WO2025149997A1 - Tinnitus management techniques - Google Patents

Abstract

A method, including applying a first stimulation to tissue of a human and applying a second stimulation tissue of a human, wherein at least one of (i) the first stimulation is applied to a different side of the human than the second stimulation in a mutually non-uniform manner or (ii) the first stimulation is a different kind of stimulation to the second stimulation, and wherein the method is a method of treating tinnitus, and the first stimulation and the second stimulation reduce tinnitus of the human.

Description

TINNITUS MANAGEMENT TECHNIQUES

CROSS-REFERENCE TO RELATED APPLICATIONS

[oooi] This application claims priority to U.S. Provisional Application No. 63/620,868, entitled TINNITUS MANAGEMENT TECHNIQUES, filed on January 14, 2024, naming Remo Albert Gerardus ARTS as an inventor, the entire contents of that application being incorporated herein by reference in its entirety.

BACKGROUND

[0002] Medical devices have provided a wide range of therapeutic benefits to recipients over recent decades. Medical devices can include internal or implantable components/devices, external or wearable components/devices, or combinations thereof (e.g., a device having an external component communicating with an implantable component). Medical devices, such as traditional hearing aids, partially or fully-implantable hearing prostheses (e.g., bone conduction devices, mechanical stimulators, cochlear implants, etc.), pacemakers, defibrillators, functional electrical stimulation devices, and other medical devices, have been successful in performing lifesaving and/or lifestyle enhancement functions and/or recipient monitoring for a number of years.

[0003] The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as “implantable medical devices,” now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease/injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and/or data received from external devices that are part of, or operate in conjunction with, implantable components.

SUMMARY

[0004] In an exemplary embodiment, there is a system, comprising a first stimulation apparatus and a second stimulation apparatus, wherein the first stimulation apparatus outputs stimulation that is different in kind from stimulation outputted by the second stimulation apparatus, the first stimulation apparatus outputs electric stimulation, and the system is configured to reduce tinnitus in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus.

[0005] In an exemplary embodiment, there is a method, comprising obtaining first data based on an effect of first stimulation on tinnitus of a human, obtaining second data based on an effect of second stimulation on tinnitus of a human and identifying a more effective stimulation for tinnitus treatment of the human based on the obtained first data and obtained second data, wherein the first stimulation is a different manner of stimulation from the second stimulation and/or the first stimulation is provided to a first sensory organ of the human and the second stimulation is provided to a second sensory organ of the human.

[0006] In an exemplary embodiment, there is a system, comprising a first stimulation apparatus, and a second stimulation apparatus, wherein the first stimulation apparatus outputs stimulation in a different manner than the stimulation outputted by the second stimulation apparatus, and the system is configured to reduce tinnitus in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus.

[0007] In an exemplary embodiment, there is a method, comprising applying a first stimulation to tissue of a human, applying a second stimulation tissue of a human, wherein at least one of the first stimulation is applied to a different side of the human than the second stimulation in a mutually non-uniform manner or the first stimulation is a different kind of stimulation to the second stimulation, and wherein the method is a method of treating tinnitus, and the first stimulation and the second stimulation reduce tinnitus of the human.

[0008] In an exemplary embodiment, there is a non-transitory computer readable medium having recorded thereon, a computer program for executing at least a portion of a method, the computer program including code for controlling a tinnitus treatment system to apply first stimulation from a first stimulation apparatus and code for controlling the tinnitus treatment system to apply second stimulation from a second stimulation apparatus and code for varying one or more parameters of the first stimulation and/or the second stimulation to treat tinnitus more effectively than that which would be the case in the absence of the variation of the one or more parameters.

[0009] In an exemplary embodiment, there is a tinnitus treatment system, comprising at least one of a first cochlear implant or a first conventional acoustic hearing aid, and at least one of a second cochlear implant or a second conventional acoustic hearing aid, wherein the first cochlear implant and/or the first conventional acoustic hearing aid outputs stimulation in a different manner than the stimulation outputted by the second cochlear implant and/or the second conventional acoustic hearing aid, the system is configured to reduce tinnitus in a human by application of respective stimulation by:

(i) at least one of the first cochlear implant or the first conventional acoustic hearing aid; and

(ii) at least one of the second cochlear implant or the first conventional acoustic hearing aid.

BRIEF DESCRIPTION OF THE DRAWINGS

[ooio] Embodiments are described below with reference to the attached drawings, in which:

[ooii] FIG. l is a perspective view of an exemplary hearing prosthesis in which at least some of the teachings detailed herein are applicable;

[0012] FIGs. 1A-1C are quasi functional diagrams of an exemplary device to which some teachings herein may be applicable;

[0013] FIGs. 1D-3C present exemplary devices and/or systems that can be used to execute at least some of the teachings herein; and

[0014] FIGs. 4-9 provide exemplary flowcharts for some exemplary methods.

DETAILED DESCRIPTION

[0015] Merely for ease of description, the techniques presented herein are described herein with reference by way of background to an illustrative medical device, namely a cochlear implant. However, it is to be appreciated that the techniques presented herein may also be used with a variety of other medical devices that, while providing a wide range of therapeutic benefits to recipients, patients, or other users, may benefit from setting changes based on the location of the medical device. For example, the techniques presented herein may be used to determine the viability of various types of prostheses, such as, for example, a vestibular implant and/or a retinal implant, with respect to a particular human being. And with regard to the latter, the techniques presented herein are also described with reference by way of background to another illustrative medical device, namely a retinal implant. The techniques presented herein are also applicable to the technology of vestibular devices (e.g., vestibular implants), visual devices (i.e., bionic eyes), sensors, pacemakers, drug delivery systems, defibrillators, functional electrical stimulation devices, catheters, seizure devices (e.g., devices for monitoring and/or treating epileptic events), sleep apnea devices, electroporation, etc.

[0016] Also, arrangements are directed to other types of hearing prostheses, such as middle ear implants, bone conduction devices (active transcutaneous, passive transcutaneous, percutaneous), and conventional hearing aids. Thus, arrangements are directed to devices that include implantable portions and arrangements that do not include implantable portions.

[0017] Any reference to one of the above-noted sensory prostheses corresponds to an alternate disclosure using one of the other above-noted sensory prostheses unless otherwise noted, providing that the art enables such.

[0018] FIG. l is a perspective view of an exemplary multimodal (here, hybrid) prosthesis 200 attached to a person 99. The ear includes outer ear 201, middle ear 205, and inner ear 207, and are described next below, followed by a description of an implanted multimodal system 200. Multimodal system 200 provides multiple types of stimulation, i.e., acoustic, electrical, and/or mechanical. These different stimulation modes may be applied ipsilaterally or contralaterally. In the arrangement shown in FIG. 1, multimodal implant 200 provides acoustic and electrical stimulation, although other combinations of modes can be implemented in some arrangements. By way of example and not by way of limitation, a middle-ear implant can be utilized in combination with the cochlear implant, a bone conduction device can be utilized in combination with the cochlear implant, etc.

[0019] It is also noted that arrangements are directed to a purely acoustic hearing aid, as detailed below. That said, arrangements are directed to non-hearing aid per se devices, but instead tinnitus treatment devices that utilize some aspects of acoustic (conventional) hearing aids, and in other arrangements, do not use such aspects. Indeed, some arrangements are directed to the use of pure tinnitus maskers (these can be devices that are conventional hearing aid based devices - more on this below)

[0020] In a person with normal hearing or a recipient with residual hearing, an acoustic pressure or sound wave 203 is collected by outer ear 201 (that is, the auricle) and channeled into and through ear canal 206. Disposed across the distal end of ear canal 206 is a tympanic membrane 204 which vibrates in response to acoustic wave 203. This vibration is coupled to oval window, fenestra ovalis 215, through three bones of middle ear 205, collectively referred to as the ossicles 217 and comprising the malleus 213, the incus 209, and the stapes 211. Bones 213, 209, and 211 of middle ear 205 serve to filter and transfer acoustic wave 203, causing oval window 215 to articulate, or vibrate. Such vibration sets up waves of fluid motion within cochlea 232. Such fluid motion, in turn, activates tiny hair cells (not shown) that line the inside of cochlea 232. Activation of the hair cells causes appropriate nerve impulses to be transferred through the spiral ganglion cells (not shown) and auditory nerve 238 to the brain (not shown), where such pulses are perceived as sound.

[0021] FIG. 1A provides a schematic of an exemplary conceptual sleep apnea system 1991. Here, this exemplary sleep apnea system utilizes a microphone 12 (represented conceptually) to capture a person’s breathing or otherwise the sounds made by a person while sleeping. The microphone transduces the captured sound into an electrical signal which is provided via electrical leads 198 to the main unit 197, which includes a processor unit that can evaluate the signal from leads 198 or, in another arrangement, unit 197 is configured to provide that signal to a remote processing location via the Internet or the like, where the signal was evaluated. Upon an evaluation that an action should be taken or otherwise can be utilitarian taken by the sleep apnea system 1991, the unit 197 activates to implement sleep apnea countermeasures, which countermeasures are conducted by a hose 1902 sleep apnea mask 195. By way of example only and not by way of limitation, pressure variations can be used to treat the sleep apnea upon an indication of such an occurrence.

[0022] In an exemplary arrangement, the tinnitus treatment methods and devices detailed herein can be combined with the sleep apnea system to treat tinnitus while treating sleep apnea and/or combined with balance treatment systems to treat tinnitus while treating balance. That is, some arrangements can be applied to provide balance treatment to a human. Any teaching herein relating to tinnitus corresponds to an alternate disclosure of using such for balance treatment, provided that the art enables such, unless otherwise noted. Some arrangements can be implemented in conventional earphones / ear buds, telephones, etc. Thus any teaching herein corresponds to an arrangement where one or more or all of the teachings herein are utilized in such devices.

[0023] FIGs. IB and 1C provide another exemplary schematic of another exemplary conceptual sleep apnea system 1992. Here, the sleep apnea system is different from that of figure 1A in that electrodes 194 (which can be implanted in some arrangements) are utilized to provide stimulation to the human who is experiencing a sleep apnea scenario. FIG. IB illustrates an external unit, and FIG. 1C illustrates the external unit 120 and an implanted unit 110 in signal communication via an inductance coil 707 of the external unit and a corresponding implanted inductance coil (not shown) of the implanted unit, according to which the teachings herein can be applicable. Implanted unit 110, can be configured for implantation in a recipient, in a location that permits it to modulate nerves of the recipient 100 via electrodes 194. In treating sleep apnea, implant unit 110 and/or the electrodes thereof can be located on a genioglossus muscle of a patient. Such a location is suitable for modulation of the hypoglossal nerve, branches of which run inside the genioglossus muscle.

[0024] External unit 120 can be configured for location external to a patient, either directly contacting, or close to the skin of the recipient. External unit 120 may be configured to be affixed to the patient, for example, by adhering to the skin of the patient, or through a band or other device configured to hold external unit 120 in place. Adherence to the skin of external unit 120 may occur such that it is in the vicinity of the location of implant unit 110 so that, for example, the external unit 120 can be in signal communication with the implant unit 110 as conceptually shown, which communication can be via an inductive link or an RF link or any link that can enable treatment of sleep apnea using the implant unit and the external unit. External unit 120 can include a processor unit 198 that is configured to control the stimulation executed by the implant unit 110. In this regard, processor unit 198 can be in signal communication with microphone 12, via electrical leads, such as in an arrangement where the external unit 120 is a modularized component, or via a wireless system, such as conceptually represented in FIG. 1C.

[0025] A common feature of both of these sleep apnea treatment systems is the utilization of the microphone to capture sound, and the utilization of that captured sound to implement one or more features of the sleep apnea system. In some arrangements, the teachings herein are used with the sleep apnea device just detailed.

[0026] Returning back to hearing prosthesis devices, in individuals with a hearing deficiency who may have some residual hearing, an implant or hearing instrument may improve that individual's ability to perceive sound. Multimodal prosthesis 200 may comprise an external component assembly 242 which is directly or indirectly attached to the body of the recipient, and an internal component assembly 244 which is temporarily or permanently implanted in the recipient. External component assembly 242 is also shown in FIG. ID. In some arrangements, components in the external assembly 242 may be included as part of the implanted assembly 244, and vice versa. Also, arrangements of the present invention may be used with implanted multimodal system 200 which are fully implanted. Arrangements of the teachings herein include utilizing such in the device of FIG. ID or FIG. 2 detailed below. [0027] External assembly 242 typically comprises a sound transducer 220 for detecting sound, and for generating an electrical audio signal, typically an analog audio signal. In this illustrative arrangement, sound transducer 220 is a microphone. In alternative arrangements, sound transducer 220 can be any device now or later developed that can detect sound and generate electrical signals representative of such sound. An exemplary alternate location of sound transducer 220 will be detailed below.

[0028] External assembly / external component 242 also comprises a signal processing unit, a power source (not shown), and an external transmitter unit. External transmitter unit 206 comprises an external coil 208 and, preferably, a magnet (not shown) secured directly or indirectly to the external coil 208. The signal processing unit processes the output of microphone 220 that is positioned, in the depicted arrangement, by outer ear 201 of the recipient. The signal processing unit generates coded signals using a signal processing apparatus (sometimes referred to herein as a sound processing apparatus), which can be circuitry (often a chip) configured to process received signals - because element 2130 contains this circuitry, the entire component 2130 is often called a sound processing unit or a signal processing unit. These coded signals can be referred to herein as a stimulation data signals, which are provided to external transmitter unit 206 via a cable 247 and to the receiver in the ear 250 via cable 252. In this exemplary arrangement of figure ID, cable 247 includes connector jack 221 which is bayonet fitted into receptacle 219 of the signal processing unit 230 (an opening is present in the dorsal spine, which receives the bayonet connector, in which includes electrical contacts to place the external transmitter unit into signal communication with the signal processor 230). It is also noted that in alternative arrangements, the external transmitter unit is hardwired to the signal processor subassembly 230. That is, cable 247 is in signal communication via hardwiring, with the signal processor subassembly. (The device of course could be disassembled, but that is different than the arrangement shown in figure ID that utilizes the bayonet connector.) FIG. IE provides additional details of an exemplary receiver 250. The overall component containing the signal processing unit is, in this illustration, constructed and arranged so that it can fit behind outer ear 201 in a BTE (behind-the-ear) configuration, but may also be worn on different parts of the recipient's body or clothing.

[0029] In some arrangements, the signal processor (also referred to as the sound processor) may produce electrical stimulations alone, without generation of any acoustic stimulation beyond those that naturally enter the ear. While in still further arrangements, two signal processors may be used. One signal processor is used for generating electrical stimulations in conjunction with a second speech processor used for producing acoustic stimulations.

[0030] As shown in FIGs. ID and IE, a receiver in the ear 250 is connected to the spine of the BTE (a general term used to describe the part to which the battery 270 attaches, which contains the signal (sound) processor and supports various components, such as the microphone - more on this below) through cable 252 (and thus connected to the sound processor / signal processor thereby). Receiver in the ear 250 (as distinguished from a simple receiver - the body of the receiver in the ear 250 supports a receiver - more on this in a moment) includes a housing 256, which may be a molding shaped to the recipient. Inside receiver in the ear 250 there is provided a capacitor 258, receiver 260 and protector 262. Also, there may a vent shaft 264 (in some arrangements, this vent shaft is not included). Receiver in the ear may be an in-the-ear (ITE) or completely-in-canal (CIC) configuration.

[0031] In an exemplary arrangement, sound transducer 220 can be located on element 250 (e.g., opposite element 262, as seen for example in FIG. IF), so that the natural wonders of the human ear can be utilized to funnel sound in a more natural manner to the sound transducer. In an exemplary arrangement, sound transducer 242 is in signal communication with remainder of the BTE device via cable 252, as is schematically depicted in figure IF via the sub cable extending from sound transducer 242 to cable 252.

[0032] Also, FIG. ID shows a removable power component 270 (sometimes battery back, or battery for short) directly attached to the base of the body / spine 230 of the BTE device. As seen, the BTE device in some arrangements includes control buttons 274. The BTE device may have an indicator light 276 on the earhook to indicate operational status of signal processor. Examples of status indications include a flicker when receiving incoming sounds, low rate flashing when power source is low or high rate flashing for other problems.

[0033] Returning to FIG. 1, internal component / implanted component 244 comprise an internal receiver unit 212, a stimulator unit 226 and an electrode assembly 218. Internal receiver unit 212 comprises an internal transcutaneous transfer coil (not shown), and preferably, a magnet (also not shown) fixed relative to the internal coil. Internal receiver unit 212 and stimulator unit 226 are hermetically sealed within a biocompatible housing. The internal coil receives power and data from external coil 208, as noted above. A cable or lead of electrode assembly 218 extends from stimulator unit 226 to cochlea 232 and terminates in an array 234 of electrodes 236. Electrical signals generated by stimulator unit 226 are applied by electrodes 236 to cochlea 232, thereby stimulating the auditory nerve 238.

[0034] In one arrangement, external coil 208 transmits electrical signals to the internal coil via a radio frequency (RF) link. The internal coil is typically a wire antenna coil comprised of at least one and preferably multiple turns of electrically insulated single-strand or multistrand platinum or gold wire. The electrical insulation of the internal coil is provided by a flexible silicone molding (not shown). In use, internal receiver unit 212 may be positioned in a recess of the temporal bone adjacent to outer ear 201 of the recipient.

[0035] As shown in FIG. 1, multimodal system 200 is further configured to interoperate with a user interface 280 and an external processor 282 such as a personal computer, workstation, or the like, implementing, for example, a hearing implant fitting system. Although a cable 284 is shown in FIG. 1A between implant 200 and interface 280, a wireless RF communication may also be used along with remote 286.

[0036] While FIG. 1 shows a multimodal implant in the ipsilateral ear, in other arrangements, the multimodal implant may provide stimulation to both ears. For example, a signal processor may provide electrical stimulation to one ear and provide acoustical stimulation in the other ear.

[0037] With the above as a primer, arrangements are also directed to non-multimodal hearing aids utilizing behind the ear devices (traditional acoustic hearing aids using the teachings herein), and non-multimodal external components of cochlear implants utilizing behind the ear devices (traditional external components of such, embodied in a BTE apparatus, utilizing the teachings herein), and some arrangements are directed to multi-modal arrangements utilizing the teachings herein. Still, as will be detailed, arrangements are also directed to multimodal hearing devices.

[0038] That is, while the teachings associated with FIGs. 1, ID, and 2 (discussed below) disclose an external device with an output that is provided external to the recipient (a receiver / speaker) that is in the form of a conventional hearing prosthesis, the disclosure of such and any teachings herein relating to such also correspond to a disclosure of an external device where the output is a bone conduction vibrator. By way of example, a passive transcutaneous bone conduction device, where the conceptual functionality of element 250 (more on this below) could instead be located at a location in back of the ear in a manner concomitant with such (this being a conceptual representation of the placement of the output device), held by magnets to the head of the recipient as conventional in the art. Also by way of example, the external device can be a percutaneous bone conduction device. These components need not be part of a multimodal hearing prosthesis, but could be standalone devices. Moreover, while the teachings associated with figures 1 and ID are directed towards a cochlear implant, disclosure of such and any teachings herein relating to such also correspond to a disclosure of an implantable / implanted device where the output is a bone conduction vibrator (such as in the case of an active transcutaneous bone conduction device, where the device of FIG. ID would be readily understood as an external component of such (with or without the conventional hearing aid functionality) or a middle ear actuator (again, where the device of figure ID would be readily understood as an external component of such) or a direct acoustic cochlear stimulator actuator (again, FIG. ID being a representative external component of such), or any other implanted mechanical device that imparts mechanical energy to tissue of the recipient. Put another way, the disclosure of the output devices relating to the external component vis-a-vis the receiver also corresponds to a disclosure of an alternate arrangement where the output device is a vibrator of a bone conduction device by way of example. Also, the disclosure of the output device relating to the implanted component vis-a-vis the cochlear implant electrode array also corresponds to a disclosure of an alternate arrangement where the output device is a vibrator of a bone conduction device or the actuator of a middle ear implant or the actuator of a direct acoustic cochlear stimulator, by way of example.

[0039] FIG. 2 depicts an exemplary BTE device 342 according to an exemplary arrangement. As seen, BTE device 342 includes element 330, which functionally and structurally can, in some arrangements, correspond to element 230 above, with exceptions according to the teachings herein, and thus corresponds to the spine of the BTE device. However, hereinafter, element 330 will be referred to by its more generic name as the signal processor subassembly, or sometimes the electronics component of the BTE device, or sometimes, for short, the signal processor, or sound processor subassembly, or sound processor for short (but that is distinguished from the processor therein, which processes sound / signals, and are also referred to as a sound processor or signal processor - this is the pure electronics portion of the overall signal processor subassembly, the latter having a housing and supporting other components), in some instances. As can be seen, attached thereto is element 270 which is thus a power component of the BTE device, which in some instances herein will be referred to as the battery sub-assembly, or the battery for short. The battery subassembly 270 is removably attached to the sound processor subassembly 330 via for example a bayonet connector.

[0040] In an exemplary arrangement, BTE device 342 is a conventional hearing aid apparatus (and note that arrangements can instead use a conventional hearing aid based device - more on this below - but in other arrangements, BTE device 342 is a tinnitus specific device, such as a masking device). In-the-ear (ITE) component 250 can correspond to any of those detailed herein and/or variations thereof. Simply put, the behind the ear device 342 is a conventional hearing aid configured for only external use. It is not an implantable component and does not include implantable components, and is not configured to electromagnetically communicate with an implantable component. Arrangements include one or more or all of the teachings herein embodied in the device of FIG. 2. Also, it is noted that while the receiver / speaker of the device of FIG. 2 is in an in the ear component 250, in other arrangements, the speaker can be adjacent the ear, above the ear, etc. Also, it is noted that earbuds or a headset can be utilized in some arrangements, which can be connected to an MP3 player or to a smart phone, etc. Moreover, a totally in the ear device can be used with one or more of the teachings herein, wherein the totally in the ear device has one or more or all of the features of the conventional hearing aid devices herein and/or other prostheses detailed herein.

[0041] It is noted that the teachings detailed herein and/or variations thereof can be utilized with a non-totally implantable prosthesis (and others with a totally implantable prosthesis, such as where, for example, there is an implanted microphone, or where the implant is not a hearing prosthesis, but instead directed to balance or tinnitus treatment for example, where, for example, there is no need for a microphone in some arrangements). That is, in some arrangements, the cochlear implant 200 is a traditional hearing prosthesis. The teachings herein can also be implemented in and in some arrangements are so implemented with respect to other types of prostheses, such as middle ear implants, active transcutaneous bone conduction devices, passive transcutaneous bone conduction deices, percutaneous bone conduction devices, and traditional acoustic hearing aids, alone or in combination with each outer (and/or with the cochlear implant), the combination achieving the bimodal prosthesis. Also, in some arrangements, the teachings detailed herein and/or variations thereof include the teachings herein utilized in totally implantable prostheses, such as those that are totally implantable middle ear implants, active transcutaneous bone conduction devices, alone or in combination with each outer (and/or with the cochlear implant), the combination achieving the multimodal prosthesis.

[0042] To be clear, the prostheses herein can include any one or more of an acoustic hearing aid, a percutaneous bone conduction device, a passive transcutaneous bone conduction device, an active transcutaneous bone conduction device, a middle ear implant, a DACS, a cochlear implant, a dental bone conduction device, etc. Thus, any disclosure of one corresponds to a disclosure of any of the others herein and thus a disclosure of using the teachings associated with one with the others unless otherwise noted and unless the art enables such.

[0043] FIG. 2 A depicts an exemplary system 2110 according to an exemplary arrangement, including device 100, which can be a hearing prosthesis, or a tinnitus treatment device such as that disclosed below, or any device configured to provide stimulation to a recipient that can treat tinnitus in accordance with the teachings herein. In an exemplary arrangement, device 100 corresponds to BTE device 342 or to the prosthesis of FIG. 1, or to any of the systems detailed below, etc. Also seen in the system is a portable body carried device (e.g. a portable handheld device as seen in FIG. 2A, a watch, a pocket device, etc.) 2140 in the form of a mobile computer (e.g., a smart phone) having a display 2142. The system includes a wireless link 2130 between the portable handheld device 2140 and the hearing prosthesis 100 (often, 100 is referred to as a hearing prosthesis, and such reference corresponds to a disclosure of an alternate arrangement where such is one of the other devices herein). In an arrangement, the prosthesis 100 is a totally external prosthesis, such as the device of FIG. 2, and in other arrangements, it includes an implanted portion implanted in recipient 99 (as represented functionally by the dashed lines of box 100 in FIG. 2A).

[0044] In an exemplary arrangement, the system 2110 is configured such that the hearing prosthesis 100 (which in other arrangements, as noted above, can be a tinnitus treatment device, such as a masker, or one or more ear buds, or the device 342 of FIG. 2, etc.) and the portable handheld device 2140 have a symbiotic relationship. In an exemplary arrangement, the symbiotic relationship is the ability to display data relating to, and, in at least some instances, the ability to control, one or more functionalities of the hearing prosthesis 100. In an exemplary arrangement, this can be achieved via the ability of the handheld device 2140 to receive data from the hearing prosthesis 100 via the wireless link 2130 (although in other exemplary arrangements, other types of links, such as by way of example, a wired link, can be utilized - concomitant with one or more ear buds connected to the device 2140). As will also be detailed below, this can be achieved via communication with a geographically remote device in communication with the hearing prosthesis 100 and/or the portable handheld device 2140 via link, such as by way of example only and not by way of limitation, an Internet connection or a cell phone connection. In some such exemplary arrangements, the system 2110 can further include the geographically remote apparatus as well. Again, additional examples of this will be described in greater detail below.

[0045] As noted above, in an exemplary arrangement, the portable handheld device 2140 comprises a mobile computer and a display 2142. In an exemplary arrangement, the display 2142 is a touchscreen display. In an exemplary arrangement, the portable handheld device 2140 also has the functionality of a portable cellular telephone. In this regard, device 2140 can be, by way of example only and not by way of limitation, a smart phone as that phrase is utilized generically. That is, in an exemplary arrangement, portable handheld device 2140 comprises a smart phone, again as that term is utilized generically.

[0046] It is noted that in some other arrangements, the device 2140 need not be a computer device, etc. It can be a lower tech recorder, or any device that can enable the teachings herein.

[0047] In an exemplary arrangement, device 2140 can execute or otherwise be utilized for processing purposes associated with the prosthesis 100, such as processing captured sound, and the processed results are then conveyed to the prosthesis via link 2130, where the prosthesis uses those results to evoke a hearing percept.

[0048] The phrase “mobile computer” entails a device configured to enable human-computer interaction, where the computer is expected to be transported away from a stationary location during normal use. Again, in an exemplary arrangement, the portable handheld device 2140 is a smart phone as that term is generically utilized. However, in other arrangements, less sophisticated (or more sophisticated) mobile computing devices can be utilized to implement the teachings detailed herein and/or variations thereof. Any device, system, and/or method that can enable the teachings detailed herein and/or variations thereof to be practiced can be utilized in at least some arrangements. (As will be detailed below, in some instances, device 2140 is not a mobile computer, but instead a remote device (remote from the hearing prosthesis 100. Some of these arrangements will be described below).)

[0049] In an exemplary arrangement, the portable handheld device 2140 is configured to receive data from a hearing prosthesis and present an interface display on the display from among a plurality of different interface displays based on the received data. Exemplary arrangements will sometimes be described in terms of data received from the hearing prosthesis 100. However, it is noted that any disclosure that is also applicable to data sent to the hearing prosthesis from the handheld device 2140 is also encompassed by such disclosure, unless otherwise specified or otherwise incompatible with the pertinent technology (and vice versa).

[0050] It is noted that in some arrangements, the system 2110 is configured such that prosthesis 100 and the portable device 2140 have a relationship. By way of example only and not by way of limitation, in an exemplary arrangement, the relationship is the ability of the device 2140 to serve as a remote microphone for the prosthesis 100 via the wireless link 2130. Thus, device 2140 can be a remote mic. That said, in an alternate arrangement, the device 2140 is a stand-alone recording / sound capture device.

[0051] It is noted that in at least some exemplary arrangements, the device 2140 corresponds to an Apple Watch ™ Series 1 or Series 2, as is available in the United States of America for commercial purchase as of June 06, 2020. In an exemplary arrangement, the device 2140 corresponds to a Samsung Galaxy Gear ™ Gear 2, as is available in the United States of America for commercial purchase as of July 20, 2020. The device is programmed and configured to communicate with the prosthesis and/or to function to enable the teachings detailed herein.

[0052] In an arrangement, a telecommunication infrastructure can be in communication with the hearing prosthesis 100 and/or the device 2140. By way of example only and not by way of limitation, a telecoil 2149 or some other communication system (Bluetooth, etc.) is used to communicate with the prosthesis and/or the remote device. FIG. 2B depicts an exemplary quasi -functional schematic depicting communication between an external communication system 2149 (e.g., a telecoil), and the hearing prosthesis 100 and/or the handheld device 2140 by way of links 2177 and 2179, respectively (note that FIG. 2B depicts two-way communication between the hearing prosthesis 100 and the external audio source 2149, and between the handheld device and the external audio source 2149 - in alternate arrangements, the communication is only one way (e.g., from the external audio source 2149 to the respective device)).

[0053] FIG. 2C provides an exemplary tinnitus treatment system which can be used in some arrangements. Here, the system is embodied in a self-contained tinnitus treatment device 2177. This device can correspond to the smart phone 2140 detailed above, or can be a dedicated device specifically designed for tinnitus treatment. In this regard, tinnitus treatment device 2177 includes an earbud jack to which is connected one or more earbuds 2155. In an exemplary arrangement, the tinnitus treatment device 2177 outputs tinnitus masking sounds (which constitutes tinnitus treatment as utilized herein). In an exemplary arrangement, the tinnitus treatment device 2177 outputs sound based treatment that can be utilized to prevent onset of tinnitus in the first place and/or to treat tinnitus. Tinnitus treatment device 2177 includes display screen 2133 as can be seen. This can be the screen of a smart phone of an alternative arrangement (in an exemplary arrangement, device 2177 is a smart phone with earbuds, and in other arrangements, there are no earbuds - the speaker is utilized instead), or can be a dedicated screen of a dedicated tinnitus treatment device 2177. With respect to speaker 2166, this can also be used to provide sound based treatment. The speaker can correspond to the speaker of a smart phone in some arrangements. Also as can be seen, there is a microphone 2188. In an exemplary arrangement, this can receive input from the user thereof and/or can receive input indicative of a portion of the ambient environment of the device, such as the audio environment.

[0054] Further as can be seen, tinnitus treatment device 2177 includes a transceiver 2144 and/or a transmitter and/or a receiver that can communicate with another device, such as a remote device or a server that can be utilized to perform analysis and/or processing or to another such device 2177. In an exemplary arrangement, the treatment device can communicate with a remote device utilizing Bluetooth and/or utilizing cellular technology, etc. Alternatively, and/or in addition to this, tinnitus treatment device 2177 can utilize wired communications to communicate with remote devices etc. It is noted that tinnitus treatment device 2177 can communicate with a cell phone or a smart phone or with a hearing prosthesis, etc. Also, device 2144 can be utilized to communicate with a device that provides stimulation to a person to treatment tinnitus, such as by way of example, a wireless earbud system, or to the behind the ear device of figure 2, or any other prosthesis that can enable the teachings detailed herein with a modicum of modification, etc. In an exemplary arrangement, tinnitus treatment device includes electronic circuitry and logic that can enable one or more or all of the method actions detailed herein as will be described in greater detail below.

[0055] It is also noted that in another exemplary system, tinnitus treatment can be achieved via an MP3 player or the like that provides an output signal to microphones and/or to earbuds, etc. In an exemplary arrangement, certain sounds or recordings or the like can be stored in the MP3 player and utilized for tinnitus treatment, when such is activated upon a determination that tinnitus is occurring and/or that a tinnitus event is likely to occur. That said, in an exemplary arrangement, other consumer electronic devices, such as a computer or a tape player even can be utilized for tinnitus treatment. In an exemplary arrangement, via the Internet for example, sounds for tinnitus treatment can be accessed in an automated or manual fashion. Any device, system, or method that can enable tinnitus treatment can be utilized in at least some exemplary arrangements

[0056] Embodiments can include utilizing the above teachings in combination with the tinnitus / balance / sleep apnea teachings herein. To be clear, embodiments can include modifying the above and/or below devices that are hearing devices / used to assist people in hearing, as well as the above tinnitus devices, for use to implement the teachings herein. The above is a baseline from which the teachings herein relating to tinnitus can be applied to advance the art. Indeed, embodiments include any of the hearing prostheses / devices herein that further include tinnitus treatment features (hence embodiments where the above devices are modified to implement tinnitus treatment).

[0057] FIG. 3A depicts a high-level functional diagram of an exemplary system 300 applied to a recipient / human 999 (view is a top view - that is a view looking downward onto the recipient’s head), with left and right auricle 110L and 110R, respectively. It is noted that the embodiment of FIG. 3A depicts one of many applications of the teachings detailed herein and/or variations thereof with respect to human physiology. In this regard, while the embodiment of FIG. 3 A is depicted in terms of the utilization of two behind-the-ear devices, it is to be noted that in alternative embodiments, the teachings detailed herein and/or variations thereof can be implemented at other locations on the human body, as will be further described below. So called “off-the-ear” (OTE) devices can be used. Body worn components structurally (chassis wise and high-level assembly wise) analogous to the “old style” hearing aids (with the signal processing components in a housing that was carried in a shirt pocket for example) can be used.

[0058] System 300 includes a first prosthetic device 100 configured to evoke a hearing percept based on a first ambient sound, which, in the exemplary embodiment depicted in FIG. 3 A, is the cochlear implant 100 of FIG. 1. System 300 also includes a second device 340, here, also a prosthetic device, configured to evoke a hearing percept based on the first ambient sound. In some exemplary embodiments, the tinnitus treatment methods and the associated actions detailed herein are implemented utilizing system 300. That said, in an alternate embedment, the second device is configured to stimulate skin based on a second captured sound, which may or may not be the same as the first captured sound, depending on the embodiment and/or the scenario of use.

[0059] That said, in an alternate embodiment, one or both of these devices do not evoke a hearing percept. Or instead, in an alternate embodiment, one or both of these devices do not evoke a hearing percept based on the ambient sound or otherwise based on the ambient environment. Instead, any hearing percept that is evoked is based on an artificial construct or otherwise is not based on a sound or otherwise energy in the environment. For example, certain frequencies can be generated by one or both of the devices in an automatic manner, which frequencies can be predetermined, and have no nexus to sound frequencies in the ambient environment at the time that they are generated. Conversely, in some embodiments, the devices of system 300 provided dual use arrangement, where hearing percepts are revoked based on ambient sound and those devices are utilized to implement one or more of the actions detailed herein and variations thereof with respect to treatment of tinnitus.

[0060] In an exemplary embodiment, one or both of the devices of system 300 are conventional hearing aid based devices. One or both devices are not implants, or at least are not associated with an implant (e.g., device 100 can be a proxy for an entire cochlear implant (external and implanted component, and device 100 can be a proxy for the entire conventional hearing aid which has no implanted component (the receiver that is located in the ear canal is not implanted - and note that instead of BTE device(s), device 100 and device 240 can be in-the-ear (ITE) devices), and corollary to this is that one or both devices can be implant or otherwise associated with implants.

[0061] In some embodiments, one or both devices are instead bone conduction devices, such as passive transcutaneous bone conduction devices, active transcutaneous bone conduction devices and/or percutaneous bone conduction devices.

[0062] In an exemplary embodiment, device 340 is a non-invasive device, such as a BTE device (or a hand-held device - again, embodiments of system 300 are not limited to the human physiology depicted in FIG. 3A). Device 340 can stimulate the skin utilizing various principles of operations, such as by way of example only and not by way of limitation, vibratory energy, electrical energy, etc. In an exemplary embodiment, the first and/or second captured sound is sound generated by a voice of a speaker, such as, for example, the voice of a person speaking to the recipient. Additional exemplary details of the system 300 will now be described.

[0063] FIG. 3B depicts a medium-level functional diagram of the exemplary system 300. System 300 includes subsystems 100 and 300, respectively corresponding to the cochlear implant 100 and the device 340 detailed above. The references to right and left refer to the sides of the recipient with respect to FIG. 3 A (right side ear of the recipient 11 OR and left side ear of the recipient is 110L). In at least some embodiments detailed herein, each of these subsystems corresponds to a separate device that can operate independently of the other. For example, subsystem 100 can operate in the absence of subsystem 340, and vice-versa.

[0064] In an exemplary embodiment, subsystem 100 corresponds to the cochlear implant and/or a “hybrid device” / multimodal device 200 detailed above with respect to FIG. 1. In an exemplary embodiment, subsystem 340 also corresponds to such. Alternatively, one or both correspond to only an implant electrical stimulation device (e.g., a cochlear implant, but could be another type of electrical stimulation device implant) or an external electrical stimulation device, and one or both could be a conventional hearing aid apparatus (or a device based thereon - it could be that the device does not function as a traditional hearing aid in that sound is not captured and transduced and then amplified for example and provided to a speaker - instead, the output is not based on ambient sound concomitant with the teachings above - note that in an embodiment, a conventional hearing aid assembly can be utilized, where the sound capture and/or the sound transduction and/or the processing features for processing the captured sound or the signal based thereon are not utilized or otherwise disabled - a conventional hearing aid provides a utilitarian platform to implement the sound based stimulations / the stimulations corresponding to sub sonic and/or sonic and/or ultrasonic frequencies) In an embodiment, one or both devices are a skin stimulator. It is noted that in some embodiments, the location of the sub-systems can be reversed (i.e., the subsystem 100 is on the left side and the subsystem 340 is on the right side).

[0065] In an exemplary embodiment, subsystem 100 and/or subsystem 340 can correspond to the tinnitus treatment device 2177 detailed above. In some embodiments, subsystem 100 and/or subsystem 340 has one or more features of the tinnitus treatment device 2177 detailed above. That said, embodiments of subsystem 100 and/or subsystem 340 can correspond to hearing devices, such as hearing prostheses, that are used to implement tinnitus treatment. [0066] Still referring to FIG. 3B, it can be seen that each subsystem includes a sound capture device (10010 and 310, respectively), but again, in some embodiments, this may not necessarily be the case, or otherwise such as disabled. In an exemplary embodiment, according to the description hereinafter, the sound capture devices can be microphones that can correspond to microphone 124 detailed above. In an alternate embodiment, one or both of the sound capture devices can instead be an audio jack that enables an audio signal to be inputted into the respective sub-system. Consistent with the embodiment of FIG. 3 A which presents two separate devices that operate independently and separately from one another, each microphone 310 captures an ambient sound that originated acoustic pressure/soundwave 103 (which as noted above, would normally be collected by the auricles 110 (left and right side) of a person having normal hearing.

[0067] The captured ambient sound is converted by the microphones 10010 and 310 into audio signals 10012 and 312, respectively. These can be electrical signals, or can be optical signals or any other signal that enable communication between the microphones and their respective sound processors (10020 and 320, described below).

[0068] Upon receipt of the respective audio signals, the respective sound processors 10020 and 320 implement one or more sound coding / sound processing strategies to translate the respective audio signals into stimulation information signals. In an exemplary embodiment, sound processors 10020 and 320 can individually correspond to sound processing unit 126 detailed above, although the functionality can differ in one of them because such is utilized for skin stimulation as opposed to that used for the cochlear implant as detailed above. That said, in some embodiments, the functionality might be the same providing that the teachings detailed herein and/or variations thereof can be implemented.

[0069] Still referring to FIG. 3B, output information signals 10022 and 322 are respectively generated by the respective sound processor systems and are supplied to respective stimulation signal generators 10030 and 330. Accordingly, signals 10022 and 322 are control signals, as these signals are used to control the signal generators. In an exemplary embodiment, stimulating signal generator 10030 can correspond to stimulator unit 120 and electrodes 148 and accompanying components of cochlear implant 100, which, as noted above, generates stimulation signals which are applied by electrodes 148 to cochlea 140, thereby stimulating auditory nerve 114. In an exemplary embodiment, stimulating signal generator 330 can be a vibrator or an electrical stimulator unit coupled to electrodes in contact with the skin. The stimulation signal generators 10030 and 330 respectively output stimulation signals 10032 and 332. In an exemplary embodiment, when the sub-system 100 is a cochlear implant, signal 10032 is an electrical current. Further, when the sub-system 340 is a vibrator / includes a vibrator component, the signal 332 is vibrational energy. Alternatively or in addition to this, when sub-system 340 operates on a principle of operation of electrical stimulation of the skin (or tissue beneath the skin (e.g., a cochlear implant), the signal 332 is electrical current. Accordingly, in an exemplary embodiment, when the subsystem 340 operates on both the principal operator operation of outputting vibrational energy and the principle of operation of outputting electrical current, there can be two signal generators and the output can be 332’ and 332”, respectively, where 332’ is vibrational energy and 332” is electrical current. Hereinafter, reference to signal 332 corresponds to either or both of signals 332’ and 332”. And note alternatively instead of vibrational energy, the output would be acoustic energy or otherwise an acoustic signal, such as that which is outputted from a speaker of a conventional hearing aid by way of example. Granted, in some embodiments, there could be vibrational output and acoustic output, although many utilitarian embodiments will have those two outputs separated, at least with respect to size of the recipient.

[0070] As noted above, the embodiment of FIG. 3B is configured such that both sub-systems thereof can operate independently of one another. But note that in an exemplary embodiment, there signal communication between the two, and one can operate as a master and the other as a slave in some embodiments. In some embodiments, there is a controller that is separate from those devices, such as the handheld device detailed above, that is in signal communication with one or both devices, which controller controls both of the devices, or otherwise provides sufficient data to one or both devices to enable the teachings detailed herein. Note that the concept of data providing can also be applicable with respect to one device providing data to the other and vice versa or both in at least some exemplary embodiments. In an alternative embodiment, now with reference to FIG. 3C, with like reference numbers corresponding to the elements of FIG. 3B, there is an exemplary system 3000 in which the sub-systems 100 and 340 interact with one another. In the embodiments of FIG. 3C, some components of the cochlear implant 100 are utilized to operate the stimulation signal generator 330 of the subsystem 340. This is done as a matter of exemplary convenience, and the opposite can be true in an alternative embodiment. Indeed, in an alternative embodiment, all of the components of FIG. 3B are present, and the components are configured to communicate with each other (e.g., the sound capture devices 10010 and 310 can output to the sound processor system 320 and 10020 respectively, in addition to outputting to the sound processor system 10020 and 320 respectively, as shown in FIG. 3B. Alternatively and/or in addition to this, the sound processor system 320 can output to the stimulation signal generator 10030, and the sound processor system 10020 can output to the stimulation signal generator 330, in addition to outputting to the stimulation signal generators as depicted in FIG. 3B.

[0071] Referring back to FIG. 3C, it can be seen that the sound processor system 10020 outputs a signal 10022 to the stimulation signal generator 10030, and also outputs a signal 322 to the stimulation signal generator 330, although in an alternate embodiment, it outputs the same signal (signal 10022) to stimulation signal generator 330.

[0072] Embodiments include the utilization of bilateral implants and/or multimodal implants and/or bilateral devices (whether implanted or not) and/or multimodal implants (whether implanted or not). Embodiments include arrangements were subsystem 100 and subsystem 340 are respectively hybrid devices that provide acoustic stimulation and electrical stimulation. In an alternate embodiment, there are three or four devices, for example. For the purposes of textual economy, in an embodiment, device 100 can be divided into device 100 A and device 100B, where the first is an acoustic energy delivery device, and the second is in electrical energy delivery device. Corollary to this is that in an exemplary embodiment, device 340 is divided into two separate devices 340A and 340B, which can also be the just noted devices (they can be different devices).

[0073] Embodiments can include optimization of the bilateral cochlear implant stimulation (or electrical stimulation) for tinnitus relief. In some embodiments, cochlear implant recipients are provided relief from the burden of tinnitus during active use of an implant which is based on sound input. But note that in some embodiments, cochlear implant recipients are also provided relief or alternatively provided relief by providing additional background stimulation which is in principle (or absolutely in other embodiments) not triggered by the ambient sound. Embodiments can include and can exclude modulations of the background stimulation to be triggered by the modulations seen in the incoming sound. In another alternative embodiment, as will be described in greater detail below, the modulations could be triggered by an EEG signal obtained by the CI from the CI user.

[0074] Embodiments can utilize the device 2177 detailed above in accordance with the teachings detailed herein. Any component disclosed herein can be combined with any other component disclosed herein if such can have utilitarian value providing that the art enables such. An overall control system can be utilized to control the combined components. Moreover, any one or more of the features of any one or device and/or system disclosed herein can be combined with any one or more of the other features of any one or more other devices and/or systems disclosed herein providing that the art enables such, unless otherwise noted.

[0075] In an embodiment, by way of example, and without being bound by theory, the teachings detailed herein include providing background stimulation in the two ears (a proxy for any one or more components of the respective ears of the two ears (outer, middle and inner) will induce neural activity in the auditory pathway, which is disrupted and causes tinnitus in some exemplary scenarios, and stimulate neural plasticity. Embodiments can include executing masking of tinnitus and/or introduction of unperceivable background activity.

[0076] Embodiments can include the combined / coordinated (for example) use of a stimulation in the two subsystems 100 and/or 340 that can be / is adjusted depending on the tinnitus characteristics of the particular human to reduce intrusive perception of tinnitus (e.g. related to loudness and/or or pitch) and related tinnitus burden. The stimulation can be modulated (e.g. current level (or magnitude (loudness whether absolute or perceived)), pulse width, pulse frequency, for example) to adapt to the tinnitus characteristics of each recipient.

[0077] Embodiments include presenting stimuli bilaterally, concomitant with system 300. The stimulation can be personalized to obtain the optimal tinnitus relief. In an embodiment, the system introduces tinnitus relief stimuli (as distinguished from hearing based on ambient sound stimuli) in both devices (e.g., two cochlear implants and/or two conventional hearing aid based devices, etc.) in a human provided with a bilateral system (cochlear implant system for example). The stimuli can be provided continuously without variation and/or can be discontinuous (at temporally different times than any continuously provided stimuli). In an embodiment the discontinuous providing of stimuli can be based on environmental conditions, such as, for example, if the sound input from the environment is already providing the relief, stimulus can be halted or not even started. In an embodiment, if prior sound in the ambient environment has reduced its tinnitus by a desired amount, whatever amount that is, there can be utilitarian value in stopping or otherwise halting further stimulation and/or not starting stimulation, at least if the tinnitus does not return in a relatively quick manner or otherwise in a time period that is deemed unacceptable to the human. Put another way, a regime where stimulation is provided discontinuously can be implemented where the stimulation has an effect of reducing the tinnitus. If the human indicates that the tinnitus is gone, the stimulation would be halted. This indication could be provided by way of example into a remote device such as a smart phone or smart device that is in communication with the other components of the system. That said, it could be that past empirical data indicates that after a certain amount of time or otherwise after a certain amount of stimulation or otherwise after certain actions are taken utilizing the treatment detailed herein, the tinnitus is reduced to an acceptable level, which can include completely eliminated, at least with respect to perception, and thus the system can be “programmed” to act on that data. If, for example, stimulation is provided for a time period, where past performance indicates that that is sufficient to eliminate the tinnitus, after that time period has elapsed, the stimulation will be discontinued. Note also that embodiments include utilizing the microphone or other sound capture device of the one or more prostheses or of the remote device, etc., to capture ambient sound. The system can analyze the captured sound of the ambient environment and determine whether or not such sound is sound has a statistically likelihood of relieving the tinnitus (if present), such as by masking or by reducing the actual neuron activity causing the tinnitus and/or increasing the actual neuron activity if the absence of such is causing the tinnitus, or any other way of doing so. This could be based on past empirical data collected for the person, or based on big data for a cohort of people similarly situated to the person, etc. In an embodiment, the system automatically continues / discontinues one or more or all of the stimulus application based on the analysis.

[0078] In embodiments where there is bilateral stimulation (whether in the separate ears, or simply to separate sides of the human), such implementation can be applicable to humans who have two cochlear implants and/or one conventional hearing aid based system and one cochlear implant - this is for the bimodal application for example - and/or two hybrid devices on each side for example. Embodiments can also include bilateral stimulation for humans without hearing loss wearing one or two conventional hearing aid based systems and/or one or two sound generators (in the case of two, one for each ear) and/or one or two implants (cochlear or otherwise) provided electrical stimulation to the auditory nerve (other device than cochlear implant). The teachings herein can be implemented by way of electroacoustic / hybrid stimulation (e.g., cochlear implant with a sound processor stimulating the implanted ear with residual hearing both with electric and acoustic stimuli). It might be that the acoustical stimuli or the electrical stimuli are preferred by the human and it might be that only one mode of stimulation can be adopted (or will be permitted to be adopted) but the teachings can thus include combined electric and acoustic stimulation (one or both ears).

[0079] Regarding the treatment principles in terms of its technology implementation, at least some of the teachings detail herein cover bilateral stimulation where at least one side is delivering subthreshold/background auditory stimulation, bilateral stimulation where at least one side is delivering dynamic stimulation (for example by way of such and not by way of limitation, random and/or programmed changes in frequency and/or amplitude - more on this below) and/or bilateral stimulation where the relative difference between certain stimulation parameters on each side are regularly adjusted or irregularly adjusted.

[0080] Embodiments can include tinnitus therapy by way of either acoustic stimulation bilaterally, or electric stimulation bilaterally and/or in a combination thereof, in a mutually non-uniform manner. For example, one side can deliver constant subthreshold stimulation (e.g., recipient never perceives the stimulation) while the other side delivers perceptible stimulation (at least partially perceptible stimulation, sometimes). In another example, one side delivers dynamically changing stimulation, such as, for example, random/programmed changes in frequency and amplitude, as noted above, while the other side delivers stimulation that is maintained (in total or for the most part) as subthreshold or perceptible stimulation. In another example, each side independently undergoes regular changes in frequency and/or amplitude.

[0081] There is utilitarian value here in some embodiments in that there can be an improvement in tinnitus outcomes which is hypothesized as due to the restoration of disrupted neural activity and/or by further stimulating neural plasticity. Tinnitus patients have an opportunity to synchronize and/or desynchronize the stimulation between ears in frequency and/or amplitude/current, based on subjective and/ or objective feedback in order to provide relief from tinnitus and in some embodiments, allow control by the patients. By way of example, synchronization can be synchronization of loudness (perceived for example), pitch, length of time of stimulation, etc.

[0082] Thus, referring to FIG. 4, there is an exemplary method, method 400, represented by the flowchart of FIG. 4, which includes method action 410, which includes applying a first stimulation to tissue of a human, and method action 420, which includes applying a second stimulation tissue of a human. In an exemplary embodiment, this can be executed utilizing the tinnitus treatment device 2177 noted above. That said, in an embodiment, the teachings detailed herein are directed towards treatment, and this treatment device would be so modified for treatment of tinnitus in accordance with the teachings detailed herein. In an exemplary embodiment of method 400, exemplary embodiment, at least one of (i) the first stimulation is applied to a different side of the human than the second stimulation in a mutually non-uniform manner or (ii) the first stimulation is a different manner of stimulation (e.g., different kind of stimulation) to the second stimulation. With respect to the former, this can be achieved utilizing the earbuds 2155 of device 2177, where one of the two earbuds is located in respective ears of the human. This could also be achieved by utilizing system 300. With respect to the latter, this can be achieved utilizing a cochlear implant and a conventional hearing aid, or utilizing a cochlear implant and the device 2177 as modified to implement the teachings detailed herein.

[0083] In this embodiment, the method is a method of treating tinnitus, and the first stimulation and the second stimulation reduce (which includes eliminate) tinnitus of the human. By reducing tinnitus, it is meant that the percept that is considered to correspond to tinnitus is reduced. In an embodiment, the activation and/or inhibition of neurons that are perceived as tinnitus is reduced.

[0084] Consistent with the teachings above, figure 5 presents an exemplary flowchart for an exemplary method, method 500, which includes method action 510, which includes the action of executing method 400. Method 500 further includes method action 520, which includes the action of adjusting a device producing the first stimulation and adjusting a device producing the second stimulation to reduce the tinnitus more than that which would otherwise be the case in the absence of the adjustings and applying the first stimulation and the second stimulation based on the adjustments. The respective devices can be devices of the subsystem 100 and/or 340 (in an embodiment where subsystem 100 is a hybrid device, there would be two devices for example). Respective devices can be the earbuds of the device 2177. In an embodiment, the adjustments can be made by a clinician or otherwise a healthcare professional, while in other embodiments, the adjustments can be made by the human that is experiencing the tinnitus. That said, in an embodiment, the adjustments can be made automatically by the system 300 for example, where one of the devices as master, or a remote device as the master, etc. or by the device 2177 or any other device that is utilized to implement the teachings detailed herein.

[0085] It is also noted that one or more of the devices detailed herein that are utilized to produce stimulus, or otherwise the apparatuses that are utilized to produce stimulus, need not be a prosthetic device, but instead, could be a noisemaker located remote from the recipient for example. Indeed, as noted above, in an exemplary embodiment, the output of a smart phone for example could be utilized as one of the stimulation devices or otherwise one of the apparatuses that is outputting stimulation. In an embodiment, two or more smart phones can be utilized so as to separately output separate stimulation. Any device, system and/or method that can enable the teachings detailed herein can be utilized in at least some exemplary embodiments.

[0086] In an embodiment, the first stimulation is applied simultaneously with the second stimulation in a continuous manner. The second stimulation can be provided continuously or discontinuous. In an embodiment, the first stimulation and/or second stimulation is applied for less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750 or 2000 or more minutes or 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300 or more hours or any value or range of values therebetween in one second increments (e.g., 10 minutes and 3 seconds, 33 minutes, 305 to 555 minutes and 17 seconds, etc.), and the temporal periods need not be the same for the first stimulation and the second stimulation (the just noted values are presented in a matter of textual economy). In an exemplary embodiment, the first and/or second stimulation is provided continuously for any one or more of those just detailed values. In an exemplary embodiment, the stimulation is provided discontinuously over one or more of those values (i.e., for a period of 33 minutes, the first and/or second stimulation would be provided discontinuously, so there would be stimulation for less than 33 minutes). In an embodiment, the total time of actual stimulation for any one or more of the just detailed periods can be less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98 or 99% or any value or range of values therebetween in 0.1% increments of the total time period (e.g., for a period of 33 minutes with stimulation at 50% of the total time period, that would be stimulation provided for 16.5 minutes). In an embodiment, the discontinuous stimulation is divided up into 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 5000, 6000, 7000, 8000, 9000, 10000, 12500, 15000 or 20000 or more blocks or any value or range of values therebetween in 1 block increments, and the blocks may or may not be the same and/or the time between a given block of stimulation may or may not be the same. [0087] In an exemplary embodiment, the first stimulation is provided discontinuously with the second stimulation. It is briefly noted that any disclosure herein with respect to a first stimulation can correspond to a disclosure corresponding to the second stimulation and vice versa, in the interest of textual economy, and note that the two need not be the same.

[0088] In an exemplary embodiment, first stimulation and the second stimulation are provided in a continuous manner. In an exemplary embodiment, only one of the stimulations is provided in a continuous manner. In an exemplary embodiment, the first stimulation and the second stimulation are provided in a discontinuous manner. In an exemplary embodiment only one of the first stimulations and the second stimulations is provided in the discontinuous manner. And again, at least with respect to the application in a discontinuous manner, the discontinuous manner of the first stimulation need not be the same as that of the second stimulation.

[0089] Note that the concept of continuous stimulation is a micro concept in that eventually the stimulation can be discontinued. It is the overall context of stimulation, or more accurately, a therapy period for example, that governs whether or not the stimulation is continuous. The above temporal periods can provide guidance in at least some exemplary embodiments. Also, the concept of continuous versus discontinuous can be relative to each other. In this regard, if the first stimulation is provided in a continuous manner over a period of time and then halted, where during that same period of time, the second stimulation is provided discontinuously, that is continuous versus discontinuous with respect to relative comparison. But if the first stimulation is provided and then halted and then provided again and then halted for example, during a first period of time, that is discontinuous.

[0090] Embodiments can be directed towards treating humans with hearing loss. Embodiments can be directed towards treating humans without hearing loss. In an exemplary embodiment, the human that is treated is an adult male and/or female inside and/or outside of the 5^th to 95^th percentile human factors engineering person or any value or range of values therebetween in 1% increments, whether in total or with respect to hearing abilities born in the United States or the European Union or Australia or The United Kingdom or the Federal Republic of Germany or the Republic of France or the People’s Republic of China and has effectively lived in the jurisdiction of birth for his or her entire life. In an exemplary embodiment, the person is a child or an adolescent or as an elderly person. In an exemplary embodiment, the person has an age of any value or range of values from 1 to 115 years old in one year increments. In an exemplary embodiment, the person is completely and totally deaf. In an exemplary embodiment, the person is legally deaf with respect to the laws of any one or more of the jurisdictions detailed above, and/or with respect to one or more of sub jurisdictions in any one or the jurisdictions detailed above (e.g., the Commonwealth of Virginia, the States of Texas, New York, California, Alaska, etc.).

[0091] In an exemplary embodiment, the first and/or second stimulation is electric stimulation, whether applied by a cochlear implant or by a tinnitus management implant (more on this below) or by an implant that includes electrodes that are not as invasive as a cochlear implant but otherwise will still stimulate the auditory nerve or other portions of the nervous system of a human so as to implement the teachings detailed herein or by an external device that applies electrical current to the surface of the skin or slightly subcutaneously (by for example, needles that go into the skin), such as a device that is implanted or at least includes parts that are implanted but all components are entirely outside of the cochlea, etc. This could be a totally implantable system as well (e.g., with batteries that are rechargeable such that the implanted component can operate without the external component. In an embodiment, the implant can operate for at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45 or 50 hours or more without the external component / communication with an external device. Any device, system and/or method that will enable the application of electrical current that can enable the teachings detailed herein can be utilized in at least some exemplary embodiments, providing that the art enables such, unless otherwise noted.

[0092] In an exemplary embodiment, the first and/or second stimulation is acoustic stimulation. In an exemplary embodiment, this is delivered by way of a speaker that transduces an electrical signal, for example, into a mechanical movement of a diaphragm, for example, which creates sound waves/pressure waves within a fluid medium, such as air at sea level, which then vibrates the tympanic membrane so as to evoke a hearing percept. In an exemplary embodiment, the first and/or second stimulation is mechanical stimulation, such as that which can be produced by a vibrator of a bone conduction device. Acoustic stimulation is not vibrational stimulation and vice versa.

[0093] In an exemplary embodiment, the first stimulation is electrical stimulation applied by first implant, and the second stimulation is electrical stimulation applied by second implant. In an exemplary embodiment, these can be two separate cochlear implants that are implanted on either side of the recipient. In an exemplary embodiment, the first stimulation is applied by an implant and the second stimulation is provided by an external component / a nonimplanted device. [0094] While embodiments up until now have generally focused on the application of a first and a second stimulus, in an exemplary embodiment, there can be the application of a third stimulation. In an exemplary embodiment, there can also be the application of a fourth stimulation or more for that matter. By way of example, embodiments where there can be a third and a fourth stimulation in addition to the first and second stimulation (and note that the numerical values do not indicate primacy - these are provided for the purposes of giving nomenclature two different stimulations - in this regard, a second method action could be executed prior to a first method action, and note that in this regard, unless otherwise noted, the presentation of method actions do not require that such be presented in the order presented providing that the art enables such, unless otherwise noted) can correspond to a bilateral system that utilizes to hybrid devices (e.g., a hybrid device that includes a cochlear implant and a conventional hearing aid or otherwise a conventional hearing aid based device on each ear, where the cochlear implant on the left ear could provide the first stimulation, the cochlear implant on the right ear could provide the second stimulation, the conventional hearing aid or device to base thereon on the left ear could provide the third stimulation and the conventional hearing aid or devised based thereon on the right ear could provide the fourth stimulation). Accordingly, figure 6 presents an exemplary flowchart for an exemplary method, method 600, which includes method action 610, which includes executing method 400. Method 600 also includes method action 620, which includes the action of applying third stimulation. Note that in an alternate embodiment, method 600 can be expanded to include an additional action of applying fourth stimulation, etc.

[0095] In an exemplary embodiment, the third stimulation is stimulation that is different in kind (e.g., electrical instead of acoustic, or visa-versa) from the first stimulation and/or the second stimulation, and is applied as part of the method to treat tinnitus. In this exemplary embodiment, the third stimulation also reduces tinnitus of the human. In an exemplary embodiment, the fourth stimulation is stimulation that is different in kind from the first stimulation and/or the second stimulation, and is applied as a part of the method to treat tinnitus. In this exemplary embodiment, the fourth stimulation also reduces tinnitus of the human.

[0096] In an exemplary embodiment, the third stimulation can be a noisemaker. In an exemplary embodiment, the third stimulation could be the addition of the device 2177 detailed above. By way of example only and not by way of limitation, the human could have a hybrid device on one side of the head, and device 2177 can be utilized to apply stimulation to the other side of the head. That said, a noisemaker could be utilized to apply simulation of the other side of the head.

[0097] And this brings us to another point in that in an exemplary embodiment, the methods and/or devices herein include occluding the ear canal so that the ambient sound is muffled or otherwise blocked out partially or completely. By way of example only and not by way of limitation, the in the ear component of the conventional hearing aid based devices could block out ambient sound. Thus, one ear would receive little to no input from a remote noisemaker, while the other ear would receive such. Embodiments thus include implementing such arrangements in some embodiments.

[0098] Note that in at least some exemplary embodiments, the third and/or fourth stimulation could be the same in kind as one or more of the first and second simulations. For example, if the first and/or second simulations are electrical, the third stimulation could also be electrical. Here, in an exemplary embodiment, where for example the first and/or second stimulations are provided by a cochlear implant, in an exemplary embodiment, the third stimulation can be provided by a device that is different than a cochlear implant, such as, for example, a dedicated tinnitus treatment device that is also implanted. And note that the devices can be integrated in a manner concomitant with the teachings detailed above with respect to the hybrid arrangement.

[0099] In an embodiment, the first and second stimulation are applied to achieve bilateral stimulation to the human.

[ooioo] In an embodiment, the first stimulation is subthreshold auditory stimulation and/or ultra sonic stimulation (in an embodiment, the first stimulation could vary from say 10Hz to 24kHz in an oscillatory manner, or within any range of values therebetween in 10 Hz increments). In an embodiment, the first and/or second and/or third and/or fourth stimulation can be subthreshold auditory stimulation and/or ultra sonic stimulation. In an embodiment, the second stimulation is at or above the threshold for auditory stimulation (and evokes a hearing percept).

[ooioi] In an embodiment, it is the magnitude of the stimulation that causes a percept or does not cause the percept. In an embodiment, it is the frequency that causes a percept or does not cause a percept. Thus, in an embodiment, the methods detailed herein can include adjusting the magnitude for controlling the magnitude and/or frequency of the stimulation so as to evoke a percept or avoid of evoking a percept in the human due to the applied stimulus. [00102] In an exemplary embodiment, the first and/or second and/or third and/or fourth stimulation is applied dynamically, and in an exemplary embodiment, the first and/or second and/or third and/or fourth stimulation is applied in a static manner.

[00103] Briefly, it is noted that any disclosure herein with respect to the application of a first stimulation corresponds to a disclosure in another embodiment where the second and/or third and/or fourth stimulation as that feature unless otherwise noted, providing that the art enables such, all in the interest of textual economy.

[00104] In an embodiment, the stimulation is provided so that one or more of the following is controlled to be static and/or one or more of the following is controlled to change: magnitude, frequency, pulse width, stimulation mode (monopolar, bipolar, bipolar, common ground, combined modes, phase array), modulation pattern (sinusoidal, sawtooth (rise/fall-times), square wave, continuous, periodic (on/off-period), modulation depth: (% of dynamic range), onset phase of the modulation frequency (0-2K or any value or range of values therebetween in 0.017t), carrier frequency (fixed frequency / modulated frequency (frequency range)), modulation mode (current level modulation, pulse width modulation, frequency modulation), etc. In an embodiment, any one or more of these can be adjusted or otherwise changed during any one or more of the aforementioned periods detailed herein. In an exemplary embodiment, these are changed 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 400, 500, 750, 1000, 1250, 1500, 2000, 2500, 3000, 3500, 4000, 5000 or more times or any value or range of values therebetween in 1 increment during any one or more of the temporal periods detailed herein. In an embodiment, there are 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 400, 500, 750, 1000, 1250, 1500, 2000, 2500, 3000, 3500, 4000, 5000, 6000, 7000, 8000, 9000 or 10000 or 15000 or more temporal periods in one or more of the methods detailed herein, and these periods can be back to back (contiguous) and/or can be separated from one another, and a period of separation can correspond to any one or more of the time periods detailed herein in the interest of textual economy, and in an embodiment, a collective period of treatment can be, in the interest of textual economy, the summation of the collective number of periods including stimulation periods and/or non-stimulation periods, by way of example only and not by way of limitation. [00105] By way of example only and not by way of limitation, the first and/or second and/or third and/or fourth stimulations are applied to achieve bilateral stimulation to the human in an exemplary embodiment. In an exemplary embodiment, a relative difference of one or more respective parameters of the first and/or second and/or third and/or fourth stimulation are regularly adjusted and/or irregularly adjusted (within one or more of the temporal periods for example). In an embodiment, the adjustments are random, and can be implemented utilizing techniques that are known to provide randomness (e.g., utilizing the onset of ambient sounds for example to trigger an adjustment, or a program that generates a random number generator, where the random number generated corresponds to some form of adjustment that is predetermined for that number).

[00106] In an exemplary embodiment, the treatment of tinnitus according to any one or more of the methods detailed herein restores disrupted neural activity and/or stimulates neural plasticity. In an exemplary embodiment, the treatment of tinnitus according to any one or more of the methods detailed herein reduces the perceived magnitude of tinnitus by less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 95 or 100% or any value or range of values therebetween in 1% increments. In an exemplary embodiment, the treatment of tinnitus according to any one or more of the methods detailed herein changes the pitch of the tinnitus. In an exemplary embodiment, the pitch can be changed by less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards relative to the initial pitch (e.g., if the initial pitch is 300 Hz, and thus the control pitch (control for the purposes of explaining the change) an upwards change of 300% would be to change it to 900 Hz). In an exemplary embodiment, this occurs in one or both ears. In an exemplary embodiment, a given change in one ear is replicated in the other ear. In an exemplary embodiment, the quantifiable change in one ear corresponds to a value that is less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 95 or 100% or any value or range of values therebetween in 1% increments of the quantifiable change in the other ear, where the change in the first ear is the control.

[00107] Embodiments can include synchronizing and/or desynchronizing the first stimulation with/from the second stimulation and/or from the third and/or from the fourth (and all visa- versa in the interests of textual economy) based on subjective and/or objective input from the human. Indeed, embodiments can include making adjustments to any one or more of the simulations based on subjective and/or objective input from the human. In an exemplary embodiment, this can be executed automatically by any one or the system detailed herein. In an exemplary embodiment, this can be executed manually, such as by user inputs. With respect to the former, by way of example only, in an exemplary embodiment, the system can be configured to interpret statements by the human and automatically adjust one or more of the stimulations based on that interpretation. For example, the device could interpret the phrase “I have high-pitched ringing in my ears” to mean that an adjustment should be made to one or more of the stimulations or stimulation should be started for that matter or otherwise implemented for that matter, with one or more parameters that are targeted towards addressing such tinnitus at a high frequency. With respect to the latter, by way of example only, in an exemplary embodiment, the system can be configured to interpret statements by the human and automatically adjust one or more of the simulations based on the interpretation. For example, the device could interpret the phrase “increase the frequency of the background noise provided by my implant” to mean that the device should increase the frequency of stimulation. This is the system responding to a command.

[00108] Note that embodiments can be less sophisticated than that just detailed. For example, there can be an application on a smart device that allows for the input of a command by the human so that the system can adjust itself accordingly. Other types of input can be provided, or more accurately, other types of queries can be provided where the answer can be interpreted in a smart manner so as to adjust the system. For example, there could be five or six or seven or more possible selections describing in different ways the tinnitus experienced by the person. For example, there can be high-pitched or low pitch tinnitus, there could be loud or soft tinnitus, etc., and the human could select one or more of these, and then the system could interpret the input from the human to adjuster otherwise develop a treatment regime, and thus adjust one or the stimulations accordingly. Alternatively, and/or in addition to this, the application can enable the human to adjust for example the frequency and/or the magnitude of the one or more stimulations by direct control, such as, for example, a sliding scrollbar on a touch screen of a remote device that allows the human to adjust the frequency and/or the perceived loudness, for example, of the stimulation, all by way of example.

[00109] In an exemplary embodiment, one or more of the stimulations results in a hearing percept in the human. In an exemplary embodiment, one or more of the stimulations do not result in a hearing percept in the human. The various scenarios can be the case because the human has normal hearing and the stimulation is sub-threshold for normal hearing or supra- threshold for normal hearing. Or this could be because the person has hearing that is aberrant from normal, for example (if no hearing percept, it could be because it is sub-threshold for that person). In an exemplary embodiment, one or more of the methods detailed herein include providing, in an automated manner, at least one cue that causes the human to distinguish between stimulation for the treatment and real-world sounds. Embodiments can include overlaying perceptible binaural cues to achieve this distinguishment. For example, in an embodiment where the method(s) are applied to a person with tinnitus who has a bilateral arrangement (one device for each ear), such as, for example, bilateral hearing aids (hearing aid + hearing aid), bilateral cochlear implants (cochlear implant + cochlear implant) or bimodal arrangements (hearing aid + cochlear implant) with one on each side. In an embodiment, the stimuli that are applied to reduce tinnitus may be audible to the human. This may cause problems for the human. For example, the human may be uncertain whether the sounds they hear are the artificial tinnitus reduction stimuli or whether they are real sounds from the environment. Secondly, the tinnitus reduction stimuli may make it harder to hear a desired sound, such as someone speaking to him or her;

[00110] Embodiments can provide a solution to this problem by generating a tinnitus reduction stimulus in the left and /or right ears in a coordinated fashion so that spatial localization cues are provided to the human, and the human perceives the left and right stimulus reduction stimuli as a single sound source coming from a controlled direction. The spatial localization cues may be interaural level differences (ILD), or interaural time differences (ITD), or spectral cues derived from a head-related transfer function (HRTF), or any combination of these cues. Any implementation that can provide the utilitarian features hereof can be provided.

[oom] In an embodiment, the left and right tinnitus reduction stimuli have a binaural cue imposed that gives the perception that the sound is coming from a fixed direction. This direction may be selectable by a clinician during a fitting session or could be chosen by the human using a remote control or an app on their remote device (smart phone for example) or similar device. For example, the perceived direction of the tinnitus reduction stimulus could be set to 45 degrees to the right of front, or 60 degrees to the left of front, etc. A dial-a- direction can be provided on the smart device for example, where the recipient dials in the direction desired. Because humans typically look at the person to whom they are speaking, the desired speech signal will be effectively coming from zero degrees and the tinnitus reduction stimuli will have an imposed ILD and/or ITD that causes it to be perceived to be coming from 45 degrees or any of the directions noted (or any direction desired by the human or set by the clinician, etc.). This difference in spatial direction allows the human’s brain to segregate the two sounds, and to identify the two sounds as two separate sound sources. Furthermore, if the human moves their head slightly to the left or right while the talker is stationary, the binaural cues and hence the perceived direction of the talker will vary appropriately with the head movement, which listeners expect for a stationary sound source. Conversely, when the human moves their head, the tinnitus reduction stimulus will be perceived to remain at 45 degrees relative to the human’s head and hence will be perceived to be moving in space, which further identifies the tinnitus stimulation(s) as an artificial sound that is not coming from the environment.

[00112] Alternatively, and/or in addition to this, the binaural cues imposed upon the left and right tinnitus reduction stimuli are varied in time. For example, the cues can be gradually changed so that the tinnitus reduction stimulus is perceived to be slowly moving from the left to the right and back again repeatedly (or fast moving, or any speed that is desired by the human recipient of the device and/or any utilitarian manner). This will distinguish the tinnitus reduction stimulus from real-world environmental sounds.

[00113] Thus, in an embodiment, one or more of the first, second, third and/or fourth stimulation(s) are controlled to provide perceptible cues that are interpreted by the human as a directional feature of the resulting hearing percept.

[00114] Embodiments include dynamically controlling the stimulation(s) to account for scenarios where a person is speaking to the human so as to reduce, including eliminate, interference of the perceived speech by the stimulus used to treat tinnitus reduction. An embodiment can include automatically detecting speech of others and/or the speech of the person with tinnitus and automatically altering / adjusting / halting one or more of the stimulations so as to reduce / avoid interference or otherwise increase perception / the likelihood of perception. An “own voice” detection arrangement can be used and/or a “speech of others” detection arrangement can be used as is known in the art and integrated into the system so that upon detection, the adjustments, etc., are automatically triggered. In an embodiment, there can be a mode / function on the smart phone for example or on one or more of the subsystems / devices of the system where upon “tapping” or “pressing” or “toggling” to start the function, the system goes into the “hear speech” mode (note that it is assumed that when the recipient is speaking, there is someone speaking to him, in embodiments where own voice detection is used). [00115] In an embodiment, the human has tinnitus that is more present in one ear vs. the other ear of the human. In an embodiment, the tinnitus has a perceived magnitude and/or frequency in one ear that is less than, greater than and/or equal to 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards than the other ear. In an embodiment, the first stimulation is applied to the one ear and the second stimulation is applied to the other ear and the first stimulation is applied in a more aggressive manner than the second stimulation. In an embodiment, any one or more of the variables that can be adjusted / controlled, are applied in one stimulation so that such is less than, greater than and/or equal to 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards relative to that of another stimulation.

[00116] In an embodiment, the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human and the first stimulation is subthreshold with respect to hearing and the second stimulation is audible in the other ear with respect to hearing. The first stimulation and the second stimulation provide bilateral input to the brain of the human, thereby adapting to tinnitus and a hearing loss of the human.

[00117] In an embodiment, the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human. The first stimulation is provided at a first frequency or within a first frequency range based on tinnitus feature(s) in the one ear and the second stimulation is provided at a second frequency or within a second frequency range based on tinnitus feature(s) in the other ear. This can be the case with respect to the third and/or fourth stimulations, respectively.

[00118] In an embodiment, the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human and the first stimulation is synchronized with the second stimulation. This can be the case with respect to the third and/or fourth stimulations, respectively. In an embodiment, the stimulations are not synchronized. That is, the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human and the first stimulation is nonsynchronized with the second stimulation. In an embodiment, the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human and the treatment includes alternating magnitude and/or frequency of the first stimulation and second stimulation.

[00119] Embodiments include applying the various variabilities disclosed herein to avoid adaptation which would otherwise be of decreased therapeutic benefit. Accordingly, embodiments include implementing any one or more of the teachings herein where there is no clinical adaptation identifiable to any one or more of the treatments / stimulations.

[00120] In an embodiment, frequency and/or amplitude is changed at a constant and/or varying rate according to any one or more of the percentage changes herein in the interests of textual economy. In an embodiment, the changes could be made over any one or more of the temporal periods detailed herein by any one or more of those percentage changes.

[00121] An embodiment can include frequency and/or amplitude modulation of the (unperceived) background sound (multi -channel/el ectrode array pulse trains for example). In an embodiment, this is done in the unilateral application for example. In an embodiment, the stimuli could include slowly changing frequency / amplitude modulations. In an embodiment, this is executed / controlled by a clinician during fitting of one or more of the systems herein.

[00122] In an embodiment, a genetic algorithm, a decision tree analysis and/or an Artificial Intelligence arrangement can be used to guide the clinician in their fitting effort to develop the utilitarian parameters to be used by the system. The algorithms can be fed by clinician and/or patient feedback on the tinnitus percept. In an embodiment, the background stimuli are not perceived but they might be perceivable and when they change they provide a different percept of spatial origin which could distract the subject from perceiving a continuous tinnitus coming from one spatial origin. Thus, it can be seen that in some embodiments, some level of automation in the stimuli can be enabled by the clinician. Automation based on genetic algorithm, decision tree analysis and/or Al can be used in some embodiments. In an embodiment, the clinician and/or the human with the prosthesis can enable and/or disable the automation of the system. Note also that the Al can be used to determine what settings / adjustments can be made and will not be made prior to use of the system for tinnitus treatment (it may not be a part of the system used by the recipient in some embodiments - it may in other embodiments - the Al can be used in real time or can be used to set up / fit the system to the recipient).

[00123] Embodiments can include a bilateral application that can have unsynchronized modulation and/or synchronized modulation (over one or more temporal periods) of frequency/amplitude modulation. The modulation could be individualized based on patient feedback on success of tinnitus suppression. Embodiments thus include providing one or more stimulations to the human in obtaining feedback, and based on the feedback, making one or more adjustments to one or more control features of the system that is utilized to treat this tinnitus. The feedback can be provided to a healthcare provider who manipulates the background stimulation or otherwise develops settings of the system that will be used in the treatment. This could instead or in addition to this be automated feedback via an app where the human provides feedback or based on the feedback of the physiological function of the patient, e.g. EEG or heart rate. The EEG feedback could focus on different brainwave frequencies (e.g. Alpha, Gamma, Delta waves). More on this below.

[00124] Embodiments can include modulations that can be based on overall low frequency modulation of incoming sound or can be based on relaxing sound stimuli, such as, for example, rain or waterfalls. In this regard, by way of example only and not by way of limitation, the sound capture device(s) can be utilized to provide a base sound signal which is modified or otherwise modulated to implement one or more of the teachings detailed herein and otherwise provide a basis for the ultimate stimulation for the first and/or second and/or third and/or fourth stimulation, etc. In an exemplary embodiment, a single signal of sound captured can be modified in two or three or four or more different ways to provide the two or more stimulations in accordance with the teachings detailed herein.

[00125] Embodiments included modulation of the background stimulation in current level (whether that outputted to the electrodes and/or provided to the speaker of the acoustic output) depending on the side and/or the loudness of the tinnitus. For instance, if the tinnitus is more present in the left ear than in the right ear, the current level in the left ear can be increased and the current level in the right ear can be decreased, and whether this is perceived or not can depend on whether or not the stimulation is intended to be perceptible. This can be considered balancing the overall stimulation regime (the 2 or more stimulation), which can adapt the stimulation to the individual needs of the human (as opposed to a generic one size fits all application).

[00126] In an exemplary embodiments, there can be a linear or nonlinear correlation between the magnitude of the first stimulation in the magnitude of the second stimulation or any of the other stimulations. In an exemplary embodiment, there can be a one to one correlation, while in another embodiment, it can be that for every one unit increase of the first stimulation, there is a 1.1 or 1.2 or 1.3, etc., unit increase for the second stimulation or a decrease for that matter. In an embodiment, there is an overall value that can be normalized for the magnitude of the stimulations, whether that be mean, median and/or mode over one or more of the temporal periods herein, and the combination of the two or three or four stimulations will equal that overall value. For example, if the unit value for the overall value is, say, three units, and the magnitude of the first stimulation is to units, then the magnitude of the second stimulation would be one unit or if there are three stimulations, the magnitude of the second stimulation and the third stimulation will collectively amount to one unit.

[00127] In an exemplary embodiment, there is a routine where the human can classify the relative loudness of the tinnitus in the first ear and/or in the second ear. In an exemplary embodiment, a sound generator or a noise generator can be utilized where the recipient can adjust the output thereof to match in frequency and/or in magnitude the tinnitus perceived in a first year and then do the same for the tinnitus perceived in the second year if such is present. Any other device, system and/or method that can enable qualification and/or quantification of a recipient’s tinnitus can be utilized in some embodiments. In an embodiment, there is an algorithm that sets one or more features of the stimulation based on the identified characteristics of the given tinnitus in the first ear and in the second ear. In an embodiment, this is frequency matching, while in other embodiments, it could be that the frequency is offset by an octave or ’A octaves or some predetermined amount. The point is that changes in the background stimulation with respect to magnitude and/or frequency can be utilized so as to address a given feature of tinnitus in a given side of the human, and feedback from the human can be utilized to aid in the identification of what changes should be made or otherwise what might be utilitarian.

[00128] In an exemplary embodiment, the magnitude as driven by, for example, the current level, can be subthreshold in one ear and audible in the other the other ear. This can provide bilateral input to the brain and/or adapt to the tinnitus and/or hearing loss of the patient. In an embodiment, the first and/or second and/or third and/or fourth stimulation can be subthreshold and/or audible (and by audible, it is meant that a hearing percept is evoked - a completely deaf person can experience an audible sensation utilizing a cochlear implant for example).

[00129] In an embodiment, there is modulation in the background stimulation in frequency depending on the side and the loudness of the tinnitus. For instance, if tinnitus in the two ears has a different pitch, the frequency of the stimulation can be adapted in each ear, and embodiment including doing so, in accordance with the teachings above, whether the treatment be to the exact frequency or a percentage or octave away or by some other amount, or whether the frequency be variable over a range that encompasses the tinnitus frequency (e.g., centered on the frequency, or uses as a floor or ceiling for that frequency, etc.).

[00130] Embodiments include adapting the synchronization of the background stimulation delivered in the two ears. Two synchronous or non-synchronous background stimulations can be delivered depending on the effect of the stimulation in each ear and the effect of the combined stimulation on the tinnitus (change of tinnitus location, loudness, pitch, etc.). In this regard, in some embodiments, the teachings detailed herein can be provided in an interactive manner, so that as the tinnitus features change over time and/or with treatment, the provided stimulations are also changed. For example, if the loudness of the tinnitus is decreasing because of the treatments, the magnitude of the stimulations, or at least some of them, could also be decreased, at least with respect to those that can be perceived, although there is utilitarian value with respect to decreasing the magnitude of output of the subthreshold stimulation, if only to preserve energy or battery power, which is utilitarian in the case of a totally implantable prosthesis that relies on power storage internal to the human, although even embodiments that utilize transcutaneous power transfer in real time can benefit from reduced magnitude to stimulation in that the external component would need to be recharged less. But we digress. In an embodiment, as a given feature changes, the methods detailed herein include effectively “chasing” that feature in that the parameters are adjusted so as to effectively constantly adapt to the changing features of the tinnitus.

[00131] In an exemplary embodiment, there can be a reevaluation or an adaptation within any one or more of the temporal periods detailed herein. Again, in an embodiment, there can be devices systems and/or methods that enable the patient to characterize his or her tinnitus, and systems that take the characterization to develop a treatment regime based thereon.

[00132] Embodiments can include alternating the stimulation background current level and/or frequency in each side of the human. Embodiments can include changing the fitting configurations of the two or more devices and/or the background stimulation(s) to restore the symmetry between the ears in terms of tinnitus and/or hearing loss, if present.

[00133] The parameters herein can be controlled by a clinician who can enable the control by the patient depending on their needs which give them a sense of control over their tinnitus that could provide relief in itself. [00134] Embodiments are directed towards improving the positive effect of cochlear implants on tinnitus, such as scenarios where a recipient / human that receives a unilateral implant does not always get rid of their tinnitus because of the presence of tinnitus in the other ear and/or because of a no complete suppression of their tinnitus. Embodiments include applying one or more mechanisms of action to improve the reduction of their tinnitus burden, such as the masking effect and /or the suppression effect. The masking effect can be achieved using acoustic and/or electrical stimulation. The sound induced (the hearing percept) can reduce the contrast between the tinnitus signal and ‘silence’, which may lead to a decrease (including elimination) in tinnitus perception. Embodiments also include utilizing the reduction mechanism, which modulates activity of the auditory cortex and suspends and/or reverses tinnitus generation.

[00135] Embodiments include the combination of acoustic and electrical stimulation in one ear and/or in two ears as noted above. This can optimize the reduction of tinnitus by way of example. The bimodal input can be adapted based on the effect of each type of stimulation on tinnitus in some embodiments. Further, the bimodal input can be modulated depending on the patient's needs and environment, as noted herein. This bimodal stimulation can be applicable for patients with hearing loss wearing a hybrid device and for patients without hearing loss wearing a tinnitus implant combined with a conventional hearing aid or conventional hearing aid based device or sound generator. The bimodal stimulation can include sound input at the hearing aid / hearing aid based device equipped ear in the very low frequencies which are potentially not heard by way of example. In an embodiment, frequencies applied are equal to, less than, and/or greater than 100, 90, 80, 70, 60, 50, 45, 40, 35, 30, 25, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6 or 5 Hz or any value or range of values therebetween in 1 Hz increments.

[00136] In some embodiments, as noted above, bone anchored hearing devices / bone conduction devices instead of conventional hearing aid based devices could be used. A combined cochlear implant and bone conduction device(s) could be used, again as noted above in bimodal stimulation scenarios. Embodiments include combined electrical and acoustic stimulation in one or both ears. This combination of stimulation is used to provide synchronized and/or desynchronized stimulation to provide relief of/cure tinnitus.

[00137] As seen above, embodiments include tinnitus therapy that is performed by providing two different kinds of stimulation that are delivered in mutual relationship with one another. The first kind of stimulation is delivered electrically, which can be done using at least one implanted electrode near or at/in the cochlear region. The second kind of stimulation can be non-electric, such as bone conduction vibrations and/or acoustic stimulation. In some embodiments, the former and/or the latter is consciously perceivable and the latter and/or the former is not consciously perceivable, in accordance with the teachings herein.

[00138] In one exemplary embodiment, the clinician separately evaluates effect of sound and electric stimulation on tinnitus relief of a specific human being, and then creates a program having ratio between each kind of stimulation, by way of example only and not by of way limitation. The ratio is defined depending on which stimulation is deemed to be most effective, such as, for example, if electric stimulation is more effective than acoustic stimulation in the tested ear, then bimodal stimulation could be 80% electric and 20% acoustic for example. The ratio will be modified/adapted based on the human’s feedback for example. In another example, there is an adaptation of synchronization of bimodal stimulation delivered in the ear. Two synchronous or non-synchronous types of stimulation can be delivered depending on the effect of the separated types of stimulation on tinnitus and the effect of the combined stimulation on the tinnitus (change of tinnitus location, loudness, pitch, etc.). In another example, there is provided alternating acoustic and electric stimulation.

[00139] By way of example, FIG. 7 provides an exemplary flowchart for an exemplary embodiment of implementing some of the teachings herein. Some additional details of this will be described in greater detail below, and note that in some embodiments, there is an algorithm where there is X% sound stimulation and 100%-X% electric stimulation.

[00140] Embodiments include specific exclusion of non somatosensory, vagal, TENS stimulation.

[00141] In some embodiments, such as where the non-electric stimulation is perceivable as sound, the application of electrical stimulation can be stimulation of the cochlear nerve via a cochlear implant for example and acoustical stimulation would be with a receiver of a conventional hearing aid for example.

[00142] Elaborating on audibility, embodiments include the use of the cochlear implant in scenarios of such to restore hearing / provide hearing. Embodiments can include the application of non-cochlear invasive promontory/round window electrical stimulation / using such a stimulator of the cochlea. Embodiments include utilizing a device that could then include an electrical stimulator anywhere in the body and acoustical stimulation via any of the teachings herein (noisemaker remote from the human (e.g., first and second stimulation could be bilateral cochlear implant stimulation, and the third could be from a noisemaker remote from the human)). Embodiments include a combination of implanted electrical stimulation (inaudible or otherwise) in combination with another mode which is perceived via the auditory cortex, such as, for example, acoustic, external electric, bone conduction, for example (external and implanted electrical stimulation are not different kinds of stimulation, but are stimulations delivered differently).

[00143] In an embodiment, the second kind of stimulation (non-electric) is delivered as a tinnitus masker by way of example only and not by way of limitation. In an embodiment, the electrical stimulation is inaudible and in other embodiments it is audible (and for example, one side provides audible electrical stimulation and the other side provides non-audible electrical stimulation).

[00144] Embodiments include electrical stimulation that is inaudible stimulation that can be subthreshold stimulation or suprathreshold stimulation that becomes inaudible due to loudness adaptation. Accordingly, embodiments can be implemented that provide mechanisms to provide tinnitus relief without adding a new sound perception.

[00145] In view of the above, there is an exemplary method 800, represented by way of example by the flowchart of FIG. 8, which includes method action 810, which includes the action of obtaining first data based on an effect of first stimulation on tinnitus of a human, and method action 820 which includes the action of obtaining second data based on an effect of second stimulation on tinnitus of a human.

[00146] Actions 810 and 820 can be executed by obtaining firsthand objective and/or subjective responses from the human. Actions 810 and 820 can be executed instead by obtaining data that corresponds to the responses from the human. By way of example only and not by way of limitation, the human could log his or her perceived effects of the stimulation or one his or her tinnitus, and this could be recorded in a database by way of example. A clinician or the like can then access that database and thus obtained first data that is based on the effect of the stimulation on tinnitus of the human. In an embodiment, the data that is obtained can be derivative data, such as normalized or smooth data of the original data, but as long as it is based on one the effect of the first stimulation on tinnitus of a human, such meets the method action. [00147] In an exemplary embodiment, method actions 810 and 820 can be based on stimulation provided by any of the devices and/or systems and/or apparatuses detailed herein, such as, for example, system 300 and/or the tinnitus treatment device 2177 detailed above, however modified so as to implement the teachings detailed herein.

[00148] Method 800 further includes method action 830, which includes the action of identifying a more effective stimulation for tinnitus treatment of the human based on the obtained first data and obtained second data. Method action 830 can be executed manually or can be executed automatically. As noted herein and as will be described in greater detail below, method action 830 can be executed by a product of a trained neural network or otherwise some form of artificial intelligence, again by way of example.

[00149] In an exemplary embodiment of method 800, the first stimulation is a different manner (e.g., different kind) of stimulation from the second stimulation and/or the first stimulation is provided to a first sensory organ of the human and the second stimulation is provided to a second sensory organ of the human. With respect to the former, in an exemplary embodiment, the first stimulation could be electrical and the second stimulation could be acoustical consistent with the teachings herein. In an exemplary embodiment, with respect to the latter, the first sensory organ of the human could be a left ear and the second sensory organ of the human could be a right ear (any parts thereof).

[00150] FIG. 9 shows a flowchart for an exemplary method, method 900, according to an exemplary embodiment. Here, there is method 910, which includes the action of executing method 800. Method 900 also includes method 920, which includes the action of creating a bimodal stimulation regime based on the identification, wherein the stimulation regime includes both electrical stimulation and stimulation different from the electrical stimulation, the electrical stimulation corresponding to the first stimulation and the stimulation different from the electrical stimulation corresponding to the second stimulation. In this exemplary embodiment, the system that delivers the stimulation can be configured or otherwise mapped so that, for example, X percent of the stimulation delivered is electrical, and Y percent of the simulation delivered is acoustic by way of example only. That is, the regime can be such that the implementation thereof results in the percentage stimulations determined for the regime between the two types of stimulation. In an embodiment, the stimulation regime weights the electrical stimulation more or less than the stimulation different from the electrical stimulation, and in an embodiment, the weighting is equal. [00151] In an embodiment, there is the action of obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations, wherein the action of creating the bimodal stimulation regime is also based on the obtained third data. In an embodiment, the adjustment of parameters include synchronization and/or desynchronization of the electrical stimulation and the stimulation different from electrical stimulation. In this regard, both stimulation outputs can be synchronized and/or desynchronized with respect to stimulus parameters, such as, for example, rate, level modulation, etc. The method and/or system is implemented according to an algorithm where there is X% sound stimulation and 100%-X% electric stimulation, and X can be 0 or can be less than, greater than and/or equal to 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or can be 100 or any value or range of values therebetween in 0.25% increments.

[00152] Synchronization can include applying the same stimulation to both sides (where the stimulation could be changed so that the stimulation could be different on both sides - that is, for example, taking two identical devices and using that is not synchronization). Synchronization can include applying stimulation at the same frequency or purposely different frequency. And with respect to electrical and say acoustic or vibrational stimulation, there is a percept frequency to which the output will correspond, as will be understood by those of skill in the art. For example, with respect to a cochlear implant, cochlear implant is configured and is implanted in a human so that the human will perceive different frequencies (e.g., owing to the tonotopic mapping of the electrode array). If the output of the cochlear implant providing electrical stimulation targets a certain frequency percept, and the acoustic output is at a given frequency (the way the cochlea works, if the recipient still has a functioning inner ear and a conductive pathway thereto, the output of the speaker/receiver of the conventional hearing aid or otherwise the conventional hearing aid based device will cause a percept at that frequency - such is also the case with respect to a bone conduction device, albeit the conductive pathway thereto, or at least the normal conductive pathway, need not be functional), if the goal is to have perception of frequencies in a certain manner, that is synchronization. Further by example, if an electric signal with a specific frequency rate is applied as the first stimulation, the second stimulation could be synchronized with the electrical stimulation, by, for example, providing the acoustic stimulation device with inputs so the output will be at the same frequency rate as the electric stimulation or a different frequency rate. In an exemplary embodiment the frequencies of the stimulation are less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 4500 or 5000 or more or any value or range of values therebetween in 0.1% increments different from each other using one as the control.

[00153] Note that the synchronization can exists where, say for example, one frequency is 125% more than the other frequency. If that is purposeful, that is synchronization. Conversely, if the frequencies are adjusted independently of each other without knowledge of the other, and they are the same by coincidence, that is not synchronization with respect to the action of synchronizing.

[00154] Synchronization can exist when there is stimulation from one device and/or on one side and not the other, and visa-versa, as well as when there is stimulation from both devices / at both sides.

[00155] In an embodiment, the synchronization or desynchronization / nonsynchronization can be present over any time periods detailed herein in the interest of textual economy, for a collective overall period of time that amounts to the addition of any two or more time periods, the time period of synchronization is less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 4500, 5000, 6000, 7000, 8000, 9000, 10000, 15000 or 20000 or more or any value or range of values therebetween in 0.1% increments different from the desynchronization / nonsynchronization using one as the control. And note that the time periods can be back to back for one or the other or both. For example, there could be two or three or more synchronization time periods and one or two nonsynchronized periods, continuously, etc. Again, this is presented in terms of textual economy.

[00156] And in the interests of a more thorough disclosure, in some embodiments, there can be the other type of stimulation during those temporal periods. That is, for example, while the embodiment just detailed represents time periods of mutual exclusion of the other, and hence alternate synch / desynch, in other embodiments, there can be the presence of synchronization and desynchronization, such as for example where there are three or four simulations being applied. The first and/or second and/or third and/or fourth can be synchronized and/or not synchronized depending on the permutation. [00157] The adjustable parameters of the methods herein can include magnitude of output of the electrical stimulation and/or magnitude of output of the stimulation different from electrical stimulation, and the magnitudes can be the same or different and can fall within the above-noted percentages which will not be repeated for purposes of textual economy. In an embodiment, again, the adjustable parameters can include frequency of the electrical stimulation and/or frequency of output of the stimulation different from electrical stimulation. In the interests of textual economy, magnitude adjustment and/or frequency adjustment can take on any of the above noted regimes for synchronization and/or desynchronization. To be clear, any of the adjustable parameters detailed herein can follow these adjustment regimes just detailed (and need not be the same) in the interests of textual economy.

[00158] In an embodiment, the adjustable parameters includes location of the electrical stimulation and/or location of output of the stimulation different from electrical stimulation. By way of example, if the devices on either side of the recipient are hybrid devices that can output electrical stimulation and acoustic stimulation or another type of stimulation different than electrical stimulation, the system can be controlled so that electrical stimulation is provided only on one side and the acoustic stimulation is applied only on the other side. This can be alternated or otherwise modulated in an exemplary embodiment so that during one or more of the time periods detailed herein, by way of example, there is stimulation from electricity on one side and then there is stimulation from electricity on the other side in other time periods. There can be stimulation from electricity on both sides during some time periods as well, and during some time periods, there is no stimulation from electricity. These can also be the case with respect to the acoustic stimulation by way of example. And these can be interleaved for example. In some embodiments, there is electric and acoustic stimulation on one side and not the other during some time periods and vice versa in other time periods. And in some time periods there is electric and acoustic stimulation at both sides. And note that while the embodiment just described is focused on the utilization of a plurality of hybrid devices, which devices of the plurality of devices are respectively located on either side of the recipient, in another embodiment, at least with respect to the acoustic stimulation, the conventional hearing aid based device for example could be moved from the left side to the right side and vice versa so as to achieve the change in location, or otherwise removed from one side to halt such stimulation. Moreover, this can be the case with respect to electrical stimulation that is applied from outside the recipient for example, as opposed to the implant. That said, the same effect can be achieved by removing, for example, the external component from one side of the recipient or the other side of the recipient or both sides of the recipient for that matter, at least with respect to embodiments that require the external component to operate the internal component.

[00159] In an embodiment, the adjustable parameters include a control parameter that alternates the electrical stimulation and the stimulation different from electric stimulation and/or location thereof. The alternation can be 50-50 temporally speaking, or can be longer one than the other, etc. In an embodiment, over any time periods detailed herein in the interest of textual economy, for a collective overall period of time that amounts to the addition of any two or more time periods, the time period of electrical stimulation is less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 4500, 5000, 6000, 7000, 8000, 9000, 10000, 15000 or 20000 or more or any value or range of values therebetween in 0.1% increments different from the non-electrical stimulation using one as the control. And note that the time periods can be back to back for one or the other or both. For example, there could be two or three or more electric stimulation time periods and one or two acoustic, continuously, etc. Again, this is presented in terms of textual economy.

[00160] And in the interests of a more thorough disclosure, in some embodiments, there can be the other type of stimulation during those temporal periods. That is, for example, while the embodiment just detailed represents time periods of mutual exclusion of the other type of stimulation, and hence alternate stimulation, in other embodiments, there can be the presence of both types of stimulation for one or more of those time periods.

[00161] Note that while the above embodiments have been presented in terms of electrical vs. non-electrical, in the interests of textual economy, any such disclosure herein of a feature of electrical stimulation vs. non-electrical stimulation corresponds to an alternate disclosure of one side vs. the other side and/or one device vs. the other device (whatever device to which this can be applicable), and visa-versa, unless otherwise noted providing that the art enables such.

[00162] Thus, by way of example, where method 800 is implemented, there is a further action of creating a bilateral stimulation regime based on the identification for example. In an embodiment of method 800, the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ. In an embodiment, where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, the stimulation regime weights the first stimulation more or less than the second stimulation and/or obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations, wherein the action of creating the bilateral stimulation regime is also based on the obtained third data. In an embodiment where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, the adjustable parameters includes synchronization and/or desynchronization of the first stimulation and the second stimulation. In an embodiment where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, the first data and/or the second data includes a loudness of tinnitus of the human relative to whether and/or an amount of first stimulation and/or the second stimulation and/or the identification of the more effective stimulation is based on which stimulation results in louder and/or softer tinnitus.

[00163] In an embodiment where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, there is the action of creating a lateral stimulation regime based on the identification, wherein the regime includes setting a perceived direction of a perceived artificial sound resulting from the first and second stimulation. In an embodiment where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, the adjustable parameters include magnitude of output of the first stimulation and/or magnitude of output of the second stimulation.

[00164] In an embodiment where the method includes creating a bilateral stimulation regime based on the identification and/or the first stimulation is provided to the first sensory organ and the second stimulation is provided to a second sensory organ, the adjustable parameters include frequency of the first stimulation and/or frequency of the second stimulation. In an embodiment where the adjustable parameters include location of the first stimulation and/or location of the second stimulation, the adjustable parameters include a control parameter that alternates locations of stimulation.

[00165] Thus, embodiments can include a combined acoustic and electrical stimulation provided in the same ear to reduce tinnitus. While some embodiments have been presented where the clinician will first evaluate the effect of sound stimulation and electrical stimulation separately on tinnitus, it is noted that instead, or in addition to this, the human could “self fit” or otherwise experiment to evaluate for himself / herself, or an automated system, such as a product of machine learning, for example, could implement such. Based on these results, the clinician and/or human (or an automated system, such as a product of machine learning, for example) can create a map for the system (or for individual devices for example that result in the stimulation regime) with a combination of the two stimulation patterns with a ratio between the two stimulations. This ratio can be defined depending on which stimulation has been the most effective for tinnitus reduction (determined using standard practices for evaluating such and/or based on human feedback / human perceptions). By way of example, if electrical stimulation is more effective than acoustic stimulation in the ear tested, the bimodal stimulation can be say 75% of the signal delivered by the electrical stimulation and 25% delivered by the acoustic stimulation. This ratio is modified in some embodiments and adapted based on the human’s feedback. Indeed, in an exemplary embodiment, the human or the clinician or some form of automated process can adjust the ratios on a sliding scale, such as for example, starting at 100% audio and 0% electrical, or vice versa, and then adjust the ratio in increments digitally and/or in an analog manner in a controlled or semi controlled experimentation process to determine what balance is most effective or otherwise utilitarian or otherwise is simply most desirable or otherwise acceptable to the human.

[00166] Embodiments can thus include modulating the bimodal stimulation in current level/intensity depending on the side and/or the loudness of the tinnitus. For instance, if the tinnitus is louder with acoustic stimulation than with electrical stimulation, the current level of the electrical stimulation can be increased and the current level with the acoustic stimulation can be decreased in order to balance the stimulation and adapt it to the needs of the patient, by way of example. The current/intensity level can be sub-threshold in one type of stimulation and audible in the other type of stimulation. Such arrangements and others as detailed herein can provide a bimodal input to the brain and adapt to the tinnitus and hearing loss of the patient. [00167] Embodiments can include modulating the bimodal stimulation in frequency/location depending on the side and the loudness of the tinnitus. For instance by way of example, if tinnitus changes in pitch after one type of stimulation, the frequency of the other stimulation can be adapted to address the pitch.

[00168] Embodiments can include adapting the synchronization of bimodal stimulation delivered in one or both ears. For example, two synchronous or nonsynchronous types of stimulation can be delivered depending on the effect of the separated types of stimulation on tinnitus and the effect of the combined stimulation on the tinnitus (change of tinnitus location, loudness, pitch, etc.). In some embodiments, one or more of the parameters detailed herein and others can be controlled by the clinician or some automated system who/that can enable the control by the human depending on their needs which gives the human a sense of control over their tinnitus that could provide relief in itself. In an embodiment, the default is that the human has control over the parameters / can adjust such.

[00169] In an embodiment, any one or more of the methods or any one or more method actions detailed herein can be executed by an artificial intelligence-based system. For example, method 800 could be executed, at least in part (e.g., method action 830 for example) utilizing, by way of example, in some embodiments, a product of and/or from machine learning, such as a trained neural network (which includes a neural network that is continuing to be “remedially” trained, in the sense that the network can be used to achieve utilitarian results, but the teachings herein include continuously training a network during use of that network - more on this below) by way of example only and not by way of limitation, according to an exemplary embodiment, while in other embodiments, the method is executed utilizing standard electronics configured to execute the method actions herein. In an embodiment, any action of analyzing and/or identifying herein can be executed using the results from machine learning or any other artificial intelligence / machine learning principles that can have utilitarian value and otherwise can enable at least some of the teachings detailed herein. In an exemplary embodiment, one or more of the method actions herein are executed using a device that includes a product of and/or resulting from machine learning. In an exemplary embodiment, any one or more of the method actions herein can be executed automatically (and in some alternate embodiments, one or more method actions detailed herein can be executed not automatically - any disclosure herein of any method action or functionality corresponds to a disclosure where such is executed automatically, and an alternative embodiment where such is not executed automatically, unless otherwise noted and providing that the art enables such). In an exemplary embodiment, any method action and/or functionality disclosed herein can be performed by a human, and such disclosure of such actions and/or functionality corresponds to an exemplary embodiment of such.

[00170] In an exemplary embodiment, the product is a chip that is fabricated based on the results of machine learning. In an exemplary embodiment, the product is a neural network, such as a deep neural network (DNN). The product can be based on or be from a neural network. In an exemplary embodiment, the product is code (such as code loaded into the smartphone 2140, or into the prosthesis 342 (or any prosthesis herein, or any tinnitus masker / tinnitus treatment device as described herein by way of example). In an exemplary embodiment, the product is a logic circuit that is fabricated based on the results of machine learning. The product can be an ASIC (e.g., an artificial intelligence ASIC). The product can be implemented directly on a silicon structure or the like. Any device, system, and/or method that can enable the results of artificial intelligence to be utilized in accordance with the teachings detailed herein, such as in a hearing prosthesis or a component that is in communication with a hearing prosthesis, can be utilized in at least some exemplary embodiments. Indeed, as will be detailed below, in at least some exemplary embodiments, the teachings detailed herein utilize knowledge / information from an artificial intelligence system or otherwise from a machine learning system.

[00171] Exemplary embodiments include utilizing a trained neural network to implement or otherwise execute at least one or more of the method actions detailed herein, and thus embodiments include a trained neural network configured to do so. Exemplary embodiments also utilize the knowledge of a trained neural network / the information obtained from the implementation of a trained neural network to implement or otherwise execute at least one or more of the method actions detailed herein, and accordingly, embodiments include devices, systems, and/or methods that are configured to utilize such knowledge. In some embodiments, these devices can be processors and/or chips that are configured utilizing the knowledge. In some embodiments, the devices and systems herein include devices that include knowledge imprinted or otherwise taught to a neural network. The teachings detailed herein include utilizing machine learning methodologies and the like to establish tinnitus treatment regimes, which may be embodied in consumer electronic devices (e.g., a smartphone with earbud(s) to provide masking, etc.).

[00172] As noted above, some method actions entail analyzing / identifying, including processing, the data utilizing a product of machine learning, such as the results of the utilization of a DNN, a machine learning algorithm or system, or any artificial intelligence system that can be utilized to enable the teachings detailed herein. This as contrasted from, for example, processing the data utilizing general code or utilizing code that does not from a machine learning algorithm or utilizing a non Al based / resulting chip, etc.

[00173] Again, in an exemplary embodiment, the machine learning can be a DNN, and the product can correspond to a trained DNN and/or can be a product based on or from the DNN (more on this below).

[00174] An exemplary machine learning algorithm can be a DNN, according to an exemplary embodiment. In at least some exemplary embodiments, the input into the system can be processed by the DNN (or the code produced/from by the DNN). One or more of the methods actions herein can be execute using such.

[00175] Embodiments thus include analyzing the obtained data / input into the system utilizing a code of and/or from a machine learning algorithm to develop data that can be utilized to implement the applicable teachings herein. Again, in an exemplary embodiment, the machine learning algorithm can be a DNN, and the code can correspond to a trained DNN and/or can be a code from the DNN. It is noted that in some embodiments, there is no “raw data” / “raw ambient environment data” input into the devices and/or systems in general, and the DNN in particular. Instead, some or all of this is pre-processed data. Any data that can enable the system and/or device and/or the DNN or other machine learning algorithm to operate can be utilized in at least some exemplary embodiments.

[00176] It is noted that any method action disclosed herein corresponds to a disclosure of a non-transitory computer readable medium that has program there on a code for executing such method action providing that the art enables such. Still further, any method action disclosed herein where the art enables such corresponds to a disclosure of a code from a machine learning algorithm and/or a code of a machine learning algorithm for execution of such. Still as noted above, in an exemplary embodiment, the code need not necessarily be from a machine learning algorithm, and in some embodiments, the code is not from a machine learning algorithm or the like. That is, in some embodiments, the code results from traditional programming. Still, in this regard, the code can correspond to a trained neural network. That is, as will be detailed below, a neural network can be “fed” significant amounts (e.g., statistically significant amounts) of data corresponding to the input of a system and the output of the system (linked to the input), and trained, such that the system can be used with only input, to develop output (after the system is trained). This neural network used to accomplish this later task is a “trained neural network.” That said, in an alternate embodiment, the trained neural network can be utilized to provide (or extract therefrom) an algorithm that can be utilized separately from the trainable neural network. In one embodiment, there is a path of training that constitutes a machine learning algorithm starting off untrained, and then the machine learning algorithm is trained and “graduates,” or matures into a usable code - code of trained machine learning algorithm. With respect to another path, the code from a trained machine learning algorithm is the “offspring” of the trained machine learning algorithm (or some variant thereof, or predecessor thereof), which could be considered a mutant offspring or a clone thereof. That is, with respect to this second path, in at least some exemplary embodiments, the features of the machine learning algorithm that enabled the machine learning algorithm to learn may not be utilized in the practice some of the method actions, and thus are not present the ultimate system. Instead, only the resulting product of the learning is used.

[00177] It is noted that any method detailed herein also corresponds to a disclosure of a device and/or system configured to execute one or more or all of the method actions associated therewith detailed herein. In an exemplary embodiment, this device and/or system is configured to execute one or more or all of the method actions in an automated fashion. That said, in an alternate embodiment, the device and/or system is configured to execute one or more or all of the method actions after being prompted by a human being. It is further noted that any disclosure of a device and/or system detailed herein corresponds to a method of making and/or using that the device and/or system, including a method of using that device according to the functionality.

[00178] Any action disclosed herein that is executed by the prosthesis 100 or the prosthesis of figure 2 or the device of figure 2C or any other device disclosed herein can be executed by the device 2140 and/or another component of any system detailed herein in an alternative embodiment, unless otherwise noted or unless the art does not enable such. Thus, any functionality of the prosthesis 100 with the prosthesis of figure 2 or the device of figure 2C, etc. can be present in the device 2140 and/or another component of any system in an alternative embodiment. Thus, any disclosure of a functionality of the prosthesis 100 or the other prostheses detailed herein and/or the other devices disclosed herein corresponds to structure of the device 2140 and/or the another component of any system detailed herein that is configured to execute that functionality or otherwise have a functionality or otherwise to execute that method action.

[00179] Any action disclosed herein that is executed by the device 2140 can be executed by the prosthesis 100 or any of the other devices such as the prostheses of figure 2 and/or the prosthesis of figure to say and/or another component of any system disclosed herein in an alternative embodiment, unless otherwise noted or unless the art does not enable such. Thus, any functionality of the device 2140 can be present in the prosthesis 100 or any the other devices disclosed herein, such as the devices of figure 2 and/or figure 2C and/or another component of any system disclosed herein in an alternative embodiment. Thus, any disclosure of a functionality of the device 2140 corresponds to structure of the prosthesis 100 or any other device disclosed herein and/or another component of any system disclosed herein that is configured to execute that functionality or otherwise have a functionality or otherwise to execute that method action.

[00180] Any action disclosed herein that is executed by a component of any system disclosed herein can be executed by the device 2140 and/or the prosthesis 100 or the prosthesis of figure 2 or the device of figure to say in an alternative embodiment, unless otherwise noted or unless the art does not enable such. Thus, any functionality of a component of the systems detailed herein can be present in the device 2140 and/or the prosthesis 100 and/or the other devices disclosed herein, such as the device of figure 2 and/or the device of figure 2C as alternative embodiment. Thus, any disclosure of a functionality of a component herein corresponds to structure of the device 2140 and/or the prosthesis 100 and/or the device of figure 2 and/or the device of figure 2C that is configured to execute that functionality or otherwise have a functionality or otherwise to execute that method action. It is further noted that any disclosure of a device and/or system detailed herein also corresponds to a disclosure of otherwise providing that device and/or system.

[00181] It is also noted that any disclosure herein of any process of manufacturing other providing a device corresponds to a device and/or system that results there from. It is also noted that any disclosure herein of any device and/or system corresponds to a disclosure of a method of producing or otherwise providing or otherwise making such.

[00182] Any embodiment or any feature disclosed herein can be combined with any one or more or other embodiments and/or other features disclosed herein, unless explicitly indicated and/or unless the art does not enable such. Any embodiment or any feature disclosed herein can be explicitly excluded from use with any one or more other embodiments and/or other features disclosed herein, unless explicitly indicated that such is combined and/or unless the art does not enable such exclusion.

[00183] Any disclosure herein of a method action corresponds to a disclosure of a computer readable medium having program there on code to execute one or more of those actions and also a product to execute one or more of those actions.

[00184] While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. It will be apparent to persons skilled in the relevant art that various changes in form and detail can be made therein without departing from the spirit and scope of the invention.

Claims

CLAIMS What is claimed is:

1. A system, comprising: a first stimulation apparatus; and a second stimulation apparatus, wherein the first stimulation apparatus outputs stimulation that is different in kind from stimulation outputted by the second stimulation apparatus, the first stimulation apparatus outputs electric stimulation, and the system is configured to reduce tinnitus in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus.

2. The system of claim 1, wherein: the second stimulation apparatus is a conventional hearing aid based apparatus; and output of the second stimulation apparatus is an acoustic signal at a frequency below a hearing threshold for an average adult human.

3. The system of claims 1 or 2, wherein: the second stimulation apparatus is bone conduction apparatus; and output of the second stimulation apparatus is a mechanical vibration at a frequency below a hearing threshold and/or above a hearing threshold for an average adult human.

4. The system of claims 1, 2 or 3, wherein: the system is configured to synchronize and/or desynchronize the respective stimulations outputted by the first and second apparatuses to reduce tinnitus in the human.

5. The system of claims 1, 2, 3 or 4, wherein: the system is configured to control output of the first stimulation apparatus and the second stimulation apparatus to control a ratio of a feature of output outputted by the respective stimulations outputted.

6. The system of claims 1, 2, 3, 4 or 5, wherein: the system is configured so that at least one of the respective outputs of the first or second stimulation apparatus is an audible sound to the average human adult; and the system is configured to provide a directional sensation to the human of an origin of the audible sound.

7. The system of claims 1, 2, 3, 4, 5 or 6, wherein: output of the second stimulation apparatus is perceivable as sound by an average human adult.

8. The system of claims 1, 2, 3, 4, 5, 6 or 7, wherein: output of the second stimulation apparatus is a tinnitus masking output; and the electric stimulation is inaudible to the average human adult.

9. The system of claims 1, 2, 3, 4, 5, 6, 7 or 8, wherein: the first stimulation apparatus is a cochlear implant; and the second stimulation apparatus is an acoustic hearing aid.

10. The system of claims 1, 2, 3, 4, 5, 6, 7 or 8, wherein: the first stimulation apparatus is a cochlear implant; and the second stimulation apparatus is a bone conduction device.

11. A method, comprising: obtaining first data based on an effect of first stimulation on tinnitus of a human; obtaining second data based on an effect of second stimulation on tinnitus of a human; and identifying a more effective stimulation for tinnitus treatment of the human based on the obtained first data and obtained second data, wherein the first stimulation is a different manner of stimulation from the second stimulation and/or the first stimulation is provided to a first sensory organ of the human and the second stimulation is provided to a second sensory organ of the human.

12. The method of claim 11, further comprising: creating a bimodal stimulation regime based on the identification, wherein the stimulation regime includes both electrical stimulation and stimulation different from the electrical stimulation, the electrical stimulation corresponding to the first stimulation and the stimulation different from the electrical stimulation corresponding to the second stimulation.

13. The method of claim 12, wherein: the stimulation regime weights the electrical stimulation more or less than the stimulation different from the electrical stimulation.

14. The method of claim 13, further comprising: obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations, wherein the action of creating the bimodal stimulation regime is also based on the obtained third data.

15. The method of claim 14, wherein: the adjustable parameters includes synchronization and/or desynchronization of the electrical stimulation and the stimulation different from electrical stimulation.

16. The method of claims 11, 12, 13, 14 or 15, wherein: the first data and/or the second data includes a loudness of tinnitus of the human relative to whether and/or an amount of electrical stimulation and/or the stimulation different from the electrical stimulation is applied; and the identification of the more effective stimulation is based on which stimulation results in louder and/or softer tinnitus.

17. The method of claims 11, 12, 13, 14, 15 or 16, wherein: the first situation is provided to the first sensory organ and the second stimulation is provided to the second sensory organ.

18. The method of claims 11, 12, 13, 14, 15, 16 or 17, further comprising: creating a bimodal stimulation regime based on the identification, wherein the regime includes setting a perceived direction of a perceived artificial sound resulting from the first and second stimulation.

19. The method of claim 14, wherein: the adjustable parameters includes magnitude of output of the electrical stimulation and/or magnitude of output of the stimulation different from electrical stimulation.

20. The method of claim 14, wherein: the adjustable parameters include frequency of the electrical stimulation and/or frequency of output of the stimulation different from electrical stimulation.

21. The method of claim 14, wherein: the adjustable parameters include location of the electrical stimulation and/or location of the stimulation different from electrical stimulation.

22. The method of claim 14, wherein: the adjustable parameters include a control parameter that alternates the electrical stimulation and the stimulation different from electric stimulation.

23. The method of claim 14, wherein: the adjustable parameters include an on/off sequence of one or more devices that produce the first and/or second stimulation.

24. The method of claims 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 or 23, further comprising: creating a bilateral stimulation regime based on the identification.

25. The method of claim 24, wherein: the stimulation regime weights the first stimulation more or less than the second stimulation.

26. The method of claim 25, further comprising: obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations, wherein the action of creating the bilateral stimulation regime is also based on the obtained third data.

27. The method of claim 24, wherein: the adjustable parameters includes synchronization and/or desynchronization of the first stimulation and the second stimulation.

28. The method of claim 17, wherein: the first data and/or the second data includes a loudness of tinnitus of the human relative to whether and/or an amount of first stimulation and/or the second stimulation; and the identification of the more effective stimulation is based on which stimulation results in louder and/or softer tinnitus.

29. The method of claim 17, further comprising: creating a bilateral stimulation regime based on the identification, wherein the regime includes setting a perceived direction of a perceived artificial sound resulting from the first and second stimulation.

30. The method of claim 26, wherein: the adjustable parameters includes magnitude of output of the first stimulation and/or magnitude of output of the second stimulation.

31. The method of claim 26, wherein: the adjustable parameters include frequency of the first stimulation and/or frequency of the second stimulation.

32. The method of claim 26, wherein: the adjustable parameters include location of the first stimulation and/or location of the second stimulation.

33. The method of claim 26, wherein: the adjustable parameters include a control parameter that alternates locations of stimulation.

34. A system, comprising: a first stimulation apparatus; and a second stimulation apparatus, wherein the first stimulation apparatus outputs stimulation in a different manner than the stimulation outputted by the second stimulation apparatus, and the system is configured to reduce an undesired sensation in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus.

35. The system of claim 34, wherein: the undesired sensation is tinnitus; the second stimulation apparatus is a conventional hearing aid based apparatus; and the first stimulation apparatus is a conventional hearing aid based apparatus.

36. The system of claims 34 or 35, wherein: the second stimulation apparatus is an electrical stimulation apparatus; and the first stimulation apparatus is an electrical stimulation apparatus.

37. The system of claims 34, 35 or 36, wherein: the undesired sensation is tinnitus; the system is configured so that the first apparatus provides dynamically changing stimulation while the second apparatus provides relatively static stimulation.

38. The system of claims 34, 35, 36 or 37, wherein: the undesired sensation is tinnitus; the system is configured so that the first apparatus and the second apparatus independently undergoes change in a parameter of the outputted stimulation.

39. The system of claims 34, 35, 36, 37 or 38, wherein: the undesired sensation is tinnitus; the system synchronizes and/or desynchronizes the respective outputs of the first and second apparatuses to reduce tinnitus in the human.

40. The system of claims 34, 35, 36, 37, 38 or 39, wherein: the undesired sensation is tinnitus; the first stimulation apparatus outputs stimulation that is the same kind as the simulation outputted by the second stimulation apparatus.

41. The system of claims 34, 35, 36, 37, 38, 39 or 40, wherein: the undesired sensation is tinnitus; the system is configured to automatically monitor a feature of human body physiology; and the system is configured to automatically adjust one or more of the outputs based on the monitored feature.

42. A method, comprising: applying a first stimulation to tissue of a human; applying a second stimulation tissue of a human, wherein at least one of: the first stimulation is applied to a different side of the human than the second stimulation in a mutually non-uniform manner; or the first stimulation is a different kind of stimulation to the second stimulation, and the method is a method of treating tinnitus, and the first stimulation and the second stimulation reduce tinnitus of the human.

43. The method of claim 42, further comprising: adjusting a device producing the first stimulation and adjusting a device producing the second stimulation to reduce the tinnitus more than that which would otherwise be the case in the absence of the adjustings and applying the first stimulation and the second stimulation based on the adjustments.

44. The method of claims 42 or 43, wherein: the first stimulation is applied simultaneously with the second stimulation in a continuous manner.

45. The method of claims 42, 43 or 44, wherein: the human is a human without hearing loss; and the first stimulation is acoustic stimulation.

46. The method of claims 42, 43, 44 or 45, wherein: the human is a human without hearing loss; and the first stimulation is electrical stimulation.

47. The method of claims 42, 43, 44, 45 or 46, wherein: the human is a human without hearing loss; and the first stimulation is electrical stimulation applied by a first implant; and the second stimulation is electrical stimulation applied by a second implant.

48. The method of claim 47, further comprising: applying third stimulation that is different in kind from the first stimulation as part of the method to treat tinnitus, and the third stimulation also reduces tinnitus of the human.

49. The method of claims 42, 43, 44, 45, 46, 47 or 48, wherein: the first and second stimulation are applied to achieve bilateral stimulation to the human; and the first stimulation is subthreshold auditory stimulation.

50. The method of claims 42, 43, 44, 45, 46, 47, 48 or 49, wherein: the first and second stimulation are applied to achieve bilateral stimulation to the human; and the first stimulation is delivered dynamically.

51. The method of claims 42, 43, 44, 45, 46, 47, 48, 49 or 50, wherein: the first and second stimulation are applied to achieve bilateral stimulation to the human; and a relative difference of one or more respective parameters of the first and second stimulation are regularly adjusted.

52. The method of claims 42, 43, 44, 45, 46, 47, 48, 49 or 50, wherein: the treatment of tinnitus restores disrupted neural activity and/or stimulates neural plasticity.

53. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51 or 52, further comprising: synchronizing and/or desynchronizing the first stimulation with/from the second stimulation based on subjective and/or objective input from the human.

54. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51 or 52, wherein: at least the first stimulation results in a hearing percept in the human; and the method includes providing in an automated manner at least one cue that causes the human to distinguish between stimulation for the treatment and real-world sounds.

55. The method of claim 54, wherein: the first stimulation and the second stimulation are controlled to provide a perceived by the human magnitude and/or temporal difference between the two that is interpreted by the human as a directional feature of the resulting hearing percept, thereby providing the at least one cue.

56. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54 or 55, wherein: the human has tinnitus that is more present in one ear vs. the other ear of the human; the first stimulation is applied to the one ear and the second stimulation is applied to the other ear; and the first stimulation is applied in a more aggressive manner than the second stimulation.

57. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 or 56, wherein: the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; and the first stimulation is subthreshold with respect to hearing and the second stimulation is audible in the other ear with respect to hearing; and the first stimulation and the second stimulation provide bilateral input to the brain of the human, thereby adapting to tinnitus and a hearing loss of the human.

58. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56 or 57, wherein: the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; and the first stimulation is provided at a first frequency or within a first frequency range based on tinnitus feature(s) in the one ear; and the second stimulation is provided at a second frequency or within a second frequency range based on tinnitus feature(s) in the other ear.

59. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57 or 58, wherein: the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; and the first stimulation is synchronized with the second stimulation.

60. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58 or 59, wherein: the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; and the first stimulation is nonsynchronized with the second stimulation.

61. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58 or 59, wherein: the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; and the treatment includes alternating magnitude and/or frequency of the first stimulation and second stimulation.

62. The method of claims 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58 or 59 or 61, wherein: the first stimulation is applied discontinuously with the second stimulation.

63. A non-transitory computer readable medium having recorded thereon, a computer program for executing at least a portion of a method, the computer program including: code for controlling a tinnitus treatment system to apply first stimulation from a first stimulation apparatus; code for controlling the tinnitus treatment system to apply second stimulation from a second stimulation apparatus; and code for varying one or more parameters of the first stimulation and/or the second stimulation to treat tinnitus more effectively than that which would be the case in the absence of the variation of the one or more parameters.

64. The medium of claim 63, wherein: the code for varying one or more parameters varies one or more parameters of the first stimulation dynamically while maintaining one or more parameters of the second stimulation static.

65. The medium of claims 63 or 64, wherein: the code for varying one or more parameters regularly adjusts a relative difference of the one or more respective parameters of the first and second stimulation.

66. The medium of claims 63, 64 or 65, further comprising: code for synchronizing and/or desynchronizing the first stimulation with/from the second stimulation.

67. The medium of claims 63, 64, 65 or 66, further comprising: code for providing at least one cue that causes the human to distinguish between stimulation for the treatment and real-world sounds.

68. The medium of claim 67, further comprising: code for controlling the first stimulation and the second stimulation to provide a perceived by the human magnitude and/or temporal difference between the two that is interpreted by the human as a directional feature of a resulting hearing percept resulting from the first and second stimulation, thereby providing the at least one cue.

69. A system, comprising: the medium of claims 63, 64, 65, 66, 67 or 68; the first stimulation apparatus; and the second stimulation apparatus, wherein the first stimulation apparatus is an electrical stimulation apparatus, and the second stimulation apparatus is at least one of: an acoustic stimulation apparatus; or an electrical stimulation apparatus configured to be placed bilaterally on the human relative to the first stimulation apparatus.

70. A tinnitus treatment system, comprising: at least one of a first cochlear implant or a first conventional acoustic hearing aid; and at least one of a second cochlear implant or a second conventional acoustic hearing aid, wherein the first cochlear implant and/or the first conventional acoustic hearing aid outputs stimulation in a different manner than the stimulation outputted by the second cochlear implant and/or the second conventional acoustic hearing aid, the system is configured to reduce tinnitus in a human by application of respective stimulation by:

(i) at least one of the first cochlear implant or the first conventional acoustic hearing aid; and

(ii) at least one of the second cochlear implant or the first conventional acoustic hearing aid.

71. A device and/or system and/or method and/or computer readable medium, wherein least one of: the computer readable medium has recorded thereon code for one or more of the method actions below; the system includes a first stimulation apparatus; the system includes a second stimulation apparatus; the first stimulation apparatus outputs stimulation that is different in kind from stimulation outputted by the second stimulation apparatus; the first stimulation apparatus outputs electric stimulation; the system is configured to reduce tinnitus in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus; the second stimulation apparatus is a conventional hearing aid based apparatus; output of the second stimulation apparatus is an acoustic signal at a frequency below a hearing threshold for an average adult human; the second stimulation apparatus is bone conduction apparatus; output of the second stimulation apparatus is a mechanical vibration at a frequency below a hearing threshold and/or above a hearing threshold for an average adult human; the system is configured to synchronize and/or desynchronize the respective stimulations outputted by the first and second apparatuses to reduce tinnitus in the human; the system is configured to control output of the first stimulation apparatus and the second stimulation apparatus to control a ratio of a feature of output outputted by the respective stimulations outputted; the system is configured so that at least one of the respective outputs of the first or second stimulation apparatus is an audible sound to the average human adult; the system is configured to provide a directional sensation to the human of an origin of the audible sound; output of the second stimulation apparatus is perceivable as sound by an average human adult; output of the second stimulation apparatus is a tinnitus masking output; and the electric stimulation is inaudible to the average human adult; the first stimulation apparatus is a cochlear implant; the second stimulation apparatus is an acoustic hearing aid; the first stimulation apparatus is a cochlear implant; the second stimulation apparatus is a bone conduction device; the method includes obtaining first data based on an effect of first stimulation on tinnitus of a human; the method includes obtaining second data based on an effect of second stimulation on tinnitus of a human; the method includes identifying a more effective stimulation for tinnitus treatment of the human based on the obtained first data and obtained second data; the first stimulation is a different kind of stimulation from the second stimulation and/or the first stimulation is provided to a first sensory organ of the human and the second stimulation is provided to a second sensory organ of the human; the first stimulation is a different manner of stimulation from the second stimulation and/or the first stimulation is provided to a first sensory organ of the human and the second stimulation is provided to a second sensory organ of the human; the method includes creating a bimodal stimulation regime based on the identification, wherein the stimulation regime includes both electrical stimulation and stimulation different from the electrical stimulation, the electrical stimulation corresponding to the first stimulation and the stimulation different from the electrical stimulation corresponding to the second stimulation; the stimulation regime weights the electrical stimulation more or less than the stimulation different from the electrical stimulation; the method includes obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations; the action of creating the bimodal stimulation regime is also based on the obtained third data; the adjustable parameters includes synchronization and/or desynchronization of the electrical stimulation and the stimulation different from electrical stimulation; the first data and/or the second data includes a loudness of tinnitus of the human relative to whether and/or an amount of electrical stimulation and/or the stimulation different from the electrical stimulation is applied; the identification of the more effective stimulation is based on which stimulation results in louder and/or softer tinnitus; the first situation is provided to the first sensory organ and the second stimulation is provided to the second sensory organ; the method includes creating a bimodal stimulation regime based on the identification; the method includes the regime includes setting a perceived direction of a perceived artificial sound resulting from the first and second stimulation; the adjustable parameters includes magnitude of output of the electrical stimulation and/or magnitude of output of the stimulation different from electrical stimulation; the adjustable parameters include frequency of the electrical stimulation and/or frequency of output of the stimulation different from electrical stimulation; the adjustable parameters include location of the electrical stimulation and/or location of the stimulation different from electrical stimulation; the adjustable parameters include a control parameter that alternates the electrical stimulation and the stimulation different from electric stimulation; the adjustable parameters include an on/off sequence of one or more devices that produce the first and/or second stimulation; the method includes creating a bilateral stimulation regime based on the identification; the stimulation regime weights the first stimulation more or less than the second stimulation; the method includes obtaining third data based on an effect of adjustable parameters of a system that delivers the stimulations for one or both of the weighted stimulations; the action of creating the bilateral stimulation regime is also based on the obtained third data; the adjustable parameters includes synchronization and/or desynchronization of the first stimulation and the second stimulation; the first data and/or the second data includes a loudness of tinnitus of the human relative to whether and/or an amount of first stimulation and/or the second stimulation; the identification of the more effective stimulation is based on which stimulation results in louder and/or softer tinnitus; the method includes creating a bilateral stimulation regime based on the identification; the regime includes setting a perceived direction of a perceived artificial sound resulting from the first and second stimulation; the adjustable parameters includes magnitude of output of the first stimulation and/or magnitude of output of the second stimulation; the adjustable parameters include frequency of the first stimulation and/or frequency of the second stimulation; the adjustable parameters include location of the first stimulation and/or location of the second stimulation; the adjustable parameters include a control parameter that alternates locations of stimulation; the system includes a first stimulation apparatus; a second stimulation apparatus; the first stimulation apparatus outputs stimulation in a different manner than the stimulation outputted by the second stimulation apparatus; the system is configured to reduce tinnitus in a human by application of respective stimulation by the first stimulation apparatus and the second stimulation apparatus; the second stimulation apparatus is a conventional hearing aid based apparatus; the first stimulation apparatus is a conventional hearing aid based apparatus; the second stimulation apparatus is an electrical stimulation apparatus; the first stimulation apparatus is an electrical stimulation apparatus; the system is configured so that the first apparatus provides dynamically changing stimulation while the second apparatus provides relatively static stimulation; the system is configured so that the first apparatus and the second apparatus independently undergoes change in a parameter of the outputted stimulation; the system synchronizes and/or desynchronizes the respective outputs of the first and second apparatuses to reduce tinnitus in the human; the first stimulation apparatus outputs stimulation that is the same kind as the simulation outputted by the second stimulation apparatus; the system is configured to automatically monitor a feature of human body physiology; the system is configured to automatically adjust one or more of the outputs based on the monitored feature; the method includes applying a first stimulation to tissue of a human; the method includes applying a second stimulation tissue of a human; at least one of the first stimulation is applied to a different side of the human than the second stimulation in a mutually non-uniform manner; or the first stimulation is a different kind of stimulation to the second stimulation; the method is a method of treating tinnitus, and the first stimulation and the second stimulation reduce tinnitus of the human; the method includes adjusting a device producing the first stimulation and adjusting a device producing the second stimulation to reduce the tinnitus more than that which would otherwise be the case in the absence of the adjustings and applying the first stimulation and the second stimulation based on the adjustments; the first stimulation is applied simultaneously with the second stimulation in a continuous manner; the human is a human without hearing loss; the first stimulation is acoustic stimulation; the human is a human without hearing loss; the first stimulation is electrical stimulation; the human is a human without hearing loss; the first stimulation is electrical stimulation applied by a first implant; the second stimulation is electrical stimulation applied by a second implant; the method includes applying third stimulation that is different in kind from the first stimulation as part of the method to treat tinnitus, and the third stimulation also reduces tinnitus of the human; the first and second stimulation are applied to achieve bilateral stimulation to the human; the first stimulation is subthreshold auditory stimulation; the first and second stimulation are applied to achieve bilateral stimulation to the human; the first stimulation is delivered dynamically; the first and second stimulation are applied to achieve bilateral stimulation to the human; a relative difference of one or more respective parameters of the first and second stimulation are regularly adjusted; the treatment of tinnitus restores disrupted neural activity and/or stimulates neural plasticity; the method includes synchronizing and/or desynchronizing the first stimulation with/from the second stimulation based on subjective and/or objective input from the human; at least the first stimulation results in a hearing percept in the human; the method includes providing in an automated manner at least one cue that causes the human to distinguish between stimulation for the treatment and real-world sounds; the first stimulation and the second stimulation are controlled to provide a perceived by the human magnitude and/or temporal difference between the two that is interpreted by the human as a directional feature of the resulting hearing percept, thereby providing the at least one cue; the human has tinnitus that is more present in one ear vs. the other ear of the human; the first stimulation is applied to the one ear and the second stimulation is applied to the other ear; the first stimulation is applied in a more aggressive manner than the second stimulation; the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; the first stimulation is subthreshold with respect to hearing and the second stimulation is audible in the other ear with respect to hearing; the first stimulation and the second stimulation provide bilateral input to the brain of the human, thereby adapting to tinnitus and a hearing loss of the human; the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; the first stimulation is provided at a first frequency or within a first frequency range based on tinnitus feature(s) in the one ear; the second stimulation is provided at a second frequency or within a second frequency range based on tinnitus feature(s) in the other ear; the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; the first stimulation is synchronized with the second stimulation; the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; the first stimulation is nonsynchronized with the second stimulation; the first stimulation is applied to one ear of the human and the second stimulation is applied to the other ear of the human; the treatment includes alternating magnitude and/or frequency of the first stimulation and second stimulation; the first stimulation is applied discontinuously with the second stimulation; the medium is a non-transitory computer readable medium having recorded thereon, a computer program for executing a method action herein; the method includes controlling a tinnitus treatment system to apply first stimulation from a first stimulation apparatus; the method includes controlling the tinnitus treatment system to apply second stimulation from a second stimulation apparatus; the method includes varying one or more parameters of the first stimulation and/or the second stimulation to treat tinnitus more effectively than that which would be the case in the absence of the variation of the one or more parameters; one or more parameters varies one or more parameters of the first stimulation dynamically while maintaining one or more parameters of the second stimulation static; varying one or more parameters regularly adjusts a relative difference of the one or more respective parameters of the first and second stimulation; the method includes synchronizing and/or desynchronizing the first stimulation with/from the second stimulation; the method includes providing at least one cue that causes the human to distinguish between stimulation for the treatment and real-world sounds; the method includes controlling the first stimulation and the second stimulation to provide a perceived by the human magnitude and/or temporal difference between the two that is interpreted by the human as a directional feature of a resulting hearing percept resulting from the first and second stimulation, thereby providing the at least one cue; the system includes at least one of a first cochlear implant or a first conventional acoustic hearing aid and at least one of a second cochlear implant or a second conventional acoustic hearing aid; the first cochlear implant and/or the first conventional acoustic hearing aid outputs stimulation in a different manner than the stimulation outputted by the second cochlear implant and/or the second conventional acoustic hearing aid; the system is configured to reduce tinnitus in a human by application of respective stimulation by:

(i) at least one of the first cochlear implant or the first conventional acoustic hearing aid; and

(ii) at least one of the second cochlear implant or the first conventional acoustic hearing aid; the system is configured to present stimuli bilaterally and/or bimodally, and can enable the stimulation to be personalized to obtain the optimal tinnitus relief; the system is configured to introduce tinnitus relief stimuli in two or more devices of the system; stimuli is provided continuously without variation and/or is discontinuous at temporally different times than any continuously provided stimuli; the discontinuous providing of stimuli can be based on environmental conditions, such as, for example, if the sound input from the environment is already providing the relief, stimulus can be halted or not even started; the method includes, if prior sound in the ambient environment has reduced its tinnitus by a desired amount, whatever amount that is, stopping or otherwise halting further stimulation and/or not starting stimulation, at least if the tinnitus does not return in a relatively quick manner or otherwise in a time period that is deemed unacceptable to the human; the method includes the human indicating that the tinnitus is gone, and the system automatically halts the stimulation; the indication is provided into a remote device such as a smart phone or smart device that is in communication with the other components of the system; the method includes providing tinnitus therapy by way of either acoustic stimulation bilaterally, or electric stimulation bilaterally and/or in a combination thereof, in a mutually non-uniform manner; the method includes synchronizing and/or desynchronizing the stimulation between ears in frequency and/or amplitude/current, based on subjective and/ or objective feedback in order to provide relief from tinnitus and in some embodiments; synchronization is synchronization of loudness (perceived or output of stimulator), pitch and/or length of time of stimulation; the first stimulation and/or second stimulation is applied for less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750 or 2000 or more minutes or 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300 or more hours or any value or range of values therebetween in one second increments; the total time of actual stimulation for any one or more of the just detailed periods can be less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98 or 99% or any value or range of values therebetween in 0.1% increments of the total time period; the discontinuous stimulation is divided up into 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 5000, 6000, 7000, 8000, 9000, 10000, 12500, 15000 or 20000 or more blocks or any value or range of values therebetween in 1 block increments; the human is a human with hearing loss; the human is a human without hearing loss; the electric stimulation is provided by extracochlear electrodes in a device that is entirely extra-cochlear; one or more of the stimulations is/are provided so that one or more of the following is controlled to be static and/or one or more of the following is controlled to change: magnitude, frequency, pulse width, stimulation mode (monopolar, bipolar, tripolar, common ground, combined modes, phase array), modulation pattern (sinusoidal, sawtooth (rise/fall-times), square wave, continuous, periodic (on/off-period), modulation depth: (% of dynamic range), onset phase of the modulation frequency (0-2K or any value or range of values therebetween in 0.0 In), carrier frequency (fixed frequency / modulated frequency (frequency range)), modulation mode (current level modulation, pulse width modulation, frequency modulation); any one or more of the parameters herein are adjustable otherwise can be changed 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 400, 500, 750, 1000, 1250, 1500, 2000, 2500, 3000, 3500, 4000, 5000 or more times or any value or range of values therebetween in 1 increment during any one or more of the temporal periods detailed herein and there are 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 400, 500, 750, 1000, 1250, 1500, 2000, 2500, 3000, 3500, 4000, 5000, 6000, 7000, 8000, 9000 or 10000 or 15000 or more temporal periods in one or more of the methods detailed herein, and these periods can be back to back (contiguous) and/or can be separated from one another, and a period of separation can correspond to any one or more of the time periods detailed herein in the interest of textual economy, and in an embodiment, a collective period of treatment can be, in the interest of textual economy, the summation of the collective number of periods including stimulation periods and/or non-stimulation periods; the treatment of tinnitus according to any one or more of the method actions herein restores disrupted neural activity and/or stimulates neural plasticity; the treatment of tinnitus according to any one or more of the method actions detailed herein reduces the perceived magnitude of tinnitus by less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 95 or 100% or any value or range of values therebetween in 1% increments; the treatment of tinnitus according to any one or more of the method actions detailed herein changes the pitch of the tinnitus by less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards relative to the initial pitch and this occurs in one or both ears; a given change of an output / perception / parameter in one ear is replicated in the other ear; the quantifiable change in one ear corresponds to a value that is less than, greater than and/or equal to 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 95 or 100% or any value or range of values therebetween in 1% increments of the quantifiable change in the other ear, where the change in the first ear is the control; one, two, three or four or more of the stimulations results in a hearing percept in the human and/or one, two, three or four of the stimulations do not result in a hearing percept in the human, because the human as normal hearing or has hearing that is aberrant from normal; the method includes providing in an automated manner, at least one cue that causes the human to distinguish between stimulation for the treatment and real-world stimulation; the method includes overlaying perceivable binaural cues to achieve this distinguishment; the method includes applying one or more of the stimulations to the human with tinnitus who has a bilateral arrangement (one device for each ear), such as, for example, bilateral hearing aids (hearing aid + hearing aid), bilateral cochlear implants (cochlear implant + cochlear implant) or bimodal arrangements (hearing aid + cochlear implant) with one on each side; the method includes applying stimuli that are applied to reduce tinnitus that are audible or inaudible to the human; the method includes dynamically controlling the stimulation(s) to account for scenarios where a person is speaking to the human so as to reduce, including eliminate, interference of the perceived speech by the stimulus used to treat tinnitus reduction; the human has tinnitus that is more present in one ear vs. the other ear; the human has tinnitus as a perceived magnitude and/or frequency in one ear that is less than, greater than and/or equal to 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards than the other earl and the first stimulation is applied to the one ear and the second stimulation is applied to the other ear and the first stimulation is applied in a more aggressive manner or less aggressive manner than the second stimulation and/or any one or more of the variables / parameters of the system that can be adjusted / controlled, are applied in one stimulation so that such is less than, greater than and/or equal to 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1500 or 2000% or more or any value or range of values therebetween in 1% increments upwards or downwards relative to that of another stimulation; the method and/or system is implemented according to an algorithm where there is X% sound stimulation and 100%-X% electric stimulation, and X can be 0 or can be less than, greater than and/or equal to 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or can be 100 or any value or range of values therebetween in 0.25% increments; there is no non somatosensory, vagal and TENS stimulation; the respective frequencies of the stimulation are less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 4500 or 5000 or more or any value or range of values therebetween in 0.1% increments different from each other using one as the control; the synchronization or desynchronization / nonsynchronization can be present over any time periods detailed herein in the interest of textual economy, for a collective overall period of time that amounts to the addition of any two or more time periods, the time period of synchronization is less than, greater than and/or equal to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, 600, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2500, 3000, 3500, 4000, 4500, 5000, 6000, 7000, 8000, 9000, 10000, 15000 or 20000 or more or any value or range of values therebetween in 0.1% increments different from the desynchronization / nonsynchronization using one as the control, and the time periods can be back to back for one or the other or both; the system includes an Al subsystem that controls one or more functions; one or more of the method actions are executed using an Al subsystem; the system is configured to implement / execute one or more of the method actions; or the method includes executing one or more of the functionalities of the system(s).