Systems and methods for intra-surgical monitoring of evoked responses that occur during an electrode lead insertion procedure

Abstract

An exemplary monitoring system 1) receives a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes and an extracochlear electrode, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the monitoring system, 2) directs, in response to the user input command, the cochlear implant to short an intracochlear electrode with the extracochlear electrode, 3) presents the acoustic stimulation to the patient, and 4) records the evoked responses that occur in response to the acoustic stimulation by using the intracochlear electrode to detect signals representative of the evoked responses and receiving the detected signals by way of the extracochlear electrode and the probe.

What is claimed is: 
     
         1 . A method comprising:
 receiving, by a sound processor included in an electro-acoustic stimulation (“EAS”) system and physically and communicatively coupled to a loudspeaker, from a programming system, a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes disposed on a distal portion of the lead that are configured to be located within the cochlea when the insertion procedure is completed and an extracochlear electrode configured to be located external to the cochlea when the insertion procedure is completed, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the sound processor;   transmitting, by the sound processor in response to the user input command and by way of a wireless link, a command to the cochlear implant to short an intracochlear electrode included in the array of intracochlear electrodes with the extracochlear electrode;   presenting, by the sound processor while the intracochlear electrode is shorted with the extracochlear electrode, the acoustic stimulation to the patient by way of the loudspeaker; and   recording, by the sound processor, the evoked responses that occur in response to the acoustic stimulation by using the intracochlear electrode to detect signals representative of the evoked responses, receiving the detected signals by way of the extracochlear electrode and the probe, and converting the detected signals from analog signals representative of the evoked responses into digital signals representative of the evoked responses.   
     
     
         2 . The method of  claim 1 , further comprising converting, by the sound processor, the detected signals from the analog signals to the digital signals by using an analog-to-digital converter included in the sound processor and that is also used by the sound processor to convert analog audio signals detected by a microphone that is communicatively coupled to the sound processor into digital audio signals. 
     
     
         3 . The method of  claim 1 , further comprising transmitting, by the sound processor, data representative of the evoked responses to a programming system. 
     
     
         4 . The method of  claim 3 , further comprising:
 presenting, by the programming system, a graphical user interface during the insertion procedure;   transmitting, by the programming system, the user input command to the sound processor in response to a selection by a user of an option included in the graphical user interface; and   displaying, by the programming system within the graphical user interface based on the data representative of the evoked responses, graphical information associated with the evoked responses.   
     
     
         5 . The method of  claim 4 , wherein the graphical information associated with the evoked responses comprises at least one of a graph that represents amplitudes of the evoked responses, a graph that represents a current time domain waveform of the evoked responses, or a graph that represents a current frequency domain waveform of the evoked responses. 
     
     
         6 . The method of  claim 4 , further comprising presenting an option for the user to select which intracochlear electrode is to be shorted with the extracochlear electrode during the insertion procedure. 
     
     
         7 . The method of  claim 1 , wherein the extracochlear electrode comprises a ring electrode. 
     
     
         8 . The method of  claim 1 , wherein the evoked responses comprise electrocochleography signals. 
     
     
         9 . A method comprising:
 receiving, by a monitoring system, a user input command to begin monitoring evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the lead having an array of intracochlear electrodes disposed on a distal portion of the lead that are configured to be located within the cochlea when the insertion procedure is completed and an extracochlear electrode configured to be located external to the cochlea when the insertion procedure is completed, the extracochlear electrode physically and communicatively coupled to a probe that is also communicatively coupled to the monitoring system;   directing, by the monitoring system in response to the user input command, the cochlear implant to short an intracochlear electrode included in the array of intracochlear electrodes with the extracochlear electrode;   presenting, by the monitoring system while the intracochlear electrode is shorted with the extracochlear electrode, the acoustic stimulation to the patient by way of a loudspeaker; and   recording, by the monitoring system, the evoked responses that occur in response to the acoustic stimulation by using the intracochlear electrode to detect signals representative of the evoked responses and receiving the detected signals by way of the extracochlear electrode and the probe.   
     
     
         10 . The method of  claim 9 , further comprising:
 presenting, by the monitoring system, a graphical user interface during the insertion procedure; and   displaying, by the monitoring system within the graphical user interface based on data representative of the evoked responses, graphical information associated with the evoked responses.   
     
     
         11 . The method of  claim 10 , wherein the graphical information associated with the evoked responses comprises at least one of a graph that represents amplitudes of the evoked responses, a graph that represents a current time domain waveform of the evoked responses, or a graph that represents a current frequency domain waveform of the evoked responses. 
     
     
         12 . The method of  claim 10 , further comprising presenting an option for a user to select which intracochlear electrode is to be shorted with the extracochlear electrode during the insertion procedure. 
     
     
         13 . The method of  claim 9 , wherein the extracochlear electrode comprises a ring electrode. 
     
     
         14 . The method of  claim 9 , wherein the evoked responses comprise electrocochleography signals.