Implantable hearing assistance system with calibration and auditory response testing

Abstract

A hearing assistance system includes electric response audiometry (ERA) functions for diagnostic, self-calibration, frequency-response parameter adjustment, feedback self-testing, and automatic gain control (AGC) purposes. The invention includes partial middle ear implantable (P-MEI), total middle ear implantable (T-MEI), cochlear implant, or other hearing assistance systems. Auditory response signals are obtained by auditory brain-stem response (ABR), cortical ERA, and electrocochleography. A mechanical vibration or electrical stimulus is introduced directly in the middle or inner ear, either in response to an input signal corresponding to sound, or in response to an independent calibration signal. Auditory response signals are obtained by surface electroencephalography (EEG) or by an implanted electrocochleographic sensor. Calibration stimuli have constant or adjustable amplitudes, frequencies, and repetition frequencies. Wide-band clicks, pure audio tones, and other calibration stimuli are included. The diagnostic and calibration capabilities are particularly useful to assess efficacy during implantation of components into a patient under general anesthesia.

What is claimed is:  
     
         1 . A method of testing an auditory response in a living organism, the method comprising: 
 introducing a stimulus directly in a middle or inner ear; and    obtaining an electrical auditory response signal in response to the stimulus.    
     
     
         2 . The method of    claim 1   , wherein the stimulus is a mechanical vibration.  
     
     
         3 . The method of    claim 2   , wherein the mechanical vibration is provided by an output stimulator comprising an electromechanical transducer disposed within the middle ear.  
     
     
         4 . The method of    claim 3   , wherein the electromechanical transducer is mechanically coupled to a stapes bone.  
     
     
         5 . The method of    claim 1   , wherein the stimulus is electrical.  
     
     
         6 . The method of    claim 5   , wherein the stimulus is provided by an output stimulator comprising a cochlear implant disposed within the inner ear.  
     
     
         7 . The method of    claim 1   , wherein the auditory response signal is obtained by electroencephalography (EEG) techniques.  
     
     
         8 . The method of    claim 1   , wherein the auditory response signal is obtained by electrocochleographic techniques.  
     
     
         9 . The method of    claim 1   , wherein the auditory response signal is obtained by cortical electric response audiometry techniques.  
     
     
         10 . The method of    claim 1   , wherein the auditory response signal is obtained by auditory brain stem response techniques.  
     
     
         11 . A method of testing an auditory response in a living organism, the method comprising: 
 applying sound to an ear;    transducing the sound into an electrical input signal;    processing the electrical input signal to provide a resulting electrical output signal;    introducing an output stimulus directly in the middle ear or inner ear in response to the output signal; and    obtaining an electrical auditory response signal in response to the output stimulus.    
     
     
         12 . The method of    claim 11   , wherein the step of transducing the sound includes sensing a mechanical vibration in the middle ear.  
     
     
         13 . The method of    claim 11   , wherein the step of transducing the sound includes sensing sound waves.  
     
     
         14 . A method of using an at least partially implantable hearing assistance device, the method comprising the steps of: 
 positioning an output stimulator in a middle or inner ear;    providing a stimulus to the middle or inner ear via the output stimulator; and    measuring an auditory response to the stimulus.    
     
     
         15 . The method of step  14 , further comprising the step of repositioning the output stimulator if insufficient auditory response is measured.  
     
     
         16 . The method of step  14 , further comprising the step of adjusting characteristics of an electrical signal provided to the output stimulator based upon the measured auditory response.  
     
     
         17 . The method of step  14 , further comprising the step of adjusting a signal processing parameter based upon the measured auditory response.  
     
     
         18 . The method of step  14 , wherein the step of providing a stimulus to the middle or inner ear via the output stimulator is in response to sound transduced by an input transducer, and further comprising the step of adjusting characteristics of an electrical signal provided to the output stimulator in response to the transduced sounds.  
     
     
         19 . A method of using an at least partially implantable hearing assistance device, the method comprising the steps of: 
 (a) providing a calibration stimulus to the middle or inner ear via an output stimulator;    (b) detecting a feedback signal; and    (c) changing a characteristic of the calibration stimulus based upon the detected feedback signal.    
     
     
         20 . The method of    claim 19   , wherein the step of changing a characteristic of the calibration stimulus comprises the step of increasing the amplitude of the calibration stimulus if the detected feedback signal does not meet a threshold.  
     
     
         21 . The method of    claim 19   , further comprising the steps of: 
 (d) adjusting a signal processing parameter if the detected feedback signal meets a threshold.    
     
     
         22 . The method of    claim 21   , wherein steps (a)-(d) are repeated using calibration stimuli of different frequencies.  
     
     
         23 . The method of    claim 19   , wherein the feedback signal is detected at an input transducer.  
     
     
         24 . The method of    claim 19   , wherein the feedback signal is detected at a response sensor.  
     
     
         25 . An apparatus, comprising: 
 an input transducer for converting a sound vibration into an electrical input signal;    an output stimulator, proportioned for disposition within a middle ear region or an inner ear region an ear and providing an output stimulus thereto in response to an electrical output signal;    a response sensor for measuring an auditory response signal; and    an electronics unit that receives the input signal and provides the output signal to the output stimulator.    
     
     
         26 . The apparatus of    claim 25   , wherein the response sensor includes an external electroencephalography (EEG) device and an external electrode.  
     
     
         27 . The apparatus of    claim 25   , wherein the response sensor includes an implantable electrode that is electrically coupled to the electronics unit.  
     
     
         28 . The apparatus of    claim 27   , wherein the response sensor is proportioned for disposition near and coupling to a cochlea or auditory nerve in the inner ear.  
     
     
         29 . The apparatus of    claim 25   , wherein the auditory response signal results from the output stimulus.  
     
     
         30 . The apparatus of    claim 25   , wherein a signal processing parameter is adjustable based upon the auditory response signal.  
     
     
         31 . The apparatus of    claim 25   , wherein the electronics unit provides an automatic gain control (AGC) function based upon the auditory response signal.  
     
     
         32 . An apparatus, comprising: 
 an input transducer for converting a sound vibration into an electrical input signal;    an output stimulator, proportioned for disposition within a middle ear region or an inner ear region an ear and providing an output stimulus thereto in response to an electrical output signal;    an electronics unit that receives the input signal and provides the output signal to the output stimulator; and    a calibration module, which is carried by the electronics unit, for providing a calibration output signal to the output stimulator.    
     
     
         33 . The apparatus of    claim 32   , wherein the output stimulator provides a calibration stimulus in response to the calibration output signal received from the electronics unit.  
     
     
         34 . The apparatus of    claim 33   , wherein the input transducer provides a feedback signal, resulting from the calibration stimulus, to the electronics unit.  
     
     
         35 . The apparatus of    claim 34   , wherein a signal processing parameter is adjusted based upon the feedback signal.  
     
     
         36 . The apparatus of    claim 33   , further comprising a response sensor for measuring an auditory response signal resulting from the calibration stimulus.  
     
     
         37 . The apparatus of    claim 36   , wherein the response sensor is electrically coupled to the electronics unit for providing the auditory response signal thereto.  
     
     
         38 . The apparatus of    claim 37   , further comprising a calibration module that adjusts characteristics of the calibration output signal based upon the auditory response signal.  
     
     
         39 . The apparatus of    claim 37   , wherein a signal processing parameter is adjustable based upon the auditory response signal.  
     
     
         40 . An apparatus, comprising: 
 a transducer positioned in transducing relation with a cochlea; and    a calibration module for sending a calibration output signal to the transducer.    
     
     
         41 . The apparatus of    claim 40   , wherein the calibration module includes calibration circuitry.  
     
     
         42 . The apparatus of    claim 40   , further comprising a signal processing unit in communication with the calibration module, wherein the calibration module includes a set of instructions executable on the signal processing unit.  
     
     
         43 . The apparatus of    claim 42   , wherein the signal processing unit includes a microprocessor.  
     
     
         44 . The apparatus of    claim 40   , further comprising a mechanism for receiving a feedback signal.  
     
     
         45 . The apparatus of    claim 40   , wherein the transducer is mechanically coupled to the cochlea.