Why Upgrading a Sound Processor Matters: A Summary of Peer-Reviewed, Published Research


When new sound processors become available, professionals want to understand the benefits to them and their patients. Evidence-based medicine (EBM), with its capacity to improve patient outcomes, has grown prominent throughout the medical field.1 EBM describes the process in which medical literature is critically assessed to define the value of different therapeutic interventions with the goal to improve clinical decision making and patient outcomes.2 Cochlear recognizes the importance of data mining, clinical research, and medical literature to make clinical decisions and optimize care models.   

Compiling the Evidence

Cochlear has reviewed the literature and compiled a clinical evidence summary of peer-reviewed publications that demonstrate how historically, upgrading to the latest sound processor technology has been beneficial for patients, clinics, and society.3-18

The journal articles are categorized into four main areas: Hearing outcomes, Patient outcomes, Patient Satisfaction and Health Economic Benefits.

Learn Why

This clinical evidence summary, along with the meaningful innovation of next-generation sound processors designed to deliver improved hearing performance, new connectivity and capabilities, and compatibility with existing implants, provide the “why” behind upgrading to the latest generation sound processor.  To learn more about how to facilitate a sound processor upgrade for your patients, watch this series of five professional-facing short videos that provide an outline of the process, resources, and support available to you and your patients to make the upgrade process for a CochlearTM next-generation sound processor as seamless as possible. 

Click here to read the Clinical Evidence Summary.

To learn more about upgrade resources available for your patients visit: click here.


  1. Shin JJ, Randolph GW, Rauch SD. Evidence-based medicine in otolaryngology, part 1: the multiple faces of evidence-based medicine. Otolaryngol Head Neck Surg. 2010;142(5):637-646. doi:10.1016/j.otohns.2010.01.018
  2. Goodin DS. Evidence-based medicine. Int MS J. 2005;12(3):94-95.
  3. Hey M, Böhnke B, Mewes A, Munder P, Mauger SJ, Hocke T. Speech comprehension across multiple CI processor generations: Scene dependent signal processing. Laryngoscope Investigative Otolaryngology. 2021 Aug;6(4):807-15.
  4. 2. Go­ -Gomez MV, Muniz L, Wiemes G, Onuki LC, Calonga L, Osterne FJ, Kós MI, Caldas FF, Cardoso C, Cagnacci B. Contribution of noise reduction pre-processing and microphone directionality strategies in the speech recognition in noise in adult cochlear implant users. European Archives of Oto-Rhino-Laryngology. 2021 Aug;278(8):2823-8.
  5. Mauger SJ, Warren CD, Knight MR, Goorevich M, Nel E. Clinical evaluation of the Nucleus® 6 cochlear implant system: Performance improvements with SmartSound iQ. International Journal of Audiology. 2014 Aug 1;53(8):564-76.
  6. Mosnier I, Sterkers O, Nguyen Y, Lahlou G. Benefits in noise from sound processor upgrade in thirty-three cochlear implant users for more than 20 years. European Archives of Oto-Rhino-Laryngology. 2021 Mar;278(3):827-31.
  7. Pinheiro MM, Mancini PC, Soares AD, Ribas Â, Lima DP, Cavadas M, Banhara MR, da Silva Carvalho SA, Buzo BC. Comparison of Speech Recognition in Cochlear Implant Users with Different Speech Processors. Journal of the American Academy of Audiology. 2021 Jul;32(07):469-76.
  8. Plasmans A, Rushbrooke E, Moran M, Spence C, Theuwis L, Zarowski A, Oeciers E, Atkinson B, McGovern J, Dornan D, Leigh J. A multi-center clinical evaluation of pediatric cochlear implant users upgrading to the Nucleus® 6 system. International Journal of Pediatric Otorhinolaryngology. 2016 Apr 1;83:193-9.
  9. Biever A, Gilden J, Zwolan T, Mears M, Beiter A. Upgrade to Nucleus® 6 in Previous Generation Cochlear™ sound processor patients. Journal of the American Academy of Audiology. 2018 Oct;29(09):802-13.
  10. Mauger SJ, Jones M, Nel E, Del Dot J. Clinical outcomes with the Kanso™ off-the-ear cochlear implant sound processor. International Journal of Audiology. 2017 Apr 3;56(4):267-76.
  11. Mosnier I, Marx M, Venail F, Loundon N, Roux-Vaillard S, Sterkers O. Bene‑ ts from upgrade to the CP810™ sound processor for Nucleus® 24 cochlear implant patients. Eur Arch Otorhinolaryngol 2014; 271:49–57.
  12. Warren CD, Nel E, Boyd PJ. Controlled comparative clinical trial of hearing bene‑ t outcomes for users of the Cochlear™ Nucleus® 7 Sound Processor with mobile connectivity. Cochlear Implants International. 2019 May 4;20(3):116-26.
  13. Maruthurkkara S, Allen A, Cullington H, MuJ, Arora K, Johnson S. Remote check test battery for cochlear implant patients: proof of concept study. International Journal of Audiology. 2021 Aug 24:1-0.
  14. Maruthurkkara S, Case S, Rottier R. Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Patients. Ear and Hearing. 2022 Mar 1;43(2):495-506.
  15. Neve OM, Boerman JA, van den Hout WB, Briaire JJ, van Benthem PP, Frijns JH. Cost-bene‑ t analysis of cochlear implants: A societal perspective. Ear and Hearing. 2021 Sep;42(5):1338.
  16. FoteC, Kennedy S, Milton AH, Deger M, Payk F, Sanderson G. Cost–utility analysis of cochlear implantation in Australian adults. Otology & Neurotology. 2016 Jun 1;37(5):454-61.
  17. Cutler H, Gumbie M, Olin E, Parkinson B, Bowman R, Quadri H, Mann T. The cost-effectiveness of unilateral cochlear implants in UK adults. The European Journal of Health Economics. 2021 Nov 2:1-7.
  18. Gumbie M, Olin E, Parkinson B, Bowman R, Cutler H. The cost-effectiveness of Cochlear implants in Swedish adults. BMC health services research. 2021 Dec;21(1):1-4.
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