Patent Description:
<CIT> relates to a system which can apply acoustic stimulation including frequency sweep, wherein loudness perception by the recipient is assessed. The loudness perception experienced by the recipient is provided as a function of acoustic stimulation frequency as the stimulation intensity, i.e., the stimulation current, for each electrode, with the C-level forming the upper limit and the T-level forming the lower limit of each bar, as a function of the frequency range to which the respective electrode is mapped to. <CIT> relates to a fitting method for an electro-acoustic stimulation ("'EAS") system wherein an interactive effect that the acoustic stimulation has on the electric stimulation is determined for an electrode by measuring an evoked response that occurs in response to the concurrent application of the acoustic stimulation and the electrical stimulation and comparing the evoked response to a baseline response that occurs in response to an application of the electrical stimulation by itself or to a baseline response that occurs in response to an application of the acoustic stimulation by itself. If the evoked response is greater than the baseline response, the fitting facility may determine that the acoustic stimulation has an enhancing interactive effect on the electrical stimulation, and, if the evoked response is less than the baseline response, the fitting facility may determine that the acoustic stimulation has a suppressive interactive effect on the electrical stimulation; if the evoked response is substantially equal to the baseline response, the fitting facility may determine that the acoustic stimulation has substantially no interactive effect on the electrical stimulation.

The invention relates to an evoked response-based system for determining electrode positioning within a cochlea as defined in claim <NUM>. The evoked response measurements may be indicative of evoked responses that occur within the recipient in response to acoustic stimulation applied to the recipient. The evoked responses may each be an ECoG potential (e.g., a cochlear microphonic potential, an action potential, a summating potential, etc.), an auditory nerve response, a brainstem response, a compound action potential, a stapedius reflex, and/or any other type of neural or physiological response that may occur within a recipient in response to application of acoustic stimulation to the recipient. Evoked responses may originate from neural tissues, hair cell to neural synapses, inner or outer hair cells, or other sources.

As will be described herein, a peak amplitude value in the tuning curve corresponds to an electrode on the electrode lead that has the highest evoked response amplitude out of all the electrodes on the electrode lead in response to the acoustic stimulation. This may mean that the electrode is closer than all of the other electrodes on the electrode lead to the location within the cochlea that corresponds to the frequency of the acoustic stimulation. Hence, in some examples, the diagnostic system may identify a peak amplitude value in the tuning curve, identify an electrode on the electrode array that corresponds to the peak amplitude value, and map the frequency to the identified electrode. The mapping may include, for example, programming a sound processor to direct a cochlear implant connected to the electrode lead to apply electrical stimulation representative of the frequency by way of the identified electrode.

In some examples, the systems described herein are implemented by a stand-alone diagnostic system that includes a computing module and a base module configured to attach to the computing module (e.g., a back side of the computing module) and serve as a stand for the computing module. The computing module includes a display screen and a processor configured to direct the display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant. The base module houses an interface unit configured to be communicatively coupled to the processor and to a cochlear implant while the base module is attached to the computing module. In this configuration, the processor may be configured to <NUM>) detect a selection by a user of the option, <NUM>) direct, in response to the selection of the option, the interface unit to apply acoustic stimulation having a frequency to the recipient, <NUM>) direct the interface unit to instruct the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation, <NUM>) determine an amplitude of each of the evoked response measurements recorded by the plurality of electrodes, and <NUM>) present, within the graphical user interface, a tuning curve that graphically indicates the amplitudes of the evoked response measurements.

The systems described herein may advantageously allow a user to readily ascertain electrode positioning within a cochlea. For example, immediately following an electrode lead insertion procedure in which an electrode lead is inserted into a cochlea of a recipient of a cochlear implant, a surgeon or other user may utilize the systems and methods described herein to determine positioning of each of the electrodes on the electrode lead within the cochlea. This may allow the surgeon to verify correct placement of the electrode lead within the cochlea, determine that one or more adjustments to the placement of the electrode lead within the cochlea are to be made, and/or determine appropriate programming for a sound processor that is to be used with the cochlear implant. In other examples, a clinician may utilize the systems and methods described herein to appropriately adjust programming parameters for a sound processor used by the recipient during one or more follow-up visits subsequent to the initial electrode lead insertion procedure.

<FIG> illustrates an exemplary cochlear implant system <NUM>. As shown, cochlear implant system <NUM> may include a microphone <NUM>, a sound processor <NUM>, a headpiece <NUM> having a coil disposed therein, a cochlear implant <NUM>, and an electrode lead <NUM>. Electrode lead <NUM> may include an array of electrodes <NUM> disposed on a distal portion of electrode lead <NUM> and that are configured to be inserted into a cochlea of a recipient to stimulate the cochlea when the distal portion of electrode lead <NUM> is inserted into the cochlea. One or more other electrodes (e.g., including a ground electrode, not explicitly shown) may also be disposed on other parts of electrode lead <NUM> (e.g., on a proximal portion of electrode lead <NUM>) to, for example, provide a current return path for stimulation current generated by electrodes <NUM> and to remain external to the cochlea after electrode lead <NUM> is inserted into the cochlea. As shown, electrode lead <NUM> may be pre-curved so as to properly fit within the spiral shape of the cochlea. Additional or alternative components may be included within cochlear implant system <NUM> as may serve a particular implementation.

As shown, cochlear implant system <NUM> may include various components configured to be located external to a recipient including, but not limited to, microphone <NUM>, sound processor <NUM>, and headpiece <NUM>. Cochlear implant system <NUM> may further include various components configured to be implanted within the recipient including, but not limited to, cochlear implant <NUM> and electrode lead <NUM>.

Microphone <NUM> may be configured to detect audio signals presented to the user. Microphone <NUM> may be implemented in any suitable manner. For example, microphone <NUM> may include a microphone that is configured to be placed within the concha of the ear near the entrance to the ear canal, such as a T-MIC™ microphone from Advanced Bionics. Such a microphone may be held within the concha of the ear near the entrance of the ear canal during normal operation by a boom or stalk that is attached to an ear hook configured to be selectively attached to sound processor <NUM>. Additionally or alternatively, microphone <NUM> may be implemented by one or more microphones disposed within headpiece <NUM>, one or more microphones disposed within sound processor <NUM>, one or more beam-forming microphones, and/or any other suitable microphone as may serve a particular implementation.

Sound processor <NUM> may be configured to direct cochlear implant <NUM> to generate and apply electrical stimulation (also referred to herein as "stimulation current") representative of one or more audio signals (e.g., one or more audio signals detected by microphone <NUM>, input by way of an auxiliary audio input port, input by way of a clinician's programming interface (CPI) device, etc.) to one or more stimulation sites associated with an auditory pathway (e.g., the auditory nerve) of the recipient. Exemplary stimulation sites include, but are not limited to, one or more locations within the cochlea, the cochlear nucleus, the inferior colliculus, and/or any other nuclei in the auditory pathway. To this end, sound processor <NUM> may process the one or more audio signals in accordance with a selected sound processing strategy or program to generate appropriate stimulation parameters for controlling cochlear implant <NUM>. Sound processor <NUM> may be housed within any suitable housing (e.g., a behind-the-ear ("BTE") unit, a body worn device, headpiece <NUM>, and/or any other sound processing unit as may serve a particular implementation).

In some examples, sound processor <NUM> may wirelessly transmit stimulation parameters (e.g., in the form of data words included in a forward telemetry sequence) and/or power signals to cochlear implant <NUM> by way of a wireless communication link <NUM> between headpiece <NUM> and cochlear implant <NUM> (e.g., a wireless link between a coil disposed within headpiece <NUM> and a coil physically coupled to cochlear implant <NUM>). It will be understood that communication link <NUM> may include a bi-directional communication link and/or one or more dedicated uni-directional communication links.

Headpiece <NUM> may be communicatively coupled to sound processor <NUM> and may include an external antenna (e.g., a coil and/or one or more wireless communication components) configured to facilitate selective wireless coupling of sound processor <NUM> to cochlear implant <NUM>. Headpiece <NUM> may additionally or alternatively be used to selectively and wirelessly couple any other external device to cochlear implant <NUM>. To this end, headpiece <NUM> may be configured to be affixed to the recipient's head and positioned such that the external antenna housed within headpiece <NUM> is communicatively coupled to a corresponding implantable antenna (which may also be implemented by a coil and/or one or more wireless communication components) included within or otherwise associated with cochlear implant <NUM>. In this manner, stimulation parameters and/or power signals may be wirelessly transmitted between sound processor <NUM> and cochlear implant <NUM> via communication link <NUM>.

Cochlear implant <NUM> may include any suitable type of implantable stimulator. For example, cochlear implant <NUM> may be implemented by an implantable cochlear stimulator. Additionally or alternatively, cochlear implant <NUM> may include a brainstem implant and/or any other type of cochlear implant that may be implanted within a recipient and configured to apply stimulation to one or more stimulation sites located along an auditory pathway of a recipient.

In some examples, cochlear implant <NUM> may be configured to generate electrical stimulation representative of an audio signal processed by sound processor <NUM> (e.g., an audio signal detected by microphone <NUM>) in accordance with one or more stimulation parameters transmitted thereto by sound processor <NUM>. Cochlear implant <NUM> may be further configured to apply the electrical stimulation to one or more stimulation sites (e.g., one or more intracochlear regions) within the recipient via electrodes <NUM> disposed along electrode lead <NUM>. In some examples, cochlear implant <NUM> may include a plurality of independent current sources each associated with a channel defined by one or more of electrodes <NUM>. In this manner, different stimulation current levels may be applied to multiple stimulation sites simultaneously by way of multiple electrodes <NUM>.

<FIG> illustrates a schematic structure of the human cochlea <NUM> into which electrode lead <NUM> may be inserted. As shown in <FIG>, cochlea <NUM> is in the shape of a spiral beginning at a base <NUM> and ending at an apex <NUM>. Within cochlea <NUM> resides auditory nerve tissue <NUM>, which is denoted by Xs in <FIG>. The auditory nerve tissue <NUM> is organized within the cochlea <NUM> in a tonotopic manner. Relatively low frequencies are encoded at or near the apex <NUM> of the cochlea <NUM> (referred to as an "apical region") while relatively high frequencies are encoded at or near the base <NUM> (referred to as a "basal region"). Hence, electrical stimulation applied by way of electrodes disposed within the apical region (i.e., "apical electrodes") may result in the recipient perceiving relatively low frequencies and electrical stimulation applied by way of electrodes disposed within the basal region (i.e., "basal electrodes") may result in the recipient perceiving relatively high frequencies. The delineation between the apical and basal electrodes on a particular electrode lead may vary depending on the insertion depth of the electrode lead, the anatomy of the recipient's cochlea, and/or any other factor as may serve a particular implementation.

<FIG> illustrates an exemplary diagnostic system <NUM> that may be configured to perform any of the operations described herein. As shown, diagnostic system <NUM> may include, without limitation, a storage facility <NUM> and a processing facility <NUM> selectively and communicatively coupled to one another. Facilities <NUM> and <NUM> may each include or be implemented by hardware and/or software components (e.g., processors, memories, communication interfaces, instructions stored in memory for execution by the processors, etc.). In some examples, facilities <NUM> and <NUM> may be distributed between multiple devices and/or multiple locations as may serve a particular implementation.

Storage facility <NUM> may maintain (e.g., store) executable data used by processing facility <NUM> to perform any of the operations described herein. For example, storage facility <NUM> may store instructions <NUM> that may be executed by processing facility <NUM> to perform any of the operations described herein. Instructions <NUM> may be implemented by any suitable application, software, code, and/or other executable data instance. Storage facility <NUM> may also maintain any data received, generated, managed, used, and/or transmitted by processing facility <NUM>.

Processing facility <NUM> may be configured to perform (e.g., execute instructions <NUM> stored in storage facility <NUM> to perform) various operations associated with determining electrode positioning within a cochlea. For example, processing facility <NUM> may direct a display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant, detect a selection by a user of the option, direct, in response to the selection of the option, an acoustic stimulation generator to apply acoustic stimulation having a frequency to the recipient, direct the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation, determine an amplitude of each of the evoked response measurements recorded by the plurality of electrodes, and present, within the graphical user interface, a tuning curve that graphically indicates the amplitudes of the evoked response measurements. These and other operations that may be performed by processing facility <NUM> are described in more detail herein.

Diagnostic system <NUM> may be implemented in any suitable manner. For example, diagnostic system <NUM> may be implemented by a stand-alone diagnostic system that may be used in a surgical operating room to perform any of the operations described herein.

<FIG> illustrates an exemplary stand-alone diagnostic system <NUM> that may implement diagnostic system <NUM>. As shown, diagnostic system <NUM> includes a computing module <NUM> and a base module <NUM>. Computing module <NUM> includes a display screen <NUM> and a processor <NUM>. Base module <NUM> includes an interface unit <NUM>, an audio amplifier <NUM>, an audio output port <NUM>, a communications port <NUM>, and a port <NUM>. Computing module <NUM> and base module <NUM> may include additional or alternative components as may serve a particular implementation. For example, computing module <NUM> and/or base module <NUM> may include one or more speakers configured to output acoustic feedback and/or other types of sound configured to be heard by a surgeon and/or other user of diagnostic system <NUM>. Diagnostic system <NUM> and exemplary implementations thereof are described more fully in co-pending PCT Application No. <CIT>, which application is filed the same day as the present application.

In the configuration shown in <FIG>, base module <NUM> is physically attached to computing module <NUM>. In this configuration, processor <NUM> is communicatively coupled to interface unit <NUM> by way of a connection <NUM>. Connection <NUM> may be implemented by any suitable connection (e.g., an internal USB connection) as may serve a particular implementation. As will be described in more detail below, base module <NUM> may be selectively detached from computing module <NUM> and connected to a different computing device by way of port <NUM>.

Display screen <NUM> may be configured to display any suitable content associated with an application executed by processor <NUM>. Display screen <NUM> may be implemented by a touchscreen and/or any other type of display screen as may serve a particular implementation.

Processor <NUM> may be configured to execute a diagnostic application associated with a cochlear implant (e.g., cochlear implant <NUM>). For example, processor <NUM> may execute a diagnostic application that may be used during a procedure (e.g., an intraoperative or postoperative procedure) associated with the cochlear implant. The diagnostic application may be configured to perform various diagnostic operations associated with the cochlear implant during the procedure. Exemplary diagnostic operations are described herein.

In some examples, processor <NUM> may direct display screen <NUM> to display a graphical user interface associated with the diagnostic application being executed by processor <NUM>. A user may interact with the graphical user interface to adjust one or more parameters associated with the cochlear implant and/or otherwise obtain information that may be useful during a procedure associated with the cochlear implant.

Base module <NUM> may be configured to attach to computing module <NUM> and serve as a stand for computing module <NUM>.

Interface unit <NUM> is configured to be communicatively coupled to processor <NUM> by way of connection <NUM> while base module <NUM> is attached to computing module <NUM>. Interface unit <NUM> is further configured to be communicatively coupled to the cochlear implant while base module <NUM> is attached to computing module <NUM>. In this manner, interface unit <NUM> provides an interface between processor <NUM> and the cochlear implant.

Interface unit <NUM> may be communicatively coupled to the cochlear implant by way of communications port <NUM>. For example, communications port <NUM> may be selectively coupled to a coil (e.g., a coil included in a headpiece, such as headpiece <NUM>, or a disposable stand-alone coil) configured to wirelessly communicate with the cochlear implant. Interface unit <NUM> may communicate with the cochlear implant by transmitting and/or receiving data to/from the cochlear implant by way of the coil connected to communications port <NUM>.

Interface unit <NUM> may be further configured to generate and provide acoustic stimulation (e.g., sound waves) to the recipient of the cochlear implant. To this end, audio output port <NUM> is configured to be selectively coupled to a sound delivery apparatus. In some examples, the sound delivery apparatus may be implemented by tubing that has a distal portion configured to be placed in or near an entrance to an ear canal of a recipient of the cochlear implant. While the sound delivery apparatus is connected to audio output port <NUM>, interface unit <NUM> may transmit the acoustic stimulation to the recipient by way of the sound delivery apparatus.

As shown, audio amplifier <NUM> may be positioned within a path between interface unit <NUM> and audio output port <NUM>. In this configuration, audio amplifier <NUM> may be configured to amplify the acoustic stimulation before the acoustic stimulation is delivered to the recipient by way of audio output port <NUM> and the sound delivery apparatus. In some alternative examples, amplification of the acoustic stimulation generated by interface unit <NUM> is not necessary, thereby obviating the need for audio amplifier <NUM> to be included in base module <NUM>. Hence, in some implementations, base module <NUM> does not include audio amplifier <NUM>.

In some examples, diagnostic system <NUM> may be configured to self-calibrate and/or perform in-situ testing. For example, processor <NUM> may calibrate an amplitude level of acoustic stimulation generated by interface unit <NUM> before and/or during a procedure in which diagnostic system <NUM> is used to perform any of the operations described herein. Such self-calibration and in-situ testing may be performed in any suitable manner.

As mentioned, base module <NUM> may be selectively detached from computing module <NUM>. To illustrate, <FIG> shows a configuration <NUM> in which base module <NUM> is detached from computing module <NUM>. This detachment is illustrated by arrow <NUM>. While detached, interface unit <NUM> of base module <NUM> may be communicatively coupled to a computing device <NUM>. For example, interface unit <NUM> may be communicatively coupled to computing device <NUM> by plugging a cable (e.g., a USB cable) into port <NUM> and into computing device <NUM>. In this configuration, computing device <NUM> may use interface unit <NUM> to interface with a cochlear implant (e.g., by providing acoustic stimulation to a recipient of the cochlear implant and/or receiving recording data from the cochlear implant).

<FIG> depicts an exemplary configuration <NUM> in which diagnostic system <NUM> is used to perform one or more diagnostic operations with respect to a recipient of a cochlear implant. Various anatomical features of the recipient's ear are shown in <FIG>. Specifically, anatomical features include a pinna <NUM> (i.e., the outer ear), an ear canal <NUM>, a middle ear <NUM>, and a cochlea <NUM>. While no specific incision or other explicit surgical representation is shown in <FIG>, it will be understood that such elements may be present when a procedure is ongoing. For example, an incision may be present to allow the surgeon internal access to the recipient to insert the lead into cochlea <NUM>. In some procedures, pinna <NUM> may be taped down and covered with surgical drapes so as to cover ear canal <NUM> (e.g., to help prevent fluids from reaching ear canal <NUM>).

In the example of <FIG>, a cochlear implant <NUM> and an electrode lead <NUM> are shown to be implanted within the recipient. Cochlear implant <NUM> may be similar, for example, to cochlear implant <NUM>, and electrode lead <NUM> may be similar, for example, to electrode lead <NUM>. Electrode lead <NUM> includes a plurality of electrodes (e.g., electrode <NUM>, which is the distal-most electrode disposed on electrode lead <NUM>).

As shown, a cable <NUM> of a headpiece <NUM> is connected to communications port <NUM>. In this configuration, interface unit <NUM> may wirelessly communicate with cochlear implant <NUM> by way a coil and/or other electronics included in headpiece <NUM>, which may be similar to headpiece <NUM>.

As also shown, a sound delivery apparatus <NUM> is connected to audio output port <NUM>. Sound delivery apparatus <NUM> includes tubing <NUM> and an ear insert <NUM>. Ear insert <NUM> is configured to fit at or within an entrance of ear canal <NUM>. Tubing <NUM> and ear insert <NUM> together form a sound propagation channel <NUM> that delivers acoustic stimulation provided by interface unit <NUM> to the ear canal <NUM>. Tubing <NUM> and ear insert <NUM> may be made out of any suitable material as may serve a particular implementation.

In some examples, processor <NUM> may execute a diagnostic application. In accordance with the diagnostic application, processor <NUM> may transmit, by way of connection <NUM>, a command (also referred to as a stimulation command) to interface unit <NUM> for interface unit <NUM> to apply acoustic stimulation to the recipient and receive recording data representative of an evoked response that occurs within the recipient in response to the acoustic stimulation. In response to receiving the command, interface unit <NUM> may generate and apply the acoustic stimulation to the recipient by way of audio output port <NUM> and sound delivery apparatus <NUM>. Interface unit <NUM> may also transmit a command (also referred to as a recording command) to cochlear implant <NUM> by way of communications port <NUM> and headpiece <NUM> for cochlear implant <NUM> to use electrode <NUM> to record the evoked response that occurs in response to the acoustic stimulation. Cochlear implant <NUM> may transmit the recording data back to interface unit <NUM> by way of headpiece <NUM> and communications port <NUM>. Interface unit <NUM> may transmit the recording data to processor <NUM> by way of connection <NUM>. Processor <NUM> may process the recording data and direct display screen <NUM> to display one or more graphical user interfaces associated with the recording data.

In configuration <NUM>, headpiece <NUM> is connected directly to communications port <NUM> by way of cable <NUM>. Hence, in configuration <NUM>, interface unit <NUM> is configured to directly control cochlear implant <NUM>. <FIG> illustrates an alternative configuration <NUM> in which a sound processor <NUM> is included in the communication path in between interface unit <NUM> and cochlear implant <NUM>. Sound processor <NUM> may be similar to any of the sound processors (e.g., sound processor <NUM>) described herein. In some examples, sound processor <NUM> is recipient-agnostic. In other words, sound processor <NUM> is not configured specifically for the recipient of cochlear implant <NUM>. Rather, sound processor <NUM> may be used in a variety of different procedures associated with a number of different recipients.

As shown, sound processor <NUM> is connected to communications port <NUM> by way of a cable <NUM>. Sound processor <NUM> is also connected to headpiece <NUM> by way of cable <NUM>. In this configuration, sound processor <NUM> may relay data and/or commands between interface unit <NUM> and cochlear implant <NUM>.

<FIG> illustrates an alternative configuration <NUM> in which sound processor <NUM> is configured to generate the acoustic stimulation that is applied to the recipient of cochlear implant <NUM>. As shown, in this configuration, a sound delivery apparatus <NUM> is coupled directly to sound processor <NUM>. For example, sound processor <NUM> may be implemented by a behind-the-ear bimodal sound processor and sound delivery apparatus <NUM> may be implemented by an audio ear hook that connects to sound processor <NUM>.

It will be recognized that diagnostic system <NUM> may be additionally or alternatively implemented in any other suitable manner. For example, diagnostic system <NUM> may be implemented by a fitting system utilized in a clinician's office and/or by any other appropriately configured system or device.

An exemplary hardware implementation of diagnostic system <NUM> will now be described in connection with <FIG>. In particular, <FIG> shows a left perspective view of diagnostic system <NUM>, <FIG> shows a right perspective view of diagnostic system <NUM>, <FIG> shows a front view of diagnostic system <NUM>, <FIG> shows a back view of diagnostic system <NUM>, <FIG> shows a left side view of diagnostic system <NUM>, <FIG> shows a right side view of diagnostic system <NUM>, and <FIG> shows a rear perspective view of diagnostic system <NUM>.

The hardware implementation of diagnostic system <NUM> illustrated in <FIG> includes computing module <NUM> and base module <NUM>. As, illustrated computing module <NUM> includes a front side <NUM>, a back side <NUM>, a left side <NUM>, a right side <NUM>, a top side <NUM>, and a bottom side <NUM>.

Display screen <NUM> is located on front side <NUM> of computing module <NUM>. Various other components are also located on the front side <NUM> of computing module <NUM>. For example, a fingerprint scanner <NUM>, physical input buttons <NUM>, and a webcam <NUM> all shown to be included on the front side <NUM> of computing module <NUM>. It will be recognized that any of these components may be located on any other side of computing module <NUM> as may serve a particular implementation.

Fingerprint scanner <NUM> is configured to facilitate authentication of a user of diagnostic system <NUM>. For example, fingerprint scanner <NUM> may detect a fingerprint of the user and provide processor <NUM> with data representative of the fingerprint. Processor <NUM> may process the fingerprint data in any suitable manner (e.g., by comparing the fingerprint to known fingerprints included in a database) to authenticate the user.

Webcam <NUM> may be configured to facilitate video communication by a user of diagnostic system <NUM> with a remotely located user (e.g., during or after a surgical procedure). Such video communication may be performed in any suitable manner.

Physical input buttons <NUM> may be implemented, for example, by a directional pad and/or any other suitable type of physical input button. A user of diagnostic system <NUM> may interact with physical input buttons <NUM> to perform various operations with respect to a diagnostic application being executed by processor <NUM>. For example, the user may use the physical input buttons <NUM> to interact with a graphical user interface displayed on display screen <NUM>.

In some examples, physical input buttons <NUM> may be configured to be selectively programmed (e.g., as hotkeys) to perform one or more functions associated with the diagnostic application. For example, a particular physical input button <NUM> may be programmed by a user to start and/or stop acoustic stimulation being applied to a cochlear implant recipient by diagnostic system <NUM>.

In some examples, processor <NUM> may be configured to wirelessly connect to an input device configured to be used by the user in connection with the diagnostic application. For example, processor <NUM> may be configured to wirelessly connect (e.g., via Bluetooth and/or any other suitable wireless communication protocol) to a keyboard, mouse, remote control, and/or any other wireless input device as may serve a particular implementation. In this manner, the user may selectively use physical input buttons <NUM>, a touchscreen capability of display screen <NUM>, and/or a wireless input device to interact with diagnostic system <NUM>.

As shown, a hole <NUM> may be formed within computing module <NUM> and configured to serve as a handle for diagnostic system <NUM>. A user may grip computing module <NUM> by placing his or her fingers within hole <NUM>.

As shown, a barcode scanner <NUM> may be located on left side <NUM> of computing module <NUM>. Barcode scanner <NUM> may alternatively be located on any other side of computing module <NUM>. In some examples, barcode scanner <NUM> may be configured to scan for an activation code included on one or more components associated with a procedure being performed with respect to cochlear implant <NUM>. The activation code may be used to associate (e.g., register) the components with cochlear implant <NUM>.

As illustrated in <FIG>, computing module <NUM> may include batteries <NUM>-<NUM> and <NUM>-<NUM>. Batteries <NUM> may be configured to provide operating power for various components included within computing module <NUM> and base module <NUM>. In some examples, batteries <NUM> may be hot-swappable. In other words, one of batteries <NUM> (e.g., battery <NUM>-<NUM>) may be removed and replaced while the other battery (e.g., battery <NUM>-<NUM>) is used to provide power to computing module <NUM> and base module <NUM>.

As illustrated in <FIG> and <FIG>, ports <NUM>, <NUM>, and <NUM> are located on a side surface <NUM> of base module <NUM>. Ports <NUM>, <NUM>, and <NUM> may alternatively be located on any other surface of base module <NUM>.

As described above, base module <NUM> may be configured to serve as a stand for computing module <NUM> while base module <NUM> is attached to computing module <NUM>. The stand functionality of base module <NUM> is illustrated in <FIG>.

As shown, base module <NUM> includes a top surface <NUM> configured to selectively attach to back side <NUM> of computing module <NUM>. Base module <NUM> may alternatively attach to any other side of computing module <NUM>. Base module <NUM> further includes a bottom surface <NUM> configured to be placed on a resting surface <NUM>. Bottom surface <NUM> is angled with respect to back side <NUM> of computing module <NUM>. This provides a viewing angle <NUM> for display screen <NUM> that is greater than zero degrees with respect to resting surface <NUM>. In some examples, base module <NUM> may be adjustable to selectively provide different viewing angles for display screen <NUM> with respect to resting surface <NUM>. This adjustability may be realized in any suitable manner. For example, a user may manually adjust bottom surface <NUM> to different angles with respect to back side <NUM> of computing module <NUM>.

<FIG> illustrates an exemplary configuration in which base module <NUM> is detached from computing module <NUM>. Base module <NUM> may be detached from computing module <NUM> in any suitable manner. For example, base module <NUM> may include one or more locking mechanisms that may be actuated by a user to detach base module <NUM> from computing module <NUM>.

Various operations that may be performed by diagnostic system <NUM> will now be described. It will be recognized that diagnostic system <NUM> may perform additional or alternative operations to those described herein as may serve a particular implementation.

As mentioned, diagnostic system <NUM> may direct a display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant. The display screen may be similar to or implemented by any of the display screens described herein. Diagnostic system <NUM> may direct the display screen to display the graphical user interface in accordance with a diagnostic application being executed by diagnostic system <NUM>.

<FIG> illustrates an exemplary graphical user interface <NUM> that may be presented by diagnostic system <NUM> by way of a display screen. As shown, graphical user interface <NUM> may include a graph <NUM>, a start option <NUM>, a stop option <NUM>, and fields <NUM>-<NUM> and <NUM>-<NUM>. Graphical user interface <NUM> may include additional or alternative display elements as may serve a particular implementation.

As shown, graph <NUM> includes a plurality of electrode numbers along an x-axis and various evoked response amplitude values along a y-axis. It will be recognized that the x and y axes may be switched in alternative examples. The electrode numbers shown along the x-axis represent a plurality of electrodes disposed on an electrode lead that has been at least partially implanted within a cochlea of a recipient of a cochlear implant. In the examples provided herein, it will be assumed that sixteen electrodes are disposed on the electrode lead. The most apical electrode (i.e., the electrode that is most distally located on the electrode lead) is labeled "<NUM>" in graph <NUM>. The most basal electrode (i.e., the electrode that is most proximately located on the electrode lead) is labeled "<NUM>" in graph <NUM>. It will be recognized that any number of electrodes may be disposed on the electrode lead as may serve a particular implementation.

In response to a user selection of the start option <NUM>, diagnostic system <NUM> may perform an electrode sweep with respect to a plurality of electrodes disposed on the electrode lead. The electrode sweep may be performed with respect to all of the electrodes disposed on the electrode lead. Alternatively, as will be described below, the electrode sweep may be performed with respect to just a subset of the electrodes disposed on electrode lead.

Diagnostic system <NUM> may detect a selection by a user of start option <NUM> in any suitable manner. In response to the selection of start option <NUM>, diagnostic system <NUM> may direct an acoustic stimulation generator to apply acoustic stimulation to the recipient. The acoustic stimulation generator may be similar to or implemented by any of the acoustic stimulation generators described herein.

The frequency and stimulation level of the acoustic stimulation applied to the recipient may be set by a user interacting with fields <NUM>-<NUM> and <NUM>-<NUM>. For example, as shown in <FIG>, field <NUM>-<NUM> indicates that the acoustic stimulation frequency is <NUM> and field <NUM>-<NUM> indicates that the acoustic stimulation level is <NUM> dB HL. The user may interact with fields <NUM>-<NUM> and <NUM>-<NUM> to adjust the frequency and stimulation level of the acoustic stimulation to any suitable values as may serve a particular implementation. In some alternative embodiments, diagnostic system <NUM> may automatically select the frequency and stimulation level of the acoustic stimulation. For example, diagnostic system <NUM> may sweep through a plurality of stimulation frequencies in order to automatically generate a plurality of different tuning curves.

Diagnostic system <NUM> may direct the cochlear implant to use each electrode in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation. In some examples, the evoked response measurements are concurrently recorded by the plurality of electrodes. Alternatively, the evoked response measurements are recorded sequentially by the plurality of electrodes.

Diagnostic system <NUM> may determine an amplitude of each of the evoked response measurements recorded by the plurality of electrodes and present, within the graphical user interface, a tuning curve that graphically indicates the amplitude of the evoked response measurements.

To illustrate, <FIG> shows a tuning curve <NUM> presented within graphical user interface <NUM> (i.e., within graph <NUM> of graphical user interface <NUM>). Tuning curve <NUM> graphically indicates the amplitude of each of the evoked response measurements recorded by electrodes <NUM> through <NUM> in response to acoustic stimulation having a frequency of <NUM>. As shown, a peak amplitude value <NUM> of tuning curve <NUM> is located at a position that corresponds to electrode <NUM>. This means that electrode <NUM> is positioned at a location within the cochlea that corresponds to <NUM>.

As shown, the amplitude of tuning curve <NUM> decays as the electrode number gets higher (i.e., closer to the base of the cochlea). For example, the amplitudes of the evoked response measurements recorded by electrodes <NUM> through <NUM> are at or around <NUM>µV. This indicates that these electrodes did not record an evoked response in response to the acoustic stimulation.

At any time during the electrode sweep, the user may stop the electrode sweep by selecting stop option <NUM>. In response to a user selection of stop option <NUM>, diagnostic system <NUM> may direct the acoustic stimulation generator to stop applying the acoustic stimulation to the recipient.

Diagnostic system <NUM> may perform additional electrode sweeps for other acoustic stimulation frequencies to determine locations of other electrodes on the electrode lead. For example, <FIG> shows graphical user interface <NUM> after the user changes the acoustic stimulation frequency from <NUM> to <NUM> and again selects start option <NUM>. As shown, a tuning curve <NUM> associated with the stimulation frequency of <NUM> is presented within graphical user interface <NUM>. Tuning curve <NUM> has a peak amplitude value <NUM> located at a position that corresponds to electrode <NUM>. This means that electrode <NUM> is positioned at a location within the cochlea that corresponds to <NUM>.

As shown, tuning curves <NUM> and <NUM> may be concurrently presented within graphical user interface <NUM>. In this manner a user may visually identify electrode positioning for a plurality of electrodes at the same time. In alternative embodiments, only a single tuning curve is displayed at any given time within graphical user interface <NUM>.

<FIG> shows graphical user interface <NUM> after the user changes the acoustic stimulation frequency from <NUM> to <NUM> and again selects start option <NUM>. As shown, a tuning curve <NUM> associated with the stimulation frequency of <NUM> is presented within graphical user interface <NUM>. Tuning curve <NUM> has a peak amplitude value <NUM> located at a position that corresponds to electrode <NUM>. This means that electrode <NUM> is positioned at a location within the cochlea that corresponds to <NUM>.

In the examples of <FIG>, all of the electrodes disposed on the electrode lead recorded evoked response measurements. In some cases, it may be desirable to have only a subset of electrodes record evoked response measurements during an electrode sweep. For example, a user may know that a peak amplitude value of a tuning curve associated with a particular frequency will likely occur within a certain range of electrodes. The user may select only these electrodes to be included in the electrode sweep in order to save time and resources associated with performing the electrode sweep across all the electrodes.

Hence, in some examples, diagnostic system <NUM> may provide, within graphical user interface <NUM>, an option for the user to select only certain electrodes to be included in the electrode sweep. In other words, a total of N electrodes may be disposed on the electrode lead. In response to user input, diagnostic system <NUM> may select M electrodes for inclusion in the plurality of electrodes that are included in the electrode sweep, where M is less than N. Additionally or alternatively, diagnostic system <NUM> may automatically select the M electrodes. For example, in response to a user selection of electrode <NUM> and electrode <NUM>, diagnostic system <NUM> may automatically select electrodes <NUM> through <NUM> for inclusion in the electrode sweep.

A user may select electrodes for inclusion in the electrode sweep in any suitable manner. For example, a user may simply click, perform a touch gesture with respect to, or otherwise manually select one or more electrodes to be excluded from the plurality of electrodes included in the electrode sweep. To illustrate, <FIG> shows graphical user interface <NUM> with electrodes <NUM> through <NUM> excluded from the electrode sweep. This is graphically indicated in <FIG> by each of these electrode numbers being crossed out. In this configuration, the electrode sweep will only include electrodes <NUM> through <NUM>.

In some examples, a phase of the evoked response measurements recorded by each electrode may additionally or alternatively be displayed within graph <NUM>. The phase of an evoked response numerically describes the relationship between timing of the evoked response (e.g., the timing of peaks of the evoked response) relative to timing of the incoming acoustic stimulation causing the evoked response. For a pure tone, the phase of the evoked response may be described in radians or degrees if the delay between input peaks (i.e. peaks of the acoustic stimulation) and output peaks (i.e. peaks of the evoked response) is scaled by the inter-peak period for each waveform. For a more complex waveform, the phase can also be described in terms of a phase delay, measured in milliseconds.

Because the phase is inherently a cyclic measure, phase delay measured based on phase alone is not unique. For example, a phase delay of P and a phase delay of P + C may result in the same phase if C represents the period of the incoming signal. Consequently, phase delay estimation may need to consider either an evoked response from an early part of the waveform (an onset response) or a more complex stimulus. The techniques for doing so shall be apparent to those skilled in the art.

In a healthy cochlea, a phase of an evoked response signal recorded within the cochlea may be expected to change methodically in accordance with the location within the cochlea (e.g., the cochlear depth) of the electrode as the electrode is inserted apically (e.g., during an insertion procedure). Specifically, it may be expected that the phase will increase in a way that is consistent with an increasing delay as the cochlear depth of the electrode increases during the insertion procedure of the electrode into the cochlea. Additionally, as the electrode approaches and/or passes near the target frequency depth associated with the acoustic stimulation, the phase may be expected to change rapidly. Specifically, at the target frequency depth, the phase may be significantly larger (e.g., <NUM> degrees larger) than the phase at more basal locations passed by the electrode prior to the target frequency depth during the insertion procedure. This is described in more detail in <CIT>.

<FIG> shows how phase of evoked response measurements recorded by each electrode may displayed within graph <NUM>. <FIG> is similar to <FIG>, but also shows a phase curve <NUM> that corresponds to tuning curve <NUM> and a phase curve <NUM> that corresponds to tuning curve <NUM>. Phase curves <NUM> and <NUM> are plotted with respect to the vertical axis on the right side of graph <NUM> and may further assist a user in determining which electrode corresponds to the frequency of the acoustic stimulation.

For example, diagnostic system <NUM> may identify a change in a phase of a phase curve associated with a tuning curve, identify an electrode that corresponds to the change in phase, and map the frequency to the identified electrode. To illustrate, in the example of <FIG>, a sudden change in phase curve <NUM> indicates that a frequency of <NUM> corresponds to electrode <NUM>. Diagnostic system <NUM> may utilize this information separate from or together with tuning curve <NUM> to map the frequency of the acoustic stimulation to electrode <NUM> in any of the ways described herein.

While phase curves <NUM> and <NUM> are displayed currently with tuning curves <NUM> and <NUM> in <FIG>, it will be recognized that phase curves <NUM> and <NUM> may alternatively be displayed in their own graph.

In the examples of <FIG>, diagnostic system <NUM> performs electrode sweeps for frequencies that are manually selected by a user. Additionally or alternatively, diagnostic system <NUM> may be configured to automatically step through a plurality of frequencies in order to generate and present a plurality of tuning curves. Each of the tuning curves may be labeled or otherwise graphically associated with its corresponding frequency. In this manner, a user may readily ascertain electrode positioning for a plurality of electrodes without having to manually input each of the different frequencies.

In some examples, diagnostic system <NUM> may dynamically select the frequencies through which diagnostic system <NUM> steps. In this manner, diagnostic system <NUM> may choose the appropriate frequencies to result in tuning curves that have peak amplitude values at each of the electrodes. For example, diagnostic system <NUM> may initially select a frequency of <NUM>. During the electrode sweep associated with this frequency, the peak amplitude value of the resulting tuning curve may be close to, but not centered at, electrode <NUM>. Diagnostic system <NUM> may accordingly slightly increase the frequency and perform electrode sweeps until diagnostic system <NUM> detects that the peak amplitude value of one of the tuning curves (e.g., tuning curve <NUM>) is exactly positioned at electrode <NUM>. Diagnostic system <NUM> may then designate the frequency associated with this tuning curve as being the frequency at which electrode <NUM> is located.

Diagnostic system <NUM> may utilize tuning curves generated in any of the ways described herein to fit a sound processor to a recipient. For example, diagnostic system <NUM> may generate tuning curves <NUM>, <NUM>, and <NUM> shown in <FIG>. Diagnostic system <NUM> may identify each of peak amplitude values <NUM>, <NUM>, and <NUM> and their corresponding electrodes (electrodes <NUM>, <NUM>, and <NUM> in the example of <FIG>). Diagnostic system <NUM> may map the frequencies associated with each of the tuning curves to the identified electrodes. For example, diagnostic system <NUM> may map <NUM> to electrode <NUM>, <NUM> to electrode <NUM>, and <NUM> to electrode <NUM>. This mapping may be performed in any suitable manner. For example, diagnostic system <NUM> may program a sound processor associated with the recipient's cochlear implant to direct the cochlear implant to apply electrical stimulation representative of <NUM> by way of electrode <NUM>, electrical stimulation representative of <NUM> by way of electrode <NUM>, and electrical stimulation representative of <NUM> by way of electrode <NUM>.

In some examples, diagnostic system <NUM> may map a range of frequencies centered around each of these frequencies to each electrode. For example, diagnostic system <NUM> may map a range of frequencies between <NUM> and <NUM> to electrode <NUM>. The range of frequencies mapped to each electrode may be of any suitable size as may serve a particular implementation.

In some examples, diagnostic system <NUM> may use the tuning curves generated as described herein to generate and present, within graphical user interface <NUM>, an electrode positioning map that graphically indicates physical locations of the electrodes within the cochlea. For example, a graphical representation of the cochlea similar to that shown in <FIG> may be presented within graphical user interface <NUM>. Within this graphical representation, markers indicating physical locations of each electrode on the electrode lead may be displayed. In this manner, a user may easily visualize the positioning of each electrode within the cochlea.

<FIG> illustrates an exemplary configuration <NUM> in which diagnostic system <NUM> is communicatively coupled to a fitting system <NUM>. Fitting system <NUM> may be selectively and communicatively coupled to a sound processor <NUM> associated with a recipient and configured to wirelessly communicate with a cochlear implant <NUM> implanted within the recipient. Sound processor <NUM> may be similar to or implemented by any of the sound processors described herein. Cochlear implant <NUM> may be similar to or implemented by any of the cochlear implants described herein.

In configuration <NUM>, diagnostic system <NUM> may transmit tuning curve data representative of one or more tuning curves generated by diagnostic system to fitting system <NUM>. Fitting system <NUM> may use the tuning curve data to fit sound processor during a fitting session in which sound processor <NUM> and cochlear implant <NUM> are fitted to the recipient. For example, sound processor <NUM> may use the tuning curve data to generate programming instructions that are transmitted to sound processor <NUM>. The programming instructions may specify one or more parameters that govern an operation of sound processor <NUM>. For example, the programming instructions may specify a mapping between frequencies and electrodes as determined using the tuning curve data.

In some examples, fitting system <NUM> may alternatively implement diagnostic system <NUM>. In these examples, fitting system <NUM> performs the tuning curve generation operations described herein. Hence, fitting system <NUM> may generate the tuning curve data itself without having to be connected to a separate diagnostic system <NUM>.

<FIG> illustrates an exemplary method <NUM>. The operations shown in <FIG> may be performed by diagnostic system <NUM> and/or any implementation thereof. While <FIG> illustrates exemplary operations according to one embodiment, other embodiments may omit, add to, reorder, and/or modify any of the operations shown in <FIG>.

In operation <NUM>, a diagnostic system directs a display screen to display a graphical user interface that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes disposed on an electrode lead implanted at least partially within a cochlea of a recipient of a cochlear implant. Operation <NUM> may be performed in any of the ways described herein.

In operation <NUM>, the diagnostic system detects a selection by a user of the option. Operation <NUM> may be performed in any of the ways described herein.

In operation <NUM>, the diagnostic system directs, in response to the selection of the option, an acoustic stimulation generator to apply acoustic stimulation having a frequency to the recipient. Operation <NUM> may be performed in any of the ways described herein.

In operation <NUM>, the diagnostic system directs the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation. Operation <NUM> may be performed in any of the ways described herein.

In operation <NUM>, the diagnostic system determines an amplitude of each of the evoked response measurements recorded by the plurality of electrodes. Operation <NUM> may be performed in any of the ways described herein.

In operation <NUM>, the diagnostic system presents, within the graphical user interface, a tuning curve that graphically indicates the amplitudes of the evoked response measurements. Operation <NUM> may be performed in any of the ways described herein.

<FIG> illustrates an exemplary computing device <NUM> that may be specifically configured to perform one or more of the processes described herein. As shown in <FIG>, computing device <NUM> may include a communication interface <NUM>, a processor <NUM>, a storage device <NUM>, and an input/output ("I/O") module <NUM> communicatively connected one to another via a communication infrastructure <NUM>. While an exemplary computing device <NUM> is shown in <FIG>, the components illustrated in <FIG> are not intended to be limiting. Additional or alternative components may be used in other embodiments. Components of computing device <NUM> shown in <FIG> will now be described in additional detail.

In some examples, any of the systems, computing devices, and/or other components described herein may be implemented by computing device <NUM>. For example, storage facility <NUM> may be implemented by storage device <NUM>, and processing facility <NUM> may be implemented by processor <NUM>.

Claim 1:
A system comprising:
a memory (<NUM>, <NUM>) storing instructions (<NUM>);
a processor (<NUM>, <NUM>) communicatively coupled to the memory and configured to execute the instructions to:
direct a display screen (<NUM>) to display a graphical user interface (<NUM>) that includes a selectable option to perform an electrode sweep with respect to a plurality of electrodes (<NUM>) disposed on an electrode lead (<NUM>) implanted at least partially within a cochlea (<NUM>) of a recipient of a cochlear implant (<NUM>, <NUM>, <NUM>);
detect a selection by a user of the option;
direct, in response to the selection of the option, an acoustic stimulation generator (<NUM>, <NUM>, <NUM>, <NUM>) to apply acoustic stimulation having a frequency to the recipient;
direct the cochlear implant to use each electrode included in the plurality of electrodes to record an evoked response measurement in response to the acoustic stimulation;
determine an amplitude of each of the evoked response measurements recorded by the plurality of electrodes; and
present, within the graphical user interface, a tuning curve (<NUM>, <NUM>, <NUM>) that graphically indicates the amplitudes of the evoked response measurements.