Extracochlear Cochlear Stimulation for Residual Hearing Preservation
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Solution Overview
Problem
Current cochlear implants pose a high risk of residual hearing loss and are invasive, making them less appealing for patients with good low-frequency hearing but poor high-frequency hearing, while hearing aids are inadequate for severe-to-profound hearing loss, leading to impaired speech comprehension.
Innovation Solution
Extracochlear stimulation devices that attach to the cochlear promontory or other external surfaces to deliver electrical stimuli, preserving residual hearing and improving high-frequency hearing without invasive surgery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a cochlear implant electrode is inserted into the cochlea to treat severe-to-profound hearing loss, then speech comprehension is improved, but the risk of residual hearing loss and damage to delicate inner ear structures increases
Solution Approach 1:
The patent divides the cochlea into different frequency regions (low-frequency apical region and high-frequency basal region) and applies different treatment strategies to each region, preserving the functional integrity of each segment while treating the specific hearing loss
Solution Approach 2:
The patent uses an intermediate approach by placing the electrode array in the scala tympani fluid space rather than directly inserting into neural tissue, using the cochlear fluid as an intermediary medium to transmit electrical stimulation while minimizing direct trauma to delicate structures
2Reliability
If a cochlear implant is used to treat severe hearing loss, then hearing function is restored, but the invasiveness of the procedure increases
Solution Approach 1:
The patent applies partial action by inserting the electrode array only into the scala tympani fluid space rather than penetrating through the cochlear bone and directly into the modiolus, achieving sufficient neural stimulation with reduced surgical invasiveness
Solution Approach 2:
The patent employs a flexible electrode array design that can be gently inserted into the scala tympani and conforms to the cochlear duct walls, reducing mechanical trauma compared to rigid electrode structures
3Reliability
If a hybrid cochlear implant is used for patients with good low-frequency hearing but poor high-frequency hearing, then high-frequency hearing is improved, but the risk of residual hearing loss remains high
Solution Approach 1:
The patent applies local quality by concentrating the electrode array insertion and electrical stimulation in the high-frequency basal region of the cochlea while deliberately avoiding the low-frequency apical region, providing targeted high-frequency hearing restoration while preserving low-frequency residual hearing
Solution Approach 2:
The patent segments the cochlear stimulation into frequency-specific zones, with the electrode array configured to stimulate primarily the high-frequency neural populations in the basal turn while leaving the low-frequency apical neural populations intact and functional
Data Source
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AI summary
Devices and methods for extracochlear stimulation are described herein. Such devices and methods may be configured for improving hearing in a subject in need thereof in any frequency range. In some embodiments, high frequency ranges are particularly targeted by the energy delivery elements provided herein. Low frequency ranges may be amplified by an acoustic amplifier, in various embodiments. Further, an external surface of the cochlea may be minimally prepared or altered prior to or during electrode placement on the cochlear surface. Such minimal preparation may include: disrupting mucosa on the external surface of the cochlea, applying an acid to the external surface of the cochlea, or applying a tissue growth factor to the external surface of the cochlea.