1. Field of Invention
The present invention relates generally to cochlear implants having a lumen for receiving a stylet, and more particularly, to a cochlear implant with an improved lumen arrangement.
2. Related Art
A cochlear implant allows for electrical stimulating signals to be applied directly to the auditory nerve fibres of the patient, allowing the brain to perceive a hearing sensation approximating the natural hearing sensation. These stimulating signals are applied by an array of electrodes implanted into the patient's cochlea.
The electrode array is connected to a stimulator unit which generates the electrical signals for delivery to the electrode array. The stimulator unit in turn is operationally connected to a signal processing unit which also contains a microphone for receiving audio signals from the environment, and for processing these signals to generate control signals for the stimulator.
When inserting the implant into the patient's cochlea, great care must be taken to avoid damaging the delicate structure of the cochlea. Since the cochlea is a coiled structure, many cochlear implants are manufactured to have a natural curve to facilitate insertion and to fit more naturally in the cochlea once implanted.
However, while inserting a cochlear implant into the cochlea, it is necessary to straighten portions of the implant as it is being inserted, and then to allow it to naturally reassume its curled state after insertion by extracting the stylet from the lumen. To provide a means for straightening the implant, a rigid or semirigid spike, known as a stylet is used as a “spine” for the implant as it is being inserted. A portion of the implant, known as a lumen, receives the stylet during the insertion process.
According to one aspect of the present invention, an electrode lead for a medical implant is disclosed. The electrode lead comprises: a lumen portion at least partially defining a lumen for receiving a stylet; and a main portion configured to carry one or more electrodes, wherein the main portion is removably connected to the lumen portion.
In accordance with another aspect of the preset invention, a cochlear implant is disclosed. The cochlear implant comprises a stimulator and an electrode lead supporting an array of electrode contacts, the electrode lead comprising: a lumen portion at least partially defining a lumen for receiving a stylet; and a main portion configured to carry one or more electrodes, wherein the main portion is removably connected to the lumen portion.
Various aspects and embodiments of the present invention will now be described in detail with reference to the following drawings in which:
The various aspects of the present invention will now be described in detail with reference to one or more embodiments of the invention, examples of which are illustrated in the accompanying drawings. The examples and embodiments are provided by way of explanation only and are not to be taken as limiting to the scope of the invention. Furthermore, features illustrated or described as part of one embodiment may be used with one or more other embodiments to provide a further new combination.
It will be understood that the present invention will cover these variations and embodiments as well as variations and modifications that would be understood by the person skilled in the art.
During the following description, the term “lumen” will be used to refer to the cavity formed within the electrode lead or a portion of the electrode lead for receiving an insert such as a stylet.
While the various aspects of the present invention will be described with specific reference to a cochlear implant, it will be understood that the principles of the various aspects of the present invention may be applied to other types of medical implants. For example:
ABI (Auditory Brainstem Implant, electrode for hearing, placed in the brainstem) such as Cochlear Corporation's Nucleus 24 [R] Multichannel Auditory Brainstem Implant (Multichannel ABI)
The auditory brainstem implant consists of a small electrode that is applied to the brainstem where it stimulates acoustic nerves by means of electrical signals. The stimulating electrical signals are provided by a signal processor processing input sounds from a microphone located externally to the user. This allows the user to hear a certain degree of sound.
FES (Functional Electrical Stimulation) is a technique that uses electrical currents to activate muscles and/or nerves, restoring function in people with paralysis-related disabilities.
Injuries to the spinal cord interfere with electrical signals between the brain and the muscles, which can result in paralysis.
This SCS (Spinal Cord Stimulator) system delivers pulses of electrical energy via an electrode in the spinal area and may be used for pain management. An example of a commercially available system is the RESTOREPRIME system by Medtronic, Inc, USA.
Connecting lumen portion 13 to main electrode lead portion 14 is a temporary connector 40. Temporary connector 40 may be a polymer, and in one example, a resorbable polymer, such as Polyacrylic acid (PAA), Polyvinyl alcohol (PVA), Polyactic acid (PLA) or Polyglycolic acid (PGA), (or any combination thereof) which, after a preset time lapse, or upon contact with fluid, begins to soften or dissolve, allowing lumen portion 13 to be separated from main electrode lead portion 14. After implantation of the implant into the patient's cochlea, the surgeon can pull out both the stylet 20 and the lumen portion 13, leaving only the main electrode lead portion 14 in the cochlea. The result is an implant of reduced bulk, and no easy path for passage of fluid to cause infection.
In this embodiment, temporary connector 40 may be a similar material to that used in the examples given with reference to
Second temporary connector 50 may be of a different material such as a resorbable polymer—for example Polyacrylic acid (PAA), Polyvinyl alcohol (PVA), Polyactic acid (PLA) or Polyglycolic acid (PGA). This material is designed to dissolve more slowly than temporary connector 40, and may slowly release drugs such as antibiotics or neurotrophins into the cochlea to facilitate the healing and recovery process and reduce the likelihood of infection.
In a further embodiment of this aspect of the invention, the lumen portion 13 defining lumen 30 may be made entirely of the dissolving material as previously mentioned.
In yet a further embodiment as shown in
According to second and third aspects of the present invention, there is shown an embodiment of electrode lead 10 in which no stylet 20 and therefore no lumen 30 is required at all.
The function of this aspect of the invention may be enhanced by designing electrode lead 10 to have one or more grooves 15 which are filled with the swelling material 60. This further enhances the curling action of electrode 10 as material 60 swells.
Examples of suitable materials for swelling material 60 include any type of suitable water-expanding material. One example is Silastic A™ silicone polymer, mixed for example with a finely-ground NaCl as will be known to the person skilled in the art. The curling effect can be even further enhanced by proving a layer of dissolvable material 70 on the side opposite the swelling material. Dissolving material 70 provides a counter force to swelling material 60 when it is present; however this counter force disappears once material 70 has dissolved. This allows more precise design of curling parameters.
The degree of curling of electrode 10 can also be controlled by controlling the shape and volume of slits or grooves 15 and 16 during the manufacturing process for example. These may be balanced by the strength or resilience of the electrode 10.
In these embodiments, the dissolving layers of material 70 may also contain antibiotics, neurotrophins or other drug compounds.
It will of course be understood that any other combination of the layers, materials and slits or grooves may be used and will not be limited to only those illustrated.
While the embodiments described with reference to
In another embodiment, the portion of lumen portion 13 above the lumen 30 as seen in
According to a fourth aspect of the present invention, electrode lead 10 may be shaped to define a partial lumen 30 or at least a portion of the lumen 30, to retain stylet 20 in place, and a swelling material may then be used to eject stylet 20 from electrode lead 10 as required after insertion.
Once electrode lead 10 is inside the cochlea of the patient, a swelling material 80 coating a lower portion of partial lumen 30 begins to swell as shown in
In a further variation of this embodiment, as shown in
The various forms of electrode lead 10 described above may be made in any manner known as would be apparent to the person skilled in the art. For example, in manufacturing the electrode lead 10 shown in
In order to form the electrode array, the electrode contacts 12, 12′, 12″ are placed in a U-shaped holding die. In this case, the electrode contacts 12, 12′, 12″ may be welded or otherwise electrically connected to their respective electrode wires or conductors 11, 11′, 11″ in sequential order, starting from the most proximal electrode contact. Once all of the wires 11, 11′, 11″ have been connected to their respective electrode contacts 12, 12′, 12″, a droplet of adhesive 41, such as adhesive silicone, is placed in the trough of each electrode contact in order to secure the wires in place.
A production stylet (for example, a PTFE coated wire) is suspended or otherwise placed over the electrode array before filling each trough with more silicone. The production stylet is used to hold the electrode contacts in spaced relationship to each other and provide further support to the electrode array, and is later removed to form a lumen in the lead. The holding die is then placed in an oven to cure the silicone.
The formed electrode lead in one form, could then be split into two portions—the main lead portion 14 and the lumen portion 13, and then reconnected by applying an amount of material 40 between them and allowing this to set.
In an alternative method, prior to the step of introducing the production stylet, silicone may be poured into the trough to a level just above the electrode contacts and wires, allowed to cure, and then applying a layer of material 40 over the partially-constructed electrode lead. This partially-constructed electrode lead may then have the remainder of the silicone applied over the layer of material 40 using a production stylet to form the lumen, to form the 2-part electrode lead as shown in
In a further alternative method, the two parts 14 and 13 may be formed separately and then combined using material 40 as described above.
In forming the arrangement shown in
In forming the electrode lead as shown in
Once formed, the electrode lead 10 may then be removed from the U-shaped holding die and placed in a curved moulding die, if a curved electrode lead is desired, as will be known to the person skilled in the art. These methods may also be combined with appropriate parts or appropriately modified parts of methods as described in International Patent Application No. PCT/AU99/00391 (WO 00/71063) to the present applicant, previously incorporated by reference.
It will be understood that the above has been described with reference to particular embodiments and that many variations and modifications may be made within the scopes of the different aspects of the present invention.
Throughout the specification and the claims that follow, unless the context requires otherwise, the words “comprise” and “include” and variations such as “comprising” and “including” will be understood to imply the inclusion of a stated integer or group of integers, but not the exclusion of any other integer or group of integers.
The reference to any prior art in this specification is not, and should not be taken as, an acknowledgement of any form of suggestion that such prior art forms part of the common general knowledge.
Number | Date | Country | Kind |
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2007906554 | Nov 2007 | AU | national |
The present invention is a National Stage Application of International Application No. PCT/AU2008/001776, filed Dec. 1, 2008, which claims priority from Australian Patent Application No. 2007906554, filed Nov. 30, 2007, which is hereby incorporated herein by reference herein.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/AU08/01776 | 12/1/2008 | WO | 00 | 8/24/2010 |