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The vast majority of implant are cochlear implants (CI). These are implantable devices which by pass the outer and middle ear and stimulate the auditory (VIII) directly with electrical current. This is used to restore hearing to proundly deaf adults or to give congenitally deaf babies to provide access sound, and eventually language.

A typical Cochlear Implant

Location of the Cochlear Implant in the patient

External Components – speech processor

In other cases the patients my need Auditory Brainstem Implants (ABI), where removal of certain types of brain tumours where the surgeons may damage/destroy the hearing nerve, so the implant is positioned in the brainstem instead of the cochlear.

Other implanted systems include Middle Ear Implants (MEI), where the transmission of sound to the cochlear has been damaged due to disease or physical abnormalities. A moving mass transducer is implanted into the middles and is used to transmit sound to the cochlear.

Finally we also implant Bone Anchored Hearing Aids (BAHA), due to middle ear disease, infection and middle ear abnromalities the patients cannot use conventional hearing aids. So a fixture (‘bolt’) is implanted and vibrating transducer transfers sound to the cochlear.

I perform intraoperative testing to measure electrically evoked patient responses from the implants, to ensure the surgeons have not damaged the fragile devices during surgery to position the electrodes. In the case of ABI to determine the correct positioning of the electrodes in the brainstem using electrical physiological response.

Work with the manufacturers and surgeons to develop new devices and techniques for intraoperative measurements. Develop electronic instrumentation to work with existing medical equipment, and develop software to perform analysis of patient responses.

Program the cochlear implant patients, especially difficult cases, where understanding of how the electronic systems work in the implant and how it interacts with the auditory nerve allows me to give improved hearing performance to even the most difficult patients.

Monitor the reliability of the implants, analyse the reason for failures (which will require surgery to replace the faulty device) and work with the manufacturers to improve reliability. Perform testing of MRI compatibility between the implants and the MRI scanner, monitor complications since there are risks involved in scanning implanted patients and find methods to minimise them.

Perform software installation tasks and to integrate the PC hardware with the medical interfaces. Work with my IT colleagues to implement new medical systems.

In Europe and Australia my function is normally performed by electronic or biomedical engineers.

So here is a typical week. Monday in the operating theatre performing intra operative measurments during implant surgery (in the case involve the removal of acoustic tumours this may finish around 10pm – 12:00 mid night) Setting up equipment to perform measurements.

Tuesdays are mainly meetings and possibly program the odd patient.

Wednesdays I get a chance to improve my instrumentation including making electronic circuits and write software.

Evaluating new intraoperative system with precision resistors and compare results with existing system.

Once satisfied with the accuracy, we use the equipment on our patients.

Currently working on a single use test electrode to perform Evoked Compound Action Potential (ECAP) measurements.

Thursdays my cochlear implant programming where I program the implant patients, including switching on the implants for the first time A typical programming screen used to fit the cochlear implant processors.

Fridays usually performing evoked potential measurements on babies under IV sedation or general anaethetic as part of their pre implant assessment after their MRI scan

Never thoguht I will get this far. Not an original idea, purchase distribute Rasberry Pi kits to local schools. And schools which participated in this zone.

If needed i can provide assistance to configure the device for the school’s needs