Cochlear Implant Electrode Lead Misplacement Detection
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Solution Overview
Problem
During lead insertion procedures for cochlear implants, electrode leads can inadvertently be inserted into the vestibular canal instead of the cochlea, which is not readily detectable intraoperatively due to the lack of visual feedback and ineffective conventional measurement methods.
Innovation Solution
A diagnostic system that applies acoustic stimulation and records evoked response signals to detect anomalies, determining if the electrode lead is mispositioned in the vestibular canal by analyzing changes in amplitude and phase of the evoked responses, and takes remedial actions such as notification or retraction.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional intraoperative measurement methods (impedance, eCAP) are used, then the measurement process is simple, but misplacement of electrode lead cannot be detected
Solution Approach 1:
The patent introduces acoustic stimulation as an intermediary to indirectly detect electrode lead placement. Instead of directly measuring electrode position, the system uses acoustic signals that propagate through fluid pathways, with the evoked response serving as a mediator that reveals placement accuracy without requiring direct visualization or complex imaging
2Loss of information
If the surgeon cannot see where the electrode lead is being placed, then the insertion procedure is simpler, but misplacement into vestibular canal cannot be detected
Solution Approach 1:
The patent replaces the mechanical/visual inspection method with an acoustic field-based detection system. Instead of relying on direct visual observation of the insertion site, the system uses acoustic stimulation and evoked response measurement to infer electrode lead position, substituting a non-invasive acoustic field measurement for direct mechanical visualization
3Reliability
If real-time detection of misplacement is implemented, then insertion procedure effectiveness is improved, but procedure time increases
Solution Approach 1:
The patent implements continuous real-time monitoring of evoked responses during the insertion procedure. Rather than performing discrete checks at intervals, the system continuously measures acoustic evoked responses as the electrode lead is being inserted, allowing immediate detection of misplacement without interrupting the procedural flow
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
Facilitates real-time detection and correction of electrode lead misplacement, leading to shorter and more effective insertion procedures.
Implementation Method 1
a diagnostic system may be configured to direct an acoustic stimulation generator to apply acoustic stimulation to a recipient of a cochlear implant
Implementation Method 2
direct the cochlear implant to use an electrode on the electrode lead to record an evoked response signal that occurs within the recipient in response to the acoustic stimulation
Data Source
AI summary
An exemplary diagnostic system may be configured to direct an acoustic stimulation generator to apply acoustic stimulation to a recipient of a cochlear implant during an insertion procedure in which an electrode lead coupled to the cochlear implant is supposed to be inserted into a cochlea of the recipient, direct the cochlear implant to use an electrode on the electrode lead to record an evoked response signal that occurs within the recipient in response to the acoustic stimulation, detect an anomaly in the evoked response signal, and determine, based on the anomaly, that the electrode lead is being inserted into a vestibular canal instead of into the cochlea.