Cochlear Implant Stimulation Adjustment for Tinnitus Masking
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Solution Overview
Problem
Existing cochlear implant systems face challenges in minimizing tinnitus through inadequate adjustment of electrode contact stimulation levels, which can lead to suboptimal tinnitus masking and discomfort for patients.
Innovation Solution
A method and system for adjusting channel threshold and maximum stimulation levels for each electrode contact based on measured tinnitus masking levels, using a channel mean stimulation level calculation to determine optimal adjustment functions, thereby minimizing tinnitus and enhancing patient comfort.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If stimulation levels are increased to improve hearing perception, then hearing ability is improved, but tinnitus projections increase causing patient discomfort
Solution Approach 1:
The patent changes the stimulation parameters by introducing separate tinnitus masking levels distinct from traditional hearing thresholds. The system adjusts stimulation levels dynamically based on whether the goal is hearing enhancement or tinnitus masking, using multiple parameters (hearing threshold, tinnitus masking threshold, MCL) to resolve the contradiction between improving hearing and reducing tinnitus projections.
2Measurement precision
If electrode contact stimulation levels are adjusted individually, then channel-specific hearing optimization is achieved, but tinnitus masking becomes inadequate across adjacent channels
Solution Approach 1:
The patent merges the fitting processes of adjacent electrode contacts by allowing tinnitus masking level measurements from one channel to inform and adjust neighboring channels. The system combines information from multiple channels to establish coordinated stimulation levels that simultaneously optimize individual channel hearing performance while ensuring comprehensive tinnitus masking across the entire electrode array.
3Adaptability or versatility
If traditional behavioral methods are used to find threshold and MCL values, then patient-specific fitting is achieved, but the process is time-consuming and subjective
Solution Approach 1:
The patent implements objective feedback mechanisms using ECAP (Electrically Evoked Compound Action Potential) measurements to determine threshold and MCL values. The system uses neural responses as feedback to automatically adjust stimulation parameters, replacing time-consuming behavioral methods with rapid objective measurements that provide real-time data for patient-specific fitting while significantly reducing adjustment time.
4Reliability
If stimulation current is increased in steps to reach MCL or THR, then adequate stimulation is achieved, but patient discomfort and tinnitus projections increase
Solution Approach 1:
The patent applies partial action by introducing intermediate tinnitus masking thresholds between the hearing threshold and MCL. Instead of directly increasing stimulation to MCL levels which causes discomfort, the system uses progressive steps including tinnitus masking thresholds that provide adequate stimulation for hearing improvement while stopping before reaching levels that cause significant patient discomfort or excessive tinnitus projections.
Data Source
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AI summary
A system is described for adjusting hearing implant operating parameters for electrode contacts in an implantable electrode array to minimize tinnitus in an implanted patient. A channel tinnitus masking stimulation level is measured for each electrode contact at which maximum tinnitus masking occurs, Ytin,n. A channel threshold stimulation level also is measured for each electrode contact that represents a lowest detectable stimulation level, Tmeas,n. And a channel maximum stimulation level is measured for each electrode contact that represents a maximum comfortable stimulation level, MCLmeas,n. Channel threshold stimulation level Tn and channel maximum stimulation level MCLn are then adjusted for each electrode contact as a function of the channel tinnitus masking stimulation level Ytin,n and tinnitus masking stimulation levels for adjacent electrode contacts, Ytin,adj.