Electro-vibrational stimulation

Abstract

Presented herein are techniques to deliver both electrical stimulation and vibrational stimulation to a recipient of a medical device such as a hearing device. A method can include delivering electrical stimulation to a recipient via a plurality of electrical stimulation contacts disposed on a carrier of a stimulating assembly and causing a pressure wave to be generated by the carrier within the recipient without introducing consequential movement of the plurality of electrical stimulation contacts relative to tissue of the recipient.

Description

ELECTRO- VIBRATIONAL STIMULATIONBACKGROUNDField of the Invention[oooi] Aspects presented herein relate generally to electro-vibrational stimulation of a medical device recipient.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: delivering electrical stimulation to a recipient via a plurality of electrical stimulation contacts disposed on a carrier of a stimulating assembly positioned in a body cavity of a recipient; and causing a pressure wave to be generated by the carrier within the body cavity without introducing consequential movement of the plurality of electrical stimulation contacts relative to the body cavity.

[0005] In another aspect, an implantable stimulation assembly is provided. The implantable stimulation assembly comprises: an elongate carrier member configured to be implanted in body cavity of a recipient; a plurality of electrical stimulation contacts disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the body cavity, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the recipient; and at least one vibrational stimulation element disposed in the elongate carrier member and configured to deliver vibrational stimulation to the body cavity without introducing consequential movement of the plurality of electrical stimulation contacts relative to a body cavity.

[0006] In another aspect, an implantable stimulation assembly is provided. The implantable stimulation assembly comprises: an elongate carrier member having an elongate axis, wherein the elongate carrier member is configured to be implanted in body cavity of a recipient; a plurality of electrical stimulation contact disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the body cavity, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the body cavity; and at least one electrically-controllable deformation element disposed in the elongate carrier member and overlapping, along the elongate axis, with at least one of the plurality of electrical stimulation contacts.

[0007] In yet another aspect, an implantable component is provided. The implantable component comprises: an elongate carrier member configured to be implanted in a recipient; a plurality of electrical stimulation contacts disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the recipient, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the recipient; and at least one vibrational stimulation element disposed in the elongate carrier member and configured to deliver vibrational stimulation to the recipient, wherein the elongate carrier member, when implanted in a recipient, is configured to enablethe plurality of electrical stimulation contacts to maintain their relative position against the tissue of the recipient while the at least one vibrational stimulation element delivers the vibrational stimulation.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:

[0009] FIG. 1A is a schematic diagram illustrating an electro-vibrational hearing device, in accordance with certain embodiments presented herein;[ooio] FIG. IB is a block diagram of the electro-vibrational hearing device of FIG. 1 A;[ooii] FIG. 2A is a schematic diagram illustrating a distal end of an elongate intra-cochlear stimulating assembly including an electrically-controllable deformation element, in accordance with certain embodiments presented herein;

[0012] FIG. 2B is a schematic diagram illustrating a first cross section through line I-I of FIG. 2A that depicts one embodiment of the electrically-controllable deformation element;

[0013] FIG. 2C is a schematic diagram illustrating an elongate intra-cochlear stimulating assembly including an electrically-controllable deformation element, in accordance with certain embodiments presented herein;

[0014] FIG. 2D is a schematic diagram illustrating an elongate intra-cochlear stimulating assembly including an electrically-controllable deformation element, in accordance with certain embodiments presented herein;

[0015] FIGs. 3A and 3B illustrate another embodiment of an elongate intra-cochlear stimulating assembly including an electrically-controllable deformation element, in accordance with certain embodiments presented herein;

[0016] FIGs. 4A and 4B illustrate, respectively, non-activation and activation states of an electrically-controllable deformation element, in accordance with certain embodiments presented herein; and

[0017] FIG. 5 is a flowchart of a method in accordance with embodiments presented herein.DETAILED DESCRIPTION

[0018] Individuals suffer from different types of hearing loss (e.g., conductive and / or sensorineural) and / or different degrees / severity of hearing loss. However, it is now common for many recipients to retain some residual natural hearing ability (acoustic hearing) after receiving a hearing device. For example, progressive improvements in the design of intracochlea electrode arrays (stimulating assemblies), surgical implantation techniques, tooling, etc. have enabled atraumatic surgeries which preserve at least some of the recipient’s fine inner ear structures (e.g., cochlea hair cells) and the natural cochlea function, particularly in the lower frequency regions of the cochlea.

[0019] Due, at least in part, to the ability to preserve residual hearing, it is becoming increasingly common for recipients to rely on both electrical hearing (i.e., induced via electrical stimulation signals) and acoustic hearing (i.e., natural or amplified acoustic sounds) at the same ear. Typically, the acoustic hearing enables the recipient to perceive sound signal components corresponding to the lower frequencies, while the electrical hearing is used to perceive sound signal components corresponding to the higher frequencies of sound signals.

[0020] Acoustic hearing, in addition to electrical hearing, can be beneficial for recipients because the acoustic hearing adds a more “natural” sound to their hearing perception compared to electrical hearing only in that ear. In particular, temporal coding of auditory signals is particularly important for low frequencies and is best achieved with acoustic hearing. As such, combined electrical and acoustic hearing benefits specifically from this low-frequency acoustic coding. For example, the addition of the acoustic hearing can provide improved pitch and music perception and / or appreciation, as the acoustic signals can contain a more salient lower frequency (e.g., fundamental pitch, F0) representation than is possible with electrical stimulation. Other benefits of acoustic hearing can include, for example, improved sound localization, binaural release from unmasking, the ability to distinguish signals in a noisy environment, etc.

[0021] Conventional hearing devices typically provide a recipient with acoustic hearing by delivering acoustic stimulation (sound waves) to the ear of the recipient (e.g., via a receiver positioned in the ear). In these arrangements, the acoustic stimulation is channeled into and through the recipient’s ear canal to the tympanic membrane, which vibrates in response to sound wave(s). This vibration is coupled to the oval window or fenestra ovalis of the cochlea through the bones of the middle ear (the malleus, the incus, and the stapes, collectivelyreferred to as the ossicles). The ossicles are positioned in the middle ear cavity and serve to fdter and amplify the sound wave(s), causing the oval window to articulate (vibrate) in response to the vibration of tympanic membrane. This vibration of the oval window sets up waves of fluid motion of the perilymph within cochlea. Such fluid motion, in turn, activates tiny hair cells (not shown) inside of cochlea. Activation of the hair cells causes appropriate nerve impulses to be generated and transferred through the spiral ganglion cells (not shown) and auditory nerve to the brain (also not shown) where they are perceived as sound.

[0022] In other conventional arrangements, sometimes referred to as bone conduction devices, the acoustic hearing is provided via vibrations that are transferred through teeth and / or bone to the cochlea. That is, bone conduction devices generate vibrations that are coupled to the cochlea through the skull and tissue surrounding the cochlea. These vibrations, when they reach the cochlea, set up waves of fluid motion of the perilymph within cochlea which, in turn, activates the hair cells inside of cochlea and cause appropriate nerve impulses to be generated and transferred through the spiral ganglion cells and auditory nerve to the brain. Bone conduction devices are typically coupled to the recipient using a direct percutaneous implant and abutment, or using transcutaneous solutions, that can contain an active or passive implant component, or other mechanisms to transmit sound vibrations through the skull bones, such as through vibrating the ear canal walls or the teeth.

[0023] In the above conventional arrangements, the acoustic hearing is induced indirectly at the cochlea, namely the stimulation is delivered indirectly to the cochlea, such as via the tympanic membrane and ossicles, the skull bone, etc. Presented herein are techniques to induce acoustic hearing directly in the cochlea, specifically via vibration delivered from within a stimulating assembly positioned in the cochlea. More specifically, presented herein are electro-vibrational hearing devices that induce / evoke both electrical hearing via delivery of electrical stimulation signals (electrical stimulation) to the cochlea, and acoustic hearing via delivery of vibration stimulation signals (vibrational stimulation) from within the cochlea.

[0024] However, there are a number of different types of device in / with which the techniques presented herein can be implemented. Merely for ease of description, the techniques presented herein are primarily described with reference to a specific device. However, it is to be appreciated that the techniques presented herein can also be partially or fully implemented by any of a number of different types of devices or systems, including consumer electronic devices (e.g., consumer hearing devices, consumer computing devices such as mobile phones and tablets, audio equipment such as home theatre and car audio systems, etc.), computingsystems (e.g., servers in data centers, Intemet-of-Things (loT) devices), various types of software systems, such as databases, machine learning and artificial intelligence systems, other medical devices, such as diagnostic equipment or life sustaining equipment, etc. For example, the techniques presented herein could be used in or with sensory protheses, including hearing aids and cochlear implants, and various medical devices, such as pacemakers, drug delivery systems, implantable defibrillators, functional electrical stimulation devices, sleep disorder devices (e.g., sleep apnea devices), seizure devices (e.g., devices for monitoring and / or treating epileptic events), balance or movement disorder devices (e.g., vestibular stimulation devices), tinnitus management devices, visual implants (e.g., bionic eyes), and other neuromodulation devices (e.g., brain-computer interfaces).

[0025] Therefore, more generally, aspects of the techniques presented herein are directed to delivering electrical stimulation to a recipient via a plurality of electrical stimulation contacts disposed on a carrier of a stimulating assembly positioned in a body cavity of a recipient; and causing a pressure wave to be generated by the carrier within the body cavity without introducing consequential movement of the plurality of electrical stimulation contacts relative to the body cavity. In certain examples, the body cavity is a cochlea of the recipient, and wherein the pressure wave generated by the carrier within the body cavity causes the pressure wave to be generated without introducing consequential movement of the plurality of electrical stimulation contacts relative to a modiolus of the cochlea.

[0026] FIG. 1A is schematic diagram of an example electro-vibrational hearing device (e.g., - vibrational hearing prosthesis) 100 configured in accordance with embodiments of the present invention, while FIG. IB is a block diagram of the electro-vibrational hearing device 100. As described further below, the electro-vibrational hearing device 100 is configured to deliver electrical stimulation to a body cavity, such as an inner ear or cochlea, of a recipient and also deliver vibrational stimulation to the recipient via an electrically-controllable deformation element disposed in the body cavity (e.g., cochlea). For ease of illustration, FIGs. 1A and IB will be described together with specific reference to one type of body cavity, namely the cochlea of a recipient.

[0027] As shown, the electro-vibrational hearing device 100 includes an external component 102 and an intemal / implantable component 104. The external component 102 is directly or indirectly attached to the body of the recipient and comprises a sound processing unit 110, an external coil 106, and, generally, a magnet (not shown in FIG. 1A) fixed relative to the external coil 106. The external coil 106 is connected to the sound processing unit 110 via acable 134. The sound processing unit 110 comprises one or more sound input devices 108 (e.g., microphones, audio input ports, cable ports, telecoils, a wireless transceiver, etc.), a sound processor 112, an external transceiver unit (transceiver) 114, and power source 116. In the example of FIGs. 1A and IB, the sound processing unit 110 is a behind-the-ear (BTE) sound processing unit. However, in other embodiments, the sound processing unit 110 could be a body-worn sound processing unit, a button sound processing unit, an in-the-ear (ITE) unit, etc.

[0028] The implantable component 104 comprises an implant body (main module) 122, a lead region 124, and an elongate intra-cochlear stimulating assembly (or, more simply, “stimulating assembly”) 126. The implant body 122 generally comprises a hermetically- sealed housing 128 in which an internal transceiver unit (transceiver) 130, a signal differentiation module 150, an electrical stimulator unit 132, and a vibrational stimulator unit 142 are disposed. The implant body 122 also includes an intemal / implantable coil 136 that is generally external to the housing 128, but which is connected to the transceiver 130 via a hermetic feedthrough (not shown in FIG. IB). Implantable coil 136 is typically a wire antenna coil comprised of multiple turns of electrically insulated single-strand or multi-strand platinum or gold wire. The electrical insulation of implantable coil 136 is provided by a flexible molding (e.g., silicone molding), which is not shown in FIG. IB. Generally, a magnet is fixed relative to the implantable coil 136.

[0029] Stimulating assembly 126 is configured to be at least partially implanted in the recipient’s cochlea 120 and includes a plurality of longitudinally spaced intra-cochlear electrical stimulation contacts (e.g., electrodes) 138 that collectively form a contact array or carrier 140 for delivery of electrical stimulation (current signals) to the recipient’s cochlea. In certain arrangements, the carrier 140 can include other types of stimulating contacts, such as optical stimulating contacts, in addition to the stimulation contacts 138.

[0030] Stimulating assembly 126 also includes, towards an apical or distal end (distal portion) 127 thereof, an electrically-controllable deformation element (deformation element) 180. In an embodiment, electrically-controllable deformation element 180 is an element that is configured to deform (e.g., expand, contract, twist, etc.) at least distal portion 127 of elongate stimulating assembly 126. In certain embodiments, the electrically-controllable deformation element 180 is itself configured to deform, while in other embodiments the electrically-controllable deformation element 180 is configured to induce deformation of a surrounding material (e.g., the carrier member). As will be explained in more detail below,deformation or vibration, by the electrically-controllable deformation element 180, of distal portion 127 of sufficient magnitude and at predetermined frequencies provides mechanical / vibrational stimulation to the recipient through pressure waves that travel toward the apical end of the cochlea through the perilymph. In this regard, electrically-controllable deformation element 180 can also be referred to as “vibrational stimulation element.” Electrically-controllable deformation element 180 can be comprised of, e.g., elements that are themselves deformable in response to electrical signals, such as an electro-activated polymer (EAP) or elements that induce deformation of a surrounding material, such as electrical coil(s) and / or magnets), or any other component that can be driven via electric signals, and that causes a vibrating deformation of distal portion 127 resulting in a generated pressure wave.

[0031] Stimulating assembly 126 extends through an opening 121 in the cochlea (e.g., cochleostomy, the round window, etc.) and has a proximal end connected to electrical stimulator unit 132 and vibrational stimulator unit 142 via lead region 124 and a hermetic feedthrough (not shown in FIG. IB). Lead region 124 includes a plurality of conductors (wires) that electrically couple the stimulation contacts 138 to the electrical stimulator unit 132, and the electrically-controllable deformation element 180 to vibrational stimulator unit 142.

[0032] Returning to external component 102, the sound input device(s) 108 are configured to detect / receive sound signals and to generate electrical output signals therefrom. The sound processor 112 is configured to execute sound processing that converts the output signals received from the sound input device(s) into coded data signals that represent vibrational and / or electrical stimulation for delivery to the recipient. That is, as noted, the electrovibrational hearing device 100 operates to evoke perception by the recipient of sound signals received by the sound input device(s) 108 through the delivery of one or both of electrical stimulation signals and vibrational stimulation signals (the latter being delivered via vibrational stimulator unit 142 and electrically-controllable deformation element 180) to the recipient. As such, depending on the current operational settings (sometimes referred to as an operational “map”), the sound processor 112 is configured to convert the output signals received from the sound input device(s) into a first set of output signals representative of electrical stimulation and / or into a second set of output signals representative of vibrational stimulation. The collective output signals 115 (shown by the indicated arrow), represent the electrical stimulation and vibrational stimulation.

[0033] The output signals 115 are provided to the external coil 106. The external coil 106 is configured to transcutaneously transfer the output signals 115, in an encoded manner, to the implantable component 104 via external coil 106. More specifically, the magnets fixed relative to the external coil 106 and the implantable coil 136 facilitate the operational alignment of the external coil 106 with the implantable coil 136. This operational alignment of the coils enables the external coil 106 to transmit the coded output signals 115, as well as power signals received from power source 116, to the implantable coil 136. In certain examples, external coil 106 transmits the encoded output signals 115 to implantable coil 136 via a radio frequency (RF) link. However, various other types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, can be used to transfer the power and / or data from an external component to an electro-vibrational hearing device and, as such, FIG. IB illustrates only one example arrangement.

[0034] Encoded output signals 115 received by the transceiver 130 are routed to one of the two stimulator units within the implantable component 104, via a signal differentiation module 150. The signal differentiation module 150 is configured to identify the incoming signals processed by transceiver 130 and to send the appropriate signals 152, 154 to the appropriate stimulation unit. Signals 152 can include M number of individual signals (perhaps equivalent to the number of stimulation contacts 138), and signals 154 can include N number of individual signals (perhaps equivalent to a number of activatable components in electrically-controllable deformation element 180).

[0035] A first, or electrical, stimulator unit 132 generates electrical stimulation signals 162 for delivery to the recipient, via stimulating assembly 126 and stimulation contacts (electrodes) 138. A second, or vibrational, stimulator unit 142 generates electrical stimulation signals 164 for delivery to the cochlea of the recipient, again via the stimulating assembly 126, but in this case to electrically-controllable deformation element 180, to generate mechanical / vibrational stimulation (vibration) to the recipient through pressure waves that travel toward the apical end of the cochlea through the perilymph. As shown, the electrical stimulator unit 132 and the vibrational stimulator unit 142 generate signals 162, 164. The signals 162, 164, however, have different characteristics and are connected to different stimulators within the stimulating assembly 126.

[0036] In an embodiment, sound processor 112 delivers signals destined for each of electrical stimulator unit 132 and vibrational stimulator unit 142 such that they can be differentiated by signal differentiation module 150. Signal differentiation in signal differentiation module 150can be accomplished using, e.g., frequency filtering, time division multiplexing, or frequency division multiplexing schemes, or any other scheme that allows signal differentiation module 150 to discriminate between signals destined for electrical stimulator unit 132 and vibrational stimulator unit 142.

[0037] FIGs. 2A-2D illustrate embodiments of stimulating assemblies having different arrangements of electrically-controllable deformation elements, in accordance with aspects presented herein. More specifically, referring first to FIG. 2A, shown is a distal end (distal portion) 11K of a stimulating assembly 226A including an electrically-controllable deformation element (deformation element) 280A. In this embodiment, stimulation contacts 238 are shown disposed on a carrier member 240 with wires 239 provided to supply appropriate electrical signals from an electrical stimulator unit (e.g., electrical stimulator unit 132 from FIG. IB). Electrically-controllable deformation element 280A can be disposed on the carrier 140 on a surface different from the surface on which the stimulation contacts 238 are exposed. Generally speaking, for a cochlear implant, the stimulation contacts 238 are arranged to be in close proximity (e.g., adjacent) with the modiolus of the cochlea, whereas the electrically-controllable deformation element 280A can be arranged to be exposed on a surface other than one towards the modiolus. However, in certain embodiments, it can be desirable to include at least portions of electrically-controllable deformation element 280A in a position such that it interacts with the modiolus. In the embodiment shown in FIG. 2A, the electrically-controllable deformation element 280A at least partially overlaps, along an elongate axis 260 of the carrier 240, with at least one of the stimulation contacts 238. However, in other embodiments, there can be no such overlap.

[0038] As noted, electrically-controllable deformation elements presented herein, such as electrically-controllable deformation element 280, are configured to deform (e.g., expand, contract, twist, etc.) at least distal portion, such as distal portion 1K, of elongate stimulating assembly 226A. Also as noted above, certain electrically-controllable deformation elements presented herein are themselves configured to deform (e.g., the electrically-controllable deformation element itself expands, contracts, twists etc.), while other electrically-controllable deformation elements presented herein do not themselves deform but are configured to induce deformation of a surrounding material (e.g., the carrier member).

[0039] FIG. 2A illustrates one specific embodiment in which the electrically-controllable deformation element 280A is itself configured to deform and comprises an electro-activatedpolymer (EAP). In this regard, at least one wire 289 connects electrically-controllable deformation element 280A with a vibrational stimulator unit (e.g., vibrational stimulator unit 142). When an electric current is supplied to the electrically-controllable deformation element 280, the material will expand, contract, stretch, flex, twist, or otherwise deform. The deformation can be in a direction along elongate axis 260 of the carrier 240A or can be in a direction transverse to the elongate axis 260, or a combination thereof. That deformation will cause a pressure wave to originate near distal portion 1K of stimulating assembly 226A and that will, in turn, extend toward the apical end of the cochlea, enabling a recipient’s residual hearing to be used to hear sound, generally at lower frequencies. In an embodiment, the electric current delivered to electrically-controllable deformation element 280A is in the form of pulses or waves that cause the electrically-controllable deformation element 280A to vibrate at a predetermined frequency.

[0040] In certain embodiments, the electrically-controllable deformation element 280A is exposed to the cochlea fluid when implanted in a recipient (e.g., directly contacts the perilymph fluid within the cochlea). In alternative embodiments, like that shown in FIG. 2B, which is a first a cross section through line I-I of FIG. 2A, the material of carrier member 240A (e.g., silicone) might cover part of the electrically-controllable deformation element 280A such that electrically-controllable deformation element is partially or fully encapsulated within carrier 240A. In FIG. 2A, broken line 282 indicates an over-molded portion of the material of carrier 240A. Such over-molding can be beneficial if, for example, the EAP (or other material) of electrically-controllable deformation element 280A is not bio-compatible with the anatomy / physiology of the cochlea environment. It will be appreciated that for any of the following embodiments describing possible structures for electrically-controllable deformation element 280, the material of electrically-controllable deformation element 280A could be exposed directly to the perilymph fluid or be encapsulated within carrier 240A.

[0041] FIG. 2C is a cross sectional view of another embodiment of a stimulating assembly 240C, in accordance with embodiments presented herein. In this example, the controllable deformation element 280C comprises two sections 280C-1 and 280C-2, each possibly being independently controlled by a vibrational stimulator unit. Similarly, FIG. 2D a cross sectional view of another embodiment of a stimulating assembly 240D, in accordance with embodiments presented herein. Here, electrically-controllable deformation element 280D comprises three sections 280D-1, 280D-2, 280D-3, each possibly being independently controlled by a vibrational stimulator unit. When electrically-controllable deformationelement comprises multiple sections (e.g., as shown in FIG.s 2C and 2D), each section can be controlled by a same control signal in unison with other sections, and / or the sections can be controlled independently such that a more complex wave pattern can be established within the cochlea to aid in lower frequency hearing.

[0042] FIGs. 3A and 3B show still other embodiments of an electrically-controllable deformation element, in accordance with aspects presented. In the case of FIG. 3A, shown is a distal portion 327A of a stimulating assembly 340A comprising an electrically-controllable deformation element 380A that is disposed in an angled or spiraled configuration, e.g., not necessarily extending in a direction of elongate axis 360. Such a configuration can be more conducive to imparting a twisting motion for distal portion 327A. In the case of FIG. 3B, shown is a distal portion 327B of a stimulating assembly 340B comprising an electrically- controllable deformation element 380B that is be disposed radially around elongate axis 360.

[0043] FIGs. 4A and 4B illustrate, respectively, non-activation and activation states of an electrically-controllable deformation element 480. Specifically, in FIG. 4A, carrier member 440 along with stimulation contact 438 are in contact with, or adjacent to, a recipient’s tissue 410, such as the modiolus of the cochlea. In the case of FIG. 4A, electrically-controllable deformation element 480 is not activated (i.e., is in a de-activated state), and is thus in a retracted or contracted state. In contrast, in FIG. 4B, electrically-controllable deformation element 480 is activated as indicated by arrows 485 and the bulging shape of electrically- controllable deformation element 480. Notably, despite electrically-controllable deformation element 480 being activated in FIG. 4B, the stimulation contact 138 does not move relative to the recipient’s tissue 410. In other words, activation of electrically-controllable deformation element 480 does not introduce any consequential movement of the stimulation contact 438 (or contacts) relative to the recipient’s tissue 410, e.g., the modiolus of the cochlea. In the context of the present disclosure, “consequential movement” means a movement that impacts the operation of a given stimulation contact 438, or interaction thereof with a recipient’s hearing attributable to the given stimulation contact 438. “Consequential movement” might also mean a movement of a given stimulation contact from a first position to a second position, where the first position can be, e.g., a position that was set upon surgical implantation of the carrier member 440 into the recipient’s cochlea. Generally, it can be desirable to avoid vibrating the components associated with electrical stimulation so that, e.g., the stimulation contacts 438 remain in the same place relative to the cochlea during operation so that each stimulation contact 438 stimulates the same neuron groups and doesnot stimulate other neuron groups, which can be an important consideration as electrical stimulation of the cochlear becomes more focused, e.g., by using smaller electrodes such as graphene electrodes, and / or by using stimulation strategies such as multi-polar stimulation.

[0044] Avoiding consequential movement can be achieved by, e.g., selecting material for electrically-controllable deformation elements presented herein (e.g., 180, 280A, 380A, 380B, 480) that is less stiff than the material employed for carrier 140, such that any deformation of the electrically-controllable deformation element will cause substantially only that material to expand, contract, twist, etc., while leaving the relatively stiffer or bulkier material of carrier member substantially unaffected.

[0045] In some embodiments, on the other hand, it can be desirable to have the electrically- controllable deformation elements presented herein (e.g., 180, 280A, 380A, 380B, 480) cause one or more stimulation contacts to move from a first position to a second position. For example, by lifting one side or edge of a given stimulation contact, it can be possible to cause a more desired evoked response from the recipient. In this regard, electrically-controllable deformation elements presented herein can be used to not only evoke residual hearing through generated pressure waves, but also to impact the way or manner in which electric stimulation via a given stimulation contact might interact with a recipient.

[0046] In addition, electrically-controllable deformation elements presented herein (e.g., 180, 280A, 380A, 380B, 480) can also be leveraged in connection with surgical implantation, such as to provide a directional guide. That is, it is sometimes difficult to insert a stimulating assembly into the cochlea of a recipient without the carrier bending at the distal portion. In this regard, an electrically-controllable deformation element presented herein (e.g., 180, 280A, 380A, 380B, 480) could be activated periodically during the implantation procedure to oscillate the distal portion during implantation thereby lessening the chance of a bent tip. This oscillating could also be controlled using, e.g., electrophysiological measurement such as an electrocochleography (ECoG) measurement.

[0047] Cochlear implants that deliver both electrical stimulation and vibrational stimulation, such as those described herein, can be utilized in a variety of configurations. For example, stimulating assembly can have up to twenty-two stimulation contacts for delivery of stimuli to a recipient, each delivering a signal associated with a specific received sound frequency range. The stimulus is typically in the form of electrical stimuli delivered directly to the cochlea / nerve. The electrically-controllable deformation elements utilized in the systemdescribed herein can replace one or more of the stimulation contacts or can be used to supplement the output of one or more of the stimulation contacts. In an embodiment, the pressure waves produced by movement / vibration of electrically-controllable deformation element can be on a lower range of the audible human frequency, such as below 2 kHz, 1.5 kHz or 1 kHz. Such low frequency mechanical stimulation can be used in conjunction with, perhaps, a shorter stimulating assembly that is implanted in the basal region of the cochlea (i.e., not past the basal turn) to help preserve low frequency hearing. The stimulation contacts on the carrier can stimulate a high frequency range not stimulated vibrationally.

[0048] Stimulation to the cochlea according to the embodiments described herein can have several advantages. With electrical stimulation provided by stimulation contacts within a cochlear implant, there are often overlaps in frequency ranges produced by the various stimulation contacts, or gaps between the frequency ranges of adjacent stimulation contacts. Pressure wave stimulation, however, can produce a finer spectrum of sound, thereby eliminating or reducing such gaps and overlaps in situations where the recipient retains some residual hearing. Additionally, pressure wave stimulation can be better suited to delivering lower frequencies within the hearing spectrum. Embodiments of the system described herein can utilize pressure wave stimulation for received sounds lower than about 2 kHz, 1.5 kHz or 1 kHz. Electrical stimulation can be used to deliver signals to the cochlea for sounds in excess of 1 kHz.

[0049] Further, by incorporating electrically-controllable deformation element into the stimulating assembly, the surgery time and complexity will not change compared to a traditional cochlear implant implantation procedure, yet the result will provide the benefit of stimulating the residual hearing of a patient vibrationally. Also, by inducing pressure waves directly at the cochlear apex the stimulation amplitude can be significantly smaller compared to other ways to stimulate residual hearing (e.g., a bone conduction or skull vibrator).

[0050] FIG. 5 is a flowchart of a method, in accordance with embodiments presented herein. At 510, an operation is configured to deliver, by a hearing device, electrical stimulation to a cochlea of a recipient via a plurality of electrical stimulation contacts disposed on a carrier of an intra-cochlear stimulating assembly. And, at 512, an operation is configured to cause, by the hearing device, a pressure wave to be generated by the carrier within the cochlea of the recipient without introducing consequential movement of the plurality of electrical stimulation contacts relative to a modiolus of the cochlea.

[0051] As noted, embodiments of the present invention have been described herein with reference to one specific type of auditory prosthesis, namely an electro-vibrational. However, it is it is to be appreciated that there are a number of different types of electronic devices in / with which the techniques presented herein can be implemented. For example, it is to be appreciated that the techniques presented herein can also be partially or fully implemented by any of a number of different types of electronic devices, including consumer electronic devices (e.g., mobile devices, wearables, computing devices, televisions, appliances / white goods, etc.), other medical devices, diagnostic equipment, etc. For example, the techniques presented herein could be implemented by hearing devices, various implantable medical devices, such as vestibular devices (e.g., vestibular implants), 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.

[0052] As used herein, the term “hearing device” is to be broadly construed as any device that delivers sound signals to a user in any form, including in the form of acoustical stimulation, mechanical stimulation, electrical stimulation, optical stimulation, etc. 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, Electrovibrational hearing prostheses, auditory brainstem stimulators, bimodal hearing prostheses, bilateral hearing prostheses, dedicated tinnitus therapy devices, tinnitus therapy device systems, combinations or variations thereof, etc.) or 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).

[0053] It is to be appreciated that the embodiments presented herein are not mutually exclusive.

[0054] The invention described and claimed herein is not to be limited in scope by the specific preferred embodiments herein disclosed, since these embodiments are intended as illustrations, and not limitations, of several aspects of the invention. Any equivalent embodiments are intended to be within the scope of this invention. Indeed, various modifications of the invention in addition to those shown and described herein will become apparent to those skilled in the art from the foregoing description. Such modifications are also intended to fall within the scope of the appended claims.

Claims

CLAIMSWhat is claimed is:

1. A method, comprising: delivering electrical stimulation to a recipient via a plurality of electrical stimulation contacts disposed on a carrier of a stimulating assembly positioned in a body cavity of a recipient; and causing a pressure wave to be generated by the carrier within the body cavity without introducing consequential movement of the plurality of electrical stimulation contacts relative to the body cavity.

2. The method of claim 1, wherein the body cavity is a cochlea of the recipient, and wherein causing the pressure wave to be generated by the carrier within the body cavity comprises: causing the pressure wave to be generated without introducing consequential movement of the plurality of electrical stimulation contacts relative to a modiolus of the cochlea.

3. The method of claim 1, wherein the pressure wave is generated using an electrically- controllable deformation element incorporated into the carrier of the stimulating assembly.

4. The method of claim 3, wherein the electrically-controllable deformation element is comprised of an electro activated polymer (EAP).

5. The method of claim 3, wherein the electrically-controllable deformation element is disposed at a distal portion of the stimulating assembly.

6. The method of claim 3, further comprising separately controlling the plurality of electrical stimulation contacts and the electrically-controllable deformation element.

7. The method of claim 6, wherein the electrically-controllable deformation element comprises multiple sections, and the method comprises independently controlling each one of the multiple sections.

8. The method of claim 3, wherein the electrically-controllable deformation element is exposed to body fluid of the body cavity.

9. The method of claim 3, wherein the electrically-controllable deformation element is not exposed to body fluid of the body cavity.

10. The method of claim 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the pressure wave evokes hearing for the recipient for frequencies below 1 kHz.

11. The method of claim 1, 2, 3, 4, 5, 6, 7, 8, or 9, further comprising fdtering signals intended for the plurality of electrical stimulation contacts with respect to signals that cause the pressure wave to be generated within the body cavity of the recipient.

12. An implantable stimulation assembly, comprising: an elongate carrier member configured to be implanted in body cavity of a recipient; a plurality of electrical stimulation contacts disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the body cavity, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the recipient; and at least one vibrational stimulation element disposed in the elongate carrier member and configured to deliver vibrational stimulation to the body cavity without introducing consequential movement of the plurality of electrical stimulation contacts relative to a body cavity.

13. The implantable stimulation assembly of claim 12, wherein the at least one vibrational stimulation element is comprised of an electro activated polymer (EAP).

14. The implantable stimulation assembly of claim 13, wherein the electro activated polymer is responsive to a control signal.

15. The implantable stimulation assembly of claim 12, 13, or 14, further comprising one or more electrically-controllable deformation elements configured to deform the elongatecarrier member in at least one of a direction along an elongate axis of the elongate carrier member or a direction transverse to the elongate axis.

16. The implantable stimulation assembly of claim 12, 13, or 14, wherein the at least one vibrational stimulation element comprises multiple sections.

17. The implantable stimulation assembly of claim 12, 13, or 14, wherein the at least one vibrational stimulation element at least partially overlaps, along an elongate axis of the elongate carrier member, with at least one of the plurality of electrical stimulation contacts.

18. The implantable stimulation assembly of claim 12, 13, or 14, wherein the at least one vibrational stimulation element is disposed at a distal end of the elongate carrier member.

19. The implantable stimulation assembly of claim 12, 13, or 14, wherein the at least one vibrational stimulation element is exposed to body fluid in the body cavity.

20. An implantable stimulation assembly, comprising: an elongate carrier member having an elongate axis, wherein the elongate carrier member is configured to be implanted in body cavity of a recipient; a plurality of electrical stimulation contact disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the body cavity, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the body cavity; and at least one electrically-controllable deformation element disposed in the elongate carrier member and overlapping, along the elongate axis, with at least one of the plurality of electrical stimulation contacts.

21. The implantable stimulation assembly of claim 20, wherein the at least one electrically-controllable deformation element is comprised of an electro activated polymer (EAP).

22. The implantable stimulation assembly of claim 21, wherein the electro activated polymer is responsive to a control signal.

23. The implantable stimulation assembly of claim 21, wherein the electro activated polymer is less stiff than a material of the elongate carrier member.

24. The implantable stimulation assembly of claim 20, 21, 22, or 23, wherein the at least one electrically-controllable deformation element is configured to deform the elongate carrier member in at least one of a direction along the elongate axis or a direction transverse to the elongate axis.

25. The implantable stimulation assembly of claim 20, 21, 22, or 23, wherein the at least one electrically-controllable deformation element comprises multiple sections.

26. The implantable stimulation assembly of claim 25, wherein each section of multiple sections is independently controllable.

27. The implantable stimulation assembly of claim 20, 21, 22, or 23, wherein the at least one electrically-controllable deformation element is disposed at a distal end of the elongate carrier member.

28. An implantable component, comprising: an elongate carrier member configured to be implanted in a recipient; a plurality of electrical stimulation contacts disposed along a surface of the elongate carrier member, wherein, when the elongate carrier member is implanted in the recipient, the plurality of electrical stimulation contacts is configured to deliver electrical stimulation to tissue of the recipient; and at least one vibrational stimulation element disposed in the elongate carrier member and configured to deliver vibrational stimulation to the recipient, wherein the elongate carrier member, when implanted in a recipient, is configured to enable the plurality of electrical stimulation contacts to maintain their relative position against the tissue of the recipient while the at least one vibrational stimulation element delivers the vibrational stimulation.

29. The implantable component of claim 28, wherein the at least one vibrational stimulation element is configured to deliver vibrational stimulation by deforming at least a portion of the elongate carrier member.

30. The implantable component of claim 28, wherein the at least one vibrational stimulation element is comprised of an electro activated polymer (EAP).

31. The implantable component of claim 28, 29, or 30, wherein the at least one vibrational stimulation element is disposed towards a distal end of the elongate carrier member.

32. The implantable component of claim 28, 29, or 30, wherein the at least one vibrational stimulation element is comprised of multiple sections, each being configured to being independently controlled.

33. The implantable component of claim 28, 29, or 30, wherein material of the at least one vibrational stimulation element is exposed to body fluid of the recipient.

34. The implantable component of claim 28, 29, or 30, wherein the at least one vibrational stimulation element is configured to evoke hearing for the recipient for frequencies below 1 kHz.

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