Apical Electrode Conditioning in Cochlear Implants
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Solution Overview
Problem
Patients with residual hearing in low frequencies and severe hearing loss in high frequencies face challenges with traditional hearing aids and cochlear implants, and electro-acoustic stimulation systems, as they may lose residual hearing over time, leading to biological buildup on apical electrodes that inhibit electrical stimulation.
Innovation Solution
An electro-acoustic stimulation system that applies sub-threshold electrical stimulation and conditioning stimulation to apical electrodes during acoustic stimulation, maintaining electrode patency and preventing biological buildup, allowing for effective electrical stimulation when acoustic stimulation is no longer beneficial.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If apical electrodes are disabled during extended periods of acoustic stimulation, then electro-acoustic stimulation functionality is maintained, but biological buildup accumulates on apical electrodes rendering them useless for future electrical stimulation
Solution Approach 1:
The system performs preliminary conditioning stimulation on apical electrodes before they are needed for full electrical stimulation. This preliminary action prevents biological buildup by periodically activating the electrodes with sub-threshold or low-level stimulation signals, ensuring they remain patent and functional when transition to electrical stimulation is required.
Solution Approach 2:
The system maintains continuous useful action by periodically applying conditioning stimulation to apical electrodes even during acoustic stimulation periods. This continuous maintenance prevents the electrodes from becoming inactive and accumulating biological deposits, ensuring readiness for future electrical stimulation needs.
2Productivity
If a relatively short electrode lead is used for electro-acoustic stimulation, then high frequency electrical stimulation is achieved, but the system cannot provide low frequency electrical stimulation when residual hearing is lost
Solution Approach 1:
The system achieves multi-functionality by equipping the electrode lead with both basal electrodes (for high frequency stimulation) and apical electrodes (for low frequency stimulation). This universal design allows the same device to provide both electro-acoustic stimulation during the acoustic phase and full electrical stimulation across the entire frequency range when acoustic stimulation is no longer beneficial.
Solution Approach 2:
The system dynamically adapts its stimulation mode and frequency range based on the patient's residual hearing status. Initially, it uses acoustic stimulation for low frequencies and electrical stimulation for high frequencies. When residual hearing deteriorates, the system transitions to provide electrical stimulation across the full frequency range, optimizing performance at each stage of hearing loss progression.
3Duration of action of stationary object
If extended periods of electrode inactivity are allowed, then acoustic stimulation can be maintained, but hearing nerve cell patency diminishes in the vicinity of apical electrodes
Solution Approach 1:
The system implements periodic conditioning stimulation to apical electrodes during acoustic stimulation periods. This periodic activation prevents extended inactivity of the electrodes and associated nerve cells, maintaining their patency and responsiveness. The conditioning stimulation occurs at intervals that are sufficient to prevent biological buildup and nerve cell deterioration without interfering with the primary acoustic stimulation therapy.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances acoustic stimulation, maintains hearing nerve cell patency, and prevents biological buildup on apical electrodes, enabling seamless transition to electrical stimulation when residual hearing is lost, thereby improving auditory perception.
Implementation Method 1
direct a cochlear implant implanted within the patient to apply sub-threshold electrical stimulation to the patient by way of one or more electrodes disposed within an apical region of a cochlea of the patient
Data Source
AI summary
An exemplary system includes an electro-acoustic stimulation (“EAS”) device, a cochlear implant, an electrode lead comprising a plurality of basal electrodes configured to be disposed within a basal region of a cochlea of a patient and a plurality of apical electrodes configured to be disposed within an apical region of the cochlea; and a loudspeaker communicatively coupled to the EAS device. The EAS device is configured to operate in an EAS mode by 1) disabling the apical electrodes for standard electrical stimulation, 2) detecting, while the apical electrodes are disabled for standard electrical stimulation, audio content presented to the patient and included in an acoustic stimulation frequency range, 3) directing the loudspeaker to apply acoustic stimulation representative of the audio content included in the acoustic stimulation frequency range to the patient, and 4) periodically directing the cochlear implant to apply conditioning stimulation by way of the disabled apical electrodes.