1. Field of the Invention
The present invention relates generally to an implantable stimulator, and more particularly, to a sub-cranial vibratory stimulator.
2. Related Art
Hearing loss, which may be due to many different causes, is generally of two types, conductive and/or sensorineural. Conductive hearing loss occurs when the normal mechanical pathways of the outer and/or middle ear are impeded, for example, by damage to the ossicular chain or ear canal. Sensorineural hearing loss occurs when there is damage to the inner ear, or to the nerve pathways from the inner ear to the brain.
Individuals suffering from conductive hearing loss typically receive an acoustic hearing aid. Hearing aids rely on principles of air conduction to transmit acoustic signals to the cochlea. Typically, a hearing aid is positioned in the ear canal or on the outer ear to amplify received sound. This amplified sound is delivered to the cochlea through the normal middle ear mechanisms resulting in the increased perception of sound by the recipient.
In contrast to acoustic hearing aids, certain types of auditory prostheses, commonly referred to as bone conduction devices, convert a received sound into vibrations. The vibrations are transferred through a recipient's skull bone to the cochlea, causing generation of nerve impulses, which result in the perception of the received sound. Bone conduction devices may be used to treat a variety of types of hearing loss and may be suitable for individuals who cannot derive sufficient benefit from acoustic hearing aids, cochlear implants, etc., or for individuals who suffer from stuttering problems.
In one aspect of the invention, an apparatus is provided. The apparatus comprises an implantable actuator configured to be implanted between a recipient's skull bone and the recipient's dura mater to vibrate bodily fluid of the recipient and an isolation member formed from a vibration damping material. The isolation member is configured to be positioned between the implantable actuator and the recipient's skull bone and is configured to substantially mechanically decouple the implantable actuator from the recipient's skull bone.
In another aspect of the present invention, a sub-cranial component is provided. The sub-cranial component comprises a body formed from a vibration damping material configured to be implanted between a recipient's skull bone and the recipient's dura mater and an implantable actuator positioned in the body and configured to generate mechanical vibrations for delivery to bodily fluid of the recipient. The body is configured to substantially mechanically decouple the actuator from the recipient's skull bone to substantially prevent mechanical vibrations generated by the implantable actuator from passing through the body to the skull bone.
Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:
Bone conduction devices generally operate by converting a received sound into vibrations that are delivered to a recipient's cochlea via a direct or indirect coupling to a recipient's skull bone. For example, percutaneous bone conduction devices are directly coupled to a recipient's skull via a percutaneous abutment that extends from an implantable component. The implantable component is attached to the recipient's skull bone via one or more bone screws and vibration from the bone conduction device passes from the abutment through the implantable component to the skull.
In certain transcutaneous bone conduction devices, an external bone conduction device (or a portion thereof) includes an external magnetic plate that magnetically couples to an implantable component that includes an internal magnetic plate. The implantable component is attached to the recipient's skull bone via one or more bone screws and vibration from the bone conduction device passes from the external magnetic plate to the internal magnetic plate for delivery to the skull. Other transcutaneous bone conduction devices use an implantable component that includes an actuator. The actuator generates vibration that is delivered to the skull directly or via a portion of implantable component.
As such, an aspect of both percutaneous and transcutaneous bone conduction devices is that those devices transfer vibration to a recipient's skull bone for conduction to the cochlea. Embodiments presented herein are directed to a sub-cranial vibratory stimulator that bypasses, or at least partially bypasses, a recipient's skull bone and delivers vibration to fluid within a recipient's skull bone. More specifically, the sub-cranial vibratory stimulator comprises an actuator (transducer) that is configured to be implanted beneath a recipient's skull bone. The actuator transfers vibration to the fluid within the recipient's skull without first passing through the skull bone. The actuator is also substantially mechanically decoupled (isolated) from the recipient's skull bone.
The electronics module 102 is configured to be positioned adjacent an outer surface 106 of a recipient's skull bone 108 beneath a recipient's skin/tissue 111. In certain circumstances, the electronics module 102 is positioned in a natural or surgically formed recess of skull bone 108. In the same or other embodiments, the electronics module 102 may be secured to the skull bone 108 via, for example, one or more bone screws, a biocompatible adhesive, etc. The electronics module 102 comprises a housing 110, a processor (e.g., sound processor) 112, an internal coil 114, a transceiver module 115, and a magnet 116 fixed relative to the internal coil 114. The processor 112, internal coil 114, and magnet 116 are positioned in housing 110.
The sub-cranial component 104 is configured to be inserted through an opening 118 in the recipient's skull 108. Following implantation, the sub-cranial component 104 is positioned adjacent to an inner surface 120 of the skull bone 108 between the skull bone and the recipient's dura mater 122 (
As shown in
In the embodiment of
Positioned in the housing 132 are a transceiver module 136, power source (battery) 137, external coil 138, and magnet 140. The magnet 140 is fixed relative to the external coil 138 and is configured to magnetically couple to the magnet 116 in electronics module 102. The coils 138 and 114 form a transcutaneous link that enables the electronics module 102 to receive signals from, or transmit signals to, the external device 130. The magnets 140 and 116 facilitate the operational alignment of the coils 138 and 114. In certain examples, external coil 138 transmits electrical signals (e.g., power and stimulation data) to internal coil 114 via a radio frequency (RF) link. It is to be appreciated that various types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, may alternatively or additionally be used to transfer the power and/or data from external device to electronics module 102.
In operation, sound input element 134 converts received sound signals into electrical signals or receives electrical signals representative of sound. These electrical signals are transferred to electronics module 102 via the coils 138 and 114. The processor 112 processes the electrical signals to generate control signals that cause the actuator 124 to generate vibration. In other words, the actuator 124 converts electrical control signals received from the processor 112 (via lead wire 128) into mechanical vibrations.
It is to be appreciated that the external device 130 may take a number of different arrangements. In certain embodiments, the external device 130 may be a Behind-The-Ear device. In other embodiments, the external device 130 may be a button processor, a body worn processors, etc.
In certain embodiments, the sub-cranial vibratory stimulator 100 may be a totally implantable device. As such, elements of the external device 130 (e.g., sound input element, battery, etc.) may be incorporated in, for example, the electronics module 102
As noted above, the isolation member (body) 126 is configured to mechanically decouple the actuator 124 from the recipient's skull bone 108. More specifically, when the actuator 124 generates mechanical vibrations, the isolation member 126 is configured to substantially prevent those vibrations from passing through the isolation member 126 to the recipient's skull bone 108. Isolation member 126 is formed from a vibration damping material such as silicon.
It is to be appreciated that a range of possible materials other than silicone could be used to form the isolation member 126. Other materials include, but are not limited to, polyurethane, polyester, polyphenylsulfone (PPSU), polyether ether ketone (PEEK), epoxy. Metals such as platinum, platinum/iridium, tungsten and titanium may be incorporated into, or form part of, the isolation member 126. Also layers of these materials or composites of these materials may also be used. Multiple materials may be used to obtain damping characteristics from both materials, or create a specific damping characteristic. This could be used to target the damping to a specific frequency range that causes feedback.
As shown in
A typical bone conduction may be suitable for recipients with a conductive hearing loss of up to 55-65 dB HL. A vibratory stimulator in accordance with embodiments presented herein could be used to provide hearing rehabilitation to recipient's with a greater degree of hearing loss. For instance, a vibratory stimulator could be used for recipients with a conductive hearing loss of up to 55-75 dB HL.
The sub-cranial vibratory stimulator 100 uses only mechanical vibration to compensate for hearing loss and no additional stimulation component, such as an implanted electrode array, middle ear implant, etc. is utilized. Additionally, the coils 128 and 114 and the processor 112 may be designed to only support vibratory stimulation.
As noted, bone conduction devices operate to transfer mechanical vibrations to a recipient's skull bone. However, mechanical vibration passing through a recipient's skull bone may experience mechanical losses. As such, bone conduction devices generally generate the mechanical vibrations with sufficient magnitude that compensates for the losses that occur within the skull bone. The generation of higher magnitude vibrations that compensate for bone losses requires the use of higher power actuators within bone conduction devices. In one specific example, an actuator of a bone conduction device has power requirements of approximately 1.45 milliwatts (mW) (while operating in a quiet environment) to 8.12 mW (while operating in a noisy environment).
Also as noted above, a sub-cranial vibratory stimulator in accordance with embodiments presented herein is configured to at least partially bypass the skull bone and deliver vibration to bodily fluid (e.g., CSF) within a recipient's skull directly or via the recipient's dura mater. In contrast to the skull bone, mechanical vibrations passing through bodily fluid generally experience minimal losses (i.e., bodily fluid is a substantially loss-less conductor of mechanical vibrations). As such, sub-cranial vibratory stimulators in accordance with embodiments presented herein have a more direct pathway to the middle/inner ear and may use lower power actuators (relative to those used in bone conduction devices) because there is no longer a need to compensate for vibration losses introduced by the skull bone.
For example, in accordance with certain embodiments presented herein, a sub-cranial vibratory stimulator, such as sub-cranial vibratory stimulator 100, may include a low-power actuator 124. In one specific example, a low-power actuator 124 has power requirements of approximately 0.1 mW. In other examples, a low-power actuator 124 has power requirements of less than approximately 1 mW. In certain embodiments, the low-power actuator 124 is a piezoelectric actuator/transducer made from a range of materials including ceramics, crystals and nano-materials. The low-power actuator 124 could also be an electromagnetic transducer, such as a balanced armature transducer or a range of rotational transducers, or a floating mass transducer. In accordance with embodiments presented herein, the transducer is, or includes elements that are, configured to deform in shape to generate vibrations within the recipient's bodily fluid.
In certain embodiments, the coils 128 and 114 and the processor 112 may be designed to only support vibratory stimulation (i.e., not designed for electrical stimulation). The use of vibratory-specific coils and/or a processor may reduce power requirements, simplify operation, and/or reduce costs.
A sub-cranial component of a sub-cranial vibratory may have different positions underneath a recipient's skull. For example,
In certain embodiments, the lead wire and connection to the actuator facilitate the positioning of a sub-cranial component in a particular sub-cranial position.
In the embodiment of
More specifically, the transition region 250 comprises a first angle 252 and a second angle 254. The first and second angles 252 and 254 face in substantially opposing directions forming the zigzag shape of the transition region 250.
In the embodiment of
As noted above, a sub-cranial component of a sub-cranial vibratory stimulator in accordance with embodiments presented herein is configured to be positioned between a recipient's skull and the recipient's dura mater. The dura mater is a thick membrane forming the outermost of three layers that surround the brain and is responsible for retaining the CSF. In general, if a sub-cranial component has too great of a thickness, then the sub-cranial component may significantly displace the dura mater in a manner that places a continuous force on the recipient's brain. A continuous force on the recipient's brain could change the brain shape that may result in a functional or cognitive change in the brain. As such, a feature of the sub-cranial component in accordance with embodiments presented herein is that the sub-cranial component is relatively thin so as to cause minimal displacement of dura mater and, accordingly, to have little or no long term effects on the brain shape. In general, the sub-cranial component has a thickness that is less than approximately five (5) millimeters (mm) deep. The width and/or length of the sub-cranial component may be substantially greater than 5 mm.
The body 362 has a generally rectangular shape where the lateral surface 318 generally has four sides connected by rounded corners. Positioned in the body 362 is an actuator (not shown in
In the illustrative embodiments of
In the embodiment of
It is to be appreciated that the dimensions of the sub-cranial component 304 of
The body 462 has a generally cylindrical or disk (i.e., a flattened-circular) shape. Positioned in the body 462 is an actuator (not shown in
In the illustrative embodiments of
In the embodiment of
It is to be appreciated that the dimensions of the sub-cranial component 404 of
It is to be appreciated that the shapes of bodies 362 and 462 shown in
In general, a body of a sub-cranial component in accordance with embodiments presented herein is configured to provide feedback isolation and provides a top surface area that operates with a recipient's skull bone to retain the sub-cranial component in an implanted position. More specifically, in accordance with certain embodiments presented herein, sub-cranial components are implanted in the recipient and are not secured to the recipient's skull bone. Instead, the large surface area of the top surface interacts with the bottom surface of the recipient's skull bone (possibly via force applied by the dura mater) to retain an implanted position. In certain embodiments, the top surface of a sub-cranial component may include one or more surface features that are configured to enhance the interaction (e.g., friction, integration, etc.) between the top surface of the sub-cranial component and recipient's skull.
The top surface 566 includes surface features 570 in the form of a plurality of recesses in the top surface 566. The recesses 570 include a plurality of spaced grooves or troughs 572 separated by ridges 574. The grooves 572 are, in this embodiment, elongate concave grooves having a radius of curvature and extending substantially across the surface 566. Similarly, the ridges 574 are, in this embodiment, elongate convex ridges having a radius of curvature and extend substantially across the surface 566. In general, the grooves 572 and ridges 574 function to increase the surface area of the surface 666 (relative to a planar surface) so as to increase the interaction between the sub-cranial component 504 and the recipient's skull bone. The grooves 572 and/or ridges 574 may have cross-sectional shapes that are rectangular, triangular, trapezoidal, L-shaped, T-shaped, J-shaped, dovetailed, frustoconical, etc.
It is to be appreciated that the surface features of
The top surface 666 includes surface features 670 in the form of a plurality of pores in the top surface 666. The pores 670 may have irregular shapes configured to encourage osteoconduction and/or osseointegration of the recipient's skull with the top surface 666. Osteoconduction and/or osseointegraton may create an interlock between the top surface 666 and the recipient's skull bone so as to maintain the sub-cranial component 604 in an implanted position.
For example, in certain embodiments screws or other fasteners may be used to secure the sub-cranial component to the recipient's skull bone. In such embodiments, the body of the sub-cranial component may include apertures configured to receive fasteners. Alternatively, the sub-cranial component may include one or more fastening members that extend from the body of the sub-cranial component that may be secured to the skull bone with a fastener. In one such embodiment, a fastening member has a length that can extend from the sub-cranial component through the opening in the recipient's skull for securement to an outer surface of the skull via, for example, a bone screw. Such fastening members may be formed from the same material as the body.
In embodiments in which fasteners are used to secure the sub-cranial component to the skull bone, the body operates to prevent the fasteners from providing a pathway for vibrations to the skull. In other words, in embodiments that use fasteners, the body still operates as an isolation member that substantially mechanical decouples the actuator from the skull bone.
In the embodiment of
The sub-cranial component 804 comprises an actuator 824 positioned in a body 826. The body 826 is formed from a vibration damping material and operates as an isolation member. Additionally, the material used to form body 826, or at least portions 890 of the body 826, is a flexible material that may be folded, bent, or otherwise manipulated into a compressed configuration to enable insertion through an opening in a recipient's skull bone. In the embodiment of
After the sub-cranial component 804 is inserted through an opening in the recipient's skull, the sub-cranial component 804 is configured to adopt the expanded configuration shown in
The sub-cranial component 904 comprises an actuator 924 positioned in a body 926. The body 926 is formed from a vibration damping material and operates as an isolation member. Additionally, the material used to form body 926, or portions thereof, is configured to expand (swell) when exposed to a recipient's bodily fluid. More specifically, after the sub-cranial component 904 is inserted through an opening in the recipient's skull, the sub-body 826 swells to the expanded configuration shown in
A sub-cranial vibratory stimulator in accordance with embodiments presented herein comprises an actuator configured to vibrate fluid within a recipient's skull directly (i.e., without first vibrating the recipient's skull bone). The use of an actuator that at least partially bypasses a recipient's skull bone may lower the power needed and enables a range of previously unavailable low-power actuators to be used to treat hearing loss. In general, the actuator is part of a sub-cranial component that is non-bone fixated or has limited bone fixation, thereby reducing or eliminating feedback pathways that may pose problem with bone anchored devices. The positioning of the actuator beneath a recipient's skull provides protection from external forces, thereby enabling the use of previously unavailable fragile material to be used as part of the sub-cranial component. Finally, in certain circumstances a sub-cranial vibratory stimulator may be activated (i.e., turned on after surgical implantation) faster than traditional bone conduction devices as there may be no or limited need for osseointegration.
The invention described and claimed herein is not to be limited in scope by the specific preferred embodiments herein disclosed, since these embodiments are intended as illustrations, and not limitations, of several aspects of the invention. Any equivalent embodiments are intended to be within the scope of this invention. Indeed, various modifications of the invention in addition to those shown and described herein will become apparent to those skilled in the art from the foregoing description. Such modifications are also intended to fall within the scope of the appended claims.