Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems
Patent
1998-12-15
2000-12-05
Getzow, Scott M.
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical therapeutic systems
A61N 136
Patent
active
061578614
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
The present invention relates to an implantable cochlear stimulator (ICS) and a method for fitting such ICS to a particular patient, where "fitting" refers to the process of determining and setting the amplitude or intensity of the stimuli generated by the ICS to a level or setting that is both effective (allows the ICS to optimally perform its intended function) and comfortable (not excessively loud or painful) for the patient. More particularly, the invention relates to a method of self-fitting an ICS to a particular patient using objective feedback rather than subjective feedback in order to determine stimulation parameters for the patient. The invention further relates to an ICS that includes implantable self-fitting circuitry.
An ICS is an electronic device that helps a profoundly deaf patient to achieve the sensation of hearing by applying electrical stimulation directly to the auditory nerve through the cochlea. An ICS includes electronic circuitry, hermetically sealed for implantation, and an electrode array (comprising a plurality of spaced-apart, independent, individual electrodes) suitable for insertion into the cochlea. An ICS system includes a microphone (for sensing audio sounds), a speech processor (for processing the sensed audio sounds and converting such to electrical stimulation signals), and a cochlear stimulator (for receiving the electrical stimulation signals and directing them to the appropriate electrode or electrodes of the electrode array). Typically, the microphone and speech processor are external components worn or carried by the patient, and the electrical stimulation signals produced by the speech processor are coupled into the implanted cochlear stimulator through an inductive, rf, or other wireless link.
Cochlear stimulators are known in the art, as evidenced, e.g., by U.S. Pat. Nos. 3,751,605 (Michelson); 4,400,590 (Michelson); 4,267,410 (Forster et al.); 4,284,856 (Hochmair et al.); 4,408,608 (Daly et al.); 4,428,377 (Zollner et al.); and 4,532,930 (Crosby et al.). All such stimulators generate electrical stimulation pulses that may be selectively applied to the cochlea of a patient through an appropriate electrode or electrode array.
When the implanted cochlear stimulator (ICS) is initially implanted in the patient, and during follow-up tests and checkups thereafter, it is usually necessary to fit the ICS to the patient. Such "fitting" includes adjustment of the base amplitude or intensity of the various stimuli generated by the ICS from the factory settings (or default values) to values that are most effective and comfortable for the patient. For example, the intensity or amplitude and/or duration of the individual stimulation pulses provided by the ICS must be mapped to an appropriate dynamic audio range so that the appropriate "loudness" of sensed audio signals is perceived. That is, loud sounds should be sensed by the patient at a level that is perceived as loud, but not painfully loud. Soft sounds should similarly be sensed by the patient at a level that is soft, but not so soft that the sounds are not perceived at all.
Fitting and adjusting the intensity of the stimuli and other parameters of a cochlear implant to meet a given patient's needs thus requires determining the electrical stimulation levels at which "sound" is perceived (threshold), at which a comfortable sound level (comfort level) is perceived, and the perceptual loudness growth function resolution within the patient's dynamic range. Heretofore, these psychophysical parameters have been determined by an expert clinician presenting various stimuli to the patient and relying on subjective feedback from the patient as to how such stimuli are perceived. Such subjective feedback typically takes the form of either verbal (adult) or non-verbal (child) feedback. Unfortunately, relying on subjective feedback in this manner is difficult, particularly for those patients who may have never heard sound before and/or who have never heard electrically-generated "sound". For young childre
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Faltys Michael A.
Loeb Gerald E.
Advanced Bionics Corporation
Getzow Scott M.
Gold Bryant R.
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