Monitoring stimulating assembly insertion
Inventors
Heasman, John Michael • Gibson, Peter • O'Leary, Stephen • Campbell, Luke
Assignees
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Publication Number
US-12318606-B2
Publication Date
2025-06-03
Expiration Date
Abstract
Presented herein are techniques for monitoring the insertion of an intra-cochlear stimulating assembly for the occurrence of one or more insertion stop conditions. The insertion stop conditions are detectable events indicating that movement of the stimulating assembly into a recipient's cochlea should be at least temporarily stopped. The insertion monitoring is based on objectively measured inner ear potentials, such as acoustically-evoked potentials.
Core Innovation
The invention relates to monitoring insertion of an electrode array into a cochlea of a recipient using acoustically-evoked inner ear potentials monitored at an intra-operative system. The monitoring forms an objective measure of residual hearing in the cochlea based on the acoustically-evoked inner ear potentials, and the objective measure is combined with a subjective measure of residual hearing to determine an insertion stop condition during implantation.
An insertion stop condition is detected during implantation and is responsive to a feedback mechanism initiated at the intra-operative system. The feedback mechanism indicates that the electrode array has interfered with a basilar membrane of the cochlea and stops insertion of the electrode array into the cochlea. The invention also covers detecting an insertion warning condition and initiating a feedback mechanism to slow insertion when interference is indicated.
The invention further defines target stop conditions associated with a predetermined target stop point during insertion of a stimulating assembly into a cochlea. Signals indicative of residual hearing are monitored during insertion, and the target stop condition is detected based on subjective and objective measures obtained before the stimulating assembly enters the cochlea. Responsive to detection of the target stop condition, a feedback mechanism indicates that the stimulating assembly has been inserted to a target insertion depth and stops insertion.
The invention is implemented with an intra-operative system that monitors acoustically-evoked inner ear potentials and residual-hearing-indicative signals. The target stop condition can be based on peak or near-peak detection of acoustically-evoked inner ear potentials associated with a predetermined frequency, and pre-operative measurements such as an audiogram and signals delivered during insertion using acoustic stimulation with frequency components matched to cochlear tonotopic regions are used to obtain the subjective and objective measures and to detect the stop condition.
Claims Coverage
The document provides two independent method claims. The shared inventive core is monitoring acoustically-evoked inner ear potentials or other residual-hearing-indicative signals to form an objective measure, combining it with a subjective residual-hearing measure to detect a stop condition, and initiating an intra-operative feedback mechanism to stop insertion; dependent claims cover warning and speed control.
Monitoring acoustically-evoked inner ear potentials during electrode array insertion
During insertion of an electrode array into a cochlea of a recipient, monitoring, at an intra-operative system, acoustically-evoked inner ear potentials obtained from the cochlea to form an objective measure of the recipient's residual hearing in the cochlea.
Determining an insertion stop condition using subjective and objective residual hearing
Determining that an insertion stop condition for the electrode array has occurred during implantation, wherein the insertion stop condition is based on a subjective measure of the recipient's residual hearing and the objective measure of the recipient's residual hearing.
Feedback mechanism indicating basilar membrane interference and stopping insertion
Responsive to detection of the insertion stop condition, initiating, at the intra-operative system, a feedback mechanism indicating that the electrode array has interfered with a basilar membrane of the cochlea and to stop insertion of the electrode array into the cochlea.
Monitoring signals indicative of residual hearing during stimulating assembly insertion
During insertion of a stimulating assembly into a cochlea of a recipient, monitoring, at an intra-operative system, signals indicative of a residual hearing of the cochlea of the recipient.
Detecting a target stop condition at a predetermined target stop point using pre-obtained subjective and objective measures
At the intra-operative system, detecting, based on the signals indicative of the residual hearing, a target stop condition associated with a predetermined target stop point, wherein the target stop condition is based on a subjective measure and an objective measure of the recipient's residual hearing, and wherein the subjective measure and the objective measure are obtained before the stimulating assembly enters the recipient's cochlea.
Feedback mechanism indicating target insertion depth and stopping insertion
Responsive to detection of the target stop condition, initiating, at the intra-operative system, a feedback mechanism indicating that the stimulating assembly has been inserted to a target insertion depth and to stop insertion of the stimulating assembly into the cochlea.
Across the two independent claims, the inventive features are intra-operative monitoring of residual-hearing-indicative signals, formation of an objective residual-hearing measure, combination of subjective and objective residual hearing to detect an insertion or target stop condition, and initiation of an intra-operative feedback mechanism that stops insertion and indicates basilar membrane interference or attainment of a target insertion depth.
Stated Advantages
Provides an objective measure of the recipient's residual hearing in the cochlea based on acoustically-evoked inner ear potentials.
Stops insertion of the electrode array into the cochlea upon detection of an insertion stop condition, with the feedback mechanism indicating interference with the basilar membrane.
Stops insertion of the stimulating assembly into the cochlea upon detection of a target stop condition associated with a predetermined target stop point and indicates target insertion depth.
Can detect an insertion warning condition and initiate a feedback mechanism to slow insertion when interference is indicated.
Documented Applications
Intra-operative monitoring of electrode array insertion into a cochlea of a recipient during cochlear implant implantation to detect an insertion stop condition and initiate a feedback mechanism to stop insertion.
Intra-operative monitoring of insertion of a stimulating assembly into a cochlea to detect a target stop condition based on residual hearing measures and stop insertion at a target insertion depth.
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