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When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo\u2010ocular reflexes (VORs) and vestibulo\u2010spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designed to modulate vestibular nerve activity during head movement should improve quality of life for these chronically dizzy individuals. We describe the impact of bilateral loss of vestibular sensation, animal studies supporting feasibility of prosthetic vestibular stimulation, the current status of multichannel vestibular sensory replacement prosthesis development, and challenges to successfully realizing this approach in clinical practice. In bilaterally vestibular\u2010deficient rodents and rhesus monkeys, the Johns Hopkins multichannel vestibular prosthesis (MVP) partially restores the three\u2010dimensional (3D) VOR for head rotations about any axis. Attempts at prosthetic vestibular stimulation of humans have not yet included the 3D eye movement assays necessary to accurately evaluate VOR alignment, but these initial forays have revealed responses that are otherwise comparable to observations in animals. Current efforts now focus on refining electrode design and surgical technique to enhance stimulus selectivity and preserve cochlear function, optimizing stimulus protocols to improve dynamic range and reduce excitation\u2013inhibition asymmetry, and adapting laboratory MVP prototypes into devices appropriate for use in clinical trials. Anat Rec, 2012. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ar.22581","type":"journal-article","created":{"date-parts":[[2012,10,9]],"date-time":"2012-10-09T00:11:13Z","timestamp":1349741473000},"page":"2010-2029","source":"Crossref","is-referenced-by-count":50,"title":["Progress Toward Development of a Multichannel Vestibular Prosthesis for Treatment of Bilateral Vestibular Deficiency"],"prefix":"10.1002","volume":"295","author":[{"given":"Gene Y.","family":"Fridman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles C.","family":"Della SAntina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,8]]},"reference":[{"key":"e_1_2_4_2_1","unstructured":"AhnJH LaskerD DaiC FridmanGY Della SantinaCC.2012.Infra\u2010red laser stimulation modulates vestibular nerve afferent responses in the mammalian labyrinth. 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