Self-adjusting cochlear implant system and method for fitting same
First Claim
1. A self-adjusting implantable cochlear stimulator (ICS) system comprising cochlea stimulus means for selectively generating a stimulus of a specified intensity on any one of a plurality of channels and evoked potential sensing means for sensing an evoked potential in response to a stimulus generated by the stimulus means, comprising:
- middle ear reflex sensing means for sensing a middle ear reflex in response to a stimulus applied by the stimulus means; and
microcontroller means for controlling the cochlea stimulus means, evoked potential sensing means and middle ear reflex sensing means to determine the stimulation threshold and most comfortable loudness of the ICS.
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Accused Products
Abstract
A self-adjusting implantable cochlear implant system (46) includes an implant portion (50) and an external portion (53). The system provides a device and a way to objectively determine selected psychophysical parameters, such as stimulation threshold, comfort level and loudness resolution, used by the implant portion, which includes an implantable cochlear stimulator (ICS), as it carries out its stimulation function. The input to the system is an electrical stimulation. The outputs of the system include a middle ear reflex (MER) and evoked potentials, such as a compound action potential (CAP) along the auditory/cerebral pathways, both of which are sensed using objective measurement techniques and tools. In accordance with one embodiment, the adjustment process uses the MER for determining a coarse threshold value, and then (using such coarse threshold value as a starting point) uses evoked potentials to determine a more precise o fine threshold value, thereby zeroing in on a desired threshold. Such zeroing-in method is preferably carried out using implanted circuitry (e.g., included as part of the ICS), which implanted circuitry uses an implanted middle ear electrode (54) and a cochlear electrode (56), along with appropriate amplification (58, 64), filtering (60, 66) and processing circuitry (62, 68, 67), to respectively determine the MER response and evoked potentials. Another embodiment uses the presence or absence of the MER to adjust the intensity of electrical stimulation continuously and automatically, thereby relieving the patient from having to perform slow and tedious manual adjustments of the loudness control of a speech processor used with the ICS.
317 Citations
20 Claims
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1. A self-adjusting implantable cochlear stimulator (ICS) system comprising cochlea stimulus means for selectively generating a stimulus of a specified intensity on any one of a plurality of channels and evoked potential sensing means for sensing an evoked potential in response to a stimulus generated by the stimulus means, comprising:
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middle ear reflex sensing means for sensing a middle ear reflex in response to a stimulus applied by the stimulus means; and microcontroller means for controlling the cochlea stimulus means, evoked potential sensing means and middle ear reflex sensing means to determine the stimulation threshold and most comfortable loudness of the ICS. - View Dependent Claims (2, 3, 4, 5)
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6. A method for self-adjusting the stimulus parameters of an implantable cochlear stimulator (ICS) by determining a dynamic range of electrical stimulation to be applied by the ICS to a patient, said ICS including means for applying an electrical stimulus to the cochlea of the patient, the method being characterized by:
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determining a low end of the dynamic range by measuring the intensity of electrical stimulation that produces a compound action potential (CAP) sensed electronically by sensing means coupled with the cochlea, and determining a high end of the dynamic range by measuring the intensity of electrical stimulation that produces a middle ear reflex (MER) sensed electronically by MER sensing means. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A self-adjusting implantable cochlear stimulator (ICS) system comprising:
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an implantable cochlear stimulator (ICS); a plurality of electrodes connected to the ICS through which a stimulus of a specified intensity is selectively applied; a first sensing electrode connected to a first amplifier and first filter that senses an evoked potential in response to a stimulus generated by the ICS; a second sensing electrode coupled to the middle ear and connected to a second amplifier and a second filter that senses a middle ear reflex in response to a stimulus applied by the ICS; and a microcontroller connected to control the ICS and to receive electrical signals from the first sensing electrode, first amplifier and first filter, and second sensing electrode, second amplifier, and second filter that determines, based on the signals received through the first and second sensing electrodes, a stimulation threshold and most comfortable loudness for the ICS. - View Dependent Claims (17, 18, 19, 20)
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Specification