No maintenence technology project

[blandman]

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Hi,

I'm doing some viability research for a project and was wondering whether anyone knows enough about the anatomy of the ear to let on what might be the barriers to having no maintenence hearing assistants? I.e. hearing implants that never need charging or removal.

(I am inspired on this topic as I've suffered from persistent tinitus for the last 4 years from the moment I wake until the moment I'm asleep.)

What are the biggest challenges for this today? (Given that implants exist for most other anatomical areas). Is it miniturisation, power sourcing? Is there a single reason why this hasn't been achieved previously?

Or perhaps that there is no way to circumvent the ears natural cleaning processes? I.e. you could only locate something permanently if it was implanted outside the ear canal itself, out of the way of the cleaning processes within it, i.e. in the canal wall?

But giving this is 1/3 bone on the inside, and 2/3 cartilage towards the outside, does anyone know if its possible to locate a device here with little surgery? Given that they obviously traverse these areas during surgery, would this ever be simplified with merely an insertion tool rather than full on surgery?

The only other location would be on the other side of the ear drum in the eustachian canal but this is for natural cleaning processes too? Would acoustics (thinking just for a sound transducer, not the microphone(s)) be viable this side? Does anyone know of any research on this area?

Hope you can help.

 

[Leforte]

What's this project for? There is tons of information out there on implantable hearing devices from cochlear implants to implantable hearing aids. I am sure Cochlear, Advanced Bionics and Med-El have all looked into this and there is some electrical engineering aspect why "recharging" the device in-vivo is not an option with our current technology. In the case of the cochlear implant, the sound processor/external RF coil device is completely separate from the implanted electroid/internal RF coil. In all implantable hearing devices, there are no parts that are located within the external auditory canal. As far as getting access to the cochlea/middle ear for the implantation, this is a standard operation with minimal risk for a well trained surgeon who maintains their volume.

No one would ever try to access this area from the eustachian tube.

i doubt there will ever be an "insertion tool" that would prevent surgery for the implantation. The middle ear and inner ear is very expensive real estate. I bet there would be a line of plantiff's attorneys salivating after someone uses an "insertion tool" to cannulate the facial nerve.

 

[Kitska]

A fully implanted prototype cochlear implant has been developed by Cochlear Corporation (see below). The device can run without any external sound processor or with a sound processor. The main challenges are a long-life rechargeable battery that won't eventually stop holding a charge and a subcutaneous microphone that doesn't sound muffled.

Otol Neurotol. 2008 Feb;29(2):114-9.

Initial clinical experience with a totally implantable cochlear implant research
device.

Briggs RJ, Eder HC, Seligman PM, Cowan RS, Plant KL, Dalton J, Money DK, Patrick
JF.

Department of Otolaryngology, University of Melbourne, East Melbourne, Victoria,
Australia.

OBJECTIVE: To evaluate the effectiveness and issues associated with a research
totally implantable cochlear implant (TIKI). STUDY DESIGN: Limited patient trial.
SETTING: Tertiary referral center. PATIENTS: Three adult human subjects with
severe-to-profound sensorineural hearing loss. INTERVENTIONS: Subjects were
implanted with a research TIKI developed by Cochlear Limited and the Co-operative
Research Centre for Cochlear Implant and Hearing Aid Innovation. The TIKI has a
lithium ion rechargeable battery, a package-mounted internal microphone, and
sound-processing electronics that enable the use of "invisible hearing" without
the use of an external device. The TIKI also functions with an external ESPrit 3G
sound processor as a conventional cochlear implant. The standard surgical
technique was modified to accommodate the larger device package. Postoperatively,
subjects used TIKI in both invisible hearing and the conventional ESPrit 3G
modes. MAIN OUTCOME MEASURES: Device use was recorded in both invisible hearing
and ESPrit 3G listening modes. Performance of the internal battery and microphone
was assessed over time. Psychophysical MAP data were collected, and speech
perception was measured at 1, 3, 6, and 12 months postoperatively in both
listening modes. RESULTS: There were no surgical or postoperative complications.
All subjects use both invisible hearing and conventional ESPrit 3G modes. Speech
perception outcomes for all patients showed improvement from preoperative scores.
As a consequence of the reduced sensitivity of the implanted microphone, speech
perception results using the invisible hearing mode were significantly lower than
the ESPrit 3G mode. Subjects reported some body noise interference that limited
use of the invisible hearing mode; however, all continue to use the invisible
hearing mode on a limited daily basis. The rechargeable battery functioned well,
with a cycle time indicating the low-power implant design is effective and will
deliver long battery life. CONCLUSION: This study demonstrates that the
challenges in developing a safe and effective TIKI can be overcome. Three
subjects implanted with the research TIKI all reported benefit from routine use.
For each subject, hearing outcomes using invisible hearing mode were not as good
as when using the external ESPrit 3G sound processor in the conventional mode.