Factors influencing time to speech processor upgrades

Cochlear implant (CI) speech processors have undergone technological advancements. Therefore, patients upgrade speech processors when new features are available or when their previous device becomes broken and is no longer serviceable. This study aimed to identify factors that impact the time to a speech processor upgrade and to evaluate patient experiences with upgrading and following upgrade.

In this retrospective cohort study, 46 CI surgeries at a single tertiary care center in 2017 and that subsequently received a speech processor upgrade were included. Data on patient demographics, hearing loss history, CI manufacturer, insurance type and status, and configuration were collected. Time to first upgrade, reasons for upgrade, patient-reported satisfaction, and speech perception scores were analyzed.

The mean time to a speech processor upgrade was 5.13 years after implantation. The most common reason for an upgrade was the device being over five years old, followed by the device being out of warranty. 45.7% of patients expressed satisfaction with speech processor upgrade, while 8.7% were not satisfied. There were no statistically significant associations between the time to upgrade and demographic factors such as age, sex, insurance type, or CI manufacturer. Following the upgrade, there were no significant changes in speech perception scores.

Speech processor upgrades at this center align with when insurance companies typically deem upgrades medically necessary. Demographic factors, insurance, and device manufacturer did not significantly influence time to upgrade. While objective speech perception measures did not significantly improve, many patients reported subjective satisfaction with the upgrade.