A panel of 60 Cleveland Clinic doctors announced its Top 10 Medical Innovations for 2010, with half being medical devices and the others being processes and drugs and research findings. The announcement came during the 2009 Cleveland Clinic “Cancer Cures Through Innovation” Medical Innovation Summit, which attracted 900 healthcare senior executives, investors, entrepreneurs, and clinicians.

The five devices were:

• Mini digital audio system that transmits sound via the teeth for those with single-sided deafness - #1 overall. The system consists of a small microphone unit worn behind the ear on the deaf side and a removable retainer-like device that contains electronics, a sealed rechargeable battery, wireless capability that picks up sound transmissions from the microphone unit, and an actuator that converts those signals into vibratory energy.

• Tracheal tub cuff to reduce ventilator-associated pneumonia - #2. The device provides continuous effective airway seals. It can be left in place for 30 days. The device is expected to replace current cuff devices that provide only a partial seal, which leads to secretions passing into the lungs.

• Continuous-flow ventricular assist devices - #3. Three-ounce pump attaches alongside the heart and runs on rechargeable batteries connected through the abdomen. The device takes over the pumping ability of the heart's left ventricle and provides continuous blood flow through the circulatory system using one moving part - a rotary pumping mechanism. The device is intended to be “a bridge” for patients awaiting heart transplants and could eventually provide “sole support” of the heart without transplantation.

• Sleep-monitoring devices for out-patient diagnosis of sleep apnea - #7. These devices are worn on the patient's wrist and use a non-invasive finger-mounted probe to measure signals that indicate changes in the autonomic nervous system caused by respiratory disturbances during sleep. Signals are stored in a removable memory card in the device to be downloaded to a computer in the doctor's office for automatic analysis using proprietary algorithms. In addition to the respiratory signal, the devices also record pulse, oxygen saturation, and rest-activity cycles.

• Implants to reduce stroke risk - #9. Device alternatives to long-term use of blood thinners can prevent clots from developing in patients with atrial fibrillation without the drug's side effect or need for constant patient monitoring. One is an umbrella-shaped mesh device that is snaked up via a catheter through a blood vessel in the groin into the right atrium of the heart and implanted permanently behind or at the opening of the left atrial appendage. The body forms tissue over the implant, closing off the appendage and eliminating the risk of blood clots. A second device is a clip placed over the left atrial appendage.

The non-device top innovations were:

• Non-vitamin K antagonist oral anticoagulants - #4. Predictable and well-tolerated alternatives to the oral anticoagulant warfarin provide a more convenient and safe way for patients to dose themselves and prevent blood-clot formation.

• Fertility preservation through oocyte-egg cryopreservation - #5. Rapidly-improving technology allows eggs of a healthy woman to be safely frozen and stored, ready to be thawed, and fertilized at a later date.

• Forced exercise to improve motor function in patients with Parkinson's disease - #6. Pedaling at 90 RPMs on a tandem bike is shown to dramatically improve motor functioning of patients with Parkinson's.

• Oral thrombopoeitin (TPO) receptor agonist that stimulates platelet production - #8. Recently approved drug stimulates production of cells in bone marrow that form platelet cells in the blood.

• Whole-slide imaging for management of digital data In pathology - #10. Technology for creating digital pathology slides with excellent image quality can be viewed, stored, streamed over the Internet, and analyzed on a computer.

The Top 10 resulted from a field of 100 nominations that were evaluated according to four criteria:

• Significant clinical impact - high patient-benefit improvement in comparison to current practices and high user-related functionality for improved healthcare delivery.

• High probability of commercial success.

• In or exiting clinical trials and likely to be available on the market in 2010.

• Sufficient data to support its application, benefits, and impact on society.

Better brain implants using conducting polymer nanotubes

Brain implants that can clearly record signals from surrounding neurons in rats have been created at the University of Michigan. The findings could lead to more effective treatment of neurological disorders such as Parkinson's disease and paralysis. Neural electrodes must work for time periods ranging from hours to years.

When the electrodes are implanted, the brain first reacts to the acute injury with an inflammatory response. Then the brain settles into a wound-healing, or chronic, response. It's during this secondary response that brain tissue starts to encapsulate the electrode, cutting it off from communication with surrounding neurons.

The brain implants were developed at the University of Michigan. For the complete story, visit medical design.com/newsletters/medical-edge-102109/