Cochlear Implant Fitting Preserving Residual Hearing
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Solution Overview
Problem
Cochlear implants often produce unnatural and harsh sound percepts due to pulsatile electrical stimulation, which can be unattractive to patients with residual natural hearing, and there is a challenge in precisely mapping frequency bands to electrodes without damaging the inner ear structures during implantation.
Innovation Solution
A method of fitting a cochlear prosthesis that determines the apical portion of the cochlea with residual acoustic hearing capability and positions the electrode array to avoid this area, using active electrodes only for the basal portion, and a speech processor that processes sound signals to produce both electrical and acoustic stimuli, optimizing the combination of both for natural hearing supplementation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If the electrode array is inserted deeply into the cochlea to stimulate all frequency bands, then the hearing coverage is improved, but the residual acoustic hearing in the apical portion is damaged
Solution Approach 1:
The invention extracts the electrode array from the cochlea at a specific depth, leaving the apical portion with residual hearing untouched. The array is positioned to stimulate only the basal and middle portions of the cochlea where hearing loss is present, while deliberately excluding the apical region to preserve natural hearing capability.
Solution Approach 2:
The invention applies different stimulation strategies to different regions of the cochlea. The basal and middle portions receive electrical stimulation through the electrode array, while the apical portion maintains its natural acoustic hearing capability without electrical interference, creating a localized treatment approach.
2Reliability
If pulsatile electrical stimulation is used to provide cochlear implant functionality, then the device can operate effectively, but the sound percepts become unnatural and harsh
Solution Approach 1:
The invention merges electrical stimulation from the cochlear implant with natural acoustic hearing in a bimodal stimulation approach. The electrical stimulation provides speech understanding while the preserved natural hearing in the apical region provides natural sound quality, creating a combined perception that is both functional and natural-sounding.
Solution Approach 2:
The invention changes the stimulation parameters by using lower intensity electrical stimulation levels compared to traditional cochlear implants. This allows the electrical stimulation to supplement rather than dominate the auditory perception, enabling patients to hear at more natural listening levels without the harshness associated with high-intensity pulsatile stimulation.
Data Source
AI summary
A method for fitting a cochlear prosthesis to a cochlea having residual acoustic hearing capability, in order to exploit the residual acoustic hearing capability to the extent possible. A portion of the cochlea having residual acoustic hearing capability is determined by measuring the neural response to acoustic and/or electrical stimulations. Electrical stimulations are applied only to the portions of the cochlea lacking acoustic hearing capability, or possessing only partial acoustic hearing capability. Surgical implantation depth may be optimised by the method, and/or a patient map may be suitably defined to implement the method.