EarSwitch

Transforming Communication for People with Neurological Conditions

Earswitch enables people with severe paralysis to communicate, by detecting a subtle ear-drum movement you can learn. We developed this from early concept to commercial trial, closely collaborating with real-world users and our electronics, software and prototyping partners.

Image: Jonathan Bryan looking at his alphabet board to communicate

Image: Jonathan Bryan, our client’s inspiration behind designing EarSwitch.Photo Credit: Tom Pilston

The Journey

The tensor tympani is a muscle that controls the tension of your ear drum. It’s what creates ‘ear-rumble’ when you yawn and something many people can learn to control. It’s also one of the last things to be affected by progressive paralysis from degenerative diseases.

After he learnt about this, Dr. Nick Gompertz, a UK GP specialising in neurological conditions, decided to create Earswitch to help people, with conditions such as Motor Neurone Disease (MND) and locked-in syndrome, to communicate.

Our team partnered with EarSwitch to develop Nick’s early concept into a commercial in-ear device that could detect movement of the tensor tympani muscle and turn this into a computer “mouse click”.

Our work resulted in successful initial trials and has now moved into expanded testing with 100 production units.

The Design Challenge

Designing a sensor, packed full of electronics, to locate precisely, comfortably and safely deep inside anyone’s ear canal was always going to be a tough challenge.

Just the heat from the electronics inside such a sensitive and confined space, was a fairly serious concern at the start of the project.

Plus, Earswitch would be have to be easy to use in some unusual real-world conditions. For example, untrained carers would need to safely position it, multiple times a day, ensuring it would fit around wheelchairs and equipment, without getting tangled or yanked out.

Finally, the regulatory hurdle: this entirely new device required safety certification for medical trials, including biocompatibility.

Our Design Solutions

Working as part of The Product Partnership (a collaboration between Realise Design, Amalgam, Cubik Electronics, and Newicon), we developed several innovative solutions:

A flexible earpiece with adjustable length and angle to accommodate different ear canal geometries, while maintaining proper positioning.

A tiny camera system capable of focusing clearly enough on the ear drum to train the algorithm to reliably detect the intended movement.

A thermal management solution that dissipated heat safely away from skin contact points during extended use.

Visual / tactile indicators to help carers position the device correctly which emerged from extensive observation during early testing.

Reinforced cable junction and strain relief to withstand daily handling and various usage scenarios.

The final design has been proven to detect movement of the tensor tympani muscle, which combined with eye-tracking for cursor control, is a complete human-computer interface solution.

Medical design prototypes development and testing

Development Process

Our development didn’t follow a linear path but evolved through research, testing, and refinement. The process included:

Initial research: Defining the medical requirements, interviewing users in context and mapping technical constraints, to form a clear specification for design.

Design & prototyping: each iteration advancing our understanding of comfort and functionality. Early models focused on form and fit, while later versions incorporated working electronics.

User testing: with the University of Bath, we conducted initial trials that revealed unexpected, valuable insights about muscle control and device positioning, that influenced the next iteration.

Detailed refinement: of the ergonomics and functionality, simplifying some aspects while enhancing others based on real-world use.

Production engineering: preparing the design for challenging precision low-volume manufacture, that could be scaled in the future.

Certification support – documentation and testing for medical device approval, navigating the complex regulatory landscape for assistive technology.

Potential Future Uses

While initially developed as a communication device, the EarSwitch technology shows promise for several additional applications:

Biometric monitoring – The ear canal provides an excellent location for measuring vital signs, including heart rate and oxygen levels.

Healthcare equity – In-ear monitoring can help address measurement disparities across different skin tones that affect some other monitoring technologies.

Alternative interfaces – The technology shows potential for applications in gaming, accessibility, and hands-free control systems.

This technology opens new doors in assistive devices by tapping into a muscle most people didn’t even know they had. For patients facing progressive conditions, it could provide a way to keep communicating even when other abilities fade.

Outcome

The EarSwitch device has progressed to expanded trials, with 100 units produced for testing in care homes and neurological centres. The testing phase will provide valuable data on real-world usage, further refining the technology.

Our work shows how thoughtful design can address complex technical challenges while meeting genuine human needs. The EarSwitch project illustrates Realise Design’s approach to developing assistive technology: combining technical knowledge, human-centred design, and collaborative development to create solutions that enhance lives.

EarSwitch continues to develop and refine this technology, with Realise Design providing ongoing support for the next generation of devices.

“Having a trusted partner as a Start-up makes a massive difference; and Realise provided exactly that. They have been nothing but exemplary in their approach, dedicated, responsive and providing amazing design work, where even the first concept design exceeded our expectations.”

Dr Nick Gompertz, Founder of EarSwitch