Systems and methods for intra-surgical monitoring of evoked responses that occur during an electrode lead insertion procedure

Patent metadata

Field	Value
Publication number	US-11090485-B2
Application number	US-201515768492-A
Country	US
Kind code	B2
Filing date	Nov 3, 2015
Priority date	Oct 13, 2015
Publication date	Aug 17, 2021
Grant date	Aug 17, 2021

Abstract

An exemplary monitoring system 1) receives a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes and an extracochlear electrode, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the monitoring system, 2) directs, in response to the user input command, the cochlear implant to short an intracochlear electrode with the extracochlear electrode, 3) presents the acoustic stimulation to the patient, and 4) records the evoked responses that occur in response to the acoustic stimulation by using the intracochlear electrode to detect signals representative of the evoked responses and receiving the detected signals by way of the extracochlear electrode and the probe.

First claim

What is claimed is:

1. A system comprising:
a sound processor included in an electro-acoustic stimulation (“EAS”) system and physically and communicatively coupled to a loudspeaker, the sound processor configured to:
receive, from a programming system communicatively coupled to the sound processor, a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes disposed on a distal portion of the lead that are configured to be located within the cochlea when the insertion procedure is completed and an extracochlear electrode configured to be located external to the cochlea when the insertion procedure is completed, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the sound processor,
transmit, in response to the user input command and by way of a wireless link, a command to the cochlear implant to short an intracochlear electrode included in the array of intracochlear electrodes with the extracochlear electrode,
present, while the intracochlear electrode is shorted with the extracochlear electrode, the acoustic stimulation to the patient by way of the loudspeaker, and
record the evoked responses that occur in response to the acoustic stimulation by using the intracochlear electrode to detect signals representative of the evoked responses, receiving the detected signals by way of the extracochlear electrode and the probe, and converting the detected signals from analog signals representative of the evoked responses into digital signals representative of the evoked responses.

2. The system of claim 1 , wherein the sound processor is configured to convert the detected signals from the analog signals to the digital signals by using an analog-to-digital converter included in the sound processor and that is also used by the sound processor to convert analog audio signals detected by a microphone that is communicatively coupled to the sound processor into digital audio signals.

3. The system of claim 1 , further comprising a programming system communicatively coupled to the sound processor, wherein the sound processor is configured to transmit data representative of the evoked responses to the programming system.

4. The system of claim 3 , wherein the programming system is configured to:
present a graphical user interface during the insertion procedure;
transmit the user input command to the sound processor in response to a selection by a user of an option included in the graphical user interface;
display, within the graphical user interface based on the data representative of the evoked responses, graphical information associated with the evoked responses.

5. The system of claim 4 , wherein the graphical information associated with the evoked responses comprises at least one of a graph that represents amplitudes of the evoked responses, a graph that represents a current time domain waveform of the evoked responses, or a graph that represents a current frequency domain waveform of the evoked responses.

6. The system of claim 4 , wherein the programming system is further configured to present an option for the user to select which intracochlear electrode is to be shorted with the extracochlear electrode during the insertion procedure.

7. The system of claim 1 , further comprising an amplifier that is physically and communicatively coupled to the probe and to the sound processor, wherein the amplifier is configured to:
receive the detected signals by way of the extracochlear electrode and the probe;
amplify the detected signals, wherein the amplification results in a plurality of amplified signals; and
transmit the amplified signals to the sound processor;
wherein the sound processor is configured to receive the detected signals by receiving the amplified signals.

8. The system of claim 1 , wherein the extracochlear electrode comprises a ring electrode.

9. The system of claim 1 , wherein the evoked responses comprise electrocochleography signals.

10. A system comprising:
a sound processor included in an electro-acoustic stimulation (“EAS”) system; and
a programming system communicatively coupled to the sound processor and configured to:
receive a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes disposed on a distal portion of the lead that are configured to be located within the cochlea when the insertion procedure is completed and an extracochlear electrode configured to be located external to the cochlea when the insertion procedure is completed, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the programming system,
transmit the user input command to the sound processor, wherein the sound processor is configured to direct, based on the user input command, the cochlear implant to short the intracochlear electrode with the extracochlear electrode by transmitting, in response to receiving the user input command from the programming system, a command to the cochlear implant by way of a wireless link that communicatively couples the sound processor and the cochlear implant, and
record the evoked responses that occur in response to acoustic stimulation that is applied to the patient during the insertion procedure by receiving, by way of the extracochlear electrode and the probe, signals representative of the evoked responses and converting the signals from analog signals representative of the evoked responses into digital signals representative of the evoked responses.

11. The system of claim 10 , wherein the sound processor is configured to present the acoustic stimulation to the patient by way of a loudspeaker.

12. The system of claim 10 , wherein the programming system is configured to present the acoustic stimulation to the patient by way of a loudspeaker.

13. The system of claim 10 , further comprising an evoked potential machine communicatively coupled to the programming system and configured to present the acoustic stimulation to the patient by way of a loudspeaker.

14. The system of claim 10 , further comprising an amplifier that is physically and communicatively coupled to the probe and to the programming system, wherein the amplifier is configured to:
receive the signals by way of the extracochlear electrode and the probe;
amplify the signals, wherein the amplification results in a plurality of amplified signals; and
transmit the amplified signals to the programming system;
wherein the programming system is configured to receive the signals by receiving the amplified signals.

15. The system of claim 10 , wherein the extracochlear electrode comprises a ring electrode.

16. The system of claim 10 , wherein the evoked responses comprise electrocochleography signals.

17. The system of claim 10 , wherein the programming system is configured to:
present a graphical user interface during the insertion procedure;
receive the user input command in response to a selection by a user of an option included in the graphical user interface; and
display, within the graphical user interface, graphical information associated with the evoked responses.

Assignees

• Koka Kanthaiah
• Litvak Leonid M
• Advanced Bionics Ag

Inventors

• Koka Kanthaiah
• Litvak Leonid M

Classifications

• A61N1/36039

  fitting procedures · CPC title

• A61N1/0541 Primary

  Cochlear electrodes · CPC title

• A61B5/38

  Acoustic or auditory stimuli · CPC title