# US 10,369,352 B2 · Reproducible placement of ABI Electrodes > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,369,352 B2 - Document ID: US10369352B2 - Status: Granted - Kind: B2 - Application number: 15/423,678 - Filed: 2017-02-03 - Published: 2017-08-10 - Granted: 2019-08-06 - Earliest claimed: 2016-02-05 - Assignees: MED-EL Elektromedizinische Geraete GmbH - Applicants: MED-EL Elektromedizinische Geraete GmbH - Inventors: Peter Grasso; Stefan Brill - Web page: https://patentgrep.com/patent/US10369352B2 ## CPC - A61N 1/0529: {Electrodes for brain stimulation} - A61B 5/12: Audiometering - A61B 5/4064: {Evaluating the brain (for intracranial pressure A61B5/031; for cerebral blood gases A61B5/14553; using EEG A61B5/369)} - A61B 5/6868: {Brain} - A61N 1/0541: {Cochlear electrodes} - A61N 1/36036: {of the outer, middle or inner ear} - A61N 1/36038: {Cochlear stimulation} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A method is described for determining an optimal placement location for an auditory brainstem implant (ABI) electrode array. A cochlear implant (CI) electrode array is inserted into a patient cochlea, and the ABI electrode array is initially placed at an initial placement location on a patient brainstem. The optimal placement location for the ABI electrode array is then determined by, for multiple electrode contacts on the ABI electrode array: i. selecting a specific electrode contact, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an efferent nerve signal from the stimulation signal using the electrode contacts of the CI electrode array, and iv. determining a maximum response location in the patient cochlea where a largest efferent nerve signal is sensed. The ABI electrode array is then repositioned to the optimal placement location. ## Claims ### Claim 1 A method for determining an optimal placement location for an auditory brainstem implant (ABI) electrode array having a plurality of electrode contacts configured for delivering electrical stimulation signals, the method comprising: inserting into a patient cochlea a cochlear implant (CI) electrode array having a plurality of electrode contacts configured for delivering electrical stimulation signals to adjacent neural tissue; initially placing the ABI electrode array at an initial placement location on a patient brainstem; determining an improved placement location for the ABI electrode array by, for a plurality of electrode contacts on the CI electrode array: i. selecting a specific electrode contact of the CI electrode array, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an afferent nerve signal response to the stimulation signal using the electrode contacts of the ABI electrode array, and iv. determining a maximum response location on the patient brainstem where a largest afferent nerve signal is sensed; repositioning the ABI electrode array to the improved placement location; determining the optimal placement location for the ABI electrode array by, for a plurality of electrode contacts on the ABI electrode array: i. selecting a specific electrode contact of the ABI electrode array, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an efferent nerve signal response to the stimulation signal using the electrode contacts of the CI electrode array, and iv. determining a maximum response location in the patient cochlea where a largest efferent nerve signal is sensed; and repositioning the ABI electrode array to the optimal placement location. ### Claim 2 (depends on 1) The method according to claim 1, further comprising: reperforming the steps of determining the improved placement location and repositioning the ABI electrode array. ### Claim 3 (depends on 1) The method according to claim 1, further comprising: reperforming the steps of determining the optimal placement location and repositioning the ABI electrode array. ### Claim 4 (depends on 1) The method according to claim 1, wherein the stimulation signal delivered to the selected electrode contact of the CI electrode array or the ABI electrode array comprises a single electrical pulse. ### Claim 5 (depends on 1) The method according to claim 1, wherein the stimulation signal delivered to the selected electrode contact of the CI electrode array or the ABI electrode array comprises a sequence of multiple electrical pulses. ### Claim 6 (depends on 1) The method according to claim 1, wherein determining the improved placement location for the ABI electrode array includes using all of the electrode contacts on the CI electrode array. ### Claim 7 (depends on 1) The method according to claim 1, wherein determining the optimal placement location for the ABI electrode array includes using all of the electrode contacts on the ABI electrode array. ### Claim 8 (depends on 1) The method according to claim 1, wherein sensing the afferent nerve signal response includes sensing a late elaboration of the afferent nerve signal response to the stimulation signal. ### Claim 9 (depends on 8) The method according to claim 8, wherein the late elaboration includes an electrically evoked auditory brainstem response (EABR) signal. ### Claim 10 A non-transitory tangible computer-readable medium having instructions thereon for determining an optimal placement location for an auditory brainstem implant (ABI) electrode array having a plurality of electrode contacts configured for delivering electrical stimulation signals, the instructions comprising: program code for determining an improved placement location for the ABI electrode array by, for a plurality of electrode contacts on a cochlear implant (CI) electrode array implanted in a patient cochlea and having the plurality of electrode contacts configured for delivering electrical stimulation signals to adjacent neural tissue: i. selecting a specific electrode contact of the CI electrode array, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an afferent nerve signal response to the stimulation signal using the electrode contacts of the ABI electrode array, and iv. determining the improved placement location based on a maximum response location on the patient brainstem where a largest afferent nerve signal is sensed; and program code for determining the optimal placement location for the ABI electrode array by, for a plurality of electrode contacts on the ABI electrode array: i. selecting a specific electrode contact of the ABI electrode array, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an efferent nerve signal response to the stimulation signal using the electrode contacts of the CI electrode array, and iv. determining the optimal placement location based on a maximum response location on the patient brainstem where a largest afferent nerve signal is sensed. ### Claim 11 (depends on 10) The computer readable medium according to claim 10, further comprising: program code for reperforming the steps of determining the improved placement location and repositioning the ABI electrode array. ### Claim 12 (depends on 10) The computer readable medium according to claim 10, further comprising: program code for reperforming the steps of determining the optimal placement location and repositioning the ABI electrode array. ### Claim 13 (depends on 10) The computer readable medium according to claim 10, wherein the stimulation signal delivered to the selected electrode contact of the CI electrode array or the ABI electrode array comprises a single electrical pulse. ### Claim 14 (depends on 10) The computer readable medium according to claim 10, wherein the stimulation signal delivered to the selected electrode contact of the CI electrode array or the ABI electrode array comprises a sequence of multiple electrical pulses. ### Claim 15 (depends on 10) The computer readable medium according to claim 10, wherein the program code for determining the improved placement location for the ABI electrode array includes program code for using all of the electrode contacts on the CI electrode array. ### Claim 16 (depends on 10) The computer readable medium according to claim 10, wherein the program code for determining the optimal placement location for the ABI electrode array includes program code for using all of the electrode contacts on the ABI electrode array. ### Claim 17 (depends on 10) The computer readable medium according to claim 10, wherein sensing the afferent nerve signal response includes sensing a late elaboration of the afferent nerve signal response to the stimulation signal. ### Claim 18 (depends on 17) The computer readable medium according to claim 17, wherein the late elaboration includes an electrically evoked auditory brainstem response (EABR) signal. ### Claim 19 A method for determining an optimal placement location for an auditory brainstem implant (ABI) electrode array having a plurality of electrode contacts configured for delivering electrical stimulation signals, the method comprising: initially placing the ABI electrode array at an initial placement location on a patient brainstem; determining an improved placement location for the ABI electrode array by, for a plurality of acoustic stimulus frequencies: i. selecting a specific acoustic stimulus frequency, ii. delivering an acoustic stimulus at the selected acoustic stimulus frequency, iii. sensing an afferent nerve signal response to the acoustic stimulus using the electrode contacts of the ABI electrode array, and iv. determining a maximum response location on the patient brainstem where a largest afferent nerve signal is sensed; repositioning the ABI electrode array to the improved placement location; determining the optimal placement location for the ABI electrode array by, for a plurality of electrode contacts on the ABI electrode array: i. selecting a specific electrode contact of the ABI electrode array, ii. delivering a stimulation signal to the selected electrode contact, and iii. sensing an otoacoustic emission response to the stimulation signal, and iv. determining a frequency and intensity of the otoacoustic emission response; and repositioning the ABI electrode array to the optimal placement location. ### Claim 20 A non-transitory tangible computer-readable medium having instructions thereon for determining an optimal placement location for an auditory brainstem implant (ABI) electrode array having a plurality of electrode contacts configured for delivering electrical stimulation signals, the instructions comprising: program code for determining an improved placement location for the ABI electrode array by, for a plurality of acoustic stimulus frequencies: i. selecting a specific acoustic stimulus frequency, ii. delivering an acoustic stimulus at the selected acoustic stimulus frequency, iii. sensing an afferent nerve signal response to the acoustic stimulus using the electrode contacts of the ABI electrode array, and iv. determining the improved placement location based on a maximum response location on the patient brainstem where a largest afferent nerve signal is sensed; and program code for determining the optimal placement location for the ABI electrode array by, for a plurality of electrode contacts on the ABI electrode array: i. selecting a specific electrode contact of the ABI electrode array, ii. delivering a stimulation signal to the selected electrode contact, iii. sensing an otoacoustic emission response to the stimulation signal, and iv. determining a frequency and intensity of the otoacoustic emission response.