EP-4736748-A1 - STATE-BASED INITIATION OF EVOKED RESPONSE-BASED MEASUREMENT TESTS DURING AN ELECTRODE LEAD INSERTION PROCEDURE

EP4736748A1EP 4736748 A1EP4736748 A1EP 4736748A1EP-4736748-A1

Abstract

An illustrative diagnostic system may perform a process comprising: performing, during a lead insertion procedure during which an electrode lead is inserted into a cochlea of a recipient of a cochlear implant, a first evoked response-based measurement test that generates first result data; determining that the first result data satisfies a first condition; performing, based on the first result data satisfying the first condition and during the lead insertion procedure, a second evoked response-based measurement test that generates second result data, the second evoked response-based measurement test being of a different type than the first evoked response-based measurement test; and performing, based on the second result data, an operation associated with the lead insertion procedure.

Inventors

KOKA, Kanthaiah
SPAHR, ANTHONY J.
ASHIRI, Mehrangiz

Assignees

Advanced Bionics, LLC

Dates

Publication Date: 20260506
Application Date: 20251024

Claims (15)

A system comprising: a memory storing instructions; and one or more processors communicatively coupled to the memory and configured to execute the instructions to perform a process comprising: performing, during a lead insertion procedure during which an electrode lead is inserted into a cochlea of a recipient of a cochlear implant, a first evoked response-based measurement test that generates first result data; determining that the first result data satisfies a first condition; performing, based on the first result data satisfying the first condition and during the lead insertion procedure, a second evoked response-based measurement test that generates second result data, the second evoked response-based measurement test being of a different type than the first evoked response-based measurement test; and performing, based on the second result data, an operation associated with the lead insertion procedure.
The system of claim 1, wherein the performing the second evoked response-based measurement test is automatically initiated without user input being provided to initiate the second evoked response-based measurement test.
The system of claim 1, wherein the performing the operation is further based on the first result data.
The system of claim 1, wherein the performing the operation comprises: determining that the second result data satisfies a second condition; and performing, based on the second result data satisfying the second condition and during the lead insertion procedure, a third evoked response-based measurement test that generates third result data.
The system of claim 4, wherein the performing the operation is further based on the third result data.
The system of claim 1, wherein the performing the operation comprises providing, during the lead insertion procedure, a notification associated with the lead insertion procedure.
The system of claim 1, wherein the performing the operation comprises providing, during the lead insertion procedure, feedback to a robotic lead insertion system, the feedback configured to adjust one or more operating parameters of the robotic lead insertion system.
The system of claim 1, wherein the performing the operation comprises adjusting one or more parameters configured to control the lead insertion procedure.
The system of claim 1, further comprising: selecting, by the system based on the first result data, a particular evoked response-based measurement test from a plurality of available evoked response-based measurement tests; and designating, by the system, the particular evoked response-based measurement test as the second evoked response-based measurement test.
The system of claim 9, further comprising: providing, by the system, the first result data as an input to a machine learning model; wherein the selecting the particular evoked response-based measurement test is based on an output of the machine learning model.
The system of claim 10, wherein the machine learning model is trained using historical test data associated with one or more lead insertion procedures performed prior to the lead insertion procedure.
The system of claim 1, wherein: the first evoked response-based measurement test comprises a single tone-based insertion depth monitoring procedure that measures an evoked response that occurs in response to application of acoustic stimulation having a single frequency; and the second first evoked response-based measurement test comprises at least one of a multi tone-based insertion depth monitoring procedure that measures multiple evoked responses that occur in response to application of an additional acoustic stimulation having multiple frequencies or an electric field imaging measurement procedure that measures one or more evoked responses that occur in response to electrical stimulation being applied to one or more electrodes of the electrode lead.
A method comprising: performing, by a diagnostic system during a lead insertion procedure during which an electrode lead is inserted into a cochlea of a recipient of a cochlear implant, a first evoked response-based measurement test that generates first result data; determining, by the diagnostic system, that the first result data satisfies a first condition; performing, by the diagnostic system based on the first result data satisfying the first condition and during the lead insertion procedure, a second evoked response-based measurement test that generates second result data, the second evoked response-based measurement test being of a different type than the first evoked response-based measurement test; and performing, by the diagnostic system based on the second result data, an operation associated with the lead insertion procedure.
The method of claim 13, wherein the performing the second evoked response-based measurement test is automatically initiated by the diagnostic system without user input being provided to initiate the second evoked response-based measurement test.
A non-transitory computer-readable medium storing instructions that, when executed, direct a processor of a computing device to perform a process comprising: performing, during a lead insertion procedure during which an electrode lead is inserted into a cochlea of a recipient of a cochlear implant, a first evoked response-based measurement test that generates first result data; determining that the first result data satisfies a first condition; performing, based on the first result data satisfying the first condition and during the lead insertion procedure, a second evoked response-based measurement test that generates second result data, the second evoked response-based measurement test being of a different type than the first evoked response-based measurement test; and performing, based on the second result data, an operation associated with the lead insertion procedure.

Description

BACKGROUND INFORMATION During an insertion procedure in which an electrode lead is placed within the cochlea, it may be desirable to ascertain an insertion state of the electrode lead. For example, it may be desirable to determine and convey in real-time to a surgeon performing the insertion procedure when an electrode on the electrode lead passes a particular characteristic frequency location within the cochlea, when an electrode on the electrode lead is within a vicinity of a cluster of hair cells, and/or when the electrode lead is possibly causing trauma to a structure of the cochlea. BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings illustrate various embodiments and are a part of the specification. The illustrated embodiments are merely examples and do not limit the scope of the disclosure. Throughout the drawings, identical or similar reference numbers designate identical or similar elements. Fig. 1 shows an illustrative cochlear implant system according to principles described herein.Fig. 2 shows an illustrative configuration of the cochlear implant system of Fig. 1.Fig. 3 shows an illustrative diagnostic system according to principles described herein.Figs. 4-5 show illustrative implementations of the diagnostic system of Fig. 3 according to principles described herein.Figs. 6A-6F show illustrative insertion procedure in which an electrode lead is inserted into a cochlea of a recipient according to principles described herein.Fig. 7 illustrates an illustrative method that may be used to perform state-based initiation of evoked response-based measurement tests during an electrode lead insertion procedure.Fig. 8 shows an implementation of the diagnostic system of Fig. 3.Fig. 9 illustrates an illustrative method.Figs. 10-14 shows an illustrative multi tone-based insertion depth monitoring procedure.Fig. 15 illustrates an exemplary computing device according to principles described herein. DETAILED DESCRIPTION Described herein is a state-based heuristic in which different types of evoked response-based measurement tests are used during an electrode lead insertion procedure to assist in performing the electrode lead insertion procedure. For example, a diagnostic system may initially perform a first evoked response-based measurement test during the electrode lead insertion procedure. Based on the results of the first evoked response-based measurement test, the diagnostic system may automatically initiate a different type of evoked response-based measurement test in place of the first evoked response-based measurement test. This second evoked response-based test may be selected to confirm the results of the first test and/or supplement the results of the first test in any other manner. The results data from the second test (and, in some cases, the first test) may be used to perform an operation with respect to the lead insertion procedure (e.g., provide a notification, provide feedback to a robotic lead insertion system, optimize parameters associated with the lead insertion procedure, etc.). Compared with conventional approaches in which a single evoked response-based measurement test is used during a lead insertion procedure, the systems and methods described herein may optimize accuracy of electrode lead placement in the cochlea, improve efficiency of the lead insertion procedure in terms of computing resources used to monitor the lead insertion procedure, reduce time in which a cochlear implant recipient has to be in surgery, and/or provide various other technical and individual benefits and advantages, as will be made apparent herein. As used herein, an evoked response may refer to any type of neural or physiological response within a cochlear implant recipient that occurs in response to any type of stimulation (e.g., acoustic and/or electrical stimulation). For example, an evoked response may include an electrocochleographic ("ECoG" or "ECochG") 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 stimulation (e.g., acoustic and/or electrical stimulation) to the recipient. Evoked responses may originate from neural tissues, hair cell to neural synapses, inner or outer hair cells, and/or other sources. An evoked response-based measurement test may refer to any test that may be performed that involves measuring at least one type of evoked response. For example, an evoked response-based measurement test may include a single tone-based insertion depth monitoring procedure that measures an evoked response (e.g., ECochG) that occurs in response to application of acoustic stimulation having a single frequency to determine an insertion depth of an electrode lead into the cochlea. As another example, an evoked response-based measureme