Few people ever think about the tiny structures at work inside their ears, keeping balance in check. But when those organs are corrupted, and a person’s equilibrium is thrown out of whack, balance becomes as important as any of the traditional senses like sight, hearing or smell. And, like deafness or blindness, a loss of balance can be devastating.

Charley Della Santina
With such patients in mind, ear surgeon Charley Della Santina has spent the past seven years developing a vestibular prosthesis. Much like the cochlear implants used to restore hearing, the device he’s inventing would restore balance by sending electric pulses into the inner ear. “When someone loses his sense of balance, it’s a real problem,” Della Santina explains. “The parts of your inner ear that control balance also keep you from falling down and keep your eyes on target. Without that, you’re unstable, and it’s hard for you to walk. And if your head is moving at all, you can’t see clearly.”
A person’s balance is determined primarily in the ear’s labyrinth. When damage occurs—whether through infection, antibiotics, chemotherapy, radiation or trauma—the ability to effectively sense and communicate directional motion is lost, crippling the labyrinth and destroying balance.
Della Santina has seen formerly active patients—many of them skiers, tennis players or swimmers, for instance—whose lives have been turned upside down because of damage to the inner ear. One of his most severe cases involves a man who suffered vestibular damage to his ear and today can no longer walk straight. When he takes a stroll down the beach, mothers cling to their children, thinking he’s drunk. The patient is first in line for a vestibular implant, as soon as the device is approved for trial and use in humans. That time, however, is a few years off.
For now, Della Santina explains, the implant is being tested in animals, but he hopes to make it available to patients within about five years. His team recently finished a new version of the prosthesis that is smaller and uses less energy than previous models. “This device is a lot like a cochlear implant, but instead of a microphone that takes in sound and stimulates the auditory nerve to help people hear,” he says, “this uses sensors of head movement and orientation to stimulate the vestibular nerve to help people maintain their balance.”



