WO2001082848A2 - Acces avec effraction minimale a la cochlee pour l'insertion d'une electrode et l'administration d'un fluide - Google Patents

Acces avec effraction minimale a la cochlee pour l'insertion d'une electrode et l'administration d'un fluide Download PDF

Info

Publication number
WO2001082848A2
WO2001082848A2 PCT/US2001/013687 US0113687W WO0182848A2 WO 2001082848 A2 WO2001082848 A2 WO 2001082848A2 US 0113687 W US0113687 W US 0113687W WO 0182848 A2 WO0182848 A2 WO 0182848A2
Authority
WO
WIPO (PCT)
Prior art keywords
grommet
cochlea
electrode
electrode array
axial passageway
Prior art date
Application number
PCT/US2001/013687
Other languages
English (en)
Other versions
WO2001082848A3 (fr
Inventor
Janusz A. Kuzma
Thomas J. Balkany
Thomas H. R. Lenarz
Original Assignee
Advanced Bionics Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Advanced Bionics Corporation filed Critical Advanced Bionics Corporation
Priority to AU2001257369A priority Critical patent/AU2001257369A1/en
Publication of WO2001082848A2 publication Critical patent/WO2001082848A2/fr
Publication of WO2001082848A3 publication Critical patent/WO2001082848A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0526—Head electrodes
    • A61N1/0541—Cochlear electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1679—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the ear
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
    • A61F11/20—Ear surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1604—Chisels; Rongeurs; Punches; Stamps

Definitions

  • the present invention relates to implantable electrodes, and more particularly to an implantable electrode configured for minimally invasive implantation within the basal end of the scala tympani duct of a human cochlea.
  • implantable electrodes may be used with a hybrid cochlear stimulator.
  • such electrode may be used with any type of electrical stimulator to compensate for hearing loss in the high frequency range, and/or to provide electrical stimulation to suppress tinnitus.
  • Hearing loss is generally of two types: conductive and sensorineural. Of these, conductive hearing loss occurs where the normal mechanical pathways for sound to reach the hair cells in the cochlea are impeded, for example, by damage to the ossicles. Conductive hearing loss may often be helped by use of conventional hearing aids, which amplify sound so that acoustic information does reach the cochlea and the hair cells. Some types of conductive hearing loss are also amenable to alleviation by surgical procedures.
  • Sensorineural hearing loss results due to the absence or the destruction of the hair cells in the cochlea which are needed to transduce acoustic signals into auditory nerve impulses.
  • Persons who suffer from sensorineural hearing loss are unable to derive any benefit from conventional hearing aid systems, no matter how loud the acoustic stimulus is made, because their mechanisms for transducing sound energy into auditory nerve impulses have been damaged.
  • auditory nerve impulses can be generated directly from sounds.
  • cochlear implant systems or cochlear prosthesis- which seek to bypass the hair cells in the cochlea by presenting electrical stimuli directly to the ganglia of the auditory nerve located adjacent the modiolar wall of the cochlea.
  • the ganglia also referred to as ganglion cells, send nerve impulses to the brain via the auditory nerve, leading to the perception of sound in the brain, and an at least partial restoration of hearing function.
  • the common denominator in these cochlear prosthesis systems has been the implantation into the cochlea of electrodes which are responsive to a suitable external source of electrical stimuli and which are intended to transmit those stimuli to the ganglion cells, and thereby to the auditory nerve fibers. It is estimated that a large segment of the hearing-impaired population exhibit sensorineural hearing loss relative to high frequency sounds, but maintain the ability to transduce middle-to-lower frequency sounds through functioning hair cells. For this segment of the population, there is thus a need for a "hybrid" cochlear stimulation system that electrically stimulates only the ganglion cells responsible for sensing higher frequency sounds, while allowing the normal hearing process to function for the purpose of sensing lower frequency sounds.
  • a cochlear prosthesis operates by direct electrical stimulation of the auditory nerve cells, bypassing the defective cochlear hair cells that normally transduce acoustic energy into electrical activity in such nerve cells. Because the ganglion cells responsible for sensing higher frequency sounds are all generally located in or near the base end of the scala tympani duct of the cochlea (the end of the scala tympani duct nearest the round window), a hybrid cochlear stimulation system thus requires at least one electrode that can be inserted into the cochlea so as to be near such cells, but so as to not block nor significantly interfere with the normal functioning of the cochlea for hair cells located deeper within the cochlea.
  • such electrode In order not to interfere with the normal functioning of the cochlea, such electrode must be implantable or insertable into the base end of the cochlea in a minimally invasive manner, i.e., so as no to significantly interfere with the normal functioning of the round window membrane, or so as not to cause a reaction in the form of tissue or new bone formation, all of which may interfere with and adversely affect residual hearing within the implanted ear. No such electrode, or electrode system, currently exists to applicants' knowledge.
  • the mechanical access thus provided by the invention advantageously provides an opening through which a relatively short cochlear electrode array may be removably inserted, and/or through which drugs, steroids, or other medicinal or tissue-growth-inhibiting fluids may be readily delivered into the cochlea.
  • the present invention addresses the above and other needs, and satisfies the above features, by providing a grommet that can be readily screwed into an opening made in the bony tissue adjacent the round window. Threads included on the outside of the grommet engage the bony tissue and form a tight seal that holds the grommet securely in position. Such tight seal also prevents cochlear fluids from escaping from inside of the cochlea.
  • the grommet further includes an access hole in its center.
  • Such access hole provides an opening, i.e., mechanical access, into the base end of the cochlea.
  • Fluids e.g., drugs, steroids, tissue-growth-inhibiting fluids, and the like, may be controllably delivered through this access hole into the cochlea.
  • a relatively short electrode array may be inserted.
  • Such electrode array has from four to eight, e.g., five, electrode contacts spaced apart along a flexible carrier.
  • the flexible carrier is about 6-8mm in length.
  • each of the electrode contacts is connected to a respective wire embedded within the carrier.
  • the wires exit a proximal end of the carrier via a wire bundle.
  • the wire bundle is connectable to an implantable cochlear stimulator (ICS), or equivalent pulse generator.
  • ICS implantable cochlear stimulator
  • the access hole through the grommet while preferably round, may also be oval or oblong in shape, or otherwise keyed, to match a cross section of the carrier of the electrode array.
  • a prescribed orientation i.e., an orientation that positions the electrode contacts so that they must face the modiolar wall of the cochlea. Further, such prescribed orientation prevents the electrode array from twisting or turning.
  • the carrier of the electrode array is made from a suitable pliable substance, such as siiicone rubber, or Silastic.
  • a suitable pliable substance such as siiicone rubber, or Silastic.
  • Such pliable substance in combination with a taper in the carrier body that provides a larger carrier cross section near a proximal tip of the electrode array than exists at a distal end of the electrode array, allows the electrode array to be tightly inserted into the access hole when fully inserted therein so as to completely close off and seal the access hole. With such a tight seal, the cochlea thus remains filled with fluid which can activate hair cells as fluid waves are established through motion of the round window membrane, which is the normal process for hearing.
  • FIGS. 1 A and 1 B show a side and top view, respectively, of a short electrode array that may be used with the present invention
  • FIG. 2A illustrates a first step of drilling a cochleostomy about 1mm to the side of the round window, but without penetrating the spiral ligament;
  • FIG. 2B illustrates a second step of using a micro-spear and/or micro- pick to remove the spiral ligament membrane from the cochleostomy
  • FIG. 3 shows screwing the threaded grommet of the present invention into the cochleostomy
  • FIG. 4 depicts insertion of the electrode array into the base end of the cochlea through the access hole in the center of the grommet
  • FIG. 5 illustrates the position of the electrode array within the cochlea when fully inserted through the access hole of the grommet, and further shows the manner in which the electrode array seals the access hole;
  • FIG. 6A shows a side view of the grommet, with a portion of the grommet cutaway;
  • FIG. 6B shows details associated with the threads on the outer surface of the grommet;
  • FIG. 7A illustrates a side view of a screw-driver tool that may be used to screw the grommet into the cochleostomy
  • FIG. 7B is an enlarged view of the tip of the tool shown in FIG. 7A.
  • FIG. 7C is an end view of just the tip portion of the tool of FIG. 7A.
  • FIGS. 1A and 1B An electrode array 10 suitable for use with the present invention is illustrated in FIGS. 1A and 1B.
  • FIG. 1A is a side view of the electrode array 10; and
  • FIG. 1B is a view of a medial side of the electrode array 10. (Thus, for purposes of the present application, the "medial side" of the electrode array 10 is the side on which a plurality of spaced-apart electrode contacts 14 are located.)
  • the electrode array 10 includes a plurality of spaced-apart electrode contacts 14 on a flexible carrier 12.
  • each of the electrode contacts 14 resides on the same side - the medial side 15- of the carrier 12.
  • Each electrode contact 14 has at least one wire conductor 22 connected thereto. These wire conductors are embedded within the flexible carrier 12 and exit through a proximal end of the carrier 12 within a flexible cable 20.
  • the cable 20, including its wire conductors 22, connect to a pulse generator, or other suitable stimulator (not shown). Such wire conductors 22 thus provide a means for making electrical contact with each of the electrode contacts 14.
  • the pulse generator When used as part of a hybrid or other cochlear stimulator system, the pulse generator, or other stimulator, thus generates electrical pulses or electrical currents ("electrical stimuli") that is/are applied to selective ones of the electrode contacts 14 in order to evoke a desired response from the ganglion cells located in the vicinity of the electrode contacts 14.
  • electrical stimuli electrical pulses or electrical currents
  • the shoulder 18 comprises a portion of the flexible carrier 12 that extends outwardly (or upwardly, as seen in FIG. 1A) from the medial surface 15 on which the electrode contacts 14 are located.
  • the shoulder 18 thus defines a boundary between the electrode array and the lead 20 which connects the electrode array to a suitable pulse generator.
  • the electrode array 10 is somewhat thinner in one direction than in the other. Stated differently, the electrode array 10 is flattened in one direction, and if viewed in cross section, would resemble a rectangle having unequal sides.
  • the width of the carrier body 12, excluding the ball 19 at the distal end of the array is a distance W1.
  • W1 may be about 0.5 to 1.0 mm; whereas W2 may be on the order of 1.5-2 mm.
  • the length of the electrode array 10, from the shoulder 18 to a distal tip 13 is a distance L1. This distance L1 will typically be 6-8 mm.
  • the number of spaced-apart electrode contacts 14 positioned on the medial side of the carrier body 14 may vary from four to eight. For the example shown in FIGS. 1A and 1B, there are five electrode contacts 14.
  • the electrode contacts 14 are all on a medial side of the electrode array, i.e., are all on the same side of the carrier 12, and the medial side is usually the only "flat" side of the carrier 12 (although in some embodiments, there may be more than one "flat” side of the carrier).
  • Such positioning is preferred because when inserted into the cochlea, this medial side of the electrode array 10 is positioned so as to face the modiolar wall of the cochlea, where the ganglion cells are located.
  • this medial side of the electrode array 10 is positioned so as to face the modiolar wall of the cochlea, where the ganglion cells are located.
  • electrical stimulation of the ganglion cells to occur more efficiently (i.e., with less power).
  • the electrode contacts 14 could be located on any side of the flexible carrier body 12, or on all sides (e.g., bands or rings), and the electrode array could still perform its intended function of stimulating the ganglion cells located near the base end of the cochlea.
  • a preferred manner of making an electrode array 10 having all of its electrode contacts on a medial side of the carrier, and having individual wires connected to each of the electrode contacts, is disclosed in U.S. Patent 6,129,753.
  • FIGS. 2A and 2B the preferred process for making a cochleostomy for use by the grommet of the present invention is illustrated.
  • FIG. 1 the preferred process for making a cochleostomy for use by the grommet of the present invention is illustrated.
  • FIG. 2A illustrates the spiraling scala tympani duct 38 of a cochlea 30.
  • the round window 32 separates the space within the cochlea, which is normally filled with a fluid, from the middle ear.
  • the cochlea, especially the base region of the cochlea in the vicinity of the round window 32 is surrounded by bony tissue 34.
  • a first step for making a suitable cochleostomy is to drill a hole 40, about 1.0mm in diameter, on a lateral side of the round window 32.
  • a preferred location for the drilled hole 40 is about 1mm from the closest edge of the round window 32.
  • the hole 40 is drilled as deep as possible without penetrating the spiral ligament membrane 36.
  • a micro-spear 42, and/or micro-pick is used to remove the spiral ligament membrane 36 from the hole 40.
  • a titanium grommet 50 is screwed into the hole 40 with the aid of a special driver tool 60, as seen in FIG. 3.
  • the grommet-insertion tool 60 has a centering rod 64 that protrudes from its distal end. This centering rod 64 has a length sufficient to allow it to pass all the way through an axial access hole 56 (seen best in FIG. 4) through the center of the grommet 50.
  • the tool 60 has a corresponding blade 62 adapted to be received within the slot 54. Once the blade 62 is seated within the slot 54, the driver tool 60 may be rotated in a clockwise direction, as shown by the arrow 63, in order to screw grommet into the cochleostomy hole 40 previously made in the bony tissue 34.
  • the grommet 50 has a treaded distal portion that is conically shaped.
  • the narrowest part of the conically-shaped distal portion 58 (see FIG. 6A) is the most distal portion.
  • Threads 52 are etched on the outer surface of the conically-shaped distal portion of the grommet that tend to drive the grommet deeper into the hole 40 as the grommet is rotated clockwise.
  • the grommet embeds itself firmer and firmer into the bony tissue 34, until it is securely seated in, and seals, the hole 40.
  • the tool 60 is removed therefrom by simply retracting the tool, including its centering rod 64, back through the axial hole 56 in the center of the grommet.
  • a suitable wetting agent and/or sealant may be placed on the threads of the grommet 50 during the process of rotatably driving the grommet deeper and deeper within the cochleostomy hole 40, much like plumber's putty is placed on the threads of one pipe being screwed into another, thereby providing a tight secure seal between the bony tissue 34 and the threads 52.
  • an access hole 56 is thus provided into the inside portion 38 of the cochlea 30, as seen best in FIG. 4.
  • This access hole 56 may be used for several purposes, including the delivery of desired or needed drugs, steroids, fluids, or tissue-growth-inhibiting substances to the inside of the cochlea.
  • the access hole 56 may be plugged to prevent fluids within the cochlea from escaping.
  • a primary purpose of the access hole 56 is to allow the electrode array 10 to be easily inserted into the cochlea 30, as shown in FIG. 4.
  • the electrode array 10 is slid through the axial hole 56 that passes through the center of the grommet 50, with the electrode array itself serving as the plug that prevents cochlea fluids from escaping from the cochlea.
  • O-rings, or equivalent sealing mechanisms placed either on the inside of the access hole and/or on the outside of the electrode array, may be utilized to enhance the seal that is made by the electrode or other plug that is placed in the access hole.
  • the electrode array As the electrode array is inserted through the access hole, it is oriented so that the electrode contacts 14 face the modiolar wall 31 of the cochlea.
  • the array 10 reaches the position where it is fully inserted within the grommet 50, as shown in FIG. 5.
  • the electrode contacts 14 are advantageously facing, and in close proximity to, the modiolar wall 31, thereby allowing stimulation of the ganglion cells located within the modiolar wall to occur more efficiently, i.e., using less power.
  • the distal tip 13 of the electrode array 10 should not be in contact with the delicate basal membrane 33, thereby preventing damage to the basal membrane.
  • a soft ball 19 is formed at the distal tip of the array 10, thereby helping prevent damage to surrounding tissue should the distal tip 13 inadvertently come in contact with the basal membrane 33 or other delicate tissue.
  • the heavy line 33 shown in FIG. 5 to represent the basal membrane is not exactly anatomically correct.
  • the basal membrane separates the scala tympani 38 from the other ducts within the cochlea, and as such, the basal membrane is more above the scala tympani 38 as shown in FIG.
  • the heavy line 33 5 than at one side of it, as suggested by the heavy line 33.
  • all of the channels within the cochlea are more or less parallel to each other, and all spiral together, it is common for an electrode inserted into the cochlea to engage the basal membrane, particularly at the first turn of the scala tympani, because the electrode must not only bend to go around the turn, but it must also bend upwards to follow the spiral.
  • the electrode array 10 used with the grommet 50 of the present invention is designed to be sufficiently short so as not to reach the first bend or turn of the scala tympani within the cochlea.
  • the operation of the round window 32 is not impaired.
  • the normal hearing processes of the inner ear e.g., establishing fluid waves or motion within the cochlea that triggers hair cells, may occur at the same time that electrical stimulation is provided through the electrode array 10.
  • the grommet 50 has a conically-shaped distal portion 58 that is threaded with threads 52.
  • the narrowest part of the conically-shaped distal portion 58, at the distal tip of the grommet, is about 1mm.
  • the widest part of the conically-shaped distal portion 58 is about 1.4mm.
  • the length of the conically-shaped distal portion 58 is about 3.2mm, of which about 2mm are threaded.
  • a shaft portion 57 of the grommet 50 extends proximally from the conically-shaped distal portion 58.
  • the length of the shaft portion 57 is about 4.8mm, making the overall length of the grommet 50, i.e., the sum of the shaft portion 57 and the conically-shaped distal portion 58, about 8.0mm.
  • the diameter of the shaft portion is about 1.2mm.
  • a slot 54 is formed at the proximal end of the shaft portion 57.
  • the slot 54 as a depth of about 0.8mm, and a width of about 0.7mm.
  • An access hole 56 (or access channel) passes through the center of the grommet 50.
  • the access hole 56 has a diameter of about 0.8mm.
  • Threads 52 are formed in the tapered portion of the conically-shaped distal portion 56 and are spiraled so as to allow clockwise rotation of the grommet drive the grommet deeper into the cochleostomy.
  • the threads 52 preferably are cut at an angle ⁇ of about 90°, as illustrated in FIG. 6B. That is, as seen in FIG. 6B, the angle ⁇ formed at the bottom of each thread is approximately 90°.
  • the depth of the threads 52 is about 0.05mm.
  • the grommet 50 is made from a suitable biocompatible metal, such as titanium ( ⁇ 95%) or a high grade stainless steel.
  • a preferred material is titanium. Ceramic or other similar substances could also be used, if adequate machining and/or molding processes are available for making the grommet.
  • present tooling techniques and machining practices suggest that the grommet 50 be made from a metal, such as titanium. It is to be emphasized that the particular size and form of the grommet 50 illustrated in FIGS. 6A and 6B is only exemplary. Variations to the size and form may be made by those of skill in the art, as needed.
  • FIG. 7A depicts a side view of the tool 60.
  • the tool 60 includes a shaft portion 66 at the distal end of which is a blade 62.
  • At least the distal end of the shaft portion 66 is hollow so as to allow a proximal end of a centering rod 64 to be inserted into the shaft 66, while a distal end of the centering rod 64 extends out from the distal end of the shaft 66 a prescribed distance, e.g., 9mm.
  • the protruding centering rod 64 thus allows the grommet 50 to be slid onto the rod 64 prior to guiding the grommet into the cochleostomy.
  • the centering rod 64 holds the grommet in place on the distal end of the tool 60 as the grommet is guided for insertion into the cochleostomy.
  • the shaft portion 66 of the tool 60 is made from the same material as is a 16 gauge I.V. catheter needle. The length of the shaft 66 is about 60 mm.
  • a handle 65 is affixed to the proximal end of the shaft portion 66 in order to allow the tool 60 to be easily rotated with one hand, like a screwdriver.
  • the blade 62 is formed at the distal tip of the shaft portion 66, as seen best in FIG. 7B. Because the centering rod 64 extends out from the distal end of the shaft portion 66, the blade 62 is bifurcated into two parts, one part on each side of the centering rod 64, as seen best in FIG. 7C. For the embodiment shown in FIGS. 7A, 7B and 7C, the blade 62 is about 0.7mm in length and width.
  • FIGS. 7A, 7B and 7C The particular embodiment of the tool 60 shown in FIGS. 7A, 7B and 7C is only exemplary. Variations in the dimensions illustrated may be made in order to best suit the needs of the particular application, and in order to better allow the tool 60 to perform its intended function of driving (turning) the grommet 50 as it is inserted into the cochleostomy.
  • the present invention provides an electrode system suitable for use with a hybrid cochlear stimulation system, e.g., a stimulation system that provides electrical stimulation of the ganglion cells located near the base of the cochlea, which cells are responsible for hearing higher frequency sounds, while allowing the normal hearing processes occur for hearing lower frequency sounds.
  • a hybrid cochlear stimulation system e.g., a stimulation system that provides electrical stimulation of the ganglion cells located near the base of the cochlea, which cells are responsible for hearing higher frequency sounds, while allowing the normal hearing processes occur for hearing lower frequency sounds.
  • invention provides mechanical access into the cochlea without destroying or damaging the ability of the cochlea to perceive sound through the round window membrane in a natural manner.
  • the mechanical access thus provided advantageously provides an opening through which a relatively short cochlear electrode array may be removably inserted, and/or through which drugs, steroids, or other fluids or tissue-growth-inhibiting substances may be readily delivered into the cochlea.
  • the invention provides a cochlear electrode system that may be inserted into the cochlea in a minimally-invasive manner, and which electrode system may thereafter function without interfering with or damaging the normal operation of the round window, thereby allowing mechanical movement of the round window to set up fluid waves within the cochlea, in conventional manner.
  • the invention allows a cochlear electrode system to be used that preserves the natural hearing ability of the patient; and which allows a cochlear electrode system to be removably inserted into the cochlea without causing damage to the basiiar membrane or other delicate parts of the inner ear.

Abstract

L'invention concerne un passant (50) fileté comprenant un passage (56) traversant, et fabriqué dans un matériau biocompatible tel que le titane. Ce passant est vissé dans une cochléostomie (40) pratiquée dans le tissu (34) osseux adjacent à la fenêtre ronde (32) de manière à former un accès dans la cochlée (30) s'accompagnant d'une effraction minimale. Le filetage (52) présent sur l'extérieur du passant (50) s'engage dans le tissu (34) osseux et forme un joint étanche permettant d'immobiliser le passant de manière sûre. Ce joint étanche empêche les fluides cochléaires de s'échapper hors de la cochlée. Le passage (56) axial dans le centre du passant comporte une ouverture, ou un accès mécanique, conduisant à l'extrémité basale (l'extrémité la plus proche de la fenêtre ronde) de la cochlée. Des médicaments, des stéroïdes et des fluides inhibant la croissance tissulaire etc., peuvent être administrés dans la cochlée d'une manière mesurée, à travers cet orifice d'accès. Cet orifice d'accès peut être bouché lorsqu'il n'est pas utilisé. Un ensemble (10) d'électrodes, p. ex. un ensemble d'électrodes relativement court, peut être introduit dans la cochlée à travers l'ouverture d'accès. L'ensemble (10) d'électrodes préféré comprend de quatre à huit contacts (14) d'électrodes espacés les uns des autres sur la longueur d'un support (12) flexible. Ce support flexible mesure environ 6-8 mm de long. Les contacts d'électrodes peuvent être connectés de manière conventionnelle à un stimulateur cochléaire implantable, ou un générateur d'impulsions équivalent. Ni le passant ni l'ensemble d'électrodes court n'interfèrent avec les processus d'audition normaux dans la cochlée. Ainsi la stimulation électrique et l'audition normale peuvent avoir lieu simultanément dans la cochlée.
PCT/US2001/013687 2000-04-28 2001-04-27 Acces avec effraction minimale a la cochlee pour l'insertion d'une electrode et l'administration d'un fluide WO2001082848A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001257369A AU2001257369A1 (en) 2000-04-28 2001-04-27 Minimally-invasive access into the cochlea for electrode insertion and fluid delivery

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US20107600P 2000-04-28 2000-04-28
US60/201,076 2000-04-28

Publications (2)

Publication Number Publication Date
WO2001082848A2 true WO2001082848A2 (fr) 2001-11-08
WO2001082848A3 WO2001082848A3 (fr) 2002-03-21

Family

ID=22744392

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2001/013687 WO2001082848A2 (fr) 2000-04-28 2001-04-27 Acces avec effraction minimale a la cochlee pour l'insertion d'une electrode et l'administration d'un fluide

Country Status (2)

Country Link
AU (1) AU2001257369A1 (fr)
WO (1) WO2001082848A2 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004069119A1 (fr) * 2003-02-10 2004-08-19 Cell Center Cologne Gmbh Dispositif de liaison avec l'oreille interne
WO2004073565A1 (fr) * 2003-02-21 2004-09-02 Cochlear Limited Stylet incurve pour une rangee d'electrodes
WO2010045432A2 (fr) * 2008-10-15 2010-04-22 Med-El Elektromedizinische Geraete Gmbh Dispositif et procédé d’administration de médicaments dans l’oreille interne
WO2011011160A3 (fr) * 2009-07-21 2011-03-31 Advanced Bionics Llc Porte-fil intégré pour réseau d'électrodes

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4645504A (en) * 1985-05-24 1987-02-24 The Regents Of The University Of California Implantable infection barrier seal and method
FR2622790A1 (fr) * 1987-11-09 1989-05-12 Matco Ligaments prothetiques avec systeme de vis a os
US4832051A (en) * 1985-04-29 1989-05-23 Symbion, Inc. Multiple-electrode intracochlear device
US4892108A (en) * 1987-07-23 1990-01-09 The Regents Of The University Of Michigan Multi-channel extracochlear implant
WO1996031087A1 (fr) * 1995-03-30 1996-10-03 Cochlear Limited Ensemble electrodes cochleaires implantes et leur systeme de positionnement

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4832051A (en) * 1985-04-29 1989-05-23 Symbion, Inc. Multiple-electrode intracochlear device
US4645504A (en) * 1985-05-24 1987-02-24 The Regents Of The University Of California Implantable infection barrier seal and method
US4892108A (en) * 1987-07-23 1990-01-09 The Regents Of The University Of Michigan Multi-channel extracochlear implant
FR2622790A1 (fr) * 1987-11-09 1989-05-12 Matco Ligaments prothetiques avec systeme de vis a os
WO1996031087A1 (fr) * 1995-03-30 1996-10-03 Cochlear Limited Ensemble electrodes cochleaires implantes et leur systeme de positionnement

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004069119A1 (fr) * 2003-02-10 2004-08-19 Cell Center Cologne Gmbh Dispositif de liaison avec l'oreille interne
WO2004073565A1 (fr) * 2003-02-21 2004-09-02 Cochlear Limited Stylet incurve pour une rangee d'electrodes
WO2010045432A2 (fr) * 2008-10-15 2010-04-22 Med-El Elektromedizinische Geraete Gmbh Dispositif et procédé d’administration de médicaments dans l’oreille interne
WO2010045432A3 (fr) * 2008-10-15 2010-08-12 Med-El Elektromedizinische Geraete Gmbh Dispositif et procédé d’administration de médicaments dans l’oreille interne
AU2009305745B2 (en) * 2008-10-15 2012-12-06 Med-El Elektromedizinische Geraete Gmbh Inner ear drug delivery device and method
AU2009305745B9 (en) * 2008-10-15 2013-07-18 Med-El Elektromedizinische Geraete Gmbh Inner ear drug delivery device and method
WO2011011160A3 (fr) * 2009-07-21 2011-03-31 Advanced Bionics Llc Porte-fil intégré pour réseau d'électrodes
US8712554B2 (en) 2009-07-21 2014-04-29 Advanced Bionics Integrated wire carrier for electrode array
US9433776B2 (en) 2009-07-21 2016-09-06 Advanced Bionics Llc Integrated wire carrier for electrode array

Also Published As

Publication number Publication date
AU2001257369A1 (en) 2001-11-12
WO2001082848A3 (fr) 2002-03-21

Similar Documents

Publication Publication Date Title
US6628991B2 (en) Minimally-invasive access into the cochlea for electrode insertion and fluid delivery
US11426576B2 (en) Securing an implanted medical device in a patient
US6889094B1 (en) Electrode array for hybrid cochlear stimulator
US6070105A (en) Modiolus-hugging cochlear electrodes
US8452411B2 (en) Electrode assembly for a stimulating medical device
US9119957B2 (en) Cochlear implant system component having multiple electrode assemblies
US8805547B2 (en) Extra-cochlear implanted hearing aid device
US9345876B2 (en) Cochlear implant having electrically nonconductive occludent for tissue openings
US20070162098A1 (en) Prosthetic hearing implant electrode assembly having optimal length for atraumatic implantation
US20100331913A1 (en) Hybrid multi-function electrode array
US20200338343A1 (en) Devices and methods for treating tinnitus using electrical stimulation
US6498954B1 (en) Apex to base cochlear implant electrode
US6487453B1 (en) Electrode system for ossified cochlea
CA2371125A1 (fr) Reseau d'electrodes pour stimulateur cochleaire hybride
US8792999B2 (en) Implantable tissue stimulating electrode assembly
US8311649B2 (en) Cochlear lead
WO2001082848A2 (fr) Acces avec effraction minimale a la cochlee pour l'insertion d'une electrode et l'administration d'un fluide
US8954169B2 (en) Systems and methods for loading a pre-curved electrode array onto a straightening member
US20060178720A1 (en) Method and apparatus for sealing a lumen in an electrode assembly
US8939993B1 (en) Pre-curved electrode array loading tools
AU2003287772A1 (en) Method and apparatus for sealing a lumen in an electrode assembly

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A2

Designated state(s): AU CA JP

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE TR

121 Ep: the epo has been informed by wipo that ep was designated in this application
AK Designated states

Kind code of ref document: A3

Designated state(s): AU CA JP

AL Designated countries for regional patents

Kind code of ref document: A3

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE TR

122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: JP