The present invention relates to medical implants, and more specifically to cochlear implant systems.
There are both long term and short term implantable devices that are positioned next to the skull. For example, the housing of a cochlear implant is typically placed on the temporal bone of the patient. Middle ear implants are also placed on the temporal bone. Other implants may be placed on the parietal or occipital bone. Pressure sensor devices and deep brain stimulator may also need to be placed on the skull. Usually a flat bed is drilled on the skull to form a flat footprint that receives the implant housing.
Implantable devices are tending to become larger as more and more system functionality is added. Moreover, more young patients are receiving implantable devices such as cochlear implants. As a result, the location where the implant is placed may involve greater curvature of the skull in all directions. And if the implant is not on a flat surface, it may have a tendency to rock, especially on a convex surface. Rocking and/or micro-movement of the implant due to poor immobilization may lead to infection and inflammation of tissues over time. Rocking can also cause wire breakage over time. The fragile implant data wiring must exit from the implant housing toward various other internal locations such as a middle ear transducer, cochlear implant electrode, deep brain electrode, visual cortex electrode, auditory brain stem electrode, inferior colliculus electrode etc.
Another issue is the development of thinner profile implant housings for pediatric patients. For a given set of electronic components, a thinner implant housing requires a larger surface having a greater footprint. This further increases the issues associated with the flat implant housing contacting the curved skull surface. Thus, the need for self-stabilization of the implant housing also increases. This is especially true for pediatric patients who have a relatively thin cortical bone in which drilling of a flat bed may not be possible beyond a depth of less than 1 mm.
So far these problems have been addressed by reducing the footprint of the implant housing, placing the implant housing on the flattest part of the skull, and drilling a flat bed to accommodate the flat undersurface of the implant housing. But as the size of the implant housing increases, the amount of drilling for the bed footprint also increases dramatically, and multiple sites may need to be drilled.
These problems have also been handled by placing the flat implant housing directly on the curved surface of the skull without drilling a bed. This can lead over time to wire breakage, skin inflammation, rocking of the implant housing on the skull underneath the skin, and the requirement to place of the implant housing in a flat region of the skull as much as possible. An unstable implant may furthermore be laterally displaced causing tissue damage and possible wire breakage.
Embodiments of the present invention are directed to components of an implant system. An implant housing contains system components for performing system operating functions. An implant stabilizer extends out from the implant housing for interacting with an underlying curved bone surface to immobilize the implant housing in a fixed position.
In a more specific embodiment, the implant stabilizer may extend laterally away from the implant housing over the bone surface; for example, as one or more stabilizing wings made of polymer or silicone. In some embodiments, the implant stabilizer may be in the form of a mesh or grid, or made from a fabric material.
In some embodiments, the implant stabilizer may extend perpendicularly away from the implant housing onto the bone surface; for example, in the specific form of a compressible cushion adapted to conform to the bone surface. Or the implant stabilizer may include multiple positioning rods; for example, three. Some or all of the positioning rods may penetrate into the bone surface. The positioning rods may be made of a somewhat compressible polymer or metal. Or the implant stabilizer may be formed from a raised tread pattern for engaging the bone surface, such as from multiple pyramid shapes.
The implant stabilizer may be formed of a relatively flexible material that hardens over time. The implant stabilizer may be separable from the implant housing so that the implant housing can be removed without disturbing tissue around the implant stabilizer.
Embodiments of the present invention also are directed to components of an implant system where an implant data lead carries one or more system data signals, and an electrode stabilizer extends out from the data lead for interacting with an underlying curved bone surface to immobilize the data lead in a fixed position.
In a further such embodiment, the electrode stabilizer may extend laterally away from the implant data lead over the bone surface; for example, as a polymer or silicone stabilizing wing. The electrode stabilizer may be formed of a relatively flexible material that hardens over time. In addition or alternatively, the electrode stabilizer may be separable from the implant data lead so that the implant data lead can be removed without disturbing tissue around the electrode stabilizer.
Various embodiments of the present invention are directed to implantable components including an implant housing that contains system components for performing system operating functions. An implant stabilizer extends out from the implant housing for interacting with an underlying curved bone surface to immobilize the implant housing in a fixed position.
Stabilizing wings 103 and 105 are useful for stabilizing the implant structures since they can be placed under a periosteum pocket which is simply lifted from the skull surface. Very quickly after closure of the surgical incision, the stabilizing wings 103 and 105 are encapsulated by the healing tissue. The expanse of the stabilizing wings 103 and 105 around the implant housing 101 and stimulator electrode 104 respectively prevents undesired movement or migration of the implant structures.
Embodiments such as the ones described above having laterally extending stabilizer wings may be adequate to stabilize and fix the implanted components in their correct positions in many circumstances, but in other specific circumstances the stabilizing action may not be sufficient to completely prevent rocking of the implant components on a convex surface such as the skull bone. Rocking and movement can be further reduced or eliminated with a compressible stabilizer cushion underneath the bottom surface of the implant housing.
Another embodiment may have just a few compressible polymer rods distributed at key locations underneath the surface of the implant housing as shown in
The distribution, size and heights of the stabilizing posts 501 can be optimized to provide a useful cushion for support and stabilizing after some compression without compromising the thickness of the implant housing 101. The stabilizing posts 501, for example, may be only distributed at the edges of the implant housing 101 and provide a support for the edges of the implant housing 101 if it sits on a convex or tilted bone surface. The polymer material of the stabilizing posts 501 may be resiliently compressible, or may harden and rigidify over time. In some embodiments, the stabilizing posts 501 may be separable from the implant housing 101 so that the stabilizing posts 501 may be pre-attached to the bone surface 702 and then the implant housing 101 fitted over them. Such an arrangement would also facilitate later removal of the implant housing 101 for repair or replacement without disturbing the bone or tissue at the site of the stabilizing structure. And while the foregoing describes a specific embodiment based on the use of three stabilizing posts 501, the idea can be formulated more generally in the form of some number N posts: 3, 4, 5, etc. which may vary in specific embodiments.
As shown in
The height of the stabilizing spikes 701 should be such that even for a highly curved infant skull, the implant housing 101 is supported and stabilized in a fixed position. In such circumstances, the position and elevation of the stabilizing spikes 701 out from the bottom surface of the implant housing 101 controls the extent of their penetration into the bone surface 702. With infant skulls, the amount of penetration into the relatively thin skull bone will be limited by contact of the bottom surface of the implant housing 101 with the bone surface 702. For a relatively high bone curvature, as in young children with a small head, the stabilizing spikes 701 would only minimally penetrate into the bone surface 702 when the bottom surface of the implant housing 101 is in contact with the bone surface 702. For less bone curvature, as in adults, the stabilizer spikes 701 would penetrate more deeply into the bone surface 702. This does not pose a problem because of the greater thickness of the bone surface 702 underneath the implant housing 101, provided an appropriate shape and length of the stabilizing spikes 701. In some embodiments, the stabilizing spikes 701 may be separable from the implant housing 101 so that the stabilizing spikes 701 may be pre-attached to the bone surface 702 and then the implant housing 101 fitted over them.
Embodiments of the present invention allow implanted components to be stabilized in a fixed position on a non-uniform or tilted bone surface such as a curved skull without having to drill a flat bed adapted to the shape of the implant housing. Surgical time and risk also are reduced, and long-term stability of the implanted components is improved by preventing or minimizing movement of the implant data lead. Moreover, as implant housings continue to get thinner but larger, the implant stabilizer removes or reduces the need for extensive drilling to make a flat surface bed to receive the implant housing.
Although various exemplary embodiments of the invention have been disclosed, it should be apparent to those skilled in the art that various changes and modifications can be made which will achieve some of the advantages of the invention without departing from the true scope of the invention.
The present application claims priority from U.S. Provisional Application 61/090,758, filed Aug. 21, 2008, and from U.S. Provisional Application 61/102,984, filed Oct. 6, 2008; which are incorporated herein by reference.
Number | Date | Country | |
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61090758 | Aug 2008 | US | |
61102984 | Oct 2008 | US |