The invention relates to a hearing assistance system comprising a cochlear implant device for neural stimulation of the cochlea and a fitting device for adjusting the cochlear implant device.
Typically, cochlear implants comprise an electrode array for electrical stimulation of the cochlear at various stimulation sites determined by the position of the respective electrode. Systems for bimodal stimulation of the hearing comprise a cochlear implant at the ipsilateral ear and a device for acoustic stimulation of the ipsilateral ear or the contralateral ear. Systems with electric and acoustic stimulation of the same ear are also known as hybrid devices or EAS devices. In systems with contralateral acoustic stimulation the acoustic stimulation device typically is an (electro-acoustic) hearing aid.
In a cochlear implant (CI) a frequency allocation map specifies which frequency sub-ranges (frequency band) of the input audio signal (i.e. the audio signal provided by the microphone and/or an external audio source) are assigned to each stimulation channel, with the stimulation channels being formed by the implant electrodes. Over time, a CI patient adapts to his specific frequency allocation, so that a modification of the specific frequency allocation may result in an acceptance problem. For example, a need to modify the frequency allocation of the CI may occur in cases in which a patient first is provided with a CI with electrical stimulation only and later is provided in addition with acoustic stimulation of the same ear (EAS system) or of the other ear (bimodal system). Typically, the lower input signal frequencies are selected for acoustic stimulation, while the remaining higher input signal frequencies are selected for electrical stimulation.
U.S. Pat. No. 8,571,674 B2 relates to an iterative fitting method for a multimodal hearing assistant system including electrical and acoustic stimulation.
EP 1 702 496 B1 relates to fitting method for a CI device, wherein a fitting curve resulting from an allocation of the input frequencies to the output channels according to a logarithmic function can be manually adjusted with regard to its position and slope via a graphical user interface comprising a first slider for adjusting the slope and a second slider for adjusting the frequency axis intercept.
US 2005/0261748 A1 relates to a fitting method for a hybrid device used by a patient having residual acoustic hearing capability at the ipsilateral ear, wherein the portion of the cochlea having residual acoustic hearing capability is determined by measuring the neural response to acoustic and/or electrical stimulation.
US 2011/0238176 A1 likewise relates to a fitting method for a hybrid device, wherein a tonotopic response for the residual hearing of the ipsilateral cochlear is measured to obtain a place-frequency map.
U.S. Pat. No. 8,155,747 B2 relates to a method of fitting a bilateral hearing system comprising a CI device at one ear and a hearing aid at the other ear.
It is an object of the invention to provide for a hearing assistance system comprising a CI device and a fitting device, which allows for a frequency allocation in a manner which is both convenient to the user of the fitting device and acceptable to the CI patient. It is a further object to provide for a corresponding fitting method.
These objects are achieved by a system as defined in claim 1 and a method as defined in claim 22.
The invention is beneficial in that, by enabling the user to select a value of a matching frequency located in between the lower cutoff frequency and the upper cutoff frequency of the input audio signal, the input audio signals frequencies can be divided into two regions, namely a first region extending from the matching frequency to the upper cutoff frequency, which keeps its frequency allocation, and a second region extending from the modified lower cutoff frequency to the mapping frequency, wherein the frequency allocation can be modified in order to adapt it to the increased lower cutoff frequency. Thereby, the user of the fitting device is enabled to provide, in a very simple manner requiring selection of only a single parameter, namely the mapping frequency, for a relatively smooth transition between a previous frequency allocation and a modified frequency allocation having an increased lower cutoff frequency. This is particularly useful, for example, in case that a CI patient is later provided with additional acoustic stimulation which may require an increase of the lower cutoff frequency of the frequency range of the input audio signal supplied to electric stimulation.
Preferred embodiments of the invention are defined in the dependent claims.
Hereinafter, examples of the invention will be illustrated by reference to the attached drawings, wherein:
It is to be understood that the programming unit 13 is used with the CI device 10 only for adjustment/fitting, but not during normal operation of the CI device 10.
In
Stimulation sub-system 12 serves to generate and apply electrical stimulation (also referred to herein as “stimulation current” and/or “stimulation pulses”) to stimulation sites at the auditory nerve within the cochlea of a patient 17 in accordance with the stimulation parameters received from the sound processing sub-system 11. Electrical stimulation is provided to the patient 17 via a CI stimulation assembly 18 comprising a plurality of stimulation channels, wherein various known stimulation strategies, such as current steering stimulation or N-of-M stimulation, may be utilized.
As used herein, a “current steering stimulation strategy” is one in which weighted stimulation current is applied concurrently to two or more electrodes by an implantable cochlear stimulator in order to stimulate a stimulation site located in between areas associated with the two or more electrodes and thereby create a perception of a frequency in between the frequencies associated with the two or more electrodes, compensate for one or more disabled electrodes, and/or generate a target pitch that is outside a range of pitches associated with an array of electrodes.
As used herein, an “N-of-M stimulation strategy” is one in which stimulation current is only applied to N of M total stimulation channels during a particular stimulation frame, where N is less than M. An N-of-M stimulation strategy may be used to prevent irrelevant information contained within an audio signal from being presented to a CI user, achieve higher stimulation rates, minimize electrode interaction, and/or for any other reason as may serve a particular application.
The stimulation parameters may control various parameters of the electrical stimulation applied to a stimulation site including, but not limited to, frequency, pulse width, amplitude, waveform (e.g., square or sinusoidal), electrode polarity (i.e., anode-cathode assignment), location (i.e., which electrode pair or electrode group receives the stimulation current), burst pattern (e.g., burst on time and burst off time), duty cycle or burst repeat interval, spectral tilt, ramp-on time, and ramp-off time of the stimulation current that is applied to the stimulation site.
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In
After appropriate automatic gain control, the digital signal is subjected to a filterbank 38 comprising a plurality of filters F1 . . . Fm (for example, band-pass filters) which are configured to divide the digital signal into m analysis channels 40, each containing a signal representative of a distinct frequency portion of the audio signal sensed by the microphone 20. For example, such frequency filtering may be implemented by applying a Discrete Fourier Transform to the audio signal and then distribute the resulting frequency bins across the analysis channels 40.
The signals within each analysis channel 40 are input into an envelope detector 42 in order to determine the amount of energy contained within each of the signals within the analysis channels 40 and to estimate the noise within each channel. After envelope detection the signals within the analysis channels 40 may be input into a noise reduction module 44, wherein the signals are treated in a manner so as to reduce noise in the signal in order to enhance, for example, the intelligibility of speech by the patient.
The optionally noise reduced signals are supplied to a mapping module 46 which serves to map the signals in the analysis channels 40 to the stimulation channels S1 . . . Sn. For example, signal levels of the noise reduced signals may be mapped to amplitude values used to define the electrical stimulation pulses that are applied to the patient 17 by the ICS 14 via M stimulation channels 52. For example, each of the m stimulation channels 52 may be associated to one of the stimulation contacts 19 or to a group of the stimulation contacts 19.
The sound processor 24 further comprises a stimulation strategy module 48 which serves to generate one or more stimulation parameters based on the noise reduced signals and in accordance with a certain stimulation strategy (which may be selected from a plurality of stimulation strategies). For example, stimulation strategy module 48 may generate stimulation parameters which direct the ICS 14 to generate and concurrently apply weighted stimulation current via a plurality 52 of the stimulation channels S1 . . . Sn in order to effectuate a current steering stimulation strategy. Additionally or alternatively the stimulation strategy module 48 may be configured to generate stimulation parameters which direct the ICS 14 to apply electrical stimulation via only a subset N of the stimulation channels 52 in order to effectuate an N-of-M stimulation strategy.
The sound processor 24 also comprises a multiplexer 50 which serves to serialize the stimulation parameters generated by the stimulation strategy module 48 so that they can be transmitted to the ICS 14 via the communication link 30, i.e. via the coil 28.
The sound processor 24 may operate in accordance with at least one control parameter which is set by a control unit 54. Such control parameters, which may be stored in a memory 56, may be the most comfortable listening current levels (MCL), also referred to as “M levels”, threshold current levels (also referred to as “T levels”), dynamic range parameters, channel acoustic gain parameters, front and back end dynamic range parameters, current steering parameters, amplitude values, pulse rate values, pulse width values, polarity values, the respective frequency range assigned to each electrode and/or filter characteristics. Examples of such auditory prosthesis devices, as described so far, can be found, for example, in WO 2011/032021 A1.
According to the example shown in
Generally, the pitch perception by the patient is determined by the frequency allocation function. An example of an initial mapping scheme/frequency allocation curve is shown at “A” in
A more practical example of an initial frequency allocation curve A is shown in
For several reasons, it may be necessary to modify the present frequency allocation curve, for example, when acoustic stimulation is added to a system which was previously used for electric stimulation only. In such cases it may be desirable to increase the lower cutoff frequency of the electric stimulation in order to avoid an undesired frequency overlap with the acoustic stimulation. For example, it may be desirable to increase the lower cutoff frequency from 350 Hz to 850 Hz, as shown in the example of
Alternatively or in addition, the fitting device 13 may provide for a default setting of such modified lower cutoff frequency fmin2.
For example, the modified lower cutoff frequency may be selected such that the upper cutoff frequency of the acoustic stimulation is not more than the modified lower cutoff frequency of the electric stimulation. Typically, the lower cutoff frequency of the acoustic stimulation is lower than the modified lower cutoff frequency of the electric stimulation, while the upper cutoff frequency of the acoustic stimulation may be equal to or higher than the modified lower cutoff frequency of the electric stimulation, but significantly lower than the upper cutoff frequency of the electric stimulation.
Usually, complete re-allocation of the analysis channels is not desired by the patient due to the fact that the patient's pitch perception is adapted to the frequency allocation function used so far. In order to avoid unpleasant hearing impressions by the patient as far as possible, the user of the fitting device 13 is enabled to select a matching frequency for the modified mapping scheme/frequency allocation curve. The selection of the mapping frequency has the effect that the allocation of frequencies above the matching frequency up to the upper cutoff frequency remains unchanged, whereas the frequencies below the matching frequency down to the modified lower cutoff frequency are re-allocated onto the stimulation channels according to the value of the modified lower cutoff frequency fmin2.
Preferably, the same type of allocation function is used for re-allocating the frequencies below the matching frequency as is used for allocating the frequencies below the matching frequency in the initial mapping scheme (this means in the example of
The fitting device 13 may provide some guidance to the user with regard to the selection of the matching frequency. For example, the fitting device 13 may suggest a default value which is determined as a function of the ratio of the modified lower cutoff frequency to the upper cutoff frequency. For example, the default value of the matching frequency may be selected such that it corresponds to the stimulation channel in the middle (corresponding to a 50% ratio, i.e. 50% of the relevant electrodes/electrode range) between the stimulation channel which corresponded in the initial mapping scheme to the modified lower cutoff frequency (channel #6 in the example of
Alternatively or in addition, the fitting device 13 may propose a range from which the matching frequency may be selected. According to one example, the upper limit of this selectable range may be increased with increasing total use time of the cochlear implant device, allowing for a more pronounced re-allocation once the patient already has adapted to a preceding re-allocation.
In general, the selection of a modified mapping scheme may be repeated at a later point in time in order to allow for gradual adjustment of the mapping scheme so as to enable the patient to gradually adapt to changes in the frequency allocation. Such repeatedly selected modified mapping schemes may have different lower cutoff frequencies and/or different matching frequencies. In the example of
According to one example, the matching frequency may be increased even up to the initial upper cutoff frequency fmax1; examples of such modified allocation curves are shown at D in
The above discussed concept of a variable/selectable matching frequency may be applied also to cases in which there is no need to preserve an adaptation of the patient to a previous frequency allocation. Such cases may occur, for example, if a
CI device is adapted for the first time to a new patient in order to provide for an individual setting for a the patient (in this case the modification of the mapping scheme would correspond to an adjustment/modification of a default frequency allocation function, such as curve A in
In the example of
According to one aspect of the invention, a default value of the modified upper cutoff frequency is selected as a function of the value of the modified lower cutoff frequency fmin2 such that the bandwidth of each analysis channel is substantially the same as in the initial mapping scheme, so that the logarithmic bandwidth allocated to each stimulation channel/electrode is substantially independent from the actually selected modified lower cutoff frequency. For example, in case of a logarithmic allocation function, as in
However, there may be a practical upper limit of the matching frequency, the bandwidth of the sound processor 24 or a maximum frequency relevant for speech perception (for example 8000 Hz), in case that the selected modified lower cutoff frequency is relatively high, such as 1600 Hz (in this case, for a logarithmic allocation function, the upper cutoff frequency would have to be increased from about 5000 Hz to 26000 Hz in order to keep the channel logarithmic bandwidth constant). This problem can also be mitigated by allowing a decreased logarithmic channel bandwidth as a function of the modified lower cutoff frequency, such that the practical upper limit of the matching frequency is just reached with the highest expected modified lower cutoff frequency.
Typically, the selected modified lower cutoff frequency will be higher than the default initial lower cutoff frequency.
Filing Document | Filing Date | Country | Kind |
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PCT/US14/37200 | 5/7/2014 | WO | 00 |