Cochlear Implant Fitting Method Using Objective Measurements
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Solution Overview
Problem
The current cochlear implant fitting process is time-consuming and often suboptimal, especially in areas with limited audiological infrastructure, and relies on subjective measurements, which can lead to improper stimulation levels, potentially causing discomfort or injury, particularly in children and pre-lingually deaf individuals.
Innovation Solution
A method for determining an initial stimulation profile and modifying its shape based on the mean stimulus level to create a fitting stimulation profile, which can be flattened or broadened, allowing for more accurate and efficient configuration of cochlear implants, taking into account variations in the auditory system and loudness growth.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual determination of T and C levels by clinician is used, then individualized fitting can be achieved, but the process becomes extremely time-consuming
Solution Approach 1:
The system performs preliminary objective measurements (ECAP, EABR, ESR) to establish baseline thresholds before the clinical fitting process. These preliminary measurements provide a starting point that reduces the number of iterative adjustments needed during manual fitting, thereby reducing overall fitting time while maintaining individualized accuracy.
Solution Approach 2:
The system creates a model or copy of the recipient's auditory system characteristics through objective measurements. This model serves as a template that guides the fitting process, allowing the clinician to work from objective data rather than starting from scratch, thus reducing time while preserving individualization.
2Loss of information
If subjective measurements are used for fitting, then recipient feedback can be obtained, but children and pre-lingually deaf recipients cannot provide accurate impressions
Solution Approach 1:
The system introduces an intermediary objective measurement process that translates auditory system responses into measurable data. Instead of relying directly on subjective recipient feedback, the intermediary measurements (ECAP, EABR, ESR) serve as proxies that provide accurate information about auditory thresholds and responses, enabling precise fitting even when recipients cannot provide reliable subjective feedback.
Solution Approach 2:
The system replaces the subjective psychological feedback mechanism with objective physiological measurement mechanisms. By substituting the unreliable subjective reporting system with reliable objective physiological measurements, the system achieves accurate fitting for recipients who cannot provide meaningful subjective feedback.
3Reliability
If T level is set too low to ensure perception, then stimuli may be applied that cannot be perceived, wasting stimulation
Solution Approach 1:
The system uses feedback from objective measurements (ECAP, EABR, ESR) to continuously monitor and adjust stimulation levels. This feedback mechanism ensures that T levels are set accurately at the threshold of perception, avoiding both understimulation (which would waste energy) and overstimulation (which would be uncomfortable). The feedback loop allows dynamic adjustment to maintain optimal energy efficiency.
Solution Approach 2:
The system dynamically changes stimulation parameters based on objective measurement results. By adjusting T and C levels according to measured auditory thresholds and response characteristics, the system optimizes stimulation efficiency, ensuring that energy is applied at effective levels without waste from subthreshold stimulation.
4Illumination intensity
If C level is set too high to ensure loudness, then recipient may be overstimulated causing pain and possible injury
Solution Approach 1:
The system employs feedback from objective measurements to monitor recipient responses and adjust C levels accordingly. The feedback mechanism detects signs of overstimulation and automatically reduces stimulation intensity, preventing pain and potential injury while maintaining adequate loudness for effective hearing restoration.
Solution Approach 2:
The system applies beforehand cushioning by setting initial C levels based on objective measurement data that predict safe stimulation thresholds. This preventive approach cushions against potential overstimulation damage before it can occur, while still allowing sufficient headroom for effective loudness perception.
Data Source
AI summary
A computer-implemented method for fitting a medical implant to a recipient, the medical implant being operative to stimulate a physiological system of the recipient over a plurality of stimulation channels. The method includes: determining, based on measurements, an initial stimulation profile for the plurality of stimulation channels; determining a representative stimulus level of the initial stimulation profile; determining a fitting stimulation profile by modifying the shape a shape of the initial stimulation based on the representative stimulus level profile; and configuring the medical implant according to the fitting stimulation profile.