Monitoring calibration of a body noise reduction system

Abstract

Presented herein are methods and systems for monitoring a calibration of an implantable adaptive body noise reduction system. The calibration of the implantable adaptive body noise reduction system is monitored to determine calibration quality information. During the monitoring, at least one measurement is performed. Based on a quality of the at least one measurement, instruction is provided to a user to adjust one or more external signals. Feedback to the user is provided iteratively until the measurement is validated.

Description

MONITORING CAUIBRATION OF A BODY NOISE REDUCTION SYSTEMBACKGROUNDField of the Invention[oooi] The present invention relates generally to monitoring calibration of an implantable adaptive body noise reduction system.Related Art

[0002] Medical devices have provided a wide range of therapeutic benefits to recipients over recent decades. Medical devices can include internal or implantable components / devices, external or wearable components / devices, or combinations thereof (e.g., a device having an external component communicating with an implantable component). Medical devices, such as traditional hearing aids, partially or fully-implantable hearing prostheses (e.g., bone conduction devices, mechanical stimulators, cochlear implants, etc.), pacemakers, defibrillators, functional electrical stimulation devices, and other medical devices have been successful in performing lifesaving and / or lifestyle enhancement functions and / or recipient monitoring for a number of years.

[0003] The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as “implantable medical devices,” now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease / injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and / or data received from external devices that are part of, or operate in conjunction with, implantable components.SUMMARY

[0004] In one aspect, a method is provided. The method comprises: calibrating an implantable adaptive body noise reduction system; monitoring operation of the implantable adaptive body noise reduction system during the calibrating; and providing calibration quality information to a user based on the monitoring of the implantable adaptive body noise reduction system.

[0005] In another aspect, a second method is provided. The second method comprises: performing at least one measurement to set at least one parameter of an implantable adaptivebody noise reduction system; monitoring a quality of the at least one measurement; and providing feedback to a user based on the monitoring.

[0006] In another aspect, a system is provided. The system comprises: a memory; and at least one processor operable coupled to the memory, wherein the at least one processor is configured to: perform at least one measurement to set at least one parameter of an implantable adaptive body noise reduction system; monitor a quality of the at least one measurement; determine if the quality of the at least one measurement is acceptable; and provide feedback to a user based on the quality of the at least one measurement.BRIEF DESCRIPTION OF THE DRAWINGS

[0007] Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:

[0008] FIG. 1A is a schematic diagram illustrating a cochlear implant system with which aspects of the techniques presented herein can be implemented;

[0009] FIG. IB is a side view of a recipient wearing a sound processing unit of the cochlear implant system of FIG. 1A;[ooio] FIG. 1C is a schematic view of components of the cochlear implant system of FIG. 1 A;[ooii] FIG. ID is a block diagram of the cochlear implant system of FIG. 1A;

[0012] FIG. IE is a schematic diagram illustrating a computing device with which aspects of the techniques presented herein can be implemented;

[0013] FIG. 2A is a schematic diagram illustrating an implantable device system with which aspects of the techniques presented herein can be implemented;

[0014] FIG. 2B is a schematic diagram illustrating the implantable device system of FIG. 2A;

[0015] FIG. 3 is a flowchart illustrating a method for calibrating an implantable adaptive body noise reduction system, in accordance with certain embodiments presented herein;

[0016] FIG. 4A is a flowchart illustrating another method for calibrating an implantable adaptive body noise reduction system, in accordance with certain embodiments presented herein;

[0017] FIG. 4B is a flowchart illustrating further details of the embodiment described in FIG. 4A;

[0018] FIG. 5A is a flowchart illustrating a method for calibrating an implantable adaptive body noise reduction system, in accordance with certain embodiments presented herein;

[0019] FIG. 5B is a flowchart illustrating further details of the embodiment described in FIG. 5A;

[0020] FIG. 6A is a flowchart illustrating another embodiment of a method for monitoring calibration of an implantable adaptive body noise reduction system, in accordance with certain embodiments presented herein;

[0021] FIG. 6B is a flowchart illustrating further details of performing of FIG. 6A;

[0022] FIG. 7 is a flowchart illustrating a method for determining a minimum value from one or more outputs while monitoring calibration of an implantable adaptive body noise reduction system, in accordance with certain embodiments presented herein;

[0023] FIG. 8A is a flowchart illustrating a method, in accordance with certain embodiments presented herein;

[0024] FIG. 8B is a flowchart illustrating another method, in accordance with certain embodiments presented herein;

[0025] FIG. 8C is a flowchart illustrating another method, in accordance with certain embodiments presented herein;

[0026] FIG. 9 is a schematic diagram illustrating a vestibular stimulator system with which aspects of the techniques presented herein can be implemented; and

[0027] FIG. 10 is a schematic diagram illustrating a retinal prosthesis system with which aspects of the techniques presented herein can be implemented.DETAILED DESCRIPTION

[0028] An implantable medical device (e.g., auditory prosthesis) can leverage an implantable adaptive body noise reduction system that automatically and accurately removes unwanted body noise signals to optimize a sound signal delivered to a recipient. As such, it is important to ensure that the implantable adaptive body noise reduction system is properly calibrated to recognize unwanted noise signals. Presented herein are techniques for calibrating an implantable adaptive body noise reduction system of an implantable medical device (e.g., auditory prosthesis), monitoring a quality of the calibration, and providinginformation / feedback related to the quality of the measurement (sometimes referred to herein as “calibration quality information”) to a user.

[0029] In one example, the implantable adaptive body noise reduction system (e.g., adaptive fdter) is calibrated based on an externally-generated body noise reference signal (e.g., uncontrolled vibration signal) captured by at least one sound sensor and at least one vibration sensor. Based on a quality of the at least one measurement, feedback is provided to the user iteratively to adjust the externally-generated body noise reference signal until the quality of the at least one measurement is acceptable (e.g., that the quality, represented as a value, falls within a predetermined range or above a predetermined threshold). In certain embodiments, determining that the quality of the at least one measurement is acceptable means that the at least one measurement is a “valid” measurement (i.e., the measurement has been validated). In certain embodiments, after a measurement has been validated, one or more operational parameters of the implantable medical device that correspond to the at least one measurement are instantiated in the device.

[0030] The techniques presented herein provide feedback relating to and, in certain examples, automated validation of, the calibration of an implantable adaptive body noise reduction system. Unlike current methods that rely on human judgment in evaluating calibration quality, certain examples presented herein utilize various objective measures of calibration quality to implement automated validation of implantable adaptive body noise reduction system calibration. As a results, aspects of the techniques presented herein provide improved consistency and efficiency in the calibration of implantable adaptive body noise reduction systems.

[0031] There are a number of different types of devices in / with which embodiments of the present invention may be implemented. Merely for ease of description, the techniques presented herein are primarily described with reference to a specific device in the form of a cochlear implant system. However, it is to be appreciated that the techniques presented herein may also be partially or fully implemented by any of a number of different types of devices, including consumer electronic device (e.g., mobile phones), wearable devices (e.g., smartwatches), hearing devices, implantable medical devices, consumer electronic devices, etc. As used herein, the term “hearing device” is to be broadly construed as any device that acts on an acoustical perception of an individual, including to improve perception of sound signals, to reduce perception of sound signals, etc. In particular, a hearing device can deliver sound signals to a user in any form, including in the form of acoustical stimulation, mechanicalstimulation, electrical stimulation, etc., and / or can operate to suppress all or some sound signals. As such, a hearing device can be a device for use by a hearing-impaired person (e.g., hearing aids, middle ear auditory prostheses, bone conduction devices, direct acoustic stimulators, electro-acoustic hearing prostheses, auditory brainstem stimulators, bimodal hearing prostheses, bilateral hearing prostheses, dedicated tinnitus therapy devices, tinnitus therapy device systems, combinations or variations thereof, etc.), a device for use by a person with normal hearing (e.g., consumer devices that provide audio streaming, consumer headphones, earphones, and other listening devices), a hearing protection device, etc. In other examples, the techniques presented herein can be implemented by, or used in conjunction with, various implantable medical devices, such as visual devices (i.e., bionic eyes), sensors, pacemakers, drug delivery systems, defibrillators, functional electrical stimulation devices, catheters, seizure devices (e.g., devices for monitoring and / or treating epileptic events), sleep apnea devices, electroporation devices, etc.

[0032] FIGs. 1A-1D illustrate an example cochlear implant system 102 with which aspects of the techniques presented herein can be implemented. The cochlear implant system 102 comprises an external component 104 that is configured to be directly or indirectly attached to the body of the user, and an intemal / implantable component 112 that is configured to be implanted in or worn on the head of the user. In the examples of FIGs. 1A-1D, the implantable component 112 is sometimes referred to as a “cochlear implant.” FIG. 1A illustrates the cochlear implant 112 implanted in the head 154 of a user, while FIG. IB is a schematic drawing of the external component 104 worn on the head 154 of the user. FIG. 1C is another schematic view of the cochlear implant system 102, while FIG. ID illustrates further details of the cochlear implant system 102. For ease of description, FIGs. 1A-1D will generally be described together.

[0033] In the examples of FIGs. 1A-1D, the external component 104 comprises a sound processing unit 106, an external coil 108, and generally, a magnet fixed relative to the external coil 108. The cochlear implant 112 includes an implantable coil 114, an implant body 134, and an elongate stimulating assembly 116 configured to be implanted in the user’s cochlea. In one example, the sound processing unit 106 is an off-the-ear (OTE) sound processing unit, sometimes referred to herein as an OTE component, which is configured to send data and power to the implantable component 112. In general, an OTE sound processing unit is a component having a generally cylindrically shaped housing 111 and which is configured to be magnetically coupled to the user’s head 154 (e.g., includes an integrated external magnet 150 configured tobe magnetically coupled to an intemal / implantable magnet 152 in the implantable component 112). The OTE sound processing unit 106 also includes an integrated external (headpiece) coil 108 (the external coil 108) that is configured to be inductively coupled to the implantable coil 114.

[0034] It is to be appreciated that the OTE sound processing unit 106 is merely illustrative of the external devices that could operate with implantable component 112. For example, in alternative examples, the external component 104 may comprise a behind-the-ear (BTE) sound processing unit configured to be attached to, and worn adjacent to, the recipient’s ear. A BTE sound processing unit comprises a housing that is shaped to be worn on the outer ear of the user. In certain examples, the BTE is connected to a separate external coil assembly via a cable, where the external coil assembly is configured to be magnetically and inductively coupled to the implantable coil 114, while in other embodiments the BTE includes a coil disposed in or on the housing worn on the outer ear of the user. It is also to be appreciated that alternative external components could be located in the user’s ear canal, worn on the body, etc.

[0035] Although the cochlear implant system 102 includes the sound processing unit 106 and the cochlear implant 112, as described below, the cochlear implant 112 can operate independently from the sound processing unit 106, for at least a period, to stimulate the user. For example, the cochlear implant 112 can operate in a first general mode, sometimes referred to as an “external hearing mode,” in which the sound processing unit 106 captures sound signals which are then used as the basis for delivering stimulation signals to the user. The cochlear implant 112 can also operate in a second general mode, sometimes referred as an “invisible hearing” mode, in which the sound processing unit 106 is unable to provide sound signals to the cochlear implant 112 (e.g., the sound processing unit 106 is not present, the sound processing unit 106 is powered-off, the sound processing unit 106 is malfunctioning, etc.). As such, in the invisible hearing mode, the cochlear implant 112 captures sound signals itself via implantable sound sensors and then uses those sound signals as the basis for delivering stimulation signals to the user. Further details regarding operation of the cochlear implant 112 in the external hearing mode are provided below, followed by details regarding operation of the cochlear implant 112 in the invisible hearing mode. It is to be appreciated that reference to the external hearing mode and the invisible hearing mode is merely illustrative and that the cochlear implant 112 could also operate in alternative modes.

[0036] In FIGs. 1A and 1C, the cochlear implant system 102 is shown with an external device 110, configured to implement aspects of the techniques presented. The external device 110,which is shown in greater detail in FIG. IE, is a computing device, such as a personal computer (e.g., laptop, desktop, tablet), a mobile phone (e.g., smartphone), a remote control unit, etc. The external device 110 and the cochlear implant system 102 (e.g., sound processing unit 106 or the cochlear implant 112) wirelessly communicate via a bi-directional communication link 126. The bi-directional communication link 126 may comprise, for example, a short-range communication, such as Bluetooth link, Bluetooth Low Energy (BLE) link, a proprietary link, etc.

[0037] Returning to the example ofFIGs. 1A-1D, the sound processing unit 106 of the external component 104 also comprises one or more input devices configured to capture and / or receive input signals (e.g., sound or data signals) at the sound processing unit 106. The one or more input devices include, for example, one or more sound input devices 118 (e.g., one or more external microphones, audio input ports, telecoils, etc.), one or more auxiliary input devices 128 (e.g., audio ports, such as a Direct Audio Input (DAI), data ports, such as a Universal Serial Bus (USB) port, cable port, etc.), and a short-range wireless transmitter / receiver (wireless transceiver) 120 (e.g., for communication with the external device 110), each located in, on or near the sound processing unit 106. However, it is to be appreciated that one or more input devices may include additional types of input devices and / or less input devices (e.g., the short- range wireless transceiver 120 and / or one or more auxiliary input devices 128 could be omitted).

[0038] The sound processing unit 106 also comprises the external coil 108, a charging coil 130, a closely-coupled radio frequency transmitter / receiver (RF transceiver) 122, at least one rechargeable battery 132, and an external processing module 124. The external processing module 124, comprising a sound processor 133 and a monitoring module 135, can be configured to perform a number of operations that are represented in FIG. ID. Each of the sound processor 133 and the monitoring module 135 can be formed by one or more processors (e.g., one or more Digital Signal Processors (DSPs), one or more uC cores, etc.), firmware, software, etc. arranged to perform operations described herein. That is, the sound processor 133 and the monitoring module 135 can each be implemented as firmware elements, partially or fully implemented with digital logic gates in one or more application-specific integrated circuits (ASICs), partially or fully in software, etc. Although FIG. ID illustrates the sound processor 133 and the monitoring module 135 as being implemented / performed at the external processing module 124, it is to be appreciated that these elements (e.g., functional operations) could also or alternatively be implemented / performed as part of the internal processing module158, as part of the external device 110, etc. As such, the sound processor 133 and the monitoring module 135 are each shown using dashed lines in FIGs. ID and IE.

[0039] Returning to the example of FIGs. 1A-1D, the implantable component 112 comprises an implant body (main module) 134, a lead region 136, and the stimulating assembly 116, all configured to be implanted under the skin (tissue) 115 of the user. The implant body 134 generally comprises a hermetically-sealed housing 138 that includes, in certain examples, at least one power source 125 (e.g., one or more batteries, one or more capacitors, etc.), in which the RF interface circuitry 140 and a stimulator unit 142 are disposed. The implant body 134 also includes the intemal / implantable coil 114 that is generally external to the housing 138, but which is connected to the RF interface circuitry 140 via a hermetic feedthrough (not shown in FIG. ID).

[0040] As noted, the stimulating assembly 116 is configured to be at least partially implanted in the user’s cochlea. The stimulating assembly 116 includes a plurality of longitudinally spaced intra-cochlear electrical stimulating contacts (electrodes) 144 that collectively form a contact array (electrode array) 146 for delivery of electrical stimulation (current) to the recipient’s cochlea. The stimulating assembly 116 extends through an opening in the recipient’s cochlea (e.g., cochleostomy, the round window, etc.) and has a proximal end connected to stimulator unit 142 via lead region 136 and a hermetic feedthrough (not shown in FIG. ID). Lead region 136 includes a plurality of conductors (wires) that electrically couple the electrodes 144 to the stimulator unit 142. The implantable component 112 also includes an electrode outside of the cochlea, sometimes referred to as the extra-cochlear electrode (ECE) 139.

[0041] As noted, the cochlear implant system 102 includes the external coil 108 and the implantable coil 114. The external magnet 150 is fixed relative to the external coil 108 and the intemal / implantable magnet 152 is fixed relative to the implantable coil 114. The external magnet 150 and the intemal / implantable magnet 152 fixed relative to the external coil 108 and the intemal / implantable coil 114, respectively, facilitate the operational alignment of the external coil 108 with the implantable coil 114. This operational alignment of the coils enables the external component 104 to transmit data and power to the implantable component 112 via a closely-coupled wireless link 148 formed between the external coil 108 with the implantable coil 114. In certain examples, the closely-coupled wireless link 148 is an RF link. However, various other types of energy transfer, such as infrared (IR), electromagnetic, capacitive, andinductive transfer, may be used to transfer the power and / or data from an external component to an implantable component and, as such, FIG. ID illustrates only one example arrangement.

[0042] As noted above, the sound processing unit 106 includes the external processing module 124. The external processing module 124 is configured to process the received input audio signals (received at one or more of the input devices, such as sound input devices 118 and / or auxiliary input devices 128) and convert the received input audio signals into output control signals for use in stimulating a first ear of a recipient or user (i.e., the external processing module 124 is configured to perform sound processing on input signals received at the sound processing unit 106). Stated differently, the one or more processors (e.g., processing element(s) implementing firmware, software, etc.) in the external processing module 124 are configured to execute sound processing logic in memory to convert the received input audio signals into output control signals (stimulation signals) that represent electrical stimulation for delivery to the recipient.

[0043] As noted, FIG. ID illustrates an embodiment in which the external processing module 124 in the sound processing unit 106 generates the output control signals. In an alternative embodiment, the sound processing unit 106 can send less processed information (e.g., audio data) to the implantable component 112, and the sound processing operations (e.g., conversion of input sounds to output control signals 156) can be performed by a processor within the implantable component 112.

[0044] In FIG. ID, according to an example embodiment, output control signals (stimulation signals) are provided to the RF transceiver 122, which transcutaneously transfers the output control signals (e.g., in an encoded manner) to the implantable component 112 via the external coil 108 and the implantable coil 114. That is, the output control signals (stimulation signals) are received at the RF interface circuitry 140 via the implantable coil 114 and provided to the stimulator unit 142. The stimulator unit 142 is configured to utilize the output control signals to generate electrical stimulation signals (e.g., current signals) for delivery to the user’s cochlea via one or more of the stimulating contacts 144. In this way, cochlear implant system 102 electrically stimulates the user’s auditory nerve cells, bypassing absent or defective hair cells that normally transduce acoustic vibrations into neural activity, in a manner that causes the recipient to perceive one or more components of the input audio signals (the received sound signals).

[0045] As detailed above, in the external hearing mode, the cochlear implant 112 receives processed sound signals from the sound processing unit 106. However, in the invisible hearing mode, the cochlear implant 112 is configured to capture and process sound signals for use in electrically stimulating the user’s auditory nerve cells. In particular, as shown in FIG. ID, an example embodiment of the cochlear implant 112 can include a plurality of implantable sound sensors 165(1), 165(2) that collectively form a sensor array 160, and an internal processing module 158. Similar to the external processing module 124, the internal processing module 158 may comprise, for example, one or more processors and a memory device (memory) that includes sound processing logic. The memory device may comprise any one or more of: Non- Volatile Memory (NVM), Ferroelectric Random Access Memory (FRAM), read only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The one or more processors are, for example, microprocessors or microcontrollers that execute instructions for the sound processing logic stored in memory device.

[0046] In the invisible hearing mode, the implantable sound sensors 165(1), 165(2) of the sensor array 160 are configured to detect / capture input sound signals 166 (e.g., acoustic sound signals, vibrations, etc.), which are provided to the internal processing module 158. The internal processing module 158 is configured to convert received input sound signals 166 (received at one or more of the implantable sound sensors 165(1), 165(2)) into output control signals 156 for use in stimulating the first ear of a recipient or user (i.e., the internal processing module 158 is configured to perform sound processing operations). Stated differently, the one or more processors (e.g., processing element(s) implementing firmware, software, etc.) in the internal processing module 158 are configured to execute sound processing logic in memory to convert the received input sound signals 166 into output control signals 156 that are provided to the stimulator unit 142. The stimulator unit 142 is configured to utilize the output control signals 156 to generate electrical stimulation signals (e.g., current signals) for delivery to the user’s cochlea, thereby bypassing the absent or defective hair cells that normally transduce acoustic vibrations into neural activity.

[0047] It is to be appreciated that the above description of the so-called external hearing mode and the so-called invisible hearing mode are merely illustrative and that the cochlear implant system 102 could operate differently in different embodiments. For example, in one alternative implementation of the external hearing mode, the cochlear implant 112 could use signalscaptured by the sound input devices 118 and the implantable sound sensors 165(1), 165(2) of sensor array 160 in generating stimulation signals for delivery to the user.

[0048] FIG. IE is a block diagram illustrating one example arrangement for an external computing device 110 configured to perform one or more operations in accordance with certain embodiments presented herein. As shown in FIG. IE, in its most basic configuration, the external computing device 110 includes at least one processing unit 183 and a memory 184. The processing unit 183 includes one or more hardware or software processors (e.g., Central Processing Units) that can obtain and execute instructions. The processing unit 183 can communicate with and control the performance of other components of the external computing device 110. The memory 184 is one or more software or hardware-based computer-readable storage media operable to store information accessible by the processing unit 183. The memory 184 can store, among other things, instructions executable by the processing unit 183 to implement applications or cause performance of operations described herein, as well as other data. The memory 184 can be volatile memory (e.g., RAM), non-volatile memory (e.g., ROM), or combinations thereof. The memory 184 can include transitory memory or non-transitory memory. The memory 184 can also include one or more removable or non-removable storage devices. In examples, the memory 184 can include RAM, ROM) EEPROM (Electronically- Erasable Programmable Read-Only Memory), flash memory, optical disc storage, magnetic storage, solid state storage, or any other memory media usable to store information for later access. By way of example, and not limitation, the memory 184 can include wired media, such as a wired network or direct-wired connection, and wireless media, such as acoustic, RF, infrared, other wireless media, or combinations thereof. In certain embodiments, the memory 184 comprises a quality determination module 131 that, when executed, enables the processing unit 183 to perform aspects of the techniques presented. More specifically, the quality determination module 131 is configured to, when executed, enable the processing unit 183 to monitor a quality of at least one measurement and determine whether the quality of the at least one measurement is acceptable (e.g., determine whether the quality, represented as a value, falls within a predetermined range or above a predetermined threshold).

[0049] In the illustrated example of FIG. IE, the external computing device 110 further includes a network adapter 186, one or more input devices 187, and one or more output devices 188. The external computing device 110 can include other components, such as a system bus, component interfaces, a graphics system, a power source (e.g., a battery), among other components. The network adapter 186 is a component of the external computing device 110that provides network access (e.g., access to at least one network 189). The network adapter186 can provide wired or wireless network access and can support one or more of a variety of communication technologies and protocols, such as Ethernet, cellular, Bluetooth, near-field communication, and RF, among others. The network adapter 186 can include one or more antennas and associated components configured for wireless communication according to one or more wireless communication technologies and protocols. The one or more input devices187 are devices over which the external computing device 110 receives input from a user. The one or more input devices 187 can include physically-actuatable user-interface elements (e.g., buttons, switches, or dials), a keypad, keyboard, mouse, touchscreen, and voice input devices, among other input devices that can accept user input. The one or more output devices 188 are devices by which the external computing device 110 is able to provide output to a user. The output devices 188 can include a display 190 (e.g., a liquid crystal display (LCD)) and one or more speakers 191, among other output devices for presentation of visual or audible information to the recipient, a clinician, an audiologist, or other user.

[0050] It is to be appreciated that the arrangement for the external computing device 110 shown in FIG. IE is merely illustrative and that aspects of the techniques presented herein can be implemented at a number of different types of systems / devices including any combination of hardware, software, and / or firmware configured to perform the functions described herein. For example, the external computing device 110 can be a personal computer (e.g., a desktop or laptop computer), a hand-held device (e.g., a tablet computer), a mobile device (e.g., a smartphone), a surgical system, and / or any other electronic device having the capabilities to perform the associated operations described elsewhere herein.

[0051] As noted, it is beneficial to remove noise from a sound signal, such as the sound signals 166 (FIG. ID). For example, during operation of a cochlear implant system, external sound (e.g., speech) is detected along with noise generated by the body of a recipient, commonly referred to as “body noise.” Therefore, sound signals can include a mixture of both external sounds and body noises However, it generally is undesirable to include the body noises in the output signals that are used to deliver a hearing percept to the recipient. For instance, the body noise can distort the external sounds that are of interest to the recipient. Accordingly, devices include implantable body noise cancellation / reduction systems configured to substantially reduce or remove body noise from sound signals to enable the recipient to perceive sound (e.g., external sound without distortions caused by body noises) more desirably.

[0052] FIGs. 2A and 2B are schematic diagrams illustrating an implantable device system 202, such as a cochlear implant system, operating with an implantable adaptive body noise reduction system 200, in accordance with certain embodiments presented herein. As described further below, the implantable adaptive body noise reduction system 200 has a “calibration mode” and a “run-time” mode. FIG. 2A primarily illustrates the “run-time” mode of the implantable adaptive body noise reduction system 200, while FIG. 2B primarily illustrates the “calibration mode,” in accordance with certain embodiments presented herein.

[0053] The implantable device system 202 includes a sensor array 260, which includes a first sensor 265A (e.g., a microphone, a sound sensor) and a second sensor 265B (e.g., an accelerometer, a vibration sensor). The first sensor 265 A is more sensitive to, and therefore primarily configured to, capture external sound, whereas the second sensor 265B is more sensitive to, and therefore primarily configured, to capture vibrations. For instance, the sensor array 260 is implanted in a recipient (e.g., embedded in a skull), and the first sensor 265A can capture external sound generated from a sound source outside of the body of the recipient, such as from an external environment and / or from another person, and the external sounds are of interest for processing for perception by the recipient. The second sensor 265B can capture body vibrations (body noises) of the recipient, which can be conducted through the body of the recipient and to the sensor array 260. As such, the sensors 265 are primarily configured to capture different signals. Although the present disclosure discusses operations of the sensor array 260 implanted in the recipient, the techniques described herein can be applied to a sensor array at any suitable location, such as on an external body part (e.g., the scalp) of the recipient.

[0054] During operation of the implantable device system 202, the first sensor 265A can also capture body noise provided by the body of the recipient. The body noise can mix with and distort the external sound that is of interest for perception by the recipient. The implantable adaptive body noise reduction system 200 is configured to filter signals captured by the sensor array 260 to reduce, remove, or cancel body noise.

[0055] As shown in FIG. 2A, during the run-time mode, the implantable adaptive body noise reduction system 200 is configured to receive and process an input sound signal 202 and / or an input vibration signal 204 respective captured by the sensors 265 to provide a processed signal 206 used for enabling the recipient to perceive sound. For example, the input sound signal 202 includes external sound that is of interest for perception by the recipient. However, the input sound signal 202 can also include body noise, and the input vibration signal 204 is representative of the body noise portion of the input sound signal 202. The implantableadaptive body noise reduction system 200 operates in the run-time mode to filter the input vibration signal 204 from the input sound signal 202 to provide a processed signal 206 that includes reduced amounts of body noise (e.g., primarily includes external sound) for perception by the recipient.

[0056] By way of example, the implantable adaptive body noise reduction system 200 is a part of a processing module 208 (e.g., the implantable processing module 158 of the cochlear implant 112 or another non-transitory computer-readable medium), such as implemented in a memory 210 and / or in a processor 212 of the sound processing module 208. As such, the processed signal 206 output by the implantable adaptive body noise reduction system 200 can be provided to a stimulator unit (e.g., the stimulator unit 142) to generate electrical stimulation signals for delivery to the cochlea of the recipient, other suitable output sound signals for enabling the recipient to perceive sound, or any other suitable processed signals. By removing the input vibration signal 204 from the input sound signal 202, the implantable adaptive body noise reduction system 200 improves the integrity of the processed signal 206 to improve the sound perceived by the recipient.

[0057] As shown in FIG. 2A, the implantable adaptive body noise reduction system 200 includes a fdter sub-system 218 configured to process the input sound signal 202 and / or the input vibration signal 204. In general, the filter sub-system 218 utilizes an algorithm with different parameters, such as coefficient weights of an algorithm (e.g., gain changes, phase changes, filter coefficients), to process the input sound signal 202 and / or the input vibration signal 204. For instance, coefficient weights are applied, such as in a particular frequency range (e.g., audible range), such that the input sound signal 202 and the input vibration signal 204 have substantially equal magnitude and / or phase.

[0058] In the example of FIG. 2A, the filter sub-system 218 includes a fixed prefilter 222 and an adaptive filter 224. The fixed prefilter 222 includes fixed parameters used to initially process the input vibration signal 204 and / or the input sound signal 202 (e.g., during a preprocessing stage) to provide a preliminarily processed signal 226. The adaptive filter 224 includes adjustable parameters used for further processing of the preliminarily processed signal 226 (e.g., during a main processing stage) to provide the processed signal 206. That is, the fixed prefilter 222 and the adaptive filter 224 sequentially process the input vibration signal 204 and / or the input sound signal 202 to provide the processed signal 206.

[0059] As further discussed herein, the fixed parameters of the fixed prefilter 222 are established during the calibration mode, and the fixed parameters are maintained during the run-time mode. In other words, the fixed parameters are unchanged during the run-time mode after being set as a result of the calibration mode. However, the implantable adaptive body noise reduction system 200 is adaptive (e.g., in the frequency domain, the time domain) in that the adjustable parameters of the adaptive filter 224 can be changed during the run-time mode to improve processing of the input vibration signal 204 and / or of the input sound signal 202.

[0060] For example, the adjustable parameters can be iteratively adjusted to improve the processed signals 206 provided via processing of the input vibration signals 204 and / or of the input sound signals 202. For instance, during a first iteration of the run-time mode (e.g., performed immediately after completion of the calibration mode), a first input sound signal 202 and a first input vibration signal 204 are received. The fixed prefilter 222 uses the fixed parameters to process the first input vibration signal 204 and / or the first input sound signal 202 to provide a first preliminarily processed signal 226 to the adaptive filter 224. In some embodiments, the adaptive filter 224 uses predetermined, preset, or default parameters during the first iteration to process the first preliminarily processed signal 226. As an example, the adaptive filter 224 functions as a pass-through filter that does not further process the first preliminarily processed signal 226 (e.g., each coefficient weight of the adaptive filter 224 is one). In other words, the adaptive filter 224 outputs the first preliminarily processed signal 226 as received from the fixed prefilter 222. The first preliminarily processed signal 226 is then removed from the first input sound signal 202 to provide a first processed signal 206. The first processed signal 206 is then output by the implantable adaptive body noise reduction system 200 to enable the recipient to perceive sound (e.g., the external sound of interest in the input sound signal 202), such as via electrical stimulation signals or other output sound signals.

[0061] The first processed signal 206 is also compared to the first input vibration signal 204 at an adaptation algorithm 220 to determine a difference (e.g., an absolute value of a difference) between the first processed signal 206 and the first input vibration signal 204. In particular, because the input sound signals 202 captured by the first sensor 265A potentially include some noise captured by the second sensor 265B, the first input sound signal 202 can include at least some similarities as the first input vibration signal 204. Therefore, the difference between the first processed signal 206 and the first input vibration signal 204 indicates an amount of the first input vibration signal 204 removed from the first input sound signal 202 to provide a desirable sound signal. Based on the difference between the first processed signal 206 and thefirst input vibration signal 204, the adaptation algorithm 220 adjusts the adjustable parameters (e.g., from the predetermined parameters used during the first iteration) of the adaptive filter 224 so that a subsequent processed signal 206 includes less of a corresponding input vibration signal 204. The adaptive filter 224 subsequently uses the adjustable parameters adjusted by the adaptation algorithm 220 to process a subsequent input sound signal 202 and / or a subsequent input vibration signal 204 to remove more of the subsequent input vibration signal 204 from the subsequent input sound signal 202.

[0062] For instance, during a second iteration of the run-time mode occurring immediately after the first iteration, a second input sound signal 202 and a second input vibration signal 204 are received. The fixed prefilter 222 uses the fixed parameters (e.g., the same fixed parameters used to process the first input sound signal 202 and / or the first input vibration signal 204) to process the second input sound signal 202 and / or the second input vibration signal 204 to provide a second preliminarily processed signal 226 to the adaptive filter 224. The adaptive filter 224 then uses the adjustable parameters established by the adaptation algorithm 220 to further process the second preliminarily processed signal 226. The further processed signal is then removed from the second input sound signal 202 to provide a second processed signal 206. The changing of the adjustable parameters of the adaptive filter 224 causes more of the second input vibration signal 204 to be removed from the second input sound signal 202 as compared to removal of the first input vibration signal 204 from the first input sound signal 202. That is, a difference between the second processed signal 206 and the input vibration signal 204 may be greater than a difference between the first processed signal 206 and the first input vibration signal 204. As such, the second processed signal 206 may be improved (e.g., include more of or better integrity of a desirable sound signal) as compared to the first processed signal 206.

[0063] The second processed signal 206 can also be compared to the input vibration signal 204 at the adaptation algorithm 220, and the adaptation algorithm 220 further changes the adjustable parameters of the adaptive filter 224 in response for the adaptive filter 224 to process a subsequent input sound signal 202 and / or a subsequent input vibration signal 204. In this manner, the adjustable parameters of the adaptive filter 224 are iteratively adjusted for each received input sound signal 202 and / or input vibration signal 204 to improve the processed signal 206 being output. In some embodiments, the adjustable parameters of the adaptive filter 224 are changed continuously during operation of the implantable device system 202 in the run-time mode. However, in additional or alternative embodiments, the adjustable parametersof the adaptive filter 224 are maintained at a certain point during operation of the implantable device system 202 in the run-time mode. For example, the adjustable parameters of the adaptive filter 224 remain unchanged after a threshold quantity of iterations of changing the adjustable parameters of the adaptive filter 224 has been reached, after a change in the adjustable parameters of the adaptive filter 224 is below a threshold change, and / or after a duration of time of operation of the implantable device system 202 in the run-time mode.

[0064] The fixed parameters of the fixed prefilter 222 can help improve operation of the implantable device system 202 in the run-time mode. For example, because the fixed parameters of the fixed prefilter 222 help perform some initial processing during the run-time mode to remove at least some of the input vibration signal 204 from the input sound signal 202, the run-time mode can immediately operate (e.g., after completion of the calibration mode) to provide a processed signal 206 with improved integrity, such as in comparison with an embodiment that does not include the fixed prefilter 222 and therefore may not immediately remove a significant amount of an input vibration signal from an input sound signal. Additionally or alternatively, a more desirable processed signal 206 can be quickly provided during the run-time mode, such as with fewer iterations of changing the adjustable parameters of the adaptive filter 224. Thus, the fixed prefilter 222 improves operation of the implantable adaptive body noise reduction system 200 to provide the processed signal 206.

[0065] In certain embodiments, the adjustable parameters of the adaptive filter 224 can be reset, such as by restarting the implantable adaptive body noise reduction system 200 (e.g., turning off and turning on the implantable device system 202). However, the fixed parameters of the fixed prefilter 222 remain stored and are not affected by restarting of the implantable device system 202. Thus, upon restarting of the implantable device system 202, the fixed parameters of the fixed prefilter 222 can be re-used to initially process an input sound signal 202 and / or an input vibration signal 204 to update / establish the adjustable parameters of the adaptive filter 224 without having to operate the implantable device system 202 in the calibration mode again (e.g., to re-establish the fixed parameters of the fixed prefilter 222). As such, the fixed prefilter 222 helps improve efficiency of operation of the implantable adaptive body noise reduction system 200 upon restarting of the implantable adaptive body noise reduction system 200. In additional or alternative embodiments, the fixed parameters of the fixed prefilter 222 can be reset, such as via a user input to prepare operation of the implantable device system 202 in another calibration mode to update the fixed parameters (e.g., to adjust to changing body parameters of the recipient).

[0066] As shown in FIG. 2B, during the calibration mode, the first sensor 265A is configured to capture a reference sound signal 220, the second sensor 265B is configured to capture a reference vibration signal 232, and the implantable adaptive body noise reduction system 200 is configured to use the reference sound signal 230 and the reference vibration signal 232 to establish the fixed parameters of the fixed prefilter 222. The reference vibration signal 232 is representative of body noise, but the reference sound signal 230 also includes some body noise (e.g., includes some commonality with the reference vibration signal 232). The implantable adaptive body noise reduction system 200 can, for example, operate in the calibration mode during fitting of the implantable device system 202 in the recipient to establish the fixed parameters of the fixed prefilter 222.

[0067] In some embodiments, the reference vibration signal 232 captured by the second sensor 265B is provided by an uncontrolled vibration source 214. The uncontrolled vibration source 214 can include any source that is not configured to output the reference vibration signal 232 having predetermined, specific, or designated properties or characteristics. That is, the properties of the reference vibration signal 232 provided by the uncontrolled vibration source 214 are generally uncontrolled and unknown before being captured by the second sensor 265B. For example, the uncontrolled vibration source 214 can be initiated by the recipient or another user, such as an action performed by the recipient or other user. These actions include, for example, a coughing action, a scratching action, a teeth brushing action, a deep / heavy breathing action, a speaking action, a chewing or biting action, a walking action, and so forth. The properties of the resulting reference vibration signal 232 can differ based on the specific action being performed and / or based on a parameter of the recipient (e.g., a force used to perform the action, a dimension or parameter related to a body part).

[0068] Additionally or alternatively, the reference vibration signal 232 could be provided by a controlled vibration source 216, which is configured to output the reference vibration signal 232 having a predetermined, specific, or designated properties or characteristics. In other words, the properties of the reference vibration signal 232 output by the controlled vibration source 216 are controlled and therefore known before receipt. By way of example, the external controlled vibration source 216 includes an external vibrator worn by the recipient (e.g., at the head of the recipient), a bone conduction earphone, or another suitable vibration generator (e.g., a transducer, a conductor) configured to transmit the reference vibration signal 232 that is representative of (e.g., has similar properties as) body noise generated by the recipient.

[0069] In either case, the filter sub-system 218 (e.g., the adaptive filter 224) is used to process the reference sound signal 230 and / or the reference vibration signal 232 to provide a processed signal 234 during the calibration mode. In the calibration mode, the processed signal 234 is compared to the reference vibration signal 232 to determine whether the reference vibration signal 232 is sufficiently removed from the reference sound signal 230, such as based on a difference (e.g., an absolute value of a difference) between the processed signal 234 and the reference vibration signal 232. The parameters of the adaptive filter 224 are iteratively changed during the calibration mode and used to process the reference sound signal 230 and / or the reference vibration signal 232 until a convergence point is reached in which the difference (absolute difference) between the processed signal 234 and the reference vibration signal 232 is above a threshold difference to indicate the processed signal 234 has a sufficiently limited amount of the reference vibration signal 232.

[0070] For example, a reference sound signal 230 and a reference vibration signal 232 are received during the calibration mode. During a first iteration of the calibration mode, the adaptive filter 224 uses predetermined, preset, or default parameters during the first iteration to process the reference sound signal 230 and / or the reference vibration signal 232 to provide a first processed signal 234. The first processed signal 234 is then compared to the reference vibration signal 232 at the adaptation algorithm 220 to determine a difference between the processed signal 234 and the reference vibration signal 232 (e.g., to determine an amount of the reference vibration signal 232 removed from the reference sound signal 230). The adaptation algorithm 220 then adjusts the parameters of the adaptive filter 224 based on the difference to improve subsequent processing of the reference sound signal 230 and / or of the reference vibration signal 232. During a second iteration of the calibration mode, the adaptive filter 224 uses the adjusted parameters established by the adaptation algorithm 220 to process the reference sound signal 230 and / or the reference vibration signal 232 (e.g., the same reference sound signal 230 and / or the same reference vibration signal 232) to provide a second processed signal 234. The use of the adjusted parameters in the second iteration may remove more of the reference vibration signal 232 from the reference sound signal 230 as compared to usage of the predetermined parameters in the first iteration. Thus, the difference between the second processed signal 234 and the reference vibration signal 232 in the second iteration is greater than the difference between the processed signal 234 and the reference vibration signal 232 in the first iteration. The adaptation algorithm 220 adjusts the parameters of the adaptive filter 224 again to further remove the reference vibration signal 232 from the reference soundsignal 230 in subsequent iterations. Therefore, the parameters of the adaptive filter 224 are iteratively adjusted until the parameters process the reference sound signal 230 and / or the reference vibration signal 232 to provide the processed signal 234 that has a sufficiently limited amount of the reference vibration signal 232 at the convergence point.

[0071] In additional or alternative embodiments, the convergence point is identified based on another determination, such as a determination that a change in the parameters of the adaptive filter 224 is below a threshold change. For example, as the processed signal 234 improves (e.g., as a difference, such as an absolute value of the difference, between the processed signal 234 and the reference vibration signal 232 increases, as more of the reference vibration signal 232 is removed from the reference sound signal 230), smaller changes are made to the parameters of the adaptive filter 224 to process the reference sound signal 230 and / or the reference vibration signal 232 to further improve the processed signal 234. Thus, a sufficiently small change in the parameters of the adaptive filter 224 can also indicate a convergence point in which the processed signal 234 has a sufficiently limited amount of the reference vibration signal 232.

[0072] After identification of the convergence point (e.g., after multiple iterations or loops in which the parameters of the adaptive filter 224 are adjusted and a resulting processed signal 234 is compared to the reference vibration signal 232), the parameters of the adaptive filter 224 at the convergence point (e.g., providing the desirable processed signal 234) are then established for the fixed prefilter 222 to use during the run-time mode. As such, in the calibration mode, the adjustable parameters of the adaptive filter 224 are used to process the reference sound signal 230 and / or the reference vibration signal 232 to establish the fixed parameters of the fixed prefilter 222 based on the processed signal 234, and in the run-time mode, the established fixed parameters of the fixed prefilter 222 and the adjustable parameters of the adaptive filter 224 are used to process the input sound signal 202 and / or the input vibration signal 204 to output the processed signal 206 for enabling the recipient to perceive sound.

[0073] Because the fixed parameters established at the convergence point have already been previously used to provide a desirable processed signal 234 during the calibration mode, using the fixed parameters during the run-time mode can help provide a processed signal 206 more effectively. For instance, initially processing of the input sound signal 202 and / or the input vibration signal 204 using the fixed parameters already removes a significant amount of the input vibration signal 204 from the input sound signal 202 even without having to use theadjustable parameters of the adaptive fdter 224 to further process the input sound signal 202 and / or the input vibration signal 204. Thus, an improved processed signal 206 may be readily provided in the run-time mode immediately following completion of the calibration mode (e.g., during a period of time of the calibration mode in which the adjustable parameters of the adaptive fdter 224 do not significantly remove the input vibration signal 204 from the input sound signal 202).

[0074] Additionally, in certain embodiments, a threshold vibration signal-to-noise ratio (SNR) of the filter sub-system 218 can be established during the calibration mode and used during operation in the run-time mode. The threshold vibration SNR is utilized to determine whether the adjustable parameters of the adaptive filter 224 of the filter sub-system 218 are to be adjusted based on an input vibration signal 204. By way of example, during the calibration mode, upon processing the reference sound signal 230 and / or the reference vibration signal 232 to provide a desirable processed signal 234 at a convergence point, the desirable processed signal 234 is compared to the reference vibration signal 232 to determine a ratio of the desirable processed signal 234 to the reference vibration signal 232, and such a ratio is established as the threshold vibration SNR. Because the desirable processed signal 234 does not include sufficient amounts of the reference vibration signal 232, the processed signal 234 primarily includes sounds of interest and is not considered to be noisy. As such, the ratio of the desirable processed signal 234 to the reference vibration signal 232 indicates a potential ratio indicative of an input sound signal that is not considered to be noisy. That is, a ratio of an input sound signal relative to an input vibration signal greater than the ratio of the processed signal 234 to the reference vibration signal 232 (e.g., the input sound signal includes significantly low amounts of the input vibration signal) indicates the input sound signal is not noisy, whereas a ratio of an input sound signal relative to an input vibration signal less than the ratio of the processed signal 234 to the reference vibration signal 232 (e.g., the input sound signal includes significant amounts of the input vibration signal) indicates the input sound signal is noisy. Thus, such a ratio can be used to determine a noisiness of the input sound signal.

[0075] For example, during the run-time mode, the implantable adaptive body noise reduction system 200 compares the input sound signal 202 to the input vibration signal 204 to determine an input vibration SNR, and the input vibration SNR is compared to the threshold vibration SNR to determine a noisiness of the input sound signal 202. An input vibration SNR that is ratio greater than the threshold vibration SNR indicates the intensity of the input sound signal 202 is substantially greater than that of the input vibration signal 204, which can indicate thatlittle or no body noise has been detected and is included in the input sound signal 202 (e.g., the input sound signal 202 is not noisy). Thus, the input vibration signal 204 does not have sufficient power relative to the input sound signal 202 to prompt changing of the adjustable parameters of the adaptive filter 224 based on the input vibration signal 204 to further process the input sound signal 202 and / or the input vibration signal 204. By way of example, the fixed parameters of the fixed prefilter 222 can be used to sufficiently process the input sound signal 202 and / or the input vibration signal 204 to provide a desirable processed signal 206. For this reason, a desirable processed signal 206 can be provided without having to change the adjustable parameters of the adaptive filter 224. For example, operation of the adaptation algorithm 220 is avoided in response to determining the input vibration SNR is higher than the threshold vibration SNR.

[0076] However, an input vibration SNR that is less than the threshold vibration SNR indicates the intensity of the input sound signal 202 is more similar to or less than that of the input vibration signal 204, thereby indicating the input sound signal 202 is noisy and includes a significant amount of body noise. As such, the adjustable parameters of the adaptive filter 224 can be effectively changed based on the input vibration signal 204 to improve processing of the input sound signal 202 and / or of the input vibration signal 204. In this way, the adjustable parameters of the adaptive filter 224 are selectively changed (e.g., by the adaptation algorithm 220) based on the input vibration SNR relative to the threshold vibration SNR to filter the input sound signal 202 and / or the input vibration signal 204 during the run-time mode more suitably. For example, limiting changing of the adjustable parameters of the adaptive filter 224 can reduce consumption of computational power while still providing a desirable processed signal 206 during the run-time mode.

[0077] In certain embodiments, one or more responses of the sound sensor 265A and one or more responses of the vibration sensor 265B are monitored after a period of silence. More specifically, after a predetermined period of silence has elapsed, one or more outputs (e.g., frequency spectra measurements) from the sound sensor 265A and the vibration sensor 265B are determined. Then, one or more minimum values of the one or more outputs from the sound sensor 265 A are determined, and one or more minimum values of the one or more outputs from the vibration sensor 265B are determined. The respective one or more minimum values are utilized to determine a respective noise floor of the sound sensor 265 A and the vibration sensor 265B. In certain embodiments, an algorithm is applied to process the respective one or more outputs to remove radio frequency (RF) interferences and noises.

[0078] As noted, presented herein are techniques for monitoring the calibration of an implantable adaptive body noise reduction system of an implantable medical device, such as body noise reduction system 200 of FIGs. 2A and 2B, and, in certain aspects, validating the calibration process. More specifically, as described in greater detail below, a calibration process is implemented (e.g., as described with reference to FIG 2B) to calibrate an implantable adaptive body noise reduction system. In accordance with the techniques presented herein, the calibration process is monitored and calibration quality information can be provided to a user. In operation, monitoring the calibration of the implantable adaptive body noise reduction system, and providing calibration quality information to the user, as described herein, can enhance the ultimate operation of the implantable adaptive body noise reduction system.

[0079] FIG. 3 is a flowchart illustrating a method 300, in accordance with certain embodiments presented herein. Method 300 begins at 361 where an implantable adaptive body noise reduction system, such as body noise reduction system 200 of FIGs. 2A and 2B, is calibrated. Upon calibration, at least one measurement is performed at 362. At 363, a quality of the at least one measurement is monitored. If the quality of the at least one measurement is acceptable at 364, the process proceeds to 365 to determine that calibration is complete (e.g., a valid measurement has been performed). On the other hand, if the quality is not acceptable at 364, feedback is provided to a user at 366. For example, in response to the quality of the at least one measurement not meeting a first threshold (e.g., in response to determining that the quality of the at least one measurement is not acceptable), instructions to adjust an uncontrolled vibration signal may be provided to the user.

[0080] FIG. 4A is a flow chart illustrating a method 400, in accordance with certain embodiments presented herein. Method 400 begins at 461 where an implantable adaptive body noise reduction system is calibrated. Upon calibration, at least one measurement is performed at 462. Then, a quality of the at least one measurement is monitored at 463.

[0081] After the quality of the at least one measurement is monitored at 463, the method 400 proceeds to determine whether the quality of the at least one measurement is below a first threshold at 464. If the quality of the at least one measurement is below a first threshold, a user is instructed to increase a level of an externally-generated body noise reference signal at 476. For example, the user (e.g., a clinician or a recipient) is instructed to increase a level of uncontrolled vibration (e.g., apply a stronger scratching action). However, if the quality of the at least one measurement is not below a first threshold, the quality of the at least onemeasurement is compared with a second threshold at 477. Further details of the method 400 are described in FIG. 4B.

[0082] FIG. 4B is a flow chart illustrating further details of the method 400 , in accordance with certain embodiments presented herein. Continuing from FIG. 4A, the quality of the at least one measurement is compared with a second threshold at 477. If the quality of the at least one measurement is above a second threshold at 478, a user is instructed to decrease a level of an externally-generated body noise reference signal at 479. For example, the user (e.g., a clinician or a recipient) is instructed to decrease a level of uncontrolled vibration (e.g., avoid saturating the sensing elements of a microphone). At 480, the method 400 returns to 462 where at least one measurement is performed again. However, if the quality of the at least one measurement is not above a second threshold at 478, the at least one measurement is considered to fall within an acceptable range defined by the first threshold and the second threshold. As such, the method 400 outputs the at least one measurement at 481. In certain embodiments, one or more operational parameters or settings that correspond to the at least one measurement are stored. At 482, the method 400 concludes by determining the calibration of the implantable adaptive body noise reduction system is complete.

[0083] In certain embodiments wherein the method 400 is implemented to calibrate the implantable adaptive body noise reduction system 200, the at least one measurement performed at 462 can include one or more coefficient weights of the adaptive filter 224 as the adaptive filter 224 adapts to remove the reference vibration signal 232 from the reference sound signal 230. In certain embodiments, calibration quality information can include a quality of the at least one measurement monitored at 463. For example, the quality of the at least one measurement can be determined as a difference between the coefficient weight of a current iteration of adaptation and the coefficient weight of a previous iteration of adaptation. If the difference converges (e.g., the difference falls within a range defined by a first threshold and a second threshold), the respective coefficient weight is considered to have been acceptable (e.g., stabilized) and the calibration of the implantable adaptive body noise reduction system 200 is considered complete. In certain embodiments, after the calibration is complete, one or more operational parameters of an implantable medical device that correspond to the one or more coefficient weights are stored. Further, in certain embodiments, the coefficient weights of the adaptive filter 224 are updated using an adaptation algorithm 220. In one example, the adaptation algorithm 220 can utilize a transfer function.

[0084] In certain embodiments wherein the method 400 is implemented to calibrate the implantable adaptive body noise reduction system 200, instructions are provided to a user (e.g., a clinician or a recipient) if the quality of the at least one measurement does not converge. In one embodiment, at 476, the user can be instructed to increase a level of uncontrolled vibration (e.g., apply a stronger scratching action) in response to the difference in coefficient weights being below a first threshold. Further, at 479, the user can be instructed to decrease a level of uncontrolled vibration (e.g., avoid saturating the sensing elements of a microphone) in response to the difference in coefficient weights being above a second threshold. After the instruction is provided to the user, the at least one measurement is performed again at 462. The method 400 proceeds iteratively to provide instructions to the user until the quality of the at least one measurement converges (e.g., the difference in coefficient weights falls within a range defined by the first threshold and the second threshold).

[0085] FIG. 5 A is a flow chart illustrating a method 500, in accordance with certain embodiments presented herein. Method 500 begins at 581 where an implantable medical device and an implantable adaptive body noise reduction system are calibrated. Upon calibration, at least one measurement is performed in response to an externally-generated sound signal at 592.

[0086] In certain embodiments, the at least one measurement can be one or more magnitude values of the one or more outputs from a sound sensor, a vibration sensor, and / or an external device. For example, in response to an externally-generated sound signal (e.g., external acoustic sound signal), the one or more magnitude values of the one or more outputs from a sound sensor (e.g., microphone of an implantable medical device), a vibration sensor (e.g., accelerometer of the implantable medical device), and / or an external device (e.g., external microphone) are monitored. By way of example, the external device incudes an external sound processor that interfaces with an auditory prosthesis, or any suitable device, external to an implantable medical device, which is configured to capture and / or process an externally- generated sound signal. In certain embodiments, the externally-generated sound signal may be delivered with variable volume. For example, the volume of the externally-generated sound signal may gradually increase. Further, in certain embodiments, the at least one measurement may be monitored with or without body noise reduction. For example, the at least one measurement may be monitored with or without the processing performed by the implantable adaptive body noise reduction system 200.

[0087] After the at least one measurement is performed at 582, the method 500 proceeds to 583, which determines whether the at least one measurement is below a first threshold. If the at least one measurement is below the first threshold, a user is instructed to increase a volume of the externally-generated sound signal at 584. By way of example, if the one or more magnitude values of the one or more outputs from the sound sensor (e.g., microphone of an implantable medical device), the vibration sensor (e.g., accelerometer of the implantable medical device), and / or an external device (e.g., external microphone) are below the first threshold, the user (e.g., a clinician or a recipient) is instructed to increase the volume of the externally-generated sound signal. The user may be iteratively instructed to increase the volume of the externally-generated sound signal until the at least one measurement (e.g., magnitude value) is above a first threshold (e.g., a noise floor threshold). In certain embodiments, the first threshold may be a signal-to-noise ratio (SNR) threshold.

[0088] However, if the at least one measurement is above the first threshold, the method 500 proceeds to monitor a quality of the least one measurement at 585. In certain embodiments, the quality of the at least one measurement is measured by a difference between the magnitude value in response to the externally-generated sound signal of a first volume level (e.g., soft input) and the magnitude value in response to the externally-generated sound signal of a second volume level (e.g., loud input).

[0089] FIG. 5B is a flow chart illustrating further details of the method 500 , in accordance with certain embodiments presented herein. Continuing from FIG. 5A, the quality of at least one measurement is monitored at 585. At 586, if the quality of at least one measurement is above a second threshold, the user is instructed to decrease a level of an externally-generated sound signal at 587. For example, the user (e.g., a clinician or a recipient) is instructed to decrease a level of the externally-generated sound signal (e.g., avoid saturating the sensing elements of a microphone). At 588, the method 500 returns to 582 where at least one measurement is performed again. However, at 586, if the quality of the at least one measurement is below the second threshold, then the method 500 outputs the at least one measurement at 589. In certain embodiments, one or more operational parameters corresponding to the at least one measurement may be stored at 589. That is, for example, if the difference between the magnitude value in response to the externally-generated sound signal of a first volume level (e.g., soft input) and the magnitude value in response to the externally-generated sound signal of a second volume level (e.g., loud input) is below the second threshold, the magnitude value is considered to have stabilized. As such, the method500 outputs the at least one measurement (e.g., magnitude value) at 589 and determines the calibration of the implantable medical device and the implantable adaptive body noise reduction system is complete at 590. In certain embodiments, upon completion of the calibration of the implantable medical device and / or the implantable adaptive body noise reduction system, the calibration for equalizing the response of the sound sensor (e.g., microphone of an implantable medical device) with that of the external device (e.g., external microphone) is considered complete.

[0090] FIG. 6A is a flow chart illustrating a method 600, in accordance with certain embodiments presented herein. The method 600 begins at 602 where at least one measurement is performed when an implantable adaptive body noise reduction system is coupled with a nonimplantable medical device. That is, for example, at least one output from a sound sensor in the implantable adaptive body noise reduction system is measured when the non-implantable medical device (e.g., hearing aid) is activated along with the implantable adaptive body noise reduction system. At 603, at least one output from the sound sensor in the implantable adaptive body noise reduction system is measured when the non-implantable medical device (e.g., hearing aid) is not activated. In certain embodiments, the at least one measurement is performed in response to an externally-generated sound signal (e.g., external acoustic sound signal). Further, in certain embodiments, the non-implantable medical device (e.g., hearing aid) is located contralaterally to the implantable adaptive body noise reduction system.

[0091] The method 600 continues to 605, which determines a difference between the at least one measurement determined at 602 with the at least one measurement determined at 603. In certain embodiments, the at least one measurement from 602 is an output from the sound sensor with body noise reduction, while the at least one measurement from 603 is an output from the sound sensor only. At 607, if the difference is greater than a threshold, the user is instructed at 608 to adjust the non-implantable medical device (e.g., hearing aid). For example, the user may be instructed to decrease a hearing aid gain, seek assistance from a clinician or other qualified professional, or invoke an automated assistive system. However, if the difference is not greater than the threshold, then at 609 the method 600 outputs the at least one measurement. The comparison between the difference and the threshold provides information on whether the implantable adaptive body noise reduction system has adequately addressed interference from the non-implantable medical device (e.g., hearing aid).

[0092] FIG. 6B is a flow chart illustrating further details of performing at least one measurement in 602 of FIG 6A. In this example, at least one measurement is performed by asound sensor (e.g., microphone) with body noise reduction at 610, and at least one measurement is performed by a sound sensor (e.g., microphone) without body noise reduction at 611. At 612, a difference between the at least one measurement performed at 610 and the at least one measurement performed at 611 is determined. At 613, the method 600 determines if the difference is above a threshold. If the difference is above a threshold, then the method 600 proceeds to 614, which outputs the at least one measurement and returns to 603. If the difference is not above a threshold, then the method 600 proceeds to 615, which outputs the at least one measurement.

[0093] FIG. 7 is a flow chart illustrating a method 700 , in accordance with certain embodiments presented herein. At 771, a predetermined period of silence is determined to have elapsed. Then, at 772, one or more outputs (e.g., frequency spectra measurements) from a sound sensor (e.g., microphone) are monitored. At 773, a minimum value of the one or more outputs is determined. In certain embodiments, after the minimum value is determined, the one or more outputs are processed to remove RF interferences and noises (e.g., breathing noises). In certain embodiments, the one or more outputs from the sound sensor are processed by an implantable adaptive body noise reduction system to remove body noise prior to determining the minimum value at 773.

[0094] FIG. 8A is a flowchart illustrating a method 800A, in accordance with certain embodiments presented herein. Method 800A begins at 857 where an implantable adaptive body noise reduction system is calibrated. For example, the implantable adaptive body noise reduction system is configured to operate based on an externally-generated body noise reference signal (e.g., uncontrolled vibration signal). At 858, operation of the implantable adaptive body noise reduction system during the calibrating is monitored. Then, at 859, calibration quality information is provided to the user based on the monitoring of the implantable adaptive body noise reduction system. For example, an instruction to adjust the externally-generated body noise reference signal may be provided to the user.

[0095] FIG. 8B is a flowchart illustrating a method 800B, in accordance with certain embodiments presented herein. Method 800B begins at 860 where at least one measurement to set at least one parameter of an implantable adaptive body noise reduction system is performed. At 861, a quality of the at least one measurement is monitored. Based on the monitoring of the quality, feedback is provided to a user at 862. For example, an instruction to adjust the externally-generated body noise reference signal may be provided to the user based on comparing the quality of the at least one measurement to a threshold.

[0096] FIG. 8C is a flowchart illustrating a method 800C, in accordance with certain embodiments presented herein. Method 800D begins at 874 where at least one measurement is performed to set one parameter of an implantable adaptive body noise reduction system. At 875, a quality of the at least one measurement is monitored. Then, the method 800D determines if the quality of the at least one measurement is acceptable at 876. Feedback to a user is provided based on the quality of the at least one measurement at 877. For example, an instruction to adjust the externally-generated body noise reference signal may be provided to the user based on the determined quality of the at least one measurement.

[0097] As noted, presented herein are techniques monitoring the calibration of an implantable adaptive body noise reduction system of an implantable medical device (e.g., auditory prosthesis) and, in certain aspects, validating the calibration process More specifically, as descried in greater detail below, a calibration process is implemented to calibrate an implantable adaptive body noise reduction system. The calibration process is monitored and calibration quality information can be provided to a user. In operation, monitoring the calibration of the implantable adaptive body noise reduction system, and providing calibration quality information to the user, as described herein, can enhance the ultimate operation of the implantable adaptive body noise reduction system. In certain embodiments, as described further below, at least one measurement is performed during the calibration of the implantable adaptive body noise reduction system. The quality of the at least one measurement is compared to one or more thresholds (e.g., at least a first threshold and a second threshold) to determine whether the calibration of the implantable adaptive body noise reduction system is complete. That is, the implantable adaptive body noise reduction system is determined to have been optimized in removing body noise from a sound signal.

[0098] In certain embodiments, as described elsewhere herein, an externally-generated body noise reference signal (e.g., uncontrolled vibration signal) is captured by at least one sound sensor and at least one vibration sensor of the implantable medical device. In one example, the at least one sound sensor provides a reference sound signal, and the at least one vibration sensor provides a reference vibration signal. A plurality of coefficient weights of the implantable adaptive body noise reduction system (e.g., adaptive filter) are repeatedly adjusted to remove the reference vibration signal from the reference sound signal. Here, the quality of at least one measurement is determined based on one or more differences between the plurality of coefficient weights. In one example, based on a comparison between the quality of the atleast one measurement with the first threshold and the second threshold, instructions to adjust the externally-generated body noise reference signal are provided to the user.

[0099] In certain embodiments, described elsewhere herein, an externally-generated sound signal (e.g., external acoustic sound signal) is captured by at least one sound sensor, at least one vibration sensor, and at least one external device. At least one measurement performed by the at least one sound sensor, the at least one vibration sensor, and / or the at least one external device is monitored in response to the externally-generated sound signal. In certain embodiments, feedback to the user to adjust a volume of the externally-generated sound signal is provide based on the quality of the at least one measurement.[ooioo] In certain embodiments, described elsewhere herein, an externally-generated sound signal (e.g., external acoustic sound signal) is captured by at least one sound sensor and at least one vibration sensor. In one example, at least one measurement is performed when the implantable adaptive body noise reduction system is coupled with a non-implantable medical device (e.g., hearing aid). The at least measurement is also performed when the implantable adaptive body noise reduction system is not coupled with a non-implantable medical device (e.g., hearing aid). The quality of the at least one measurement is determined as a difference between the at least one measurement when the implantable adaptive body noise reduction system is coupled with a non-implantable medical device and the at least one measurement when the implantable adaptive body noise reduction system is not coupled with the non- implantable medical device. Feedback to the user is provided based on the quality of the at least one measurement.[ooioi] In certain embodiments, described elsewhere herein, one or more outputs from the implantable adaptive body noise reduction system are monitored after a period of silence. A minimum value is determined from the one or more outputs. In certain embodiments, the minimum value may be considered a noise floor of the implantable adaptive body noise reduction system.

[0102] As previously described, the technology disclosed herein can be applied in any of a variety of circumstances and with a variety of different devices. Example devices that can benefit from technology disclosed herein are described in more detail in FIGS. 9 and 10. The techniques of the present disclosure can be applied to other devices, such as neurostimulators, cardiac pacemakers, cardiac defibrillators, sleep apnea management stimulators, seizure therapy stimulators, tinnitus management stimulators, and vestibular stimulation devices, aswell as other medical devices that deliver stimulation to tissue. Further, technology described herein can also be applied to consumer devices. These different systems and devices can benefit from the technology described herein.

[0103] FIG. 9 illustrates an example vestibular stimulator system 902, with which embodiments presented herein can be implemented. As shown, the vestibular stimulator system 902 comprises an implantable component (vestibular stimulator) 912 and an external device / component 904 (e.g., external processing device, battery charger, remote control, etc.). The external device 904 comprises a transceiver unit 960. As such, the external device 904 is configured to transfer data (and potentially power) to the vestibular stimulator 912.

[0104] The vestibular stimulator 912 comprises an implant body (main module) 934, a lead region 936, and a stimulating assembly 916, all configured to be implanted under the skin / tissue (tissue) 915 of the recipient. The implant body 934 generally comprises a hermetically-sealed housing 938 in which RF interface circuitry, one or more rechargeable batteries, one or more processors, and a stimulator unit are disposed. The implant body 134 also includes an intemal / implantable coil 914 that is generally external to the housing 938, but which is connected to the transceiver via a hermetic feedthrough (not shown).

[0105] The stimulating assembly 916 comprises a plurality of electrodes 944(l)-(3) disposed in a carrier member (e.g., a flexible silicone body). In this specific example, the stimulating assembly 916 comprises three (3) stimulation electrodes, referred to as stimulation electrodes 944(1), 944(2), and 944(3). The stimulation electrodes 944(1), 944(2), and 944(3) function as an electrical interface for delivery of electrical stimulation signals to the recipient’s vestibular system.

[0106] The stimulating assembly 916 is configured such that a surgeon can implant the stimulating assembly adjacent the recipient’s otolith organs via, for example, the recipient’s oval window. It is to be appreciated that this specific embodiment with three stimulation electrodes is merely illustrative and that the techniques presented herein may be used with stimulating assemblies having different numbers of stimulation electrodes, stimulating assemblies having different lengths, etc.

[0107] In operation, the vestibular stimulator 912, the external device 904, and / or another external device can be configured to implement the techniques presented herein. That is, the vestibular stimulator 912, possibly in combination with the external device 904 and / or anotherexternal device, can include an evoked biological response analysis system, as described elsewhere herein.

[0108] FIG. 10 illustrates a retinal prosthesis system 1001 that comprises an external device 1010 (which can correspond to the wearable device 100) configured to communicate with an implantable retinal prosthesis 1000 via signals 1051. The retinal prosthesis 1000 comprises an implanted processing module 1025, and a retinal prosthesis sensor-stimulator 1090 is positioned proximate the retina of a recipient. The external device 1010 and the processing module 1025 can communicate via coils 1008, 1014.

[0109] In an example, sensory inputs (e.g., photons entering the eye) are absorbed by a microelectronic array of the sensor-stimulator 1090 that is hybridized to a glass piece 1092 including, for example, an embedded array of microwires. The glass can have a curved surface that conforms to the inner radius of the retina. The sensor-stimulator 1090 can include a microelectronic imaging device that can be made of thin silicon containing integrated circuitry that convert the incident photons to an electronic charge.

[0110] The processing module 1025 includes an image processor 1023 that is in signal communication with the sensor-stimulator 1090 via, for example, a lead 1088 that extends through surgical incision 1089 formed in the eye wall. In other examples, processing module 1025 is in wireless communication with the sensor-stimulator 1090. The image processor 1023 processes the input into the sensor-stimulator 1090 and provides control signals back to the sensor-stimulator 1090 so the device can provide an output to the optic nerve. That said, in an alternate example, the processing is executed by a component proximate to, or integrated with, the sensor-stimulator 1090. The electric charge resulting from the conversion of the incident photons is converted to a proportional amount of electronic current which is input to a nearby retinal cell layer. The cells fire and a signal is sent to the optic nerve, thus inducing a sight perception.[ooni] The processing module 1025 can be implanted in the recipient and function by communicating with the external device 1010, such as a BTE unit, a pair of eyeglasses, etc. The external device 1010 can include an external light / image capture device (e.g., located in / on a behind-the-ear device or a pair of glasses, etc.), while, as noted above, in some examples, the sensor-stimulator 1090 captures light / images, in which sensor-stimulator 1090 is implanted in the recipient.

[0112] As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant to suggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. In general, additional configurations can be used to practice the processes and systems herein and / or some aspects described can be excluded without departing from the processes and systems disclosed herein.

[0113] This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

[0114] As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and / or some aspects described can be excluded without departing from the methods and systems disclosed herein.

[0115] According to certain aspects, systems and non-transitory computer readable storage media are provided. The systems are configured with hardware configured to execute operations analogous to the methods of the present disclosure. The one or more non-transitory computer readable storage media comprise instructions that, when executed by one or more processors, cause the one or more processors to execute operations analogous to the methods of the present disclosure.

[0116] Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosed steps can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.

[0117] Although specific aspects were described herein, the scope of the technology is not limited to those specific aspects. One skilled in the art will recognize other aspects orimprovements that are within the scope of the present technology. Therefore, the specific structure, acts, or media are disclosed only as illustrative aspects. The scope of the technology is defined by the following claims and any equivalents therein.

[0118] It is also to be appreciated that the embodiments presented herein are not mutually exclusive and that the various embodiments may be combined with another in any of a number of different manners.

Claims

CLAIMSWhat is claimed is:

1. A method, comprising: calibrating an implantable adaptive body noise reduction system; monitoring operation of the implantable adaptive body noise reduction system during the calibrating; and providing calibration quality information to a user based on the monitoring of the implantable adaptive body noise reduction system.

2. The method of claim 1, wherein calibrating an implantable adaptive body noise reduction system includes: capturing an externally-generated body noise reference signal with at least one sound sensor and at least one vibration sensor; and operating the implantable adaptive body noise reduction system based on the externally-generated body noise reference signal.

3. The method of claim 2, wherein the externally-generated body noise reference signal is an uncontrolled vibration signal.

4. The method of claim 3, wherein providing quality information to a user based on the monitoring of the implantable adaptive body noise reduction system comprises: instructing the user to adjust the uncontrolled vibration signal.

5. The method of claim 1, 2, 3, or 4, wherein capturing the externally-generated body noise reference signal with the at least one sound sensor and the at least one vibration sensor provides a reference sound signal and a reference vibration signal, and wherein operating the implantable adaptive body noise reduction system based on the externally-generated body noise reference signal comprises repeatedly adjusting coefficient weights of the implantable adaptive body noise reduction system to remove the reference vibration signal from the reference sound signal to provide a respective processed signal.

6. The method of claim 1, 2, 3, or 4, wherein the implantable adaptive body noise reduction system includes a fixed prefilter portion, and wherein the calibrating the implantable adaptive body noise reduction system comprises: setting one or more parameters of the fixed prefilter portion.

7. A method, comprising: performing at least one measurement to set at least one parameter of an implantable adaptive body noise reduction system; monitoring a quality of the at least one measurement; and providing feedback to a user based on the monitoring.

8. The method of claim 7, wherein monitoring the quality of the at least one measurement comprises: determining if the quality of the at least one measurement is below a first threshold; and determining if the quality of the at least one measurement is above a second threshold.

9. The method of claim 8, wherein providing feedback to the user based on the monitoring comprises: instructing the user to adjust an externally-generated body noise reference signal if the quality of the at least one measurement is below the first threshold or above the second threshold.

10. The method of claim 9, wherein instructing the user to adjust the externally-generated body noise reference signal if the quality of the at least one measurement is below the first threshold comprises: instructing the user to increase a level of the externally-generated body noise reference signal, wherein the externally-generated body noise reference signal is an uncontrolled vibration signal.

11. The method of claim 9, wherein instructing the user to adjust the externally-generated body noise reference signal if the quality of the at least one measurement is above the second threshold comprises:instructing the user to decrease a level of the externally-generated body noise reference signal, wherein the externally-generated body noise reference signal is an uncontrolled vibration signal.

12. The method of claim 7, 8, 9, 10, or 11, wherein the quality of the at least one measurement is determined based on one or more differences between a plurality of coefficient weights of the implantable adaptive body noise reduction system.

13. The method of claim 7, 8, 9, 10, or 11, wherein the quality of the at least one measurement is determined based on one or more differences between a plurality of coefficient weights of the implantable adaptive body noise reduction system.

14. The method of claim 7, 8, 9, 10, or 11, wherein performing the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system comprises: capturing an externally-generated sound signal with at least one sound sensor, at least one vibration sensor, and at least one external device; and monitoring the at least one measurement in response to the externally-generated sound signal.

15. The method of claim 14, wherein providing feedback to the user based on the monitoring comprising: determining if an attribute of the at least one measurement is below a first threshold; and instructing the user to adjust a volume of the externally-generated sound signal if the attribute of at least one measurement is below the first threshold.

16. The method of claim 15, wherein providing feedback to the user based on the monitoring comprises: determining if the quality of the at least one measurement is above a second threshold; and instructing the user to decrease a level of an externally-generated sound signal if the quality of the at least one measurement is above the second threshold.

17. The method of claim 7, 8, 9, 10, or 11, wherein the quality of the at least one measurement is determined based on a difference between the at least one measurement when the implantable adaptive body noise reduction system is coupled with a non-implantable medical device and the at least one measurement when the implantable adaptive body noise reduction system is not coupled with the non-implantable medical device.

18. The method of claim 17, wherein monitoring the quality of the at least one measurement comprises: comparing the difference with a threshold.

19. The method of claim 18, wherein providing feedback to the user based on the monitoring comprises: instructing the user to adjust the non-implantable medical device if the difference is above the threshold.

20. The method of claim 7, 8, 9, 10, or 11, wherein the non-implantable medical device is a hearing aid device.

21. The method of claim 7, 8, 9, 10, or 11 , wherein performing the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system comprises: monitoring one or more outputs from at least one sound sensor after a period of silence; and determining a minimum value from the one or more outputs.

22. The method of claim 21 , wherein performing the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system comprises: processing the one or more outputs with the implantable adaptive body noise reduction system.

23. A system, comprising: a memory; and at least one processor operable coupled to the memory, wherein the at least one processor is configured to:perform at least one measurement to set at least one parameter of an implantable adaptive body noise reduction system; monitor a quality of the at least one measurement; determine if the quality of the at least one measurement is acceptable; and provide feedback to a user based on the quality of the at least one measurement.

24. The system of claim 23, wherein the at least one processor is further configured to monitor the quality of the at least one measurement by: determining if the quality of the at least one measurement is below a first threshold; and determining if the quality of the at least one measurement is above a second threshold.

25. The system of claim 24, wherein the at least one processor is further configured to provide feedback to a user based on the quality of the at least one measurement by instructing the user to adjust an externally-generated body noise reference signal if the quality of the at least one measurement is below the first threshold or above the second threshold.

26. The system of claim 25, wherein the at least one processor is further configured to instruct the user to adjust the externally-generated body noise reference signal if the quality of the at least one measurement is below the first threshold by: instructing the user to increase a level of the externally-generated body noise reference signal, wherein the externally-generated body noise reference signal is an uncontrolled vibration signal.

27. The system of claim 25, wherein the at least one processor is further configured to instruct the user to adjust the externally-generated body noise reference signal if the quality of the at least one measurement is above the second threshold by: instructing the user to decrease a level of the externally-generated body noise reference signal, wherein the externally-generated body noise reference signal is an uncontrolled vibration signal.

28. The system of claim 25, wherein the quality of the at least one measurement is acceptable when the quality falls within a range defined by the first threshold and the second threshold.

29. The system of claim 23, 24, 25, 26, 27, or 28, wherein the quality of the at least one measurement is determined based on one or more differences between a plurality of coefficient weights of the implantable adaptive body noise reduction system.

30. The system of claim 23, 24, 25, 26, 27, or 28, wherein the at least one processor is further configured to perform the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system by: capturing an externally-generated sound signal with at least one sound sensor, at least one vibration sensor, and at least one external device; and monitoring the at least one measurement in response to the externally-generated sound signal.

31. The system of claim 30, wherein the at least one processor is further configured to provide feedback to the user by: determining if the at least one measurement is below a first threshold; and instructing the user to adjust a volume of the externally-generated sound signal if the at least one measurement is below the first threshold.

32. The system of claim 31, wherein the at least one processor is further configured to provide feedback to the user by: determining if the quality of the at least one measurement is above a second threshold; and instructing the user to decrease a level of an externally-generated sound signal if the quality of the at least one measurement is above the second threshold.

33. The system of claim 23, 24, 25, 26, 27, or 28, wherein the quality of the at least one measurement is determined based on a difference between the at least one measurement when the implantable adaptive body noise reduction system is coupled with a non-implantable medical device and the at least one measurement when the implantable adaptive body noise reduction system is not coupled with the non-implantable medical device.

34. The system of claim 33, wherein the at least one processor is further configured to monitor the quality of the at least one measurement by comparing the difference with a threshold.

35. The system of claim 34, wherein the at least one processor is further configured to provide feedback to the user by instructing the user to adjust the non-implantable medical device if the difference is above the threshold.

36. The system of claim 33, wherein the non-implantable medical device is a hearing aid device.

37. The system of claim 23, 24, 25, 26, 27, or 28, wherein the at least one processor is further configured to perform the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system by: monitoring one or more outputs from at least one sound sensor after a period of silence; and determining a minimum value from the one or more outputs.

38. The system of claim 37, wherein the at least one processor is further configured to perform the at least one measurement to set the at least one parameter of the implantable adaptive body noise reduction system by processing the one or more outputs with the implantable adaptive body noise reduction system.

39. One or more non-transitory computer readable storage media comprising instructions that, when executed by one or more processors, are configured to: monitor the quality of at least one measurement performed to set at least one parameter of an implantable adaptive body noise reduction system; and providing feedback to a user based on the quality of the measurement.

40. The one or more non-transitory computer readable storage media of claim 39, wherein the instructions configured to monitor the quality of the at least one measurement comprise instructions configured to: determine if the quality of the at least one measurement is below a first threshold; and determine if the quality of the at least one measurement is above a second threshold.

41. The one or more non-transitory computer readable storage media of claim 40, wherein the instructions configured to provide feedback to the user based on the monitoring comprise instructions configured to: instruct the user to adjust an externally-generated body noise reference signal if the quality of the at least one measurement is below the first threshold or above the second threshold.

42. The one or more non-transitory computer readable storage media of claim 39, 40, or 41, wherein the quality of the at least one measurement is determined based on one or more differences between a plurality of coefficient weights of the implantable adaptive body noise reduction system.

43. The one or more non-transitory computer readable storage media of claim 39, 40, or 41, wherein the instructions configured to provide feedback to the user based on the monitoring comprise instructions configured to: determine if an attribute of the at least one measurement is below a first threshold; and instruct the user to adjust a volume of the externally-generated sound signal if the attribute of at least one measurement is below the first threshold.

44. The one or more non-transitory computer readable storage media of claim 43, wherein the instructions configured to provide feedback to the user based on the monitoring comprise instructions configured to: determine if the quality of the at least one measurement is above a second threshold; and instruct the user to decrease a level of an externally-generated sound signal if the quality of the at least one measurement is above the second threshold.

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