Cochlear Implant Fitting via Neighboring Electrode Masking
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current cochlear implant fitting methods are time-consuming and require extensive clinical experience, often relying on subjective patient feedback, and are not efficient, especially when performed on sedated or anesthetized patients, due to the need for lengthy objective measurements and adjustments to avoid overstimulation.
Innovation Solution
A method involving iterative fitting of electrode contacts by delivering stimulation signals with a charge level distribution function to both the fitting and neighboring electrodes, obtaining patient responses, and defining a patient-specific fit map, which can use Gaussian or geometric distribution functions and prioritize neighboring electrode masking to avoid overstimulation, allowing for quicker and more efficient fitting.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional cochlear implant fitting methods are used, then patient-specific fit maps can be obtained, but the fitting process is time-consuming and requires extensive clinical experience
Solution Approach 1:
The system performs preliminary objective measurements and automated threshold/MCL estimations before the actual fitting process. This preliminary action provides initial fit map parameters that guide the subsequent fitting, reducing the time required for manual adjustments and clinical experience dependency.
Solution Approach 2:
The system continuously obtains patient responses (both subjective feedback and objective physiological responses) during the fitting process and uses this feedback to iteratively refine the fit map parameters. This feedback loop enables real-time optimization of stimulation parameters, improving fitting accuracy while reducing the time needed for manual trial-and-error adjustments.
2Ease of operation
If traditional fitting methods are used on sedated or anesthetized patients, then fitting can be performed, but the process requires lengthy objective measurements and adjustments to avoid overstimulation
Solution Approach 1:
The system uses objective physiological measurements (such as ECAP - electrically evoked compound action potentials) that do not require patient subjective feedback. The system automatically processes these objective responses to estimate thresholds and MCLs, enabling the fitting process to proceed without requiring the patient to be awake or provide verbal feedback, thus making it suitable for sedated or anesthetized patients while reducing time requirements.
Solution Approach 2:
The system performs preliminary objective measurements and automated parameter estimations during the surgical procedure itself, before the patient wakes up. This preliminary action captures baseline physiological data that is used to generate initial fit map parameters, eliminating the need for lengthy post-operative adjustment sessions and reducing overall fitting time for sedated patients.
3Measurement precision
If stimulation signals are delivered to electrode contacts during fitting, then patient responses can be obtained, but there is risk of overstimulation and discomfort
Solution Approach 1:
The system continuously monitors patient responses (both subjective comfort feedback and objective physiological responses) during stimulation and uses this feedback to dynamically adjust stimulation parameters. When overstimulation is detected, the system automatically reduces stimulation intensity, thereby maintaining measurement accuracy while minimizing the risk of discomfort or harm.
Solution Approach 2:
The system delivers stimulation signals at progressively increasing levels, starting from low intensities and gradually escalating. This partial action approach allows the system to establish safe baseline parameters first, then incrementally test higher stimulation levels while monitoring patient responses, thereby reducing the risk of sudden overstimulation while still obtaining comprehensive response data for accurate fit map generation.
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
This approach enables a more rapid and comfortable fitting process for cochlear implants by leveraging both subjective and objective responses, reducing the risk of overstimulation and shortening the fitting time, even for patients who cannot provide immediate feedback.
Implementation Method 1
delivering fitting stimulation signals to a fitting electrode contact and at least one neighboring electrode contact to stimulate adjacent auditory neural tissue
Data Source
AI summary
A fitting arrangement is described for fitting electrode contacts of cochlear implant electrode array implanted in a cochlea of an implanted patient. This involves iteratively fitting multiple fitting electrode contacts by for each of the fitting electrode contacts: i. delivering fitting stimulation signals to the fitting electrode contact and at least one neighboring electrode contact to stimulate adjacent auditory neural tissue, wherein the fitting stimulation signals are characterized by a charge level distribution function having a non-zero noise level charge at the at least one neighboring electrode contact and a response level charge much greater than the noise level charge at the fitting electrode contact, and ii. obtaining patient responses from the implanted patient to the fitting stimulation signals. A patient-specific fit map is then defined for the electrode contacts of cochlear implant electrode array based on the patient responses.