Unsynchronized electrocochleography monitoring

Abstract

Presented herein are techniques related to monitoring electrocochleography (ECochG) signals evoked by a recipient for evaluating hearing ability of the recipient. For example, an acoustic signal is delivered to a recipient, and ECochG signals evoked by the recipient in response to the acoustic signal are recorded. The delivery of the acoustic signal and the recording of the ECochG signals are unsynchronized. Additionally, the ECochG signals are recorded such that each ECochG signal recording spans a corresponding period duration of the acoustic signal.

Description

Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1UNSYNCHRONIZED ELECTROCOCHLEOGRAPHY MONITORINGBACKGROUNDTechnical Field[ooot] The present disclosure relates generally to delivering acoustic signals to a recipient and recording electrocochleography signals in an unsynchronized manner.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 an acoustic signal to a recipient; and recording, via one or more electrodes, one or more electrocochleography (ECochG) signals evoked in response to the acoustic signal, wherein the acoustic signal and the recording of the one or more ECochG signals are unsynchronized.

[0005] In another aspect, a system is provided. The apparatus comprises: an acoustic output device configured to deliver, to a recipient, an acoustic tone at a target frequency; one orAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 more electrodes; and a recording sub-system configured to record, via the one or more electrodes, one or more electrocochleography (ECochG) signals evoked by the recipient in response to the acoustic tone, wherein the recording sub-system is configured to record the one or more ECochG signals based on the target frequency of the acoustic tone.

[0006] In yet another aspect, a method is provided. The method comprises: delivering an acoustic signal to a recipient; and recording, via one or more electrodes, one or more electrocochleography (ECochG) signals evoked in response to the acoustic signal in a plurality of successive recordings based on a period of the acoustic signal such that each recording of the plurality of successive recordings spans a respective period duration of the acoustic signal.

[0007] In another example, one or more non-transitory computer readable storage media are provided. The one or more non-transitory computer readable storage media comprise instructions that, when executed by one or more processors, are configured to: determine an acoustic signal is being delivered to an ear of a recipient; and record, via one or more electrodes, one or more electrocochleography (ECochG) signals from the ear of the recipient, where the one or more ECochG signals evoked in response to the acoustic signal, and wherein the one or more ECochG signals are recorded based on a frequency of the acoustic signal.BRIEF DESCRIPTION OF THE DRAWINGS

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

[0009] FIG. 1 is a block diagram of a cochlear implant system and an electrocochleography (ECochG) monitoring system associated with the cochlear implant system, in accordance with certain embodiments presented herein;[ooto] FIG. 2 is a schematic diagram of a system configured to deliver acoustic signals to a recipient and record ECochG signals evoked by the recipient in response to the acoustic signals, in accordance with certain embodiments presented herein;[ooit] FIG. 3 is a flowchart of a method for preparing the system of FIG. 2 to deliver acoustic signals and record evoked ECochG signals, in accordance with certain embodiments presented herein;Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1

[0012] FIG. 4 illustrates an example delivered acoustic signal and time windows for recording evoked ECochG signals, in accordance with certain embodiments presented herein;

[0013] FIG. 5 illustrates a time shift between delivering acoustic signals to a recipient and recording evoked ECochG signals, in accordance with certain embodiments presented herein;

[0014] FIG. 6 is a flowchart of a method for delivering acoustic signals and recording evoked ECochG signals, in accordance with certain embodiments presented herein;

[0015] FIG. 7 is a flowchart of another method for delivering acoustic signals and recording evoked ECochG signals, in accordance with certain embodiments presented herein; and

[0016] FIG. 8 is a schematic diagram illustrating a vestibular stimulator system with which aspects of the techniques presented herein can be implemented.DETAILED DESCRIPTION

[0017] Auditory / hearing device recipients / users suffer from different types of hearing loss (e.g., conductive and / or sensorineural) and / or different degree s / severity of hearing loss. However, it is now common for many recipients to retain some residual natural hearing ability (residual hearing) after receiving the hearing device. That is, hearing device recipients often retain at least some of their natural ability to hear sounds without the aid of their hearing prosthesis. For example, cochlear implants can now be implanted in a manner that preserves at least some of the recipient’s cochlear hair cells and the natural cochlear function, particularly in the lower frequency regions of the cochlea. Presented herein are techniques for delivering acoustic signals to a recipient having some natural function (e.g., some cochlear hair cells) and recording resulting electrocochleography (ECochG or ECoG) signals evoked by the recipient. As described further below, in accordance with the techniques present perform, the delivery of acoustic signals and the recording of ECochG signals recording are unsynchronized.

[0018] As used herein, an ECochG signal can include one or a plurality of different characteristics, such as stimulus related electrical potentials (e.g., a set of ECochG responses) that include a cochlear microphonic (CM), a cochlear summating potential (SP), and an auditory nerve neurophonic (ANN)Zauditory nerve Action Potential (AP), in which these parameters are measured / recorded independently or in various combinations in response to delivery of acoustic signals that include an acoustic stimulus to the inner ear. In general, theAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1ECochG signal recording can be completed during acoustic presentation, such as within a short time period (e.g., a few milliseconds (ms)) after the initiating delivery of the acoustic stimuli.

[0019] As noted, embodiments of the present disclosure are directed to a systems and methods for performing unsynchronized ECochG monitoring / measurements. As used herein, an “unsynchronized” ECochG measurement is a technique / process in which there is no realtime coordination, in terms of timing or control, between the acoustic signal delivery (e.g., the signals used to evoke ECochG responses) and the recording or capture of the ECochG responses. That is, the recording or capture of the ECochG responses is performed using separate devices, without linking control signals, etc. For example, instead of coordinating a timing of the recording windows of ECochG responses with a timing of acoustic signal delivery (e.g., determining a period of time an acoustic burst is to be output and aligning the recording window with the period of time), ECochG responses are recorded without having to determine the timing of acoustic signal delivery. In one implementation, an acoustic tone is delivered over a period of time (e.g., regardless of timing of ECochG recording operations), and ECochG recording is performed during delivery of the acoustic signal such that desirable ECochG responses are recorded without having to coordinate performance of acoustic signal delivery and ECochG response recording. To record ECochG responses in a desirable relationship relative to the acoustic signal delivery, the time windows of the ECochG recordings are established based on a frequency of the acoustic signal(s) being delivered.

[0020] In certain examples, unsynchronized ECochG measurements enable the timing of delivery of acoustic signals and recording of ECochG signals to be adjustable relative to one another. For example, the acoustic signals can be delivered (e.g., constantly or periodically delivered) during a first period of time, the ECochG signals can be recorded during a second period of time, and the first period of time and / or the second period of time can be adjusted independently of one another, such as to adjust the overlap between ECochG signal recording and acoustic signal delivery. As such, time windows during which the ECochG signals are recorded can be adjusted without changing when the acoustic signals are delivered.

[0021] As noted above, the unsynchronized ECochG measurement techniques do not require real-time coordination, in terms of timing or control, to align the recording windows with the acoustic signal delivery. However, it would be appreciated that the ECochG responses are only to be recorded while acoustic signals are being delivered. That is, in some examples,Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1ECochG response recording operations are configured to initiate upon acoustic signals being delivered, but ECochG measurements are unsynchronized in that the time windows during which ECochG signals are recorded can occur at any suitable point in time during which the acoustic signals are delivered. Therefore, even though the timing of ECochG response recording is unsynchronized in comparison to delivery of acoustic signals, initiating operation of ECochG response recording can be at least loosely arranged to occur in conjunction with acoustic signal delivery.

[0022] The unsynchronized ECochG measurements (e.g., separate control of acoustic signal delivery and ECochG signal recording) can also enable more flexible implementation of ECochG signal monitoring. As an example, separate components (e.g., components that do not use the same software and / or that do not communicate with one another) can be used to deliver the acoustic signals and to record the ECochG signals, respectively. As another example, acoustic signal delivery and ECochG signal recording can be more easily controlled, such as without having to implement and / or adjust a complicated control / time scheme. In either case, evaluating residual hearing of a recipient using recording ECochG signals can be more readily performed.

[0023] There are a number of different types of devices in / with which embodiments of the present disclosure can 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 can 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, 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, mechanical stimulation, 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 withAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 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.

[0024] FIG. 1 illustrates 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 recipient, and an intemal / implantable component 112 that is configured to be implanted in or worn on the head of the recipient. The implantable component 112 is sometimes referred to as a “cochlear implant.”

[0025] The cochlear implant system 102 operates with an ECochG monitoring system 180. The ECochG monitoring system 180 could be implemented by an suitable computing system, environment, or configuration including, but are not limited to, personal computers, server computers, hand-held devices, laptop devices, desktop devices, multiprocessor systems, microprocessor-based systems, programmable consumer electronics (e.g., smart phones), remote control units, network PCs, minicomputers, mainframe computers, tablets, distributed computing environments that include any of the above systems or devices, and the like. The ECochG monitoring system 180 and the cochlear implant system 102 (e.g., a sound processing unit 106 or the implantable component 112) communicate via a wireless communication link, such as a short-range communication (e.g., a Bluetooth link, Bluetooth Low Energy (BLE) link, a proprietary link, etc.), and / or using a wired connection.

[0026] As noted, the cochlear implant system 102 includes an external component 104 that is configured to be directly or indirectly attached to the body of the recipient and an implantable component 112 configured to be implanted in the recipient. In the example of FIG. 1, the external component 104 includes a sound processing unit 106 and is configured to send data and power to the implantable component 112 as described herein.

[0027] The sound processing unit 106 can have a number of different arrangements. For example, the sound processing unit 106 can include an integrated external magnet 150 configured to be magnetically coupled to an implantable magnet 152 in the implantableAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 component 112. The sound processing unit 106 also includes an integrated external coil 108 that is configured to be wirelessly (e.g., inductively) coupled to an implantable coil 114 of the implantable component 112. The external magnet 150 and the implantable magnet 152 are shown using dashed lines, indicating the external coil 108 and the implantable coil 114 are disposed around the magnet 150 and magnet 152, respectively.

[0028] The sound processing unit 106 is used for communication between the ECochG monitoring system 180 and the implantable component 112. As such, during a surgical procedure, the sound processing unit 106 could be replaced by any other device that is able to communicate with the ECochG monitoring system 180 and the implantable component 112. In certain embodiments, the sound processing unit 106 could be a so-called “surgical processor” having less capabilities (e.g., no sound processing logic, etc.). In various embodiments, the communication between the ECochG monitoring system 180 and the sound processing unit 106, or another device operating in place of the sound processing unit 106, could communicate via a wireless or wired connection. In other embodiments, the implantable component 112 could communicate directly (e.g., via a wireless connection) with the ECochG monitoring system 180. By way of example, the cochlear implant system 102 is a totally implantable system that can operate without the external component 104 (e.g., the implantable component 112 includes its own sound processing unit). Thus, the implantable component 112 can communicate directly with the ECochG monitoring system 180 without usage of the external component 104. As a further example, the ECochG monitoring system 180 is implemented as a part of the sound processing unit 106 and / or the implantable component 112 instead of as its own separate device.

[0029] In the specific example of FIG. 1, the sound processing unit 106 includes the external coil 108, a wireless transmitter / receiver (transceiver) 120, a charging coil 121, closely- coupled interface circuitry (transceiver) 122, sometimes referred to as a radio-frequency (RF) interface transceiver 122, at least one rechargeable battery 123, and a processing module 124 that includes one or more processors 125 and a memory device (memory) 126. For example, the processor(s) 125 execute instructions stored on the memory device 126 to instruct the RF interface transceiver 122 to communicate with the implantable component 112 (e.g., to receive ECochG signal data from the implantable component 112 via the external coil 108), and / or the processor(s) 125 execute instructions stored on the memory device 126 to instruct the wireless transceiver 120 to communicate with the ECochG monitoring system 180 (e.g., to forward ECochG signal data to the ECochG monitoring system 180). In someAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 embodiments, the sound processing unit 106 includes one or more input devices 113, including one or more sound input devices 118 and / or one or more auxiliary input devices 119, which can receive data (e.g., sound data) used to operate the sound processing unit 106, such as to communicate with the implantable component 112 and / or with the ECochG monitoring system 180. The sound processing unit 106 further includes a charging coil 121 and at least one rechargeable battery 123. The at least one rechargeable battery 123 stores power used to enable operation of the sound processing unit 106 (e.g., of the processor(s) 125), and the charging coil 121 provides the power to be stored in the at least one rechargeable battery 123. In additional or alternative embodiments, the sound processing unit 106 is configured to receive power via a different component, such as a wired connection.

[0030] The implantable component 112 includes an implant body (main module) 134, a lead region 136, and an intra-cochlear stimulating assembly 116, all configured to be implanted under a skin / tissue 115 of the recipient. The magnets 150 and 152 magnetically couple the external component 104 to the implantable component 112 through the skin / tissue 115 to establish a wireless link between the coils 108 and 114, such as an RF link, an infrared (IR) link, an electromagnetic link, a capacitive and inductive link, and so forth, that can be used to transfer the power and / or data between the external component 104 and the implantable component 112. The implant body 134 generally comprises a hermetically-sealed housing 138 in which an RF interface transceiver 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 transceiver 140 via a hermetic feedthrough (not shown in FIG. 1).

[0031] The stimulating assembly 116 is configured to be at least partially implanted in the recipient’s cochlea. The stimulating assembly 116 includes a plurality of longitudinally spaced intra-cochlear electrical stimulating contacts (electrodes) 144 that collectively form a contact or electrode array 146. The stimulating assembly 116 is configured to be inserted into 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 the lead region 136 and hermetic feedthrough. The 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.Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1

[0032] The stimulator unit 142 generates electrical stimulation signals (e.g., current signals), such as based on data provided by the sound processing unit 106 (e.g., by the RF interface transceiver 122) for delivery to the recipient’s cochlea via one or more of the electrodes 144. In this way, the cochlear implant system 102 electrically stimulates the recipient’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). Additionally, the electrodes 144 are configured to record ECochG signals provided by the cochlea, and the RF interface transceiver 140 is configured to direct the recorded ECochG signals to the sound processing unit 106 and to the ECochG monitoring system 180. Although the present disclosure primarily discusses the usage of implantable electrodes (e.g., the electrodes 144) to record ECochG signals, it should be noted that another component, such as an external electrode and / or any other suitable external recording component / device, can be used to record ECochG signals using the techniques discussed herein.

[0033] The ECochG monitoring system 180 includes a user interface 181, one or more processors 182, a network interface (e.g., wireless module) 183, and a memory device (memory) 184 storing ECochG monitoring logic 185. The ECochG monitoring system 180 can also include other components, such as a system bus, component interfaces, a graphics system, a power source (e.g., a battery), among other components. The memory device 184 can include 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 memory 184 can store, among other things, instructions executable by the processors 182 to implement applications or cause performance of operations described herein, as well as other data. The one or more processors 182 are, for example, microprocessors, microcontrollers, or any other firmware elements, partially or fully implemented with digital logic gates in one or more applicationspecific integrated circuits (ASICs), partially or fully in software, etc. configured to execute instructions associated with the ECochG monitoring logic 185.

[0034] The network interface 183 enables communication with the external component 104 and / or the cochlear implant 112. For example, the network interface 183 can include a wireless module that is similar to wireless transceiver 120 for wireless communication with the external component 104 (or cochlear implant 112, if enabled with a wireless module).Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1Additionally or alternatively, the network interface 183 can provide wired network access. The network interface 183 can support one or more of a variety of communication technologies and protocols, such as Wi-Fi, cellular, Bluetooth, near-field communication, and RF, among others. The network interface 183 can include one or more antennas and associated components configured for wireless communication according to one or more wireless communication technologies and protocols.

[0035] The user interface 181 includes, for example, one or more input devices over which the ECochG monitoring system 180 receives input from a user, and one or more output devices by which the ECochG monitoring system 180 is able to provide output to a user. The one or more input devices can include physically-actuatable user-interface elements (e.g., buttons, switches, or dials), touch screens, keyboards, mice, pens, and voice input devices, among others input devices configured to receive a user input. The one or more output devices can include displays, speakers, and printers, among other output devices for presentation of feedback (e.g., visual, audible, or tactile information) to the recipient, a clinician, an audiologist, and / or other user.

[0036] It is to be appreciated that the arrangement for the ECochG monitoring system 180 shown in FIG. 1 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 ECochG monitoring system 180 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.

[0037] In accordance with embodiments presented herein, the ECochG monitoring system 180 is configured to record ECochG signals from a recording site, such as while the stimulating assembly 116 is inserted into the recipient’s cochlea. More specifically, the ECochG monitoring system 180 is configured to use the electrodes 144 of the electrode array 146 to capture ECochG signals from the cochlea.

[0038] In a normal or fully functional ear, an acoustic pressure or sound wave (i.e., a sound signal) is collected by the outer ear and channeled into and through the ear canal. Disposed across the distal end of ear cannel is a tympanic membrane that vibrates in response to sound wave. This vibration is coupled to the oval window through three bones of middle ear. TheAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 middle ear bones serve to fdter and amplify sound wave, causing the oval window to articulate, or vibrate, in response to vibration of tympanic membrane. This vibration sets up waves of fluid motion of a perilymph within the cochlea to activate the cochlea hair cells. Activation of the hair cells causes appropriate nerve impulses to be generated and transferred through the recipient’s spiral ganglion cells and auditory nerve to the brain where the nerve impulses are perceived as sound.

[0039] As noted above, it is common for hearing device recipients to retain at least part of this normal hearing functionality (i.e., retain at least some residual hearing). Therefore, the cochlea of a hearing device recipient can be acoustically stimulated upon delivery of a sound signal to the recipient’s outer ear. In accordance with embodiments presented herein, this residual hearing function is leveraged by the ECochG monitoring system 180 to record ECochG signals from the cochlea of the recipient. For example, acoustic stimuli are delivered to the recipient’s cochlea, and the ECochG monitoring system 180 records one or more ECochG signals evoked by the recipient in response to the acoustic stimulus. As used herein, acoustic stimuli refer to any type of stimulation that is delivered in a manner so as to set up waves of fluid motion of the perilymph within the cochlea that, in turn, activates the hair cells inside of cochlea. As such, acoustic stimuli for performance of an ECochG signal recording in accordance with embodiments presented herein can be delivered via a recipient’s normal hearing functionality, via an acoustic transducer, via a mechanical transducer, a combination thereof, etc. Although the present disclosure primarily discusses recording ECochG signals for a recipient of an implantable device, ECochG signals can be recorded for any other suitable implementations. For example, ECochG signals can be recorded for a recipient during a surgical procedure (e.g., prior to the implantable device being implanted in the recipient) and / or for a patient that is to receive an external hearing device (e.g., by using promontory electrodes that are external to the recipient to record ECochG signals).

[0040] FIG. 1 illustrates an embodiment in which an acoustic transducer 189 delivers an acoustic stimulus 187 to the cochlea of the recipient. As described elsewhere herein, the acoustic transducer 189 can take any of a number of different forms. For example, the acoustic transducer 189 could be an in-the-ear (ITE) device (e.g., earbud) that is positioned within an ear canal of the recipient (e.g., as a separate component from the external component 104 and from the cochlear implant 112). Alternatively, the acoustic transducer 189 could be a stand-alone component that is in wired or wireless connection to, for example,Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 the sound processing unit 106. In one example, the receiver 189 is a component of a hearing aid.

[0041] FIG. 1 also illustrates that the cochlear implant 112 includes a recording module 188 that is configured to record ECochG signals induced in the cochlea by the acoustic stimulus 187. The recording module 188 can include, for example, sense amplifiers configured to digitally record ECochG signals / responses presented on an input line connected to one or more of the electrodes 144. Data recorded by the sense amplifiers can, in certain embodiments, be stored in a buffer.

[0042] As an example, the RF interface transceivers 122, 140 cooperate to provide ECochG signal data (e.g., the captured ECochG signals, data associated with the captured ECochG signals, such as recording position and / or time information) to the sound processing unit 106, where the ECochG signal data is then provided to the ECochG monitoring system 180. The ECochG signal data is generally represented in FIG. 1 by arrows 190. The processors 182 then process the ECochG signal data to generate an output signal (e.g., control signal for a surgical robot, to generate a visual or audible output, etc.). In additional or alternative embodiments, the ECochG monitoring system 180 receives ECochG signal data directly from the implantable component 112 (e.g., in a totally implantable system).

[0043] As discussed, the delivery of the acoustic signals to a recipient and the recording of evoked ECochG signals from a recipient are unsynchronized (e.g., uncoordinated in timing) and can be separately and independently adjusted with respect to one another. As an example, operation of the acoustic transducer 189 is controlled independently from operation of the recording module 188. Thus, the acoustic stimuli 187 can be delivered separately from recording ECochG signals induced in the cochlea as in response to the acoustic stimulus 187. In such implementations, it remains desirable to record ECochG signals at particular times with respect to delivery of the acoustic stimulus 187. For this reason, the sound processing unit 106 and / or the implantable component 112 utilize a clock 192 for use in recording ECochG signals, such as to establish time windows of ECochG signal recording.

[0044] FIG. 2 is a schematic diagram of an ECochG monitoring system 200 configured to deliver acoustic signals to a recipient and receive resulting ECochG signals evoked by the recipient. The ECochG monitoring system 200 includes a first computing device 202 (e.g., a laptop computer), an acoustic output device 204 (e.g., an ITE receiver, such as earbuds and / or a hearing aid), and an implantable device / component 206 (e.g., a cochlear implant) disposedAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 in the recipient. The acoustic output device 204 is configured to deliver acoustic stimuli to the recipient, while the implantable device 206 includes electrical contacts or electrodes configured to capture / record ECochG signals evoked in response to the acoustic stimuli. Although the implantable device 206 is configured to record ECochG signals in the illustrated ECochG monitoring system 200, it should be noted that any suitable component or device, such as an externally positioned electrode (e.g., placed on a scalp of the recipient) and / or any other external recording device, can be used to record ECochG signals in additional or alternative embodiments.

[0045] The first computing device 202 is communicatively coupled to the acoustic output device 204 via a communication link 208, and the first computing device 202 is communicatively coupled to the implantable device 206 as a part of a recording sub-system 210. By way of example, the communication link 208 is wireless link (e.g., a Bluetooth link, a Bluetooth Low Energy (BLE) link, a proprietary link, etc.).

[0046] In this example, the recording sub-system 210 comprises a plurality of components, including a programming interface 212 communicatively coupling the first computing device 202 to a processing unit or sound processor 214, a processing unit 214, and an external coil 216 communicatively coupling the processing unit to the implantable device 206. The components of the recording sub-system 210 (e.g., the processing unit 214 and the external coil 216) can be communicatively coupled to one another via a wired or wireless connection. However, as shown, the first computing device 202 communicates with the acoustic output device 204 and with the implantable device 206 using different, unrelated connections. For at least this reason, the operations of the acoustic output device 204 and the operations of the implantable device 206 are unsynchronized (e.g., there is coordination between the acoustic signal delivery and the ECochG response recording or, stated differently, the recording or capture of the ECochG responses is performed independent from the acoustic signal delivery).

[0047] In additional or alternative embodiments, a separate computing device controls the acoustic output device 204 and the implantable device 206. For example, in one embodiment, the first computing device 202 is configured to instruct the acoustic output device 204 to deliver acoustic signals to the recipient, but a second computing device 218 (e.g., a tablet) operates with the implantable device 206 to record ECochG signals. That is, in this example, the second computing device 218 is communicatively coupled to the implantable device 206 (e.g., via a communication link 220), but not with the acoustic outputAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 device 204. In further embodiments, the second computing device 218 communicates with both the acoustic output device 204 and the implantable device 206, such as using separate communication links (e.g., separate wireless connections).

[0048] In either case, the delivery of the acoustic signals and recording of the ECochG signals are unsynchronized. Separating control of the acoustic output device 204 from control of the implantable device 206 can enable the ECochG monitoring system 200 to be more easily implemented to deliver acoustic signals and record resulting ECochG signals. For instance, the communication link 208 can enable the acoustic output device 204 to be more flexibly positioned (e.g., without having to accommodate arrangement of the recording sub-system 210) while remaining communicatively coupled to the first computing device 202. As an example, the recipient can be isolated from the first computing device 202 (e.g., using protective shielding, such as drapes) without deteriorating the communication link 208. As another example, the first computing device 202 can be readily communicatively coupled to the acoustic output device 204 without having to modify a control scheme of the first computing device 202 and / or of the acoustic output device 204 (e.g., to accommodate or incorporate a control scheme used to communicate with the implantable device 206).

[0049] Although the delivery of the acoustic signals and recording of the ECochG signals are unsynchronized, the techniques presented herein ensure that there is a desirable relationship between the acoustic signals being delivered by the acoustic output device 204 and the corresponding evoked ECochG signals. By way of example, the implantable device 206 is configured to record ECochG signals at particular time windows (e.g., during multiple durations of time) that span corresponding phases / values of the sound wave or waveform (e.g., a particle displacement of a medium through which the acoustic signals propagate over time) of the acoustic output device 204. As such, the resulting ECochG signals are received in response to corresponding acoustic stimuli (e.g., similar phases of sound waves) and are usable for accurately determining residual hearing of the recipient.

[0050] In some embodiments, the acoustic output device 204 is instructed to deliver specific acoustic signals. For example, the acoustic signals are acoustic tones at a selected frequency, and the ECochG signal recording is performed based on that frequency. In particular, the time windows of each ECochG signal recording are established based on the frequency to cause the ECochG signals being recorded to result from corresponding acoustic stimuli. In other words, the time windows of the ECochG signal recording span corresponding portions of the sound wave of the acoustic stimuli.Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1

[0051] In certain embodiments, to ensure that desirable acoustic signals are being delivered, the ECochG monitoring system 200 includes a microphone 222 or other acoustic input device configured to capture the acoustic signals output by the acoustic output device 204. The first computing device 202 is configured to use the received acoustic signals to determine whether the acoustic signals being delivered by the acoustic output device 204 are desirably received by the implantable device 206. For instance, the first computing device 202 is configured to compare the received acoustic signals with a target acoustic signal and to adjust operation of the acoustic output device 204 based on the comparison, such as to adjust the acoustic signals output by the acoustic output device 204 to adjust the received acoustic signals toward the target acoustic signal. As an example, the target acoustic signal is generated at a target frequency and the first computing device 202 is configured to compare a frequency of the received acoustic signals to the target frequency. The first computing device 202 can, for example, adjust operation of the acoustic output device 204 to adjust the received acoustic signals toward the target frequency based on a difference between the frequency of the received acoustic signals and the target frequency. Thus, the acoustic signal can be delivered in a manner that enables the ECochG signals to be recorded more desirable (e.g., based on a frequency of the acoustic signal). As another example, a difference between the acoustic signal output by the acoustic output device 204 and the received acoustic signal can indicate the placement of the acoustic output device 204 is undesirable. For instance, delivery of the acoustic signal is being obstructed. Thus, a placement of the acoustic output device 204 can be adjusted (e.g., manually adjusted) based on the comparison between the received acoustic signals and the target acoustic signal to enable the implantable device 206 to receive acoustic signal output by the acoustic output device 204 (e.g., indicated by feedback from the microphone 222).

[0052] The first computing device 202 is additionally or alternatively configured to use the received acoustic signals to monitor and address a mismatch (e.g., a possible drift, a latency shift) between delivering the acoustic signals and recording the ECochG signals, such as during long continuous periods of stimulating / recording. To this end, the first computing device 202 compares the acoustic signals captured via the microphone 222 (e.g., indicative of a frequency of the acoustic signals delivered by the acoustic output device 204) with the time windows of the recording of the ECochG signals by the implantable device 206. Operation of the acoustic output device 204 and / or the implantable device 206 can then be adjusted based on a frequency of the received acoustic signals such that the time windows duringAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 which the implantable device 206 records ECochG signals correspond to the frequency of the acoustic stimuli delivered by the acoustic output device 204.

[0053] In any case, the microphone 222 is utilized to operate the acoustic output device 204 and / or the implantable device 206 more desirably. In certain embodiments, the microphone 222 (e.g., a feedback microphone) is a part of the acoustic output device 204 and is also positioned at the recipient (e.g., in a receiver in an ear canal of the recipient). In additional or alternative embodiments, the microphone 222 is separate from the acoustic output device 204. For example, the microphone 222 is part of the implantable device 206 and is implanted in the recipient, and / or the microphone 222 is a standalone or dedicated device for capturing acoustic signals and is separate from the recipient. However, it should be noted that in some embodiments, the ECochG monitoring system 200 operates without usage of the microphone 222.

[0054] FIG. 3 is a flowchart of a method 350 (e.g., used with any of the ECochG monitoring systems 180, 200) to deliver acoustic signals to a recipient and receive evoked ECochG signals from the recipient. As a preliminary matter, it would be appreciated that the method 350 can be performed differently than depicted. For example, an additional operation can be performed, and / or any of the depicted operations can be performed differently, may not be performed, and / or can be performed in a different order.

[0055] At block 352, a recipient (patient) is prepared for measuring ECochG signals. For example, an acoustic output device (e.g., an earbud, a hearing aid) is inserted into an ear canal of the recipient. The acoustic output device is to be sufficiently charged and switched on to maintain communicative coupling between the acoustic output device and a computing device while ECochG signals are being measured. In some embodiments, a pinna of the recipient is folded to cover the acoustic output device, thereby isolating the acoustic output device from a surrounding environment (e.g., a surgical field or site behind the pinna).

[0056] At block 354, operation of the computing device is started by initiating a software application. The software application is used for operating the acoustic output device to deliver acoustic signals to the recipient. At block 356, the computing device is wirelessly connected to the acoustic output device, such as using a Bluetooth connection. Thus, the computing device can be located remotely from the acoustic output device while remaining communicatively coupled to the acoustic output device, thereby enabling more flexible placement of the acoustic output device and of the computing device with respect to oneAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 another. However, in some implementations, the computing device is connected to the acoustic output device using a wired connection.

[0057] At block 358, the acoustic output device is instructed to deliver acoustic signals, and the acoustic signals are confirmed. That is, a determination is made that the acoustic signals are being desirably delivered by the acoustic output device. For instance, the delivered acoustic signals are captured by a microphone (e.g., of the acoustic output device) and are compared to a target acoustic signal. In some embodiments, the acoustic signals include pure tones and can encompass a frequency sweep over a spectrum or range of frequencies. In such embodiments, the frequency of each acoustic signal is compared to a corresponding target frequency. The comparison between the received acoustic signals and the target acoustic signal can help determine whether the acoustic output device is operating desirably. By way of example, in response to a determination that a difference between the received acoustic signals and the target acoustic signal is greater than a threshold, operation of the acoustic output device is adjusted (e.g., to adjust the received acoustic signals toward the target acoustic signal).

[0058] At block 360, the computing device or a separate computing device is connected to a sound processor and to an implantable device (e.g., a cochlear implant) configured to record ECochG signals. In certain embodiments, at least part of the connection includes a wired connection, such as a cable. The connection enables the computing device to operate the implantable device to record ECochG signals, such as a time window during which the ECochG signals are being recorded.

[0059] At block 362, the computing device instructs the acoustic output device to deliver a continuous stream of acoustic signals. In some embodiments, a characteristic, such as a frequency and / or an amplitude, of the delivered acoustic signals is user-defined. Feedback of the delivered acoustic signals can be used to adjust operation of the acoustic output device. For example, the delivered acoustic signals can be received and compared to a target acoustic signal, and operation of the acoustic output device can be adjusted accordingly (e.g., similar to block 358).

[0060] At block 364, the implantable device is instructed to perform a recording sequence to record ECochG signals, such as in response to a determination that acoustic signals are being delivered (e.g., based on a user input, based on detections made by a sensor, based on a received control signal). Initiating ECochG signal recording operations while acousticAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 signals are delivered avoids trying to record ECochG signals while no acoustic stimulus is being delivered to the recipient (e.g., such that no desirable ECochG signals are being evoked from the recipient). Because the acoustic stream and the recording sequence are separately controlled, delivery of acoustic signals is unsynchronized with recording of ECochG signals. Thus, to record ECochG signals desirably, the implantable device is instructed to record ECochG signals at certain time windows or durations of time while acoustic signals are being delivered based on the frequency of the acoustic signals. It is desirable for each time window to correspond to similar portions of the sound wave of the acoustic signals to record corresponding ECochG signals that can be used for evaluating residual hearing of the recipient. In some embodiments, a characteristic, such as electrodes used for recording, a gain, a length of the time windows, and / or a quantity of ECochG signals used to provide an average reading, is user-defined. At block 366, the acoustic stream is stopped.

[0061] Blocks 362, 364, 366 can be repeated to help evaluate residual hearing of the recipient. For example, acoustic signals of different frequencies are delivered, and a recording sequence to record resulting ECochG signals at the different frequencies is performed. Thus, the recorded ECochG signals evoked in response to acoustic signals at different frequencies can then be used to evaluate the capability of the recipient to hear at different frequencies. In such embodiments, the time windows of ECochG signal recording are adjusted based on adjusting the frequency of the acoustic signal being delivered. Moreover, while the acoustic stream is delivered and ECochG signals are recorded, stimulation voltages can be measured, such as for monitoring impedance and / or angular depth of insertion of an implantable device in the recipient sequentially or altematingly with evaluating residual hearing of the recipient.

[0062] FIG. 4 is a graphical representation of an acoustic signal 400 being delivered while resulting ECochG signals are being recorded. In particular, the acoustic signal 400 is shown as a sound wave over time, and ECochG signals are recorded at multiple time windows 402 that are established based on a frequency / period of the sound wave. Each time window spans a separate period duration of the acoustic signal 400 such that the time windows 402 are sequential. Accordingly, the ECochG signals are successively recorded.

[0063] The ECochG signals are recorded based on the frequency / period of the sound wave such that the respective period durations spanned by the time windows 402 correspond to one another. That is, each time window 402 initiates at a corresponding phase (e.g., sound wave value) of the acoustic signal 400, each time window 402 terminates at another correspondingAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 phase of the acoustic signal 400, and the duration of each time window substantially matches one another. For example, a first time window 402A initiates at a first phase 404 of the acoustic signal 400 having a first sound wave value, the first time window 402A terminates at a second phase 406 of the acoustic signal 400 having a second sound wave value, and the first time window 402A spans a first period duration 408 of the acoustic signal 400. A second time window 402B occurring after the first time window 402A initiates at a third phase 410 of the acoustic signal 400 having a third sound wave value, terminates at a fourth phase 412 of the acoustic signal 400 having a fourth sound wave value, and spans a second period duration 414 of the acoustic signal 400. The first sound wave value of the first phase 404 of the first time window 402A is substantially equal to the third sound wave value of the third phase 410 of the second time window 402B, the second sound wave value of the second phase 406 of the first time window 402A is substantially equal to the fourth sound wave value of the fourth phase 412 of the second time window 402B, and the first period duration 408 of the first time window 402A spans approximately the same duration of time as that spanned by the second period duration 414. Hence, the first period duration 408 of the first time window 402A corresponds to the second period duration 414 of the second time window 402B. Indeed, the initiation, duration, and / or termination of each time window 402 is established based on the frequency of the acoustic signal 400 to correspond the ECochG signal recordings with one another.

[0064] In the illustrated embodiment, the first sound wave value of the first phase 404 is different from the second sound wave value of the second phase 406, and therefore the third sound wave value of the third phase 410 is different from the fourth sound wave value of the fourth phase 412. However, in alternative embodiments, the first sound wave value of the first phase 404 is the same as the second sound wave value of the second phase 406, the third sound wave value of the third phase 410, and the fourth sound wave value of the fourth phase 412. Additionally, the illustrated first phase 404 and the third phase 410 occur at troughs of the acoustic signal 400, whereas the second phase 406 and the fourth phase 412 occur adjacent to crests of the acoustic signal 400. Alternatively, the first phase 404 and the third phase 410 can each occur at a different part of the acoustic signal 400, such as at / adjacent to crests of the acoustic signal 400, and / or the second phase 406 and the fourth phase 412 can each occur at a different part of the acoustic signal 400, such as at / adjacent to troughs of the acoustic signal 400. Indeed, each phase 404, 406, 410, 412 can be arbitrarily established soAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 long as the first period duration 408 and the second period duration 414 correspond to one another.

[0065] To provide the timings of the recordings such that the period durations 408, 414 correspond to one another, a gap interval 416 during which no ECochG signal recording occurs spans between the time windows 402. As such, one or more first ECochG signals are recorded during the first period duration 408, then no ECochG signals are recorded during the gap interval 416 after the first period duration 408, and one or more second ECochG signals are recorded during the second period duration 414 after the gap interval 416. The gap interval 416 can span any suitable duration of time so long as the period durations 408, 414 correspond to one another. Thus, the time between the time windows 402 is also established based the frequency of the acoustic signal 400. In some embodiments, the acoustic signal 400 is delivered such that there is sound wave during at least a portion of the gap interval 416. As an example, the acoustic signal 400 is constantly delivered (e.g., as a continuous tone) such that the frequency and period 418 remains constant during the gap interval 416. As another example, a characteristic (e.g., the frequency, the period 418) of the acoustic signal 400 changes during the gap interval 416. In additional or alternative embodiments, delivery of the acoustic signal 400 during at least a portion of the gap interval 416 is suspended such that there is no sound wave during part of the gap interval 416. In other words, there are periods of silence between the time windows of adjacent ECochG recordings. By way of example, delivery of the acoustic signal 400 is suspended at a portion 419 within the gap interval 416. Implementing periods of silence between adjacent recordings can avoid causing neural adaptation from the recipient to capture compound action potential. Regardless of the delivery of the acoustic signal 400 during the gap interval, deviation / jitter of the acoustic signal 400 during the time windows 402 is limited to provide a constant acoustic signal 400 for evoking ECochG signals to be recorded.

[0066] Moreover, each time window 402 spans a sufficient duration of time to enable desirable recording of ECochG signals, such as to avoid having to stitch together separate recordings made during shorter durations of time. For instance, the period durations 408, 414 encompass at least two periods 418 of the acoustic signal 400. Therefore, the time windows 402 depend on certain characteristics of the acoustic signal 400. By way of example, for an acoustic signal 400 having a higher frequency and therefore a shorter period 418, each time window 402 can span a relatively shorter duration of time (i.e., the period durations 408, 414 are shorter) and encompass a sufficient quantity (e.g., at least two) periods 418 of the acousticAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 signal 400. In contrast, for an acoustic signal 400 having a lower frequency and therefore a longer period 418, each time window 402 can span a relatively longer duration of time (i.e., the period durations 408, 414 are longer) to encompass a sufficient quantity of periods 418. The duration of each time window 402 can also be limited to avoid excessive and potentially unnecessary / redundant recordings, thereby improving efficiency of recording ECochG signals. For example, the duration of each time window 402 is less than 20 milliseconds. Thus, each time window 402 can have a duration of time that is between two periods of the acoustic signal 400 and 20 milliseconds. However, in some implementations, the time windows 402 can be outside of such a range. For instance, each time window 402 can have a duration below two periods 418, and recordings are stitched to provide a comprehensive and desirable ECochG signal recording. That is, instead of providing a contiguous recording of an ECochG signal, recordings that are separately performed can be combined together.

[0067] The ECochG signals recorded during each time window 402 can be averaged to provide a comprehensive ECochG signal that is used to evaluate residual hearing of a recipient. Indeed, because the period durations 408, 414 of each recording correspond to one another, the ECochG signals recorded during the period durations 408, 414 can correspond to one another to be suitably utilized in conjunction with one another. In certain embodiments, a particular quantity of recordings is acquired for each acoustic signal 400. For example, at least six successive recordings spanning corresponding period durations of the acoustic signal 400 are acquired, and the ECochG signals acquired during the six recordings are averaged. However, any suitable quantity of recordings can be made and averaged, such as between two and five recordings, to provide accurate measurements while accommodating for noise reduction and potential frequency drift. Regardless of the quantity of recordings that are made and averaged, each recording spans a corresponding period duration of the acoustic signal, and / or the same gap interval 416 spans between each adjacent recording.

[0068] In some embodiments, a processing unit (e.g., the processing unit 214) establishes the timing of ECochG signal recording with respect to one another based on the frequency of the acoustic signal 400. For instance, the processing unit includes a clock for providing the time windows 402 and / or the gap interval 416. Thus, upon initiating operations to record ECochG signals (e.g., via a user input provided to a computing device) based on the frequency of the acoustic signal 400, the processing unit automatically performs successive recordings having time windows based on the clock (e.g., without having to additionally coordinate timing with the acoustic signal 400).Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1

[0069] In any case, the ECochG signals (e.g., an average of ECochG signals) recorded during delivery of the acoustic signal 400 can be readily analyzed to evaluate different aspects regarding the hearing of the recipient, such as without having to restart the acoustic signal 400 and change its polarity. By way of example, an ECochG signal can include various characteristics, such as CM and ANN. The CM is an alternating current (AC) voltage that mirrors the waveform of the acoustic signal 400 at low to moderate levels of acoustic stimulation. The CM is generated by the outer hair cells of the organ of Corti and is dependent on the acoustic stimulus, and the recorded portion of the CM depends on the proximity of the recording electrode to the stimulated hair cells. In general, the CM is proportional to the displacement of a basilar membrane. Meanwhile, the ANN represents phase-locked firing of auditory nerve fibers in response to the acoustic signal 400, and the ANN appears as an alternating current voltage with maximal energy as twice the stimulus frequency for acoustic stimuli that include pure tones. The ANN includes a magnitude that reflects the number of nerves that are firing.

[0070] To obtain the CM and ANN, ECochG signal recordings made during half of a period 418 of the acoustic signal 400 are utilized, and such ECochG signal recordings include first electrical potentials during a rarefaction period 420 in which the period displacement of the acoustic signal 400 is negative and a condensation period 422 in which the period displacement of the acoustic signal 400 is positive. For ANN, the first electric potentials and the second electrical potentials are added to one another. For CM, the first electrical potentials are subtracted from the second electrical potentials. In embodiments in which acoustic signals 400 having different frequencies are delivered to record resultant ECochG signals, the dominant CM, which can be of main interest for determining positioning of electrode insertion, can be determined. In particular, the CMs at different frequencies of delivered acoustic signals 400 are determined until an acoustic signal 400 having a peak frequency (e.g., 1000 Hz) is delivered, at which no CM can be determined. As such, the peak frequency indicates the frequency limit of hair cell functionality of the recipient. Thus, the CM can be monitored in the frequency domain to evaluate residual hearing of the recipient.

[0071] The acoustic signal 400 can be customized and have a particular frequency and / or period 418 suitable for the recipient, and the ECochG signal recording is adapted accordingly based on the particular frequency and / or period 418 of the acoustic signal 400 such that the period durations 408, 414 correspond to one another. Indeed, the acoustic signal 400 can have any suitable characteristic. As an example, the acoustic signal 400 is a pure tone. AsAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 another example, the acoustic signal 400 includes a successive burst of rarefaction stimuli and condensation stimuli. In either case, the acoustic signal 400 can include a consistent frequency to enable ECochG signal recording to correspond with one another. Additionally, ECochG signal recording can be dynamically and automatically adjusted in response to a determined change of the acoustic signal 400 (e.g., of the frequency) to ensure that the period durations 408, 414 remain in correspondence with one another, even though, for example, the period 418 and / or phasing of the acoustic signal 400 has changed. Indeed, the timing of ECochG signal recording with respect to one another is based on a frequency and / or period 418 of the acoustic signal 400. As a result, ECochG signals that have been recorded continue to correspond to one another and are usable for evaluating residual hearing of the recipient.

[0072] FIG. 5 is a graphical representation of recording ECochG signals while one or more acoustic signals 448 are provided over time. In general, timing of ECochG signal recording with respect to one another can change over time such that the time window of the ECochG signals shift to occur at different phases of the acoustic signal 448, even though a duration of each time window remains substantially the same. For example, signal buffer and software script execution to record / transfer ECochG signals can be used to detect a latency shift in which the time window of recording ECochG signals moves relative to the delivery of acoustic signals. In the illustrated embodiment, ECochG signals are recorded at first time windows 450 during a first duration of time 452 of acoustic signal delivery, second time windows 454 during a second duration of time 456 of acoustic signal delivery, and third time windows 458 during a third duration of time 460 of acoustic signal delivery. The first time windows 450 encompass corresponding period durations of an acoustic signal 448, the second time windows 454 encompass corresponding period durations of the acoustic signal 448 (e.g., the same or different acoustic signal 448 as that of the first time windows 450), and the third time windows 458 encompass corresponding period durations of the acoustic signal 448 (e.g., the same or different acoustic signal 448 as that of the first time windows 450 and the second time windows 454). That is, each time window of the first time windows 450 initiates at first phases having substantially the same sound wave value, terminates at second phases having substantially the same sound wave value, and spans substantially the same duration of time. Similarly, each time window of the second time windows 454 initiates at a phase having substantially the same sound wave value, terminates at another phase having substantially the same sound wave value, and spans substantially the same duration of time, and each time window of the third time windows 458 initiates at a phase having substantiallyAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 the same sound wave value, terminates at another phase having substantially the same sound wave value, and spans substantially the same duration of time.

[0073] However, the first time windows 450, the second time windows 454, and the third time windows 458 do not correspond to one another. For example, the phase at which the first time windows 450 initiate, the phase at which the second time windows 454 initiate, and / or the phase at which third time windows 458 initiate have different sound wave values, and / or the phase at which the first time windows 450 terminate, the phase at which the second time windows 454 terminate, and / or the phase at which the third time windows 458 terminate have different sound wave values. Because the time windows 450, 454, 458 do not correspond to one another, the ECochG signals recorded at the different time windows 450, 454, 458 are not evoked by corresponding parts of the acoustic signal 448. By way of example, because ECochG signals recorded during the first duration of time 452 and ECochG signals recorded during the second duration of time 456 are in response to different phases of the acoustic signal 448 and therefore likely include different and non-corresponding properties (e.g., electrical potential values), the ECochG signals recorded during the first duration of time 452 may not be suitably averaged with the ECochG signals recorded during the second duration of time 456. Therefore, averaging of the ECochG signals recorded during different durations of time 452, 456, 460 is avoided.

[0074] As such, because of the timing shift of the ECochG signal recordings with respect to the acoustic signal 448, the ECochG signal recordings within each duration of time 452, 456, 460 are averaged, but ECochG signal recordings at different durations of time 452, 456, 460 are not averaged. The timing shift of the ECochG signal recordings can be identified to prompt adjustment of how the ECochG signal recordings are processed / analyzed (e.g., to adjust which ECochG signal recordings are averaged). By way of example, in response to determining a first period duration during which first ECochG signals are recorded does not correspond to a second period duration during which second ECochG signals are recorded, the second ECochG signals are blocked from being averaged with the first ECochG signals. In other words, processing the ECochG signals includes avoiding a moving average in which a subsequently recorded ECochG signal is automatically averaged with a previously recorded ECochG signal (e.g., regardless of whether the time windows of the recorded ECochG signals correspond to one another).

[0075] However, in embodiments in which correspondence between the period durations associated with each ECochG signal recording is maintained, a moving average of recordedAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1ECochG signals can be performed. That is, by avoiding a timing shift (e.g., a latency shift) such that the time window of each ECochG signal corresponds to one another (e.g., each ECochG signal is evoked from corresponding phases of an acoustic signal), each of the ECochG signals can be averaged with one another such that subsequently recorded ECochG signals can be automatically averaged with a previously recorded ECochG signal. For example, to mitigate a timing shift, firmware in an implantable device can be configured to replicate a buffer in a processing unit to continue to run the same software script and maintain timing of ECochG signals with respect to one another using an accurate clock (e.g., of the processing unit).

[0076] Each of FIGs. 6 and 7 discussed below illustrates a respective method for delivering acoustic signals and recording resulting ECochG signals, such as using any of the components discussed herein. Each method can be performed differently than depicted. As an example, an additional operation can be performed for any of the methods, and / or any of the depicted operations of either method can be performed differently, may not be performed, and / or can be performed in a different order. Moreover, the respective operations of each method can be performed in any suitable manner with respect to one another, such as sequentially (e.g., in response to one another) and / or concurrently (e.g., in parallel with one another).

[0077] FIG. 6 is a flowchart of a method 500 for adjusting recording of ECochG signals. At block 502, an acoustic signal is delivered to the recipient. For example, an earbud, headphone, hearing aid, or any other suitable device (e.g., wearable device) having a speaker delivers the acoustic signal to the recipient. In some embodiments, the acoustic signal includes an acoustic tone having a substantially constant frequency.

[0078] At block 504, ECochG signals evoked by the recipient in response to the acoustic signal are recorded based on a frequency and / or period of the acoustic signal. In particular, the timing of the recording of the ECochG signals with respect to one another provides successive recordings that each span a respective period duration of the acoustic signal. It is desirable for the period durations to correspond to one another such that the ECochG signals can be more suitably used in conjunction (e.g., averaged) with one another. That is, it is desirable for the time window of each recording to initiate at first phases of the acoustic signal that each have substantially the same first value, to terminate at second phases of the acoustic signal that each have substantially the same second value, and to span substantially the same duration of time. Correspondence between the period durations indicates that theAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1ECochG signals are evoked by corresponding phases or portions of the acoustic signal. In some embodiments, operations to record ECochG signals are initiated upon delivery of the acoustic signal, such as based on a determination that the acoustic signal is output and / or in response to a user input.

[0079] At block 506, a determination is made regarding whether the period durations correspond to one another. As an example, the timing of ECochG signal recordings with respect to one another is compared to the frequency and / or period of the acoustic signal. In particular, each ECochG signal recording spans substantially the same duration of time, and adjacent ECochG signal recordings are separated by the same gap interval. For instance, a first duration of a time window of a first ECochG signal recording plus a second duration of the gap interval between the first ECochG signal recording and a second, subsequent ECochG signal recording is determined. The summation of the first duration and the second duration encompassing a whole number (i.e., not a decimal) quantity of periods of the acoustic signal indicates the period durations of the ECochG signal recordings correspond to one another. That is, for instance, the summation of the first duration and the second duration encompassing four periods of the acoustic signal indicates the period durations of the ECochG signal recordings correspond to one another, whereas the summation of the first duration and the second duration encompassing 4.5 periods of the acoustic signal indicates the period durations of the ECochG signal recordings do not correspond to one another (e.g., the second ECochG signal recording initiates at a phase having a different value than the value of a phase at which the first ECochG signal recording initiates). In some embodiments, the delivered acoustic signal is received via a microphone to enable the timing of ECochG signal recordings to be compared to the frequency and / or period of the acoustic signal for determining whether the period durations of the ECochG signal recordings correspond to one another. Additionally or alternatively, respective timings related to recording ECochG signals are compared to one another to determine whether the period durations of the ECochG signal recordings correspond to one another. By way of example, the time windows encompassed by each ECochG signal are compared to one another and / or the gap interval between adjacent ECochG signal recordings are compared to one another. A consistent duration of time encompassed by the different time windows and by the different gap intervals can indicate the period durations of the ECochG signal recordings correspond to one another, whereas a deviation between the time windows and / or between the gap interval canAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 indicate the period durations of the ECochG signal recordings do not correspond to one another.

[0080] In response to a determination that the period durations of the recorded ECochG signals correspond to one another, no adjustments to the recording of ECochG signals can be performed, and the ECochG signals continue to be recorded to span the respective period durations that correspond to one another. However, at block 508, in response to a determination that the period durations of the recorded ECochG signals do not correspond to one another, the recording of the ECochG signals is adjusted to provide ECochG signals that span period durations corresponding to one another. By way of example, the timing of recording ECochG signals with respect to one another is adjusted based on the frequency of the acoustic signal to change the gap interval that spans between adjacent recording of ECochG signals such that the first duration of the time window of an ECochG signal recording plus the second duration of the gap interval between adjacent ECochG signal recordings includes a whole number quantity of periods of the acoustic signal. For instance, electrical stimulation, voltage telemetry, and / or amplification for capturing ECochG can be adjusted to align with the acoustic signal and to span period durations corresponding to one another.

[0081] In certain embodiments, the acoustic signal (e.g., its frequency, its period) can change while ECochG signals are being recorded. The changing of the acoustic signal can initially cause an ECochG signal to be recorded during a period duration that does not correspond to the period durations of previous ECochG signals. However, such a lack of correspondence between period durations can be determined at block 506, and recording of subsequent ECochG signals can be adjusted (e.g., based on an adjusted frequency / period) to mitigate the lack of correspondence between period durations. As a result, subsequent ECochG signals are recorded at period durations that correspond to one another. Therefore, the recording of ECochG signals can be dynamically adjusted in response to changes in the acoustic signal to maintain correspondence between period durations of recording ECochG signals.

[0082] Moreover, in some embodiments, the acoustic signal can change in addition to or as an alternative to adjusting the recording of ECochG signals such that the period durations of the recorded ECochG signals correspond to one another. For example, the frequency of the acoustic signal is changed (e.g., without also changing timing of recording ECochG signals with respect to one another) such that the first duration of a time window of a ECochG signalAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 recording plus a second duration of a gap between ECochG signal recordings encompasses a whole number quantity of periods of the acoustic signal.

[0083] FIG. 7 is a flowchart of a method 550 for adjusting an acoustic signal being delivered to a recipient. At block 552, an acoustic signal is delivered to the recipient. At block 554, a determination is made regarding whether the acoustic signal matches a target acoustic signal. For example, the acoustic signal is received at a microphone and is compared to the target acoustic signal. In certain embodiments, the target acoustic signal is indicative of an acoustic signal that evokes a desirable ECochG response from the recipient for evaluating residual hearing of the recipient. As an example, the target acoustic signal can include a particular frequency, period, and / or amplitude.

[0084] At block 556, in response to a determination that the acoustic signal matches the target acoustic signal, thereby indicating that the acoustic signal is being delivered desirably to the recipient, ECochG signals evoked by the recipient in response to the acoustic signal are recorded (e.g., based on a frequency / period of the acoustic signal) without further adjusting the acoustic signal. Recording the ECochG signals provides successive recordings that can each span a corresponding period duration of the acoustic signal and that can be usable (e.g., averaged) for evaluating the residual hearing of the recipient. However, in response to a determination that the acoustic signal does not match the target acoustic signal, the acoustic signal being delivered is adjusted, as shown at block 558. For instance, a mismatch between the acoustic signal and the target acoustic signal indicates an obstruction or other alteration of the delivery of the acoustic signal (e.g., to provide an acoustic signal with an undesirable frequency) that does not cause desirable ECochG signals to be evoked by the recipient. As a result, the acoustic signal is adjusted toward the target acoustic signal, and ECochG signals evoked by the recipient in response to the adjusted acoustic signal are then recorded after the adjustment to the acoustic signal is made. Thus, more suitable ECochG signals are recorded for accurately evaluating the residual hearing of the recipient.

[0085] As previously described, the technology disclosed herein can be applied in any of a variety of circumstances and with a variety of different devices. Another example device that can benefit from technology disclosed herein is described in more detail in FIG. 8. 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, as well as other medical devices that deliver stimulation to tissue. Further, technology describedAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 herein can also be applied to consumer devices. These different systems and devices can benefit from the technology described herein.

[0086] FIG. 8 illustrates an example vestibular stimulator system 1002, with which embodiments presented herein can be implemented. As shown, the vestibular stimulator system 1002 comprises an implantable component (vestibular stimulator) 1012 and an external device / component 1004 (e.g., external processing device, battery charger, remote control, etc.). The external device 1004 comprises a transceiver unit 1060. As such, the external device 1004 is configured to transfer data (and potentially power) to the vestibular stimulator 1012.

[0087] The vestibular stimulator 1012 comprises an implant body (main module) 1034, a lead region 1036, and a stimulating assembly 1016, all configured to be implanted under the skin / tissue (tissue) 1015 of the recipient. The implant body 1034 generally comprises a hermetically-sealed housing 1038 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 1014 that is generally external to the housing 1038, but which is connected to the transceiver via a hermetic feedthrough (not shown).

[0088] The stimulating assembly 1016 comprises a plurality of electrodes 1044(l)-(3) disposed in a carrier member (e.g., a flexible silicone body). In this specific example, the stimulating assembly 1016 comprises three (3) stimulation electrodes, referred to as stimulation electrodes 1044(1), 1044(2), and 1044(3). The stimulation electrodes 1044(1), 1044(2), and 1044(3) function as an electrical interface for delivery of electrical stimulation signals to the recipient’s vestibular system.

[0089] The stimulating assembly 1016 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.

[0090] In operation, the vestibular stimulator 1012, the external device 1004, and / or another external device can be configured to implement the techniques presented herein. That is, the vestibular stimulator 1012, possibly in combination with the external device 1004 and / orAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 another external device, can include an evoked biological response analysis system, as described elsewhere herein.

[0091] 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.

[0092] 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.

[0093] 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.

[0094] 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.

[0095] 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.Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1

[0096] 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 or improvements 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.

[0097] 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

Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1CLAIMSWhat is claimed is:

1. A method, comprising: delivering an acoustic signal to a recipient; and recording, via one or more electrodes, one or more electrocochleography (ECochG) signals evoked in response to the acoustic signal, wherein delivery of the acoustic signal and recording of the one or more ECochG signals are unsynchronized.

2. The method of claim 1, wherein the one or more ECochG signals are recorded based on a frequency of the acoustic signal.

3. The method of claim 1 or 2, wherein the one or more ECochG signals are recorded in a plurality of successive recordings, and wherein each recording of the plurality of successive recordings spans a corresponding period duration of the acoustic signal.

4. The method of claim 3, wherein the corresponding period duration associated with each recording of the plurality of successive recordings comprises at least one period of the acoustic signal.

5. The method of claim 1 or 2, wherein the acoustic signal is delivered via an in-the-ear receiver.

6. The method of claim 5, wherein the acoustic signal is delivered via the in-the-ear receiver as part of a hearing aid.

7. The method of claim 1 or 2, further comprising: capturing the acoustic signal via an in-the-ear microphone; comparing, via a processor, the acoustic signal to a target acoustic signal; and adjusting, via the processor, the acoustic signal based on comparison of the acoustic signal to the target acoustic signal.

8. The method of claim 1 or 2, further comprising:Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 recording, via the one or more electrodes, one or more initial ECochG signals evoked by the recipient in response to the acoustic signal to provide an initial plurality of successive recordings such that the one or more initial ECochG signals each span a respective period duration of the acoustic signal; comparing the respective period durations to one another; and adjusting the recording via the one or more electrodes based on determining the respective period durations do not correspond to one another, wherein the one or more ECochG signals are recorded subsequent to adjusting of the recording via the one or more electrodes.

9. The method of claim 1 or 2, wherein recording the one or more ECochG signals provides six successive ECochG recordings.

10. The method of claim 1 or 2, wherein the acoustic signal comprises periods of silence, and wherein the one or more ECochG signals are recorded such that a respective period of silence spans between adjacent recordings of the one or more ECochG signals.

11. The method of claim 1 or 2, wherein the one or more ECochG signals are recorded such that a same duration of time spans between adjacent recordings of the one or more ECochG signals.

12. The method of claim 1 or 2, wherein the acoustic signal is an acoustic tone having a target frequency.

13. A system, comprising: an acoustic output device configured to deliver, to a recipient, an acoustic tone at a target frequency; one or more electrodes; and a recording sub-system configured to record, via the one or more electrodes, one or more electrocochleography (ECochG) signals evoked by the recipient in response to the acoustic tone, wherein the recording sub-system is configured to record the one or more ECochG signals based on the target frequency of the acoustic tone.

14. The system of claim 13, further comprising:Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 a processor communicatively coupled to the acoustic output device and the recording sub-system, wherein the processor is configured to: control the acoustic output device to deliver the acoustic tone; and control the recording sub-system to record the one or more ECochG signals.

15. The system of claim 14, wherein the recording sub-system is configured to record the one or more ECochG signals to provide a plurality of successive recordings, and the processor is configured to control the acoustic output device and / or the recording sub-system such that each recording of the plurality of successive recordings initiates at a corresponding first phase of the acoustic tone, terminates at a corresponding second phase of the acoustic tone, and spans substantially the same duration of time.

16. The system of claim 14, wherein the processor is configured to control the acoustic output device and the recording sub-system.

17. The system of claim 14, wherein the acoustic output device is configured for wireless communication with the processor.

18. The system of claim 13, 14, 15, 16, or 17, further comprising: an acoustic input device configured to receive the acoustic tone, wherein the acoustic output device is configured to adjust the acoustic tone toward a target acoustic tone based on comparison of the acoustic tone received by the acoustic input device to the target acoustic tone.

19. The system of claim 18, wherein the acoustic input device and the acoustic output device are integrated in the same component.

20. The system of claim 18, wherein the acoustic input device is implanted in the recipient.

21. A method, comprising: delivering an acoustic signal to a recipient; and recording, via one or more electrodes, one or more electrocochleography (ECochG) signals evoked in response to the acoustic signal in a plurality of successive recordings basedAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 on a period of the acoustic signal such that each recording of the plurality of successive recordings spans a respective period duration of the acoustic signal.

22. The method of claim 21, further comprising: comparing the respective period duration of each recording of the plurality of successive recordings to one another.

23. The method of claim 22, further comprising: averaging the one or more ECochG signals in response to determining the respective period duration of each recording of the plurality of successive recordings corresponds to one another.

24. The method of claim 21, further comprising: changing the acoustic signal delivered to the recipient; determining the respective period duration of each recording of the plurality of successive recordings do not correspond to one another as a result of changing the acoustic signal; and changing recording of the one or more ECochG signals based on changing of the acoustic signal such that the respective period duration of each recording corresponds to one another.

25. The method of claim 21, 22, 23, or 24, further comprising: recording, via the one or more electrodes, one or more additional ECochG signals evoked in response to the acoustic signal in an additional plurality of successive recordings based on the period of the acoustic signal such that each recording of the additional plurality of successive recordings spans an additional respective period duration of the acoustic signal.

26. The method of claim 25, further comprising: averaging the one or more ECochG signals in response to determining the respective period duration of each recording of the plurality of successive recordings corresponds to one another; and averaging the one or more additional ECochG signals in response to determining the additional respective period duration of each recording of the additional plurality of successive recordings corresponds to one another.Atty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC127. The method of claim 26, further comprising: blocking averaging of the one or more ECochG signals with the one or more additional ECochG signals in response to determining the respective period duration of each recording of the plurality of successive recordings does not correspond to the additional respective period duration of each recording of the additional plurality of successive recordings.

28. The method of claim 21, 22, 23, or 24, wherein the acoustic signal comprises a condensation period and a rarefaction period, the one or more ECochG signals comprise first electrical potentials evoked during the condensation period and second electrical potentials evoked during the rarefaction period, and the method further comprises: adding the first electrical potentials and the second electrical potentials to one another to determine an auditory nerve neurophonic; subtracting the first electrical potentials from the second electrical potentials to determine a cochlear microphonic; or both.

29. The method of claim 28, further comprising: adjusting the acoustic signal to change the condensation period and the rarefaction period; and adjusting recording of the one or more ECochG signals in response to adjusting the acoustic signal such that the respective period duration of the acoustic signal corresponds to one another.

30. One or more non-transitory computer readable storage media comprising instructions that, when executed by one or more processors, are configured to: determine an acoustic signal is being delivered to an ear of a recipient; and record, via one or more electrodes, one or more electrocochleography (ECochG) signals from the ear of the recipient, where the one or more ECochG signals evoked in response to the acoustic signal, and wherein the one or more ECochG signals are recorded based on a frequency of the acoustic signal.

31. The one or more non-transitory computer readable storage media of claim 30, wherein the one or more ECochG signals are recorded in a plurality of successive recordings, andAtty. Docket No. 3065.0809i Client Ref. No. CID03833WOPC1 wherein each recording of the plurality of successive recordings spans a corresponding period duration of the acoustic signal.

32. The one or more non-transitory computer readable storage media of claim 31, wherein the corresponding period duration associated with each recording of the plurality of successive recordings comprises at least one period of the acoustic signal.

33. The one or more non-transitory computer readable storage media of claim 30, 31, or 32, further comprising instructions that, when executed by the one or more processors, are configured to: capture the acoustic signal via an in-the-ear microphone; compare the acoustic signal to a target acoustic signal; and initiate an adjustment to the acoustic signal based on comparison of the acoustic signal to the target acoustic signal.

34. The one or more non-transitory computer readable storage media of claim 30, 31, or 32, wherein the acoustic signal is an acoustic tone having a target frequency.

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