Patent Description:
The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as "implantable medical devices," now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease/injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and/or data received from external devices that are part of, or operate in conjunction with, implantable components.

The same number represents the same element or same type of element in all drawings.

Technology disclosed herein includes systems and methods for sensory substitution by suppressing one sensory channel and providing signals via another. In one example, a system suppresses a dysfunctional vestibular system and provides substitute vestibular information via another sensory channel. Dysfunctional balance information from a recipient's vestibular system can be suppressed using electrical stimulation. The electrical stimulation can be provided to the otolith region, semicircular canals, vestibular nerve or another portion of the recipient's vestibular system. Balance information that would normally be provided by a healthy vestibular system (e.g. how the recipient is positioned with respect to gravity, such as rotation along pitch and roll axes) is provided via stimulation of another sensory channel. Such sensor channels can include visual, audible, or tactile sensory channels. For example, audible percepts can be generated via an auditory prosthesis (e.g., a cochlear implant providing electrical stimulation in the recipient's cochlea). By suppressing one sensory channel and providing stimulation via another, one sense can be substituted for another. While described herein primarily in the context of vestibular sensory substitution, sensory substitution can be extended to other sensory systems.

In another aspect there is an architecture for a combined auditory prosthesis and sensory substitution system. In an example, sensory substitution is delivered as perceptible auditory cues that are provided via intracochlear electrodes. The sensory substitution cues can be provided via one or more dedicated intracochlear electrode channels, rather than being superimposed on all hearing channels. In such examples, the remaining electrodes can deliver standard cochlear implant stimulation (e.g., to cause auditory precepts to make up for a dysfunctional auditory system). Balance signals that can substitute for the dysfunctional vestibular system can originate from one or more accelerometers, magnetometers other sensors, or combinations thereof that pass pitch, roll and yaw information to a balance signal generator. The balance signals that substitute for the dysfunctional vestibular system can then be injected into the cochlear stimulation signal processing path in such a manner as to not interfere with (or be interfered by) other signal channels. Thus, while some of the sound processing path can be shared between balance signals and sound input signals (e.g., from a microphone or other sound source), some of the processing path can be exclusive to the balance input signals. In at least some examples, some of the processing path can be exclusive to the sound input signals and some of the processing path can be shared by both the sound input signals and the balance input signals.

The various balance signals that can be used to substitute for a dysfunctional vestibular system include movement or position compared to gravity that is used as an indicator of stability of the recipient. Such a signal can be used to provide information allowing the recipient to quickly recover from stumble or incident of balance failure, which can aid in fall prevention. In another example, gait information is extracted from one or more sensors placed at different locations on the recipient's body (e.g., in a smart watch, phone, gait monitor, step counter, or another device having one or more sensors). Extraction of gait information can be used to predict falls. Fall prediction can be used in combination with fall prevention techniques by, for example, providing balance substitution when gait analysis indicates that there is a risk of falling.

An example system usable to implement one or more examples of this technology is described in <FIG>.

<FIG> illustrates an example system <NUM> for treating a balance dysfunction of a recipient. The illustrated system <NUM> includes a vestibular inhibitor <NUM> and a stimulator <NUM>.

The vestibular inhibitor <NUM> is a portion of the system <NUM> configured to inhibit the recipient's vestibular system. The vestibular inhibitor <NUM> can include a vestibular inhibitor signal generator <NUM> and an inhibition assembly <NUM>, which can be disposed in the same or separate housings.

The vestibular inhibitor signal generator <NUM> can be a component that controls the stimulation provided by the inhibition assembly <NUM>, such as by being or including one or more processors that provide signals. For example, the vestibular inhibitor signal generator <NUM> can be configured to provide stimulation signals to the inhibition assembly <NUM>.

The inhibition assembly <NUM> can take any of a variety of forms. The inhibition assembly <NUM> can include one or more stimulation electrodes. The inhibition assembly <NUM> can be or include an implantable assembly configured to apply electrical stimulation to an otolith region, semicircular canals, other vestibular tissue of the recipient, or combinations thereof using the one or more electrodes. The electrical stimulation can inhibit the signals provided by the vestibular system to reduce the perception of signals produced by a portion of the vestibular system. For example, where the vestibular system of the recipient is dysfunctional, the stimulation provided by the vestibular inhibitor <NUM> can be sufficient to reduce or eliminate the perception of dysfunctional signals by the recipient. In some examples, this is achieved by preventing the vestibular system from producing signals or by causing the signals that are produced by the vestibular system to be noisy or otherwise have properties that cause the signals to be disregarded by the recipient.

Additional example implementations of a vestibular stimulator that can act as one or both of the vestibular inhibitor signal generator <NUM> and the inhibition assembly <NUM> are described in relation to <CIT> and <CIT>.

The stimulator <NUM> is a portion of the system <NUM> configured to cause a sensory percept (e.g., audio, visual, or tactile precepts) for the recipient. Such a sensory percept can be used to, for example, provide balance compensation signals to the recipient via one or more non-vestibular sensory channels of the recipient. Balance compensation signals can be signals that cause sensory percepts configured to compensate for a dysfunctional vestibular system. For instance, the balance compensation signals can provide balance information relating to the percepts that would be provided by a normally functioning vestibular system, such as information regarding balance, equilibrium, and orientation in space, among others.

The stimulator <NUM> can be configured to target one or more non-vestibular sensor channels of the recipient with stimulation to convey balance information. The stimulator <NUM> can include a balance signal generator <NUM> and a stimulation assembly <NUM>, disposed in a same or separate housings.

The balance signal generator <NUM> can be a component configured to generate one or more balance compensation output signals to cause stimulation via the stimulation assembly <NUM>. The balance compensation output signals can be configured to compensate a vestibular deficiency, such as by providing precepts indicative of balance information in a manner that bypasses a defective vestibular system of a recipient.

The stimulation assembly <NUM> can be a component configured to cause one or more sensory percepts in the recipient to provide the balance information based on the balance compensation output signals. For example, the sensory percepts can provide the balance information to the recipient via one or more non-vestibular sensory channels of the recipient. The one or more sensory channels can include, for example, a visual sensory channel, an auditory sensory channels, a tactile sensory channels, other sensor channels, or combinations thereof. Various characteristics of these sensory channels can be modified to convey different components of balance information. For example, providing balance information regarding rotation about a first axis (e.g., a roll axis) can be performed using a first characteristic, and providing balance information regarding rotation about a second axis (e.g., a pitch axis) can be performed using a second characteristic. In another example, providing balance information regarding rotation about a first axis (e.g., a roll axis) can be performed using a first sensory channel, and providing balance information regarding rotation about a second axis (e.g., a pitch axis) can be performed using a second sensory channel.

Where the sensory channel is a visual sensory channel, the stimulation assembly <NUM> can be configured to cause the recipient to experience visual percepts that convey the balance information. The balance signal generator <NUM> can provide signals to the stimulation assembly <NUM> to vary characteristics of the visual percept to convey the balance information. The visual characteristics can include, for example, characteristics of light provided by a set of one or more lights that make up the stimulation assembly <NUM> (e.g., LED lights), such as color, brightness, blinking frequency, location, pattern, other characteristics, or combinations thereof. In an example, the stimulation assembly <NUM> includes a display (e.g., an LCD display) that can show balance information in any of a variety of forms (e.g., a visual diagram or textual description). The stimulator <NUM> can be configured to provide such information visually by, for example, disposing one or more light emitting elements of the stimulation assembly <NUM> proximate the recipient's eyes such that the light emitting elements are disposed in the recipient's field of view. The stimulator <NUM> can be configured as a wearable headset (e.g., shaped like a pair of eyeglasses). In examples, the stimulator <NUM> can directly stimulate portions of the recipient's visual system, such as with a visual prosthesis. In such an example, the stimulation assembly <NUM> can be an implantable component configured to provide electrical stimulation to the recipient to cause visual percepts.

Where the sensory channel is a tactile sensory channel, the stimulation assembly <NUM> can be configured to cause tactile percepts that are indicative of the balance information. In an example, the stimulation assembly <NUM> can include one or more vibratory actuators that vibrate the recipient's skin to convey the balance information tactilely. The balance signal generator <NUM> can provide signals to the stimulation assembly <NUM> to vary characteristics of the tactile percept to convey the balance information. The characteristics modifiable to indicate balance information can include, for example, vibration strength, vibration frequency, and vibration location, among others.

Where the sensory channel is an audio sensory channel, the stimulation assembly <NUM> can be configured to cause audio percepts in the recipient that are indicative of the balance information. In an example, the stimulation assembly <NUM> can be a headset with speakers. The stimulator <NUM> can be a wearable or implantable auditory prosthesis medical device, such as a bone conduction device or a cochlear implant. In such examples, the stimulation assembly <NUM> can be or include a vibratory bone conduction actuator or an electrode assembly of a cochlear implant. The balance signal generator <NUM> can provide signals to the stimulation assembly <NUM> to vary characteristics of the audio percept to convey the balance information. The characteristics modifiable to indicate balance information can include, for example, loudness, pitch, stimulation frequency, location (e.g., left or right side), other characteristics, or combinations thereof. In addition to or instead of tones, the audio percepts can be audio descriptions, such as can be provided by a text-to-speech system describing the balance information.

The balance compensation signals can be generated to cause precepts that convey balance information relating to movement about one or more of pitch, roll, or yaw axes. Rotation about the pitch axis can relate to the recipient's head tilting up and down (e.g., in a nodding motion). Rotation about the roll axis can relate to the recipient's head tilting left or right. Rotation about the yaw axis can relate to the recipient's head rotating left or right. As an example implementation of the stimulator <NUM> can provide audio signals at a first frequency (e.g., corresponding to the pitch D<NUM>) to represent a positive rotation about the roll axis and at a second frequency (e.g., corresponding to the pitch C<NUM>) to represent a negative rotation about the roll axis. A degree of rotation can be represented by changing a volume of the audio signal provided. For instance, a volume can be approximately <NUM> dB when the rotation is approximately <NUM> degrees and can increase to approximately <NUM> dB as the rotation approaches <NUM> degrees. As the recipient becomes accustomed to such signals indication rotation, the signals can substitute for a dysfunctional vestibular system of the recipient. In some examples, the stimulator <NUM> can further include a sound processing path <NUM>. The balance signal generator <NUM> can be configured to inject balance compensation output signals into the sound processing path <NUM>, such as is described in more detail in relation to <FIG> herein. Audible percepts are one of a variety of kinds of ways such information can be provided. The stimulator <NUM> can take any of a variety of forms.

While the system <NUM> can be a single-purpose system (e.g., to solely treat balance dysfunctions by inhibiting vestibular organs and providing balance signals). The system can be a multi-purpose system, such as by the stimulator <NUM> providing sensory compensation for multiple sensory systems of the recipient. For example, in addition to providing compensation for a dysfunctional vestibular system, the stimulator <NUM> can cause stimulation to compensate for a dysfunctional visual or auditory system of the recipient. In such an example, the balance signal generator <NUM> can be in addition to a signal generator to treat the sensory defect. For instance, the stimulator <NUM> can be an auditory prosthesis configured to cause hearing percepts in the recipient that are indicative of the auditory environment around the recipient. Such a stimulator <NUM> can further include a sound processing path configured to convert an environmental sound input signal into an auditory stimulation signal to cause stimulation via the stimulation assembly <NUM>. The balance signal generator <NUM> can inject a balance information output signal into the sound processing path to cause a hearing percept in the recipient that is indicative of the balance information.

As described above, the various components of the system <NUM> can be disposed in same or separate housings. As illustrated, the system <NUM> can include a wearable housing <NUM> in which the vestibular inhibitor signal generator <NUM>, balance signal generator <NUM>, and the sound processing path <NUM> are disposed. The wearable housing <NUM> can be configured to be worn by the recipient, such as via a headband, magnetic connection, hair clip, or via another technique. As further illustrated, the system <NUM> can include an implantable housing <NUM>. The implantable housing <NUM> can at least partially include the inhibition assembly <NUM> and the stimulation assembly <NUM>. For example, the assemblies <NUM>, <NUM> can extend from the implantable housing <NUM>. The implantable housing <NUM> can be constructed from or coated with a biocompatible material. In some examples, the implantable housing <NUM> further includes one or more of the vestibular inhibitor signal generator <NUM>, the balance signal generator <NUM>, and the sound processing path <NUM>. While the various components can be separated into a wearable housing <NUM> and an implantable housing <NUM>, in some examples, the components can be disposed entirely in the wearable housing <NUM> or the implantable housing <NUM>. For example, some implementations can implement the vestibular inhibitor <NUM> and the stimulator <NUM> as a totally-implantable device.

As illustrated, there is one stimulator <NUM> and one vestibular inhibitor <NUM> disposed on one side of the recipient's head. In other examples, the recipient can have multiple different stimulators <NUM> and vestibular inhibitors <NUM>. In an example, there is a bi-lateral configuration where there are both left- and right-side vestibular inhibitors <NUM> and left- and right-side stimulators <NUM>. Such components can be configured to stimulate respective left and right vestibular or other tissue of the recipient. In some examples, the multiple components can cooperate with each other to provide substantially the same or different stimulation. In some examples, the sidedness of the stimulation (e.g., more intense signals on one side rather than the other) can indicate a particular balance state.

As illustrated, some examples of the system <NUM> can further include one or more sensors <NUM> disposed in various locations throughout the system <NUM>. The sensors <NUM> can be, for example, one or more sensors for detecting data used for the balance or gait information, such as accelerometers, gyroscopes, piezoelectric sensors, other sensors, or combinations thereof. Additional example sensors <NUM> include physiological sensors, such as heartbeat, galvanic skin response sensors, blood pressure sensors, electromyography sensors, other sensors, or combinations thereof. Still further examples of the sensors <NUM> include microphones and light sensors, among others. The sensors <NUM> can include components disposed within or connected to (e.g., via wired or wireless connections) the components of the system <NUM>. In some examples, the sensors <NUM> include software sensors, such as software that obtains data from one or more of the sensors <NUM> and produces additional data based thereon. For example, a software sensor can be configured to obtain data from one or more gyroscopes and accelerometers to produce gait data regarding the recipient. The gait data can relate to how the recipient is walking, running, or otherwise moving. Such data can describe whether the recipient is limping, lurching, or otherwise has an abnormal gate that can be indicative of a balance issue.

As further illustrated, some examples of the system <NUM> can further include a computing device <NUM>. The computing device <NUM> can be a computing device associated with the recipient of the stimulator <NUM>. In many examples, the computing device <NUM> is a cell phone, tablet, smart watch, step counter, or heart rate monitor, but the computing device <NUM> can take other forms. Although described primarily in the context of the recipient, the computing device <NUM> can be a computing device owned or primarily used by a parent or caregiver for the recipient. The computing device <NUM> can have one or more processors configured to perform operations based on instructions stored in memory of the computing device <NUM>. The computing device can further include one or more interfaces for interacting with a user (e.g., via a touchscreen) or other devices (e.g., a wireless transceiver). In the illustrated example, the computing device <NUM> includes one or more sensors <NUM> and a control application <NUM>.

The control application <NUM> can be a computer program stored as computer-executable instructions in memory of the computing device <NUM> that, when executed, performs one or more tasks relating to the system <NUM>. The control application <NUM> can cooperate with one or both of the vestibular inhibitor <NUM> and the stimulator <NUM>. For instance, the control application <NUM> can control when and how inhibition is provided by the vestibular inhibitor <NUM> and when and how signals are provide by the stimulator <NUM>. In some examples, such control of the functioning of components of the system <NUM> can be performed automatically by the control application <NUM> or based on input received from a user of the computing device <NUM>. The control application <NUM> can further provide data from one or more signals from sensors <NUM> of the computing device <NUM> to the stimulator <NUM> for use by the balance signal generator <NUM>. The computing device <NUM> can connect to one or both of the vestibular inhibitor <NUM> and the stimulator <NUM> using, for example, a wireless radiofrequency communication protocol (e.g., BLUETOOTH). The control application <NUM> can transmit or receive data from one or both of the vestibular inhibitor <NUM> and the stimulator <NUM> over such a connection. Where the stimulator <NUM> includes the sound processing path <NUM>, the control application <NUM> can be configured to stream audio as input into the sound processing path <NUM>, such as from a microphone of the sensors <NUM> or an application running on the computing device <NUM> (e.g., a video or audio application). In other examples, another application running on the computing device <NUM> can stream audio to the sound processing path <NUM>.

As described above, the components of the system <NUM> can take any of a variety of forms. An example apparatus that can be used to implement one or both of the vestibular inhibitor <NUM> and the stimulator <NUM> is described in <FIG>.

<FIG> is a functional block diagram of an example apparatus <NUM> that be used to implement one or both of the vestibular inhibitor <NUM> and the stimulator <NUM>. In the illustrated example, the apparatus <NUM> includes a first device <NUM> acting as an external processor device and a second device <NUM> acting as an implanted stimulator device. In examples, the second device <NUM> is an implantable stimulator device configured to be implanted beneath a recipient's tissue (e.g., skin). In examples, the second device <NUM> includes a biocompatible housing. The first device <NUM> can be a device configured to couple with (e.g., wirelessly) the second device <NUM> to provide additional functionality, such as stimulation control signals or charging. While the apparatus <NUM> is shown as having both implantable and external components, implementations of the apparatus <NUM> can be entirely external or entirely implantable.

In the illustrated example, the first device <NUM> includes one or more sensors <NUM>, a processor <NUM>, a transceiver <NUM>, and a power source <NUM>. The one or more sensors <NUM> can be units configured to produce data based on sensed activities. In an example where the stimulation system <NUM> is an auditory prosthesis system, the one or more sensors <NUM> can include sound input sensors, such as a microphone, a telecoil, wireless audio sources (e.g., a BLUETOOTH transceiver), an electrical input for an FM hearing system, and/or another component for receiving sound input. Where the stimulation system <NUM> is a visual prosthesis system, the one or more sensors <NUM> can include one or more cameras or other visual sensors. The processor <NUM> can be a component (e.g., a central processing unit) configured to control stimulation provided by the second device <NUM>. The stimulation can be controlled based on data from the sensor <NUM>, a stimulation schedule, or other data. Where the stimulation system <NUM> implements an auditory prosthesis, the processor <NUM> can be configured to convert sound signals received from the sensor(s) <NUM> (e.g., acting as a sound input unit) into external device signals <NUM>, using, for example, a sound processing path as is described elsewhere herein. The transceiver <NUM> is a component configured to send signals <NUM>, such as power signals, data signals, other signals, or combinations thereof (e.g., by interleaving the signals). The transceiver <NUM> can be configured to receive power or data. Stimulation signals can be generated by the processor <NUM> and transmitted, using the transceiver <NUM>, to the second device <NUM> for use in providing stimulation.

In the illustrated example, the second device <NUM> includes an electronics module <NUM>, a stimulator assembly <NUM>, a transceiver <NUM>, a power source <NUM>, and a coil <NUM>. The second device <NUM> further includes a hermetically sealed, biocompatible housing enclosing one or more of the components.

The electronics module <NUM> can include one or more other components to provide stimulation. In many examples, the electronics module <NUM> includes one or more components for receiving a signal and converting the signal into the stimulation signal <NUM>. The electronics module <NUM> can further include a stimulator unit. The electronics module <NUM> can generate or control delivery of the stimulation signals <NUM> to the stimulator assembly <NUM> to stimulate tissue proximate the stimulation assembly <NUM>. In examples, the electronics module <NUM> includes one or more processors (e.g., central processing units) coupled to memory components (e.g., flash memory) storing instructions that when executed cause performance of an operation described herein. In examples, the electronics module <NUM> generates and monitors parameters associated with generating and delivering the stimulus (e.g., output voltage, output current, or line impedance). In examples, the electronics module <NUM> generates a telemetry signal (e.g., a data signal) that includes telemetry data. The electronics module <NUM> can send the telemetry signal to the first device <NUM> or store the telemetry signal in memory for later use or retrieval.

The apparatus <NUM> can include one or more stimulator assemblies <NUM> can be one or more components configured to provide stimulation to target tissue. In the illustrated example, there are two stimulator assemblies <NUM> with one corresponding to the implantable inhibition assembly <NUM> and the implantable stimulation assembly <NUM>. Further in the illustrated example, the stimulator assemblies <NUM> are electrode assemblies that includes arrays of electrodes <NUM> disposed on a lead configured to be inserted into the recipient's cochlea. The stimulator assembly <NUM> can be configured to deliver stimulation signals <NUM> (e.g., electrical stimulation signals) generated by the electronics module <NUM> to the cochlea to cause a hearing percept in the recipient. In some examples, the stimulator assembly <NUM> is a vibratory actuator disposed inside or outside of a housing of the second device <NUM> and configured to generate vibrations. The vibratory actuator receives the stimulation signals <NUM> and, based thereon, generates a mechanical output force in the form of vibrations. The actuator can deliver the vibrations to the skull of the recipient in a manner that produces motion or vibration of the recipient's skull, thereby causing a hearing percept by activating the hair cells in the recipient's cochlea via cochlea fluid motion. In addition or instead, the actuator can deliver the vibrations to cause tactile percepts in the recipient.

The transceivers <NUM> can be components configured to transcutaneously receive or transmit a signal <NUM> (e.g., a power signal or a data signal). The transceiver <NUM> can be a collection of one or more components that form part of a transcutaneous energy or data transfer system to transfer the signal <NUM> between the first device <NUM> and the second device <NUM>. Various types of signal transfer, such as electromagnetic, capacitive, and inductive transfer, can be used to usably receive or transmit the signal <NUM>. The transceiver <NUM> can include or be electrically connected to the coil <NUM>.

The coils <NUM> can be components configured to receive or transmit a signal <NUM>, typically via an inductive arrangement formed by multiple turns of wire. In examples, in addition to or instead of a coil, other arrangements can be used, such as an antenna or capacitive plates. Magnets <NUM> can be used to align respective coils <NUM> of the first device <NUM> and the second device <NUM>. For example, the coil <NUM> of the second device <NUM> can be disposed in relation to (e.g., in a coaxial relationship) with a magnet <NUM> to facilitate orienting the coil <NUM> in relation to the coil <NUM> of the first device <NUM> via a magnetic connection <NUM>. The coil <NUM> of the first device <NUM> can also be disposed in relation to (e.g., in a coaxial relationship with) a magnet <NUM>.

The power source <NUM> of the respective devices can be configured to provide operational power to other components. The power sources <NUM> can be or include one or more rechargeable batteries. Power for the batteries can be received from a source and stored in the battery. The power can then be distributed to the other components of the second device <NUM> as needed for operation.

As should be appreciated, while particular components are described in conjunction with this, technology disclosed herein can be applied in any of a variety of circumstances. The above discussion is not meant to suggest that the disclosed techniques are only suitable for implementation within systems akin to that illustrated in and described with respect to the figure. In general, additional configurations can be used to practice the methods and systems herein and/or some aspects described can be excluded without departing from the methods and systems disclosed herein. For example, while <FIG> illustrates a second device <NUM> being implanted beneath the recipient's tissue, the system <NUM> can be formed without an implanted component. Instead, for example, the stimulation assemblies <NUM> can be configured to be used external stimulators can be used.

The various components of the system <NUM> can cooperate to compensate for a balance dysfunction of a recipient of the system <NUM>. An example process of using the components for such compensation is described in <FIG>.

<FIG>, which is made up of <FIG> and <FIG>, illustrates an example process <NUM> for compensating for a balance dysfunction. The process <NUM> can begin with operation <NUM>.

Operation <NUM> can include selecting a recipient having a balance disorder. For example, the recipient can be selected as the recipient having or being thought to have one or more symptoms of a balance disorder. The balance disorder can be a dysfunction of the recipient's vestibular system. Following operation <NUM>, the flow of the process <NUM> can move to operation <NUM> or operation <NUM>.

Operation <NUM> can include obtaining data from the one or more sensors <NUM>. For example, one or both of vestibular inhibitor <NUM> (e.g., the vestibular inhibitor stimulator generator <NUM> thereof) and the stimulator <NUM> (e.g., the balance signal generator <NUM> thereof) can obtain the data. The one or more sensors <NUM> can be one or more balance sensors that obtain data relating to balance data. Such data can include, for example, accelerometer data, gyroscope data, or magnetometer data. That data can describe rotation around one or more axes, such as pitch, yaw, or roll axes. Obtaining the data from one or more sensors <NUM> can include obtaining data from physiological sensors, such as heartbeat, galvanic skin response sensors, electromyography sensors, or other sensors. In some examples, one or more of the sensors <NUM> are disposed remote from the component obtaining the data. The obtaining can include wirelessly obtaining the data from a remote sensor <NUM>. For instance, in an example, the balance signal generator <NUM> obtains the data from the commuting device <NUM>. Following operation <NUM>, the flow of the process <NUM> can move to operation <NUM> or remain at operation <NUM>.

Operation <NUM> can include inhibiting the recipient's vestibular system. The inhibiting can include the vestibular inhibitor signal generator <NUM> generating a signal that causes the inhibition assembly <NUM> to stimulate the recipient's vestibular system in a manner that inhibits dysfunctional signals supplied by the recipient's vestibular system.

In various implementations inhibiting can be substantially constant, intermittent, performed in response to a schedule, or performed based on the sensor data obtained in operation <NUM>. The inhibiting can be controlled automatically or manually. For example, a user interface (e.g., a switch, button, touch screen, or wirelessly connected control) can be provided (e.g., at the computing device <NUM>) to permit the recipient or a caregiver thereof to engage or disengage the inhibition. Such a user interface can also be used to modify an intensity or other parameters of the inhibition being provided.

Where the inhibiting is based on the sensor data, the inhibiting can be activated in response to sensor data passing a threshold. In an example, the inhibiting can be activated responsive to the sensor data indicating balance difficulties by the recipient. Difficulty can be indicated by, for example, detecting movement patterns indicative of balance issues. Such movement patterns can be detected using hard-coded rules, such as decision trees. In other examples, a machine-learning approach is used to determine whether balance difficulties are present. For instance, there can be a machine learning framework (e.g., a neural network) trained to obtain sensory data as input and provide as output an indication whether a balance dysfunction event is occurring. Responsive to the balance dysfunction event occurring, the inhibition can be activated. In some examples, the process <NUM> can remain at operation <NUM> until the sensor data passes a particular threshold. For example, the process <NUM> can remain at operation <NUM> until the sensor data indicates that the recipient is experiencing a above a threshold amount of vestibular deficiency. For example, the sensor data can indicate that the recipient is falling or about to fall. In response to such an indication, the flow of the process can move to operation <NUM>. In other examples, the flow can remain at operation <NUM>.

In some examples, inhibiting the vestibular system can include deactivating tissue associated with the vestibular system, such as by ablating tissue associated with the vestibular system. In some examples, a pharmacological agent is provided to the recipient that inhibits the vestibular system or a perception of signals provided by the vestibular system. In an example, operation <NUM> can include operation <NUM> and operation <NUM>.

Operation <NUM> includes generating inhibition stimulation signals. The inhibition stimulation signals can be generated using, for example, a processor <NUM> or an electronics module <NUM> associated with the inhibitor <NUM>. The generation of the signals can cause the inhibiting to be substantially constant, intermittent, performed in response to a schedule, or performed based on the sensor data. The inhibition stimulation signals can be signals usable to control the delivery of stimulation. For example, the inhibiting can include electrically stimulating the vestibular system with one or more electrodes of the inhibition assembly <NUM>. The stimulation can be configured to mask naturally-occurring signals generated by the vestibular system that can cause abnormal vestibular percepts in the recipient. In some examples, the inhibiting can include delivering stimulation at approximately <NUM>, approximately <NUM>, or at less than <NUM>. Following operation <NUM>, the flow of the process <NUM> can move to operation <NUM>.

Operation <NUM> can include applying inhibition stimulation based on the inhibition. stimulation signals. Techniques for applying the stimulation can vary depending on the configuration of the stimulator assembly <NUM> being used. For example, where the stimulator assembly <NUM> is an electrode assembly, applying the stimulation can include electrically stimulating the recipient using the stimulator assembly. The stimulation can be delivered to an otolith region, semicircular canals, or other regions of the vestibular system of the recipient to inhibit the vestibular system. In another example, the stimulation is delivered to a vestibular nerve.

Following operation <NUM>, the flow of the process can move to operation <NUM> or operation <NUM>.

Operation <NUM> can include ceasing inhibiting the vestibular system. For example, this operation can include ceasing performing operation <NUM>. For instance, electrical or other stimulation of the vestibular system can be stopped. The ceasing can be performed in response to any of a variety of events, such as detecting that the recipient is not walking or otherwise moving. For example, it can be desirable to inhibit the vestibular system while the recipient is moving around and to cease the inhibiting at other times (e.g., when the recipient is sitting or lying down). In some examples, the inhibiting is ceased when the recipient is sleeping (e.g., which can be detected based on a variety of factors, such as a time of day, movement of the recipient, a lack of light detected by a light sensor, other factors, or combinations thereof). In some examples, the inhibiting can occur responsive to detecting that the recipient has an abnormal gait or is falling or about to fall. The inhibiting can cease responsive to determining that such events (e.g., a heightened risk of falling) are no longer occurring. Following operation <NUM>, the flow of the process can move to operation <NUM>.

Operation <NUM> can include providing balance compensation output signals to the recipient via one or more non-vestibular sensory channels of the recipient. The providing can include providing first balance compensation output signal while inhibiting the recipient's vestibular system. The providing can include providing second balance compensation output signal while the inhibiting is ceased. Operation <NUM> can include operation <NUM>.

Operation <NUM> can include generating one or more balance compensation output signals. The balance compensation output signals can be configured for use in compensation of a vestibular deficiency of the recipient. The operation <NUM> can include generating the balance compensation output signals using the balance signal generator <NUM>. Operation <NUM> can include operation <NUM>, operation <NUM>, operation <NUM>.

Operation <NUM> includes obtaining balance compensation input signals <NUM> from one or more sensors <NUM>. Such balance compensation input signals <NUM> can include, for example signals relating to rotation about one or more axes. The balance compensation input signals <NUM> can further include data relating to gait information of the recipient. Following operation <NUM>, the flow of the process can move to operation <NUM>.

Operation <NUM> includes generating the one or more balance compensation output signals based on balance compensation input. For example, such operation <NUM> can include operation <NUM>. Operation <NUM> includes encoding data regarding rotation about one or more axes using one or more characteristics. For example, the operation <NUM> can include encoding data regarding rotation about first, second, and third axes using respective first, second, and third characteristics. In some examples, the axes are selected from a group consisting of a yaw axis, a roll axis, and a pitch axis. The axes can be with respect to the recipient, such that the rotation about the particular axis provides information about movement of, for example, the recipient's head. The rotation about a first axis can be determined based on, for example compensation input signals obtained from the one or more sensors <NUM>. The characteristics can be characteristics of a percept that is ultimately perceived by a recipient. The encoding can include modifying a signal (e.g., the balance compensation output signals) such that the signal ultimately causes a percept to be detected by the recipient having the characteristic. The characteristics can vary based on a stimulation modality (e.g., tactile precept, audio percept, or visual percept). Further, the chosen stimulation modality itself can be a characteristic that can be used to convey balance information. For instance, where the stimulation modality is audio, such audio characteristics that can be varied to indicate rotation about the various axes can include: loudness, pitch, stimulation frequency, melody, rhythm, location (e.g., left or right side), stereo effect (e.g., a relative loudness or other difference between playback on left or right sides), other characteristics, or combinations thereof. Further, the same characteristic can be used to indicate information regarding rotation about multiple axes.

In an example, rotation about first and second axes is encoded using pitch and encoding an extent of the rotation about the axes using volume. For instance, as a recipient rotates their head about a roll axis, a tone having a first pitch can be played at a first volume. As the recipient continues to rotate their head further, the first volume can increase while the pitch remains the same. In addition, as the recipient rotates their head about a pitch axis, a tone having a second pitch can be played at a second volume. As the recipient continues to rotate their head further, the second volume can increase while the second pitch remains the same. The two tones can be played substantially simultaneously to each other. In some examples, negative or positive rotation angles can be encoded based on which side of a head the sound is played. In some examples, operation <NUM> can include operation <NUM>.

Operation <NUM> can include applying stimulation based on the balance compensation output signals. Applying the stimulation can include generating electrical, vibratory, visual, or other kinds of stimulation based on the signal, such as is described herein. Such stimulation can be configured to provide balance compensation. In some examples, operation <NUM> can include one or more of operation <NUM>, operation <NUM>, and operation <NUM>.

Operation <NUM> can include causing a hearing percept. Causing a hearing percept can include stimulating the recipient's auditory system so the recipient perceives an audio event. In some examples, operation <NUM> can include operation <NUM>, which includes electrically stimulating a cochlea of the recipient. For example, the cochlear can be stimulated with one or more intracochlear electrodes. An example of a cochlear implant with which hearing percepts can be caused is described in <FIG>. In some examples, operation <NUM> can include operation <NUM>. Operation <NUM> can include applying vibratory stimulation. The vibratory stimulation can include, for example, causing bone-conducted or air-conducted vibrations, such as from a bone conduction apparatus or consumer audio product, respectively. Such vibrations can cause an auditory precept to be experienced by the recipient.

Operation <NUM> can include causing a visual percept. Causing a visual percept can include stimulating the recipient's visual system so that the recipient perceives a visual event. In some examples, operation <NUM> can include activating LEDs (Light Emitting Diodes) or an LCD (Liquid Crystal Display) to cause the visual percept. In other examples, operation <NUM> can include directly stimulating a recipients visual sensory system via electrical or other stimulation.

Operation <NUM> can include causing a tactile percept. Causing a tactile percept can include causing one or more vibratory actuators to vibrate the recipient's skin to tactilely convey balance information.

Following operation <NUM>, the flow of the process <NUM> can return to operation <NUM> or operation <NUM>.

<FIG> is schematic diagram of a cochlear implant <NUM> with which examples herein can be implemented. The cochlear implant <NUM> includes an external component <NUM>. The external component <NUM> can be directly or indirectly attached to the body of the recipient and comprises a sound processor <NUM> (which can correspond to the first device <NUM>), an external coil <NUM> (which can correspond to coils <NUM>). In the illustrated example, the external coil <NUM> is remote from a main housing of the sound processor <NUM>, and the external coil <NUM> is connected to the sound processor <NUM> via a cable <NUM>. The sound processor <NUM> can be, for example, a behind-the-ear (BTE) sound processing unit, a body-worn sound processing unit, a button sound processing unit, etc..

The example cochlear implant <NUM> is shown as including an implantable component <NUM>. The implantable component includes an implant body <NUM>, a lead region <NUM>, and an elongate intra-cochlear stimulating assembly <NUM>. The implant body <NUM> generally comprises a hermetically-sealed housing in which an internal transceiver (e.g., transceiver <NUM>) and a stimulator unit (as a part of electronics module <NUM>) are disposed. The implant body <NUM> also includes a coil <NUM> that can be generally external to the housing, but which can be connected to the transceiver via a hermetic feedthrough. The coil <NUM> can be a wire antenna coil comprised of multiple turns of electrically insulated single-strand or multi-strand platinum or gold wire. The electrical insulation of the coil <NUM> can be provided by a flexible molding (e.g., silicone molding).

The elongate stimulating assembly <NUM> (e.g., corresponding to the assembly <NUM>) is configured to be at least partially implanted in the recipient's cochlea <NUM> and includes a plurality of longitudinally spaced intra-cochlear electrical stimulating electrodes <NUM> (e.g., electrodes <NUM>) that collectively form a contact array <NUM>. In certain arrangements, the contact array <NUM> can include other types of stimulating contacts, such as optical stimulating contacts or vibrational portions, in addition to the electrodes <NUM>. The stimulating assembly <NUM> extends through an opening <NUM> in the cochlea (e.g., cochleostomy, the round window, etc.) and has a proximal end connected to the stimulator unit via lead region <NUM> and a hermetic feedthrough. The lead region <NUM> includes a plurality of conductors (e.g., wires) that electrically couple the electrodes <NUM> to the stimulator unit.

The cochlear implant <NUM> further includes the implantable inhibition assembly <NUM> extending from the lead region <NUM>. As illustrated, the implantable inhibition assembly <NUM> includes one or more of the electrodes <NUM> disposed proximate vestibular anatomy. The electrodes <NUM> can be disposed in vestibular anatomy.

Returning to external component <NUM>, the sound source <NUM> is a component configured to detect/receive sound signals and to generate electrical signals therefrom. These signals are representative of the detected sound signals. The sound processor can execute sound processing and coding to convert the input signals generated by the sound source <NUM> into output data signals that represent electrical stimulation signals for delivery to the recipient. In some examples, the sound source <NUM> is a microphone. In other examples, the sound source <NUM> is a wireless data receiver configured to obtain, for example, audio data over a wireless transmission protocol, such as via an FM signal or BLUETOOTH.

Signals generated by the processor <NUM> can be transcutaneously transferred to the cochlear implant <NUM> the coil <NUM>. For example, the external coil <NUM> can transmit power and coded data signals to the implantable coil <NUM>. In certain examples, the external coil <NUM> transmits the signals to the implantable coil <NUM> via a radio frequency (RF) link. However, various other types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, can be used to transfer the power and/or data from an external component to a cochlear implant.

The coded data signals received at implantable coil <NUM> are provided to the transceiver <NUM> and forwarded to the electronics module <NUM>. The electronics module <NUM> can be configured to use the coded data signals to generate stimulation signals (e.g., current signals) for delivery to the recipient's cochlea via one or more of the electrodes <NUM>. In this way, the cochlear implant <NUM> stimulates the recipient's auditory nerve cells in a manner that causes hearing percepts, such that the recipient perceives the received sound signals by bypassing absent or defective hair cells that normally transduce acoustic vibrations into neural activity.

The external component <NUM> or a component connected to the external component can include the balance signal generator <NUM> as part of a balance signal system <NUM>. As described further below, the balance signal system <NUM> can be configured to generate one or more balance compensation output signals configured to compensate a vestibular deficiency. The balance compensation output signals can be injected into a sound processing path <NUM> of the sound processor <NUM> to cause hearing percepts in the recipient. An example of such a sound processing path <NUM> and injection of balance compensation output signals is described in <FIG>.

<FIG> is a schematic diagram illustrating example arrangements for a sound processor <NUM> and a balance signal system <NUM> forming part of a system <NUM> of a cochlear implant in accordance with embodiments presented herein. The illustrated sound processor <NUM> comprises a pre-filterbank processor <NUM>, a filterbank <NUM>, a post-filterbank processor <NUM>, a channel selector <NUM>, and a channel mapper <NUM> that collectively form the sound processing path <NUM> that is configured to convert one or more sound input signals <NUM> into one or more sound processing path output signals <NUM> for use in causing a hearing percept in a recipient. The components of the sound processing path <NUM> (e.g., components <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>) can be modifiers configured to modify the sound input signal <NUM>. The sound processing path output signals <NUM> that results from the sound processing path <NUM> can be used in generating electrical stimulation signals for delivery to the recipient to evoke perception of the received sound signals and other data injected into the sound processing path <NUM>. In the illustrated example, the sound processing path <NUM> begins at the pre-filterbank processing operations of the pre-filterbank processor <NUM> and sequentially moves through the filterbank operations performed at filterbank <NUM>, the operations performed at the post-filterbank processor <NUM>, the channel selecting operations of the channel selector <NUM>, and terminates at the channel mapping operations performed at channel mapper <NUM>. In other examples, the sound processing path <NUM> can have more or fewer operations and components, as well as other arrangements of components in parallel, branching, other arrangements, or combinations thereof.

As shown, multiple sound sources <NUM>, such as one or more microphones <NUM> and one or more auxiliary inputs <NUM> (e.g., audio input ports, cable ports, telecoils, a wireless transceiver, etc.) receive/detect sound signals which are then provided to the pre-filterbank processor <NUM>. If not already in an electrical form, sound sources <NUM> convert the sound signals into an electrical form for use by the pre-filterbank processor <NUM>, such as via an analog-to-digital converter. Sound input signal <NUM> are provided to the pre-filterbank processor <NUM> (e.g., in the form of electrical input signals). For ease of understanding, the term "sound input signal" <NUM> can be used to refer to not just the signals as received form the sound sources <NUM> but also such signals as they are transformed, converted, or otherwise processed through the sound processing path. For instance, sound input signals <NUM> can be used to refer to pre-filtered input signal <NUM>, hearing signal components <NUM>, processed channelized signals <NUM>, and selected channelized signals <NUM>, unless otherwise noted.

The pre-filterbank processor <NUM> can be a component configured to, as needed, combine the electrical input signals received from the sound sources <NUM> and prepare those signals for subsequent processing. The pre-filterbank processor <NUM> then generates a pre-filtered input signal <NUM> that is provided to the filterbank <NUM>. The pre-filterbank processor <NUM> can create the pre-filtered input signal <NUM> via any of a variety of combining operations. The pre-filtered input signal <NUM> represents the collective sound signals received at the sound sources <NUM> at a given point in time.

The filterbank <NUM> uses the pre-filtered input signal <NUM> to generate a suitable set of bandwidth limited channels, or frequency bins, that each includes a spectral component of the received sound signals that are to be used for subsequent sound processing. The filterbank <NUM> can be implemented as a plurality of band-pass filters that separate the pre-filtered input signal <NUM> into multiple components, each component carrying frequency sub-band (e.g., a single frequency) of the original signal (e.g., frequency components of the received sounds signal as included in pre-filtered input signal <NUM>). For example, the filterbank <NUM> can be or implement a plurality of band-pass filters configured to convert a sound input signal <NUM> into a signal having a plurality of hearing signal components that each correspond to one of a set of two or more channels created by the filterbank <NUM>.

The channels created by the filterbank <NUM> can be referred to as sound processing channels, and the sound signal components within each of the sound processing channels are sometimes referred to herein in as channelized signals. The channelized signals created by the filterbank <NUM> can be adjusted or modified as the signals pass through the sound processing path <NUM>. As such, the channelized signals can be referred to differently at different stages of the sound processing path <NUM>. Reference herein to a channelized signal can refer to the spectral component of the received sound signals at any point within the sound processing path <NUM> (e.g., pre-processed, processed, or selected).

At the output of the filterbank <NUM>, the channelized signals are initially referred to herein as hearing signal components <NUM>. As illustrated, there are x channels defined by the filterbank. The value of x can depend on a number of different factors, such as implant design, number of active electrodes, coding strategy, recipient preferences, other factors, and combinations thereof. In certain arrangements, twenty-two channelized signals are created, thus the sound processor <NUM> would be said to have twenty-two channels.

In many examples, the sound input signals <NUM> and the pre-filtered input signal <NUM> are time domain signals (e.g., processing at pre-filterbank processor <NUM> occurs in the time domain). However, the filterbank <NUM> can operate to deviate from the time domain and, instead, create a channelized domain in which further sound processing operations are performed. As used herein, the channel domain refers to a signal domain formed by a plurality of amplitudes at various frequency sub-bands. In certain embodiments, the filterbank <NUM> passes through amplitude information, but not phase information, for each of the x channels. This can be due to methods of envelope estimation that can be used in each channel, such as half wave rectification (HWR), low pass filtering (LPF), quadrature envelope estimation, or Hilbert envelope estimation methods, other techniques, or combinations thereof. As such, the channelized or band-pass filtered signals can be referred to as phase-free signals. In other examples, both phase and amplitude information can be retained for subsequent processing.

In embodiments in which the band-pass filtering operations eliminate the phase information (e.g., generate phase-free signals), the channel domain can be viewed as distinguishable from the frequency domain because signals within the channel domain cannot be precisely converted back to the time domain. That is, due to the removal of the phase information in certain embodiments, the phase-free channelized signals in the channel domain are not exactly convertible back to the time domain.

The sound processing path <NUM> also includes a post-filterbank processor <NUM>. The post-filterbank processor <NUM> is a component that can be configured to perform a number of sound processing operations on the plurality of hearing signal components <NUM>. These sound processing operations include, for example gain adjustments (e.g., multichannel gain control), noise reduction operations, or signal enhancement operations (e.g., speech enhancement, wind reduction), other operations, or combinations thereof, in one or more of the channels. Noise reduction can include processing operations that identify unwanted components of a signal (e.g., noise components), and then subsequently reduce the presence of these unwanted components. Signal enhancement can refer to processing operations that identify the target signals (e.g., speech or music) and then subsequently increase the presence of these target signal components. Speech enhancement is a particular type of signal enhancement. After performing the sound processing operations, the post-filterbank processor <NUM> outputs a plurality of processed channelized signals <NUM>. The plurality of processed channelized signals <NUM> can be transmitted to the channel selector <NUM>.

The channel selector <NUM> can be a component that selects a subset of y channels of the x processed channelized signals <NUM> for use in generation of stimulation for delivery to a recipient. For example, the channels input into the channel selector <NUM> are reduced from x channels to y channels. In one specific example, the y largest amplitude channels (maxima) from the x available channels is made, with x and y being programmable during cochlear implant fitting or operation. Different channel selection methods can be used and need not be limited to maxima selection. The signals selected at channel selector <NUM> are represented as selected channelized signals <NUM> or, more simply, selected signals.

The illustrated sound processing path <NUM> also includes a channel mapper <NUM>. The channel mapper <NUM> can be configured to map the amplitudes of the selected signals <NUM> into a set of stimulation commands that represent the attributes of stimulation signals (current signals) that are to be delivered to the recipient so as to evoke perception of the received sound signals. This channel mapping can include, for example, threshold and comfort level mapping, dynamic range adjustments (e.g., compression), volume adjustments, etc., and can encompass sequential and/or simultaneous stimulation paradigms.

In the illustrated example, the set of stimulation commands that represent the stimulation signals are encoded for transcutaneous transmission (e.g., via an RF link) to an implantable component <NUM>. This encoding can be performed at channel mapper <NUM>. As such, channel mapper <NUM> is sometimes referred to herein as a channel mapping and encoding module and operates as an output block configured to convert the plurality of channelized signals into a plurality of sound processing path output signals <NUM>.

As illustrated, the filterbank <NUM>, the post-filterbank processor <NUM>, the channel selector <NUM>, and the channel mapper <NUM> collectively form a sound processing path <NUM> that converts the one or more received sound signals into one or more output signals for use in compensation of a hearing loss of a recipient of the cochlear implant. In other words, the sound processing path <NUM> extends from the filterbank <NUM> to the channel mapper <NUM>. The output signals <NUM> generated by the sound processor <NUM> comprise a plurality of encoded signals for delivery to the implantable component <NUM>.

The sound processing path <NUM> can include other components. In addition to or instead of the components described herein. For example, the sound processing path <NUM> can include adaptive dynamic range optimization components, automatic gain control components, channel combiner components, mixing components, fast Fourier transform components, level detection components, beamforming components, windowing components, calibration filtering components, pre-emphasis components, other components, and combinations thereof. Additional examples of components and techniques that can be used with the sound processing path <NUM> to modify the sound input signal <NUM> are described in <CIT> and <CIT>, which are both incorporated herein by reference for any and all purposes.

As further shown in <FIG>, a balance signal system <NUM> can operate with the sound processor <NUM>. In the illustrated example, the balance signal system <NUM> includes a balance signal generator <NUM> and an injector <NUM>. The balance signal generator <NUM> is configured to generate a balance compensation output signal <NUM>. The balance compensation output signal <NUM> generated by the balance signal generator <NUM> can be channelized by being formed by a plurality of discrete amplitudes at different frequency sub-bands that each correspond to a channel (e.g., a specific frequency sub-band) of the sound processing path <NUM>. For example, balance signal generator <NUM> can be configured to generate channelized balance compensation output signal having a plurality of balance compensation signal components that each correspond to one of a first subset of N-M channels. In <FIG>, the balance compensation output signals <NUM> can include frequency-limited components or full-band components. In other examples, the balance compensation output signal is not channelized. Such an unchanneled signal can be provided into the sound processing path <NUM> prior to the filterbank <NUM>, whereby the balance compensation output signal is channelized.

The balance signal generator <NUM> can receive or obtain balance compensation input signals <NUM> from one or more of the sensors <NUM>. The balance signal generator <NUM> can use the balance compensation input signals <NUM> to generate the balance compensation output signal <NUM>.

As noted, the balance signal system <NUM> also comprises an injector <NUM>. The injector <NUM> can be configured to inject the balance compensation output signal <NUM> into the sound processing channels of the sound processing path <NUM>. For example, one or more components of the balance compensation output signal <NUM> are combined with, or otherwise applied to, channelized signals in a corresponding sound processing channel (e.g., the components of the balance compensation output signal are separately combined with separate channelized signals). In another example, the injector <NUM> injects the balance compensation output signal <NUM> to a pre-channelized signal. As a result, the balance compensation output signal <NUM> forms part of the one or more sound processing path output signals generated by the sound processor <NUM> for use in compensation of a hearing loss of a recipient of the cochlear implant <NUM>. The injection of the balance compensation output signal <NUM> into the sound processing channels of the sound processing path <NUM> is generally shown at the illustrated injection points <NUM>.

Injection of the balance compensation output signal <NUM> into one or more sound processing channels can occur in any of a variety of ways, such as: weighted or unweighted summation, weighted or unweighted addition, weighted or unweighted superposition, gated selective injection, rules-based selective injection (e.g., injection only occurs if the channel level satisfies a threshold, such as a masker signal level or a post-filterbank processor output level), random injection, or stochastic injection, other techniques, or combinations thereof. The injection of the balance compensation output signal into one or more of the sound processing channels can also be further controlled by time-based rules, such as: simultaneous injection into two or more channels, round robin channel injection, multiplexed selection of channels for injection, random selection, occasional selection of channels for injection, other techniques or combinations thereof. In some examples, the injection completely replaces (e.g., overwrites) the sound signal that was on the channel prior to injection.

The location at which the balance compensation output signal <NUM> is injected into the sound processing path <NUM> can vary. For example, the balance compensation output signals <NUM> can be injected at a location in the sound processing path after any noise reduction or signal enhancement operations are completed at post-filterbank processor <NUM>, but before channel selection at channel selector <NUM>. In such an example, the channel selection is based on the combination of the processed channelized signals <NUM> and the balance compensation output signal <NUM>. In other examples, the balance compensation output signal <NUM> is injected after the channel selector <NUM> operation is performed. In some examples, certain channels can be treated differently than other channels. For example, a certain subset of the x channels can be set to always be selected by the channel selector <NUM>. For instance, where the balance compensation output signal <NUM> is injected prior to the channel selector <NUM>, the channel selector <NUM> can be configured such that the balance compensation output signal <NUM> is present in the y channels after selection.

In the illustrated example, the balance compensation output signal is injected into all of the sound processing channels. In the illustrated example, there are x sound processing channels and N-M balance signal channels. In some examples, channels N through M are dedicated balance signal channels that are not used to carry signals based on the sound input. In some examples, N-M < x. The balance compensation output signal <NUM> can be channelized (e.g., by the balance signal generator <NUM> or the filterbank <NUM>) into having a plurality of balance compensation signal components that each correspond to one of a first subset of N-M (e.g., where N-M > <NUM>) channels. And the filterbank <NUM> can be configured to convert the sound input signal <NUM> into a signal having a plurality of hearing signal components <NUM> that each correspond to one of a second subset of X channels (e.g., where X > <NUM>). The resulting first and second subsets can be disjoint, intersecting, or identical.

In the illustrated example, the injector <NUM> is configured to inject the balance compensation output signal <NUM> into the sound processing path <NUM> between the post-filterbank processor <NUM> and the channel selector <NUM>. In other words, the injection occurs after the noise reduction, signal enhancement, gain adjustment, and other sound processing operations that have the potential to affect the success of the balance stimulation in some unintended manner, but before a channel selection process. The channel selection process at channel selector <NUM> is configured to select, according to one or more selection rules, which of the Y processed channelized signals <NUM>, when combined with the balance compensation output signal <NUM>, should be used for hearing compensation.

Balance compensation output signals <NUM> can have a variety of different number of channels (e.g., more or less than <NUM> channels is possible). As illustrated, there are N-M channels for the balance signal generator <NUM>. The balance compensation output signals <NUM> need not be present across an entire spectrum of audible frequencies able to be produced by the system. Instead, the a relatively smaller number of hearing frequencies can be targeted for use in causing percepts representative of balance compensation output signals <NUM>. Thus, in certain examples, there can only be a small number of channels (e.g., one or two channels) used for providing balance compensation output signals <NUM>. The low number of channels can facilitate the recipient associating the particular frequencies produced by those channels as being particular to balance compensation signals rather than general hearing. The channels used for balance compensation output signals <NUM> being dedicated can further contribute to such an association. In other examples, there can be many more channels used for balance compensation output signals <NUM> and such channels can be shared with environmental audio signals.

As noted, <FIG> illustrates an embodiment in which the injection points <NUM> for the balance compensation output signal <NUM> is between the post-filterbank processor <NUM> and the channel selector <NUM>. However, it is to be appreciated that a balance compensation output signal can be injected into other locations/points of the sound processing path <NUM> subsequent to noise reduction, signal enhancement, gain adjustment, and other sound processing operations that have the potential to affect the success of the balance compensation in some unintended manner.

An example process for compensating for a balance dysfunction that can be used with the implemented using the components of <FIG> and <FIG> (among other components), is described in relation to <FIG>.

<FIG> illustrates an example process <NUM> for compensating a balance dysfunction. The process <NUM> can begin with operation <NUM>.

Operation <NUM> includes converting a sound input signal <NUM> into a sound processing path output signals <NUM>. This operation <NUM> can include obtaining the sound input signal <NUM> from one or more sound sources <NUM>. For example, the operation <NUM> can include obtaining the sound input signal from one or more sensors <NUM> selected from the group consisting of: microphones, telecoils, and wireless audio sources. The converting can include processing the sound input signal <NUM> using one or more components of the sound input signal <NUM>, such as a pre-filterbank processor, a filterbank <NUM>, a post-filterbank processor <NUM>, a channel selector <NUM>, a mapper <NUM>, and an encoder <NUM>, among other components. In some examples, the operation <NUM> includes operation <NUM>.

The operation <NUM> includes applying a filtering portion of the sound processing path <NUM> to the sound input signal <NUM>. For instance applying the filtering portion can include processing the sound input signal <NUM> using the filterbank <NUM>. As described above, processing with the filterbank <NUM> can include applying one or more band-pass filters to separate the sound input signal <NUM> into multiple components, each one carrying a single frequency sub-band of the original sound input signal <NUM>. In another example, applying the filtering portion can include processing the sound input signal <NUM> using the post-filterbank processor <NUM>. For instance, as described above, processing with the post-filterbank processor <NUM> can include: adjusting gain, reducing noise, enhancing particular portions of the sound input signal <NUM> (e.g., enhancing a speech portion of the sound input signal <NUM>, reducing a wind portion of the sound input signal <NUM>), other operations, or combinations thereof.

The operation <NUM> can include applying a channelizing portion of the sound processing path <NUM> to the sound input signal <NUM>. For example, the channelizing portion can be the filterbank <NUM> and the channelizing can include forming one or more channels from the sound input signal <NUM>.

Following operation <NUM>, the flow of the process <NUM> can move to operation <NUM>, which as described above in relation to <FIG>, can include generating one or more balance compensation output signals <NUM>. The balance compensation output signals <NUM> can be can be channelized. During performance of the process <NUM>, following operation <NUM>, the flow of the process <NUM> can move to operation <NUM>.

Operation <NUM> can include injecting the one or more balance compensation output signals <NUM> into the sound processing path <NUM> for ultimate inclusion in the sound processing path output signal. The operation <NUM> can be performed using the injector <NUM>. For example, the injector <NUM> can be configured to perform operation <NUM>. As a result of the injecting, the sound processing path output signals <NUM> is based on the one or more injected balance compensation output signals <NUM>. In an example, the balance compensation output signals <NUM> is injected as input into the pre-filterbank processor <NUM>. In an example, the balance compensation output signals <NUM> are injected after the pre-filterbank processor <NUM>. In an example, the balance compensation output signals <NUM> are injected between a pre-filterbank processor <NUM> and a filterbank <NUM>. In an example, the balance compensation output signals <NUM> are injected as input into the filterbank <NUM>. In an example, the balance compensation output signals <NUM> are injected after the filterbank <NUM>. In an example, the balance compensation output signals <NUM> are injected between the filterbank <NUM> and a post-filterbank processor <NUM>. In an example, the balance compensation output signals <NUM> are injected into or after the post-filterbank processor <NUM>. In an example, the balance compensation output signals <NUM> are injected between the post-filterbank processor <NUM> and the channel selector <NUM>. In an example, the balance compensation output signals <NUM> are injected into or after the channel selector <NUM>. In an example, the balance compensation output signals <NUM> are injected between the channel selector <NUM> and a mapper and an encoder <NUM>. The injecting can be prior to one or more components of the sound processing path <NUM>, such as prior to one or more of: the pre-filterbank processor <NUM>, the filterbank <NUM>, the post-filterbank processor <NUM>, the channel selector <NUM>, the mapper <NUM>, the encoder <NUM>, other components, or combinations thereof). In an example, the balance compensation output signals <NUM> are injected into or after the mapper and encoder <NUM>. Where the operation <NUM> includes operation <NUM>, the injecting can be subsequent to the filtering portion of the sound processing path <NUM>. For example, the injecting can be such that the balance compensation output signals <NUM> bypass the filtering portion.

The injecting can occur in any of a variety of ways. The injecting can include performing, with respect to the sound input signal <NUM>: weighted or unweighted summation, weighted or unweighted addition, weighted or unweighted superposition, gated selective injection, rules-based selective injection (e.g., injecting responsive to a channel level satisfying a threshold, such as a masker signal level or a post-filterbank processor output level), random injection, or stochastic injection, other techniques, or combinations thereof. The injection of the balance compensation output signal into one or more of the sound processing channels can also be further controlled by time-based rules, such as: simultaneous injection into two or more channels, round robin channel injection, multiplexed selection of channels for injection, random selection, occasional selection of channels for injection, other techniques or combinations thereof. In some examples, the injection completely replaces (e.g., overwrites) the sound signal that was on the channel prior to injection. In some examples, the injection is into a dedicated balance-only portion of the sound processing path <NUM>. In some examples, the injection is into a channel where there was no sound signal (e.g., no prior signal is modified, overwritten, or otherwise interacted with).

Following operation <NUM>, the flow of the process <NUM> can move to operation <NUM>. Operation <NUM> can include stimulating tissue based on the sound processing path output signals <NUM>. For example, the sound processing path output signals <NUM> can be used by the electronics module <NUM> to provide stimulation using the stimulator assembly <NUM>. Where the sound processing path <NUM> is disposed in an external component and the stimulator assembly <NUM> is part of an implantable component <NUM>, then the sound processing path output signals <NUM> can be transmitted to an implantable component <NUM> or be generated within an implantable component <NUM>. The operation <NUM> can include stimulating the tissue using one or more dedicated balance stimulation electrodes based on a portion of the sound processing path output corresponding to the one or more balance compensation output signals.

Although disclosed examples are described herein with respect to particular examples, technology described herein can be applied elsewhere. For example, dysfunctional sensory signals in general can be inhibited with the inhibitor <NUM> and substituted with signals from the signal generator <NUM>. Other sensory organs than the vestibular system can be inhibited.

As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant to suggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. For examples, while certain technologies described herein were primarily described in the context of auditory prostheses (e.g., cochlear implants), technologies disclosed herein are applicable to medical devices generally (e.g., medical devices providing pain management functionality or therapeutic electrical stimulation, such as deep brain stimulation). In general, additional configurations can be used to practice the processes and systems herein and/or some aspects described can be excluded without departing from the processes and systems disclosed herein.

This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and/or some aspects described can be excluded without departing from the methods and systems disclosed herein.

Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosed steps can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.

Claim 1:
A system comprising:
a vestibular inhibitor (<NUM>) configured to inhibit a recipient's vestibular system;
characterized by
a stimulator (<NUM>) configured to stimulate tissue of the recipient via one or more non-vestibular sensory channels of the recipient based on balance compensation output signals (<NUM>) to compensate for a balance dysfunction.