Various types of hearing prostheses may provide persons with different types of hearing loss with the ability to perceive sound. Hearing loss may be conductive, sensorineural, or some combination of both conductive and sensorineural hearing loss.
Conductive hearing loss typically results from a dysfunction in any of the mechanisms that ordinarily conduct sound waves through the outer ear, the eardrum, or the bones of the middle ear. Persons with some forms of conductive hearing loss may benefit from hearing prostheses such as acoustic hearing aids, bone anchored hearing aids, direct acoustic stimulation prostheses, or other types of vibration-based hearing prostheses.
Sensorineural hearing loss typically results from a dysfunction in the inner ear, including the cochlea where sound vibrations are converted into neural signals, or any other part of the ear or auditory nerve, that may process the neural signals. Persons with some forms of sensorineural hearing loss may benefit from hearing prostheses such as cochlear implants and auditory brain stem implants.
In some situations, it may be desirable to fully implant one or more components of the above-described hearing prostheses into the prosthesis recipient.
The present disclosure includes a description of various coupling systems for use with implantable microphones and implantable actuators associated with medical prostheses. In some embodiments, the medical prosthesis is a hearing prosthesis, such as a cochlear implant, a direct acoustic stimulation prosthesis, an auditory brain stem implant, an acoustic hearing aid, a bone anchored hearing aid or other type of vibration-based hearing prosthesis configured to transmit sound via direct vibration of teeth or other cranial or facial bones, an auditory brain stem implants, a hybrid prosthesis, or any other type of hearing prosthesis.
In some embodiments, the prosthesis includes a flexible elongate member having a first end mechanically coupled to a vibrating structure of a prosthesis recipient's body and a second end secured to a diaphragm. The flexible elongate member is configured to transfer vibrations between the vibrating structure and the diaphragm. The vibrating structure of the recipient's body may be any structure in the recipient's middle or inner ear, such as an eardrum, a malleus, an incus, a stapes, an oval window of the recipient's inner ear, a round window of the recipient's inner ear, a horizontal canal of the recipient's inner ear, a posterior canal of the recipient's inner ear, and a superior canal of the recipient's inner ear.
For microphone embodiments, the prosthesis may further include a vibration sensor configured to detect vibrations of the diaphragm and generate electrical signals based at least in part on the detected vibrations. The vibration sensor may be an electret microphone, an electromechanical microphone, a piezoelectric microphone, a MEMS microphone, an accelerometer, an optical interferometer, a pressure sensor, or any other type of vibration sensor.
For actuator embodiments, the prosthesis may further include an actuation mechanism configured to apply mechanical vibration signals to the vibrating structure of the recipient's body via the flexible elongate member by causing the diaphragm to vibrate. The mechanical vibration signals generated by the actuation mechanism are based on signals received from a sound processor associated with the prosthesis. Some prostheses may include one or more microphones and one or more actuators according to some of the disclosed embodiments.
In some embodiments, the first end of the flexible elongate member includes a contact. The contact may be a ball-shaped contact, a flat contact, a U-shaped contact, a contact shaped to receive the vibrating structure of the prosthesis recipient's body, or any other type of contact configured to transmit vibration between the contact and the vibrating structure of the prosthesis recipient's body.
In some embodiments, the contact may be secured to the vibrating structure with a biocompatible bonding agent such as bone cement. The contact may alternatively be mechanically coupled to the vibrating structure via a fixture that includes a socket configured to mechanically receive the contact. The fixture in some embodiments is secured to the vibrating structure of the recipient's body with bone cement. In some embodiments, the socket may be formed from bone cement.
The flexible elongate member is a solid but flexible wire in some embodiments. In other embodiments, the flexible elongate member is a coil-shaped flexible wire, where at least a portion of the coil-shaped flexible wire is configured to receive bone cement during implantation. The bone cement later hardens and reduces the flexibility of the elongate member. In further embodiments, the flexible elongate member includes at least one curved portion. In still further embodiments, the flexible elongate member comprises one or more rigid portions and one or more flexible portions. In even further embodiments, the flexible elongate member includes a set of one or more interconnected adjustable portions, such as ball-and-socket joints and/or hinges.
Alternative embodiments include internal and/or external support structures alone or in combination with flexible and/or rigid elongate members.
In alternative embodiments that include an internal support structure, a hearing prosthesis has an elongate member with a first end mechanically coupled to a vibrating structure of a prosthesis recipient's body and a second end attached to a first diaphragm. The elongate member is configured to transfer vibrations between the vibrating structure and the first diaphragm. The internal support structure is mechanically coupled to the first diaphragm and a second diaphragm. In operation, the internal structure is configured to transfer vibrations between the first diaphragm and the second diaphragm and to limit radial movement of the elongate member.
In alternative embodiments that include an external support structure, a hearing prosthesis has an elongate member with a first end mechanically coupled to a vibrating structure of a prosthesis recipient's body and a second end attached to a diaphragm. The elongate member is configured to transfer vibrations between the vibrating structure and the diaphragm. The external support structure at least partially encloses at least a portion of the elongate member so as to limit radial movement of the elongate member.
The following detailed description discloses various features and functions of various embodiments with reference to the accompanying figures. The figures are for illustration purposes and are not necessarily drawn to scale. In the figures, similar symbols typically identify similar components, unless context dictates otherwise. The example embodiments described herein are not meant to be limiting. Certain aspects of the example embodiments can be arranged and combined in a wide variety of different configurations, all of which are contemplated herein.
Certain aspects of the example embodiments may be described herein with reference to cochlear implant and direct acoustic stimulator embodiments. However, the claims are not so limited. Many of the features and functions described with respect to the cochlear implant and direct acoustic stimulator embodiments may be equally applicable to other embodiments that may include other types of hearing prostheses, such as, for example, acoustic hearing aids, bone anchored hearing aids or other types of vibration-based hearing prostheses configured to transmit sound via direct vibration of teeth or other cranial or facial bones, auditory brain stem implants, or any other type of hearing prosthesis. Additionally, certain features and functions may be applicable to other types of medical prostheses as well.
Hearing Prosthesis
The hearing prosthesis 101 includes a data interface 102, a microphone 103, a sound processor 104, an output signal interface 105, and data storage 106, all of which may be connected directly or indirectly via circuitry 107. In some embodiments, the hearing prosthesis 101 may have additional or fewer components than the prosthesis shown in
The data interface 102 may be any type of wired or wireless communications interface now known or later developed that can be configured to send and/or receive data. In operation, the data interface 102 is configured to send and/or receive data to and/or from an external computing device. The data sent from the external computing device to the hearing prosthesis 101 may be configuration data for the hearing prosthesis 101. The data sent from the hearing prosthesis 101 to the external computing device may be telemetry measurements taken by the prosthesis (in some embodiments) and/or data associated with the operation and function of the hearing prosthesis 101. Other data could be sent to and/or from the hearing prosthesis 101 via the data interface 102 as well.
The data storage 106 can be any type of non-transitory, tangible, computer readable media now known or later developed that can be configured to store program code for execution by the hearing prosthesis 101 and/or other data associated with the hearing prosthesis 101.
The microphone 103 of the hearing prosthesis 101 may be an external microphone, a partially-implanted microphone, or a fully-implanted microphone. In embodiments with external microphones and partially-implanted microphones, the microphone 103 may be configured to detect external sound waves 109 and generate electrical signals based at least in part on the external sound waves 109 for analysis by the sound processor 104.
In embodiments with fully-implanted microphones, the microphone 103 may be configured to detect vibrations and/or pressure changes inside the recipient's body. The vibrations and/or pressure changes may be based on external sound waves 109. For example, for a recipient having at least a partially functional middle ear, certain structures in the recipient's middle ear may vibrate in response to (or at least based on) external sound waves 109. Similarly, for a recipient having at least a partially functional inner ear, certain structures and/or cavities in the recipient's inner ear may vibrate or exhibit changes in pressure in response to (or at least based on) external sound waves 109. In embodiments with fully-implanted microphones, the microphone 103 may be configured to detect vibrations of certain middle and/or inner ear structures and/or pressure changes in certain inner ear cavities and structures, and then convert those detected vibrations and/or pressure changes into electrical signals that are indicative of the external sound waves 109 that caused the detected vibrations and/or pressure changes in the recipient's middle and/or inner ear.
The sound processor 104 is configured to receive electrical signals from the microphone 103, and generate instructions for generating and applying the output signals 110 to the recipient's ear via the output signal interface 105. The output signal interface 105 is configured to generate and apply the output signals 110 to the recipient's ear based on the instructions received from the sound processor 104.
In embodiments where the hearing prosthesis 101 is a cochlear implant, the output signal interface 105 may include an array of electrodes, and the output signals 110 may be a plurality of electrical stimulation signals applied to the recipient's cochlea via the array of electrodes (not shown). In embodiments where the hearing prosthesis 101 is a direct acoustic stimulator, the output signal interface 105 may include a mechanical actuator, and the output signals 110 may be a plurality of mechanical vibrations applied to the recipient's middle and/or inner ear via the mechanical actuator (not shown). In embodiments where the hearing prosthesis 101 is an acoustic hearing aid, the output signals interface 105 may be a speaker, and the output signals 110 may be a plurality of acoustic signals applied to the recipient's outer or middle ear via the speaker (not shown). In embodiments where the hearing prosthesis 101 is a bone-anchored hearing aid or other type of mechanical vibration based hearing prosthesis, the output signal interface 105 may include a mechanical actuator (not shown), and the output signals 110 may be a plurality of mechanical vibrations applied to the recipient's skull, teeth, or other cranial and/or facial bone via the mechanical actuator. In embodiments wherein the hearing prosthesis 101 is an auditory brain stem implant, the output signal interface 105 may include an array of electrodes, and the output signals 110 may be a plurality of electrical signals applied to the recipient's brain stem via the array of electrodes.
The diaphragm 206 of the microphone 201 is flexible and configured to vibrate. The thickness of the diaphragm 206 may be based on the material that the diaphragm 206 is made from and the location in the prosthesis recipient's body where the microphone 200 will be implanted. In some embodiments, the diaphragm 206 is made from titanium or a titanium alloy. The diaphragm 206 can be made from other biocompatible materials as well.
The biocompatible housing 201 of the microphone 200 encloses a vibration sensor (not shown) configured to detect vibrations of the diaphragm 206. The microphone 200 generates electrical signals based at least in part on the vibrations of the diaphragm 206 detected by the vibration sensor. In some embodiments, the enclosed vibration sensor may be an electret microphone, an electromechanical microphone, a piezoelectric microphone, a micro-electromechanical system (MEMS) microphone, an accelerometer, an optical interferometer, a pressure sensor, or any other device now known of later developed that is configured to detect vibrations.
The vibrating structure 204 of the prosthesis recipient's body may be any vibrating structure in the recipient's middle or inner ear. For example, the vibrating structure 204 may be any of the recipient's eardrum, ossicles (including any of the malleus, incus, or stapes), oval window, round window, horizontal canal, posterior canal, or superior canal. A physician, surgeon, or other trained medical professional typically makes the determination of which inner or middle ear structure to mechanically couple to the first end 203 of the flexible elongate member 202. Typically, the determination is based on an analysis of the recipient's middle and ear structures and the recipient's hearing capabilities.
The mechanical coupling between the first end 203 of the flexible elongate member 202 and the vibrating structure 204 may be accomplished in a variety of ways. For example, in some embodiments, the first end 203 can be a surface-to-surface mechanical contact with perhaps a slight loading force to hold the first end 203 in place against the vibrating structure 204. In other embodiments, the first end 203 may be secured to the vibrating structure 204 with bone cement or another type of biocompatible adhesive. Different ways to mechanically couple the first end 203 of the flexible elongate member 202 to the vibrating structure 204 are shown and described with respect to
The flexible elongate member 202 shown with the example microphone 200 depicted in
The flexible elongate member 202 of the microphone 200 is configured to transfer vibrations from the vibrating structure 204 to the diaphragm 206. Thus, the flexible elongate member 202 is sufficiently stiff to transfer vibration. However, in contrast to existing systems that employ rigid rods or other similar rigid structures, the flexible elongate member 202 is sufficiently flexible to bend and flex in response to forces applied thereto without causing damage to the diaphragm 206. Ideally, the flexible elongate member 202 exhibits a greater flexibility along a substantial portion of its length than a flexibility of the second portion 205 of the flexible elongate member 202 that is attached to the diaphragm 206.
In operation, elastic deformation of the flexible elongate member 202 in response to force (or forces) applied thereto minimizes any deformation of the diaphragm 206 and/or the second portion 205 (attaching the flexible elongate member 202 to the diaphragm 206) that would otherwise be caused by force (or forces) applied to a non-flexible elongate member. As a result, microphone 200 equipped with the flexible elongate member 202 is more robust and less prone to damage from the various forces encountered during manufacturing of the microphone 200, implantation of the microphone 200 into a recipient by a surgeon, and operation of the microphone 200 once implanted in the recipient's body. Additionally, in some embodiments, a microphone 200 configured with a flexible elongate member 202 may be fitted to a particular recipient's anatomy better than microphones with rigid rods or other similar structures. Different configurations of the flexible elongate member 202 for use with the microphone 200 are shown and described in more detail with respect to
The diaphragm 209 of the actuator 207 is flexible and configured to vibrate. The thickness of the diaphragm 209 may be based on the material that the diaphragm 209 is made from and the location in the prosthesis recipient's body where the actuator 207 will be implanted. In some embodiments, the diaphragm 209 is made from titanium or a titanium alloy. The diaphragm 209 can be made from other biocompatible materials as well.
The actuator 207 is similar to the microphone 200 in many respects. However, one difference between the actuator 207 of
The flexible elongate member 202 shown with the example actuator 207 depicted in
The flexible elongate member 202 of the actuator 207 is configured to transfer vibrations from the diaphragm 209 of the actuator 207 to the vibrating member 204 of the recipient's body. Although the flexible elongate member 202 is sufficiently stiff to transfer vibration, it is also sufficiently flexible to bend and flex in response to forces without causing damage to the diaphragm 209 of the actuator 207. Ideally, the flexible elongate member 202 exhibits a greater flexibility along a substantial portion of its length than a flexibility of the second portion 205 of the flexible elongate member 202 that is attached to the diaphragm 209.
In operation, elastic deformation of the flexible elongate member 202 in response to force (or forces) minimizes any deformation of the diaphragm 209 of the actuator 207 and/or the second portion 205 (attaching the flexible elongate member 202 to the diaphragm 209) that would otherwise be caused by force (or forces) applied to a non-flexible elongate member. As a result, the actuator 207 equipped with the flexible elongate member 202 is more robust and less prone to damage from the various forces encountered during manufacturing of the actuator 207, implantation of the actuator 207 into a recipient by a surgeon, and operation of the actuator 207 once implanted in the recipient's body. Additionally, in some embodiments, an actuator 207 configured with a flexible elongate member 202 may be fitted to a particular recipient's anatomy better than actuators with rigid rods or other similar structures. Different configurations of the flexible elongate member 202 for use with the actuator 207 are shown and described in more detail with respect to
Mechanically Coupling an Elongate Member to a Vibrating Structure
In
Elongate Member Configurations
Each example in
Like the flexible elongate members described elsewhere herein, the rigid elongate member 414 is configured to transfer vibrations between the diaphragm 413 and a vibrating structure (not shown) of the recipient's middle or inner ear that is mechanically coupled to a first end 402 of the rigid elongate member 414. One difference between the flexible elongate members described herein and the rigid elongate member 414 of
Example Microphone Configurations
The flexible elongate member 502 of
The microphone 500 also includes a vibration detector 506 and circuitry 509 enclosed within a biocompatible housing 501. The vibration detector 506 may be any of an electret microphone, an electromechanical microphone, a piezoelectric microphone, a MEMS microphone, an accelerometer, an optical interferometer, a pressure sensor, or any other type of vibration detector now known or later developed. A gas or liquid-filled chamber 507 exists between the diaphragm 505 and the vibration detector 506. For example, in embodiments where the vibration detector 506 is an electret microphone, MEMS microphone, accelerometer, or optical interferometer, the chamber 507 may be filled with gas such as helium or another gas. For embodiments where the vibration detector 506 is a piezoelectric microphone or pressure sensor, the chamber 507 may be filled with a liquid such as an oil, silicone gel, or other liquid. In operation, the vibration detector 506 is configured to detect vibrations of the diaphragm 505 and generate electrical signals based at least in part on the detected vibrations.
In some embodiments, electrical signals generated by the vibration detector 506 are sent to circuitry 509 via a wire 508 or other similar electrical connection mechanism. The circuitry 509 may include one or more discrete circuit components, one or more integrated circuits, and/or a special-purpose processor. In operation, the circuitry 509 is configured to prepare or condition the signal (e.g., amplification, etc.) for transmission to a sound processor, such as sound processor 104 shown and described with respect to
Although the example microphone 500 shown in
Microphone 511 includes a flexible elongate member 502 having a first end 503 mechanically coupled to a vibrating structure (not shown) of a prosthesis recipient's body and a second end 504 attached to a first diaphragm 505. In operation, the flexible elongate member 502 is configured to transfer vibrations between the vibrating structure (not shown) and the first diaphragm 505 in a manner similar to the flexible elongate members described herein with respect to
In operation, the internal support structure 512 is configured to transfer vibrations between the first diaphragm 505 and the second diaphragm 513 while also limiting radial movement of the flexible elongate member 502 along a direction parallel to the face of the first diaphragm 505. In some embodiments, the second diaphragm 513 is a spring bearing configured to limit radial movement of the flexible elongate member 502. By limiting radial movement of the flexible elongate member 502, the internal support structure 512 reduces the risk of damage to the first diaphragm 505 or the second diaphragm 513 that may result from force (or forces) applied to the flexible elongate member 502 along a direction parallel to the face of the first diaphragm 505, for example, during implantation of the microphone 511 in the recipient's ear and/or while positioning the flexible elongate member 502 during implantation. Thus, the protection against damage to the first diaphragm 505 (and/or the second diaphragm 513) provided by the internal support structure 512 may, at least in some embodiments, compliment the protection against diaphragm damage provided by the flexibility of the flexible elongate member 502.
Although the example microphone 511 shown in
Example Actuator Configurations
The actuator 600 includes a flexible elongate member 602 having a first end 603 mechanically coupled to a vibrating structure (not shown) of a prosthesis recipient's body and a second end 604 attached to a first diaphragm 605. The flexible elongate member 602 may be similar to any of the flexible elongate members shown and described herein with respect to
In operation, the flexible elongate member 602 is configured to transfer vibrations from the first diaphragm 605 to the vibrating structure (not shown) of the recipient's middle or inner ear in a manner similar to the flexible elongate members described herein with respect to
In operation, the actuation mechanism 606 enclosed within the biocompatible housing 601 is configured to generate vibrations based on signals received from a sound processor of the prosthesis. The vibrations generated by the actuation mechanism 606 are transferred to the second diaphragm 612, the internal support mechanism 611 transfers the vibrations of the second diaphragm 612 to the first diaphragm 605, and the flexible elongate member 602 transfers the vibrations of the first diaphragm 605 to the vibrating structure (not shown) of the recipient's middle or inner ear. The actuation mechanism 606 may be any of a piezoelectric stack, a piezoelectric disc, a MEMS-based activator, or any other type of vibration-generating device now known or later developed.
The internal support structure 612 is configured to transfer vibrations from the second diaphragm 612 to the first diaphragm 605 while also limiting radial movement of the flexible elongate member 602 along a direction parallel to the face of the first diaphragm 605. In some embodiments, the second diaphragm 612 is a spring bearing configured to limit radial movement of the flexible elongate member 602. By limiting radial movement of the flexible elongate member 602, the internal support structure 612 reduces the risk of damage to the first diaphragm 605 or the second diaphragm 612 that may result from force (or forces) applied to the flexible elongate member 602 along a direction parallel to the face of the first diaphragm 605, for example, during implantation of the actuator 600 in the recipient's ear and/or while positioning the flexible elongate member 602 during implantation. Thus, the protection against damage to first diaphragm 605 (or the second diaphragm 612) provided by the internal support structure 612 may, at least in some embodiments, compliment the protection against diaphragm damage provided by the flexibility of the flexible elongate member 602.
The actuator 600 also includes circuitry 609 enclosed within the biocompatible housing 601. The circuitry 609 may include one or more discrete circuit components, one or more integrated circuits, and/or a special-purpose processor. In operation, the circuitry 609 is configured to receive signals from a sound processor via a communications link 610. The communications link 610 may be any type of wired or wireless communications link. The communications link 610 may also be used to provide operating power to the actuator in some embodiments. In some embodiments, the actuator 600 may include a battery (not shown).
After receiving the signals from the sound processor, such as sound processor 104 shown and described with respect to
Although the example actuator 600 shown in
While various aspects and embodiments have been disclosed herein, other aspects and embodiments will be apparent to those skilled in the art. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting, with the true scope and spirit being indicated by the following claims.