Cochlear Implant Fitting via Synchronized Neural Acoustic Stimulation
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Solution Overview
Problem
Current methods for optimizing bimodal and bilateral cochlear implant systems, which involve both electric and acoustic stimulation, face challenges in achieving effective pitch matching and fusion of stimuli across different devices, leading to suboptimal performance in speech recognition due to inefficient integration of stimuli.
Innovation Solution
A system that uses synchronized probe neural and acoustic stimulation signals, with specific spectral regions allocated to each signal to optimize parameter settings, allowing patients to fuse the stimuli into a single percept, thereby improving pitch matching and device alignment through an iterative process.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If behavioral pitch matching is used to determine electrode location and pitch, then the method is practical and avoids additional radiation dose, but the procedure is very tedious and unreliable
Solution Approach 1:
The patent introduces an intermediary measurement method using ECAP (electrically evoked compound action potentials) and acoustic masking signals as mediators to objectively determine pitch and electrode location. This replaces the subjective and tedious behavioral pitch matching with an automated physiological measurement, improving reliability while avoiding radiation exposure from CT scans.
2Measurement precision
If CT scans are used to determine electrode location, then accurate positioning is achieved, but the method is expensive and requires additional appointment and radiation dose
Solution Approach 1:
The patent replaces the mechanical/radiological imaging system (CT scan) with an electrical and acoustic measurement system. By using ECAP measurements and acoustic masking signals, the system achieves electrode location and pitch determination through physiological responses rather than radiation-based imaging, simplifying the overall system while maintaining accuracy.
3Measurement precision
If pitch matching procedure is performed using pure tones or filtered harmonic complexes, then electrode location can be determined, but the procedure is very tedious and time-consuming
Solution Approach 1:
The patent implements a self-service approach where the patient's own physiological responses (ECAPs and acoustic masking thresholds) are automatically measured and processed to determine pitch and electrode location. This eliminates the need for lengthy behavioral pitch matching procedures, significantly reducing fitting time while maintaining measurement precision through objective physiological data.
4Loss of information
If acoustic masking signals are used to measure threshold elevations, then information about residual hearing capability is obtained, but the measurement process becomes more complex
Solution Approach 1:
The patent merges multiple measurement functions into a single integrated procedure. By combining ECAP measurements with acoustic masking signal presentation, the system simultaneously obtains information about electrode location, pitch, and residual hearing capability. This consolidation reduces overall measurement complexity while comprehensively capturing all necessary physiological information.
Data Source
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AI summary
There is provided a system comprising a first device (10) for neural stimulation of a cochlea of a patient's (17) ipsilateral ear, a second hearing stimulation device (21) and a fitting device (13) for adjusting at least one of the first stimulation device and the second stimulation device according to a response of the patient to combined stimulation by the first stimulation device and the second stimulation device. The fitting device comprises a unit cooperating with the first stimulation device and with the second stimulation device in order to generate, in a synchronized manner, a probe neural stimulation signal to be supplied to the cochlear implant stimulation arrangement (12) and a second probe stimulation signal be supplied to the stimulation means (23) of the second stimulation device, with the probe neural stimulation signal and the second stimulation signal being adapted to be recognized by the patient as carrying a target speech information in case that the patient is able to correctly fuse the stimuli. The fitting device further includes a unit for recording the perceptual behavioral response of the patient to the synchronized neural stimulation of the patient's hearing with the probe neural stimulation signal and the second stimulation signal and a unit for programming the first stimulation device and/or the second stimulation device according to the recorded perceptual response.