sports that will improve balance conditioning.
HEARING LOSS CAN BE COMPENSATED FOR WITH A BIONIC EAR. IS THERE SUCH A METHOD FOR BALANCE LOSS? IS IT POSSIBLE TO ELECTRICALLY STIMULATE THE INNER EAR BALANCE ORGAN?
- Cohen et al. first demonstrated through animal experiments in the 1960s that eye movements could also be stimulated by electrically stimulating the balance organs in the inner ear. Considerable progress has been made as a result of this study and subsequent studies. Currently, four separate research groups are conducting studies to develop vestibular implants in humans.
However, these studies are still at an experimental stage. They have been applied to a limited number of people.
The studies are primarily based on the design and processing strategies of the cochlear implant, known as the bionic ear, which is used for hearing loss. However, the balance organ in the inner ear is very different from the hearing organ. Therefore, studies are continuing on many details, including the design of the internal component of the device, which processing strategies will be used, how adjustments will be made for each patient, which surgical technique will be used to perform the operation, and how rehabilitation services should be provided before and after implantation surgery.
Researchers are currently investigating three main approaches:
- Vestibular Co-stimulation With a Cochlear Implant (CI),
- Electrical Stimulation of the Inner Ear With a Vestibular Implant,
- GVS (Stimulation of the Inner Ear Through Surface Electrodes).
Currently, galvanic vestibular stimulation therapies, also known as Electrical Balance Therapy, are the most applicable methods with limited side effects. These therapies are easily tolerated treatment methods. Therefore, they are considered the most reliable method.
A PROMISING PROJECT IN THE TREATMENT OF BALANCE LOSS
- In addition to the studies mentioned above, there is also the BALANCI project. The project, led by Dr. Sharon Cushing, who works at Toronto Children’s Hospital, involves children with both hearing loss and balance loss. According to the current results of the project conducted with children who use a bionic ear for hearing loss, the children using bionic ears who were included in the project experienced a significant decrease in the number of falls and demonstrated better postural control.
Frequently Asked Questions
Vestibular rehabilitation, advanced diagnostic tests, and personalized treatment approaches are providing significant progress in the treatment of balance loss. With early diagnosis, it may be possible to improve balance functions in many patients.
Scientific studies show that personalized vestibular rehabilitation programs may be effective in improving balance. Exercises planned by an audiologist may support the brain’s adaptation to the balance system.
Advanced tests such as v-HIT, VEMP, and computerized dynamic posturography allow detailed evaluation of the balance system. These technologies can make the treatment process more effective by facilitating an accurate diagnosis.
New rehabilitation approaches and balance exercises aim to reduce the risk of falling and increase independence in daily life among older individuals. Regular follow-up can significantly support treatment success.
Virtual reality-assisted rehabilitation applications may allow balance training to be implemented in a more motivating and controlled manner in some patients. These methods may support conventional rehabilitation in suitable patients.
Treatment success may vary according to the cause of balance loss, the patient’s age, accompanying diseases, and adherence to the rehabilitation program. Personalized treatments can generally provide more successful results.
In patients with chronic balance disorders, advanced assessment methods and vestibular rehabilitation may contribute to reducing symptoms. Early intervention plays an important role in improving quality of life.
Research into vestibular implants, artificial intelligence-assisted assessment systems, and more advanced rehabilitation technologies is ongoing. These developments may offer new treatment options for selected patients in the future.
Treatment for children and young people is determined according to the underlying cause. Advanced diagnostic methods and age-appropriate vestibular rehabilitation programs may contribute to supporting balance development.
People who experience dizziness, imbalance, frequent falls, or loss of balance during movement should undergo an audiological evaluation without delay. Early diagnosis may increase the likelihood of benefiting from current treatment options in the most appropriate way.
Dr. Audiologist Emel Uğur was born in 1982 in Çanakkale. She specialized in Pediatric Audiology, Otologic Disorders, and Vestibular System Disorders, and served for 15 years at the Istanbul Training and Research Hospital. In 2015, she joined the Acıbadem Healthcare Group. She currently works as an Audiologist at the Acıbadem Altunizade Hospital and also serves as a faculty member and program director in the Acıbadem University Vocational School of Health Services Audiometry Program.
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