Why Real Ear Measurements Are Important in Hearing Aid Fittings
Buying a hearing aid and simply inserting it into your ear is not enough. There are several more critical steps that hearing aid providers must complete to ensure your hearing aid purchase is beneficial to you. As hearing health professionals, we not only want you to understand how to use your new hearing aids but that the hearing aids are correctly calibrated and configured for your specific requirements.
Real Ear Measurements help guarantee that your new hearing aids are programmed with the utmost precision. Many, but not all, hearing aid providers will perform Real Ear Measurements as part of the hearing aid fitting procedure.
Real Ear Measurement (also known as Probe Microphone Measurement) is performed by inserting a probe tube into your ear canal and measuring the volume of your hearing aid over a wide range of frequencies/pitches. It helps determine the sound you’re obtaining from your hearing aid, pitch by pitch.
This test ensures that your hearing aid’s settings provide soft and loud sounds at the appropriate amplification. REMs report the sound levels you are experiencing rather than relying entirely on your assessment of how things sound with your hearing aid.
How Are Real Ear Measurements (REMs) Performed?
Real Ear Un-Aided Gain, Real Ear Occluded Gain, Real Ear Aided Gain, and Real Ear Insertion Gain are four steps in performing REM. Executing these necessary steps will achieve our primary goal of accurately fitting the patient’s hearing aid.
The basic procedure for REM requires a tiny probe microphone inserted into the ear canal, which measures the sound at the ear drum. The data collected includes the effect on the ear canal acoustics with the hearing aid, which can assist the hearing health professional to customize the hearing device to the patient’s ears.
Following a hearing evaluation, the REM procedure consists of the following steps:
- Calibration Of The Probe Microphone
This step can be performed without the patient being present and include calibrating the external microphone with the probe microphone to correct any variations and aligning the external microphone with the probe microphone to compensate for any differences between the two. Your hearing health professional will play a stimulus, and a trace appears on the screen.
The calibration can be checked in the upcoming Real Ear Un-Guided (REUG) measure by running a measurement in the same configuration as the calibration. When completed, a flat trace with a gain value of 0 dB should be displayed.
- Real Ear Un-Aided Gain (REUG)
It is the step after inserting the probe microphone into the ear. It is an ear canal measurement without a hearing device that displays the patient’s ear acoustics.
This measurement allows your hearing health professional to evaluate the ears’ natural sound amplification. It ensures that your hearing aid does not over-amplify in specific frequency response zones.
- Real Ear Occluded Gain (REOG)
This measurement includes placing the hearing device on the ear while muted or turned off. It allows consideration of the attenuation caused by the earpiece and its obstructing effect on external sounds. This tracing is often completed with the REUG in view so that they can be compared. The difference between these curves represents the attenuation provided by the earpiece.
- Real Ear Aided Gain (REAG)
The enabled/on hearing device is placed on the ear with the earpiece and probe microphone inserted as normal. It assesses the amplification impact on the hearing device within the patient’s ear and the effects on the patient’s ear acoustics.
This test may be performed at various intensities. But it is best to do it at speech level (65 dB) to guarantee that the device is examined for the intensity for which it will be used. The hearing device software is frequently adjusted to precisely match your prescribed target during this step.
- Real Ear Insertion Gain (REIG)
Your hearing health professional will perform this step in the same manner as the REAR and REAG above. But it requires REUG to be done first because it only shows the dB gain view of how the hearing aid is performing and excludes the REUR acoustics from this display.
After this measurement, it is common to adjust the hearing device software again to change the response towards the prescribed target.
Why Are Real Ear Measurements (REMs) SO IMPORTANT?
Real Ear Measurements are essential since each ear is unique, like our eyes, and must be treated accordingly. Can you imagine walking around with a prescription in your eyeglasses twice the strength of what it should be? It would be so frustrating and potentially dangerous!
Without REMs, anyone wearing hearing aids is likely to get either too little or too much sound at certain frequencies and pitches. To hear sounds as clearly as possible, you need high audibility over various frequencies.
Hearing aids will likely not be appropriately programmed if REMs are not performed in an audiology clinic. As a result, many “over-the-counter” hearing aids are sold but never used. If the hearing aids are not consistently worn, it may lead to many more problems, including an increased risk of falls, injury, dementia, isolation, and even irreversible hearing loss.
All hearing impairments are not corrected in the same way; there are sometimes significant differences in the hearing devices prescribed, the patient’s unique ear canal acoustics, and the mechanism by which the hearing device transmits sound into the ear.
REMs resolve these differences by allowing the hearing aid professional to accurately measure and evaluate the sound delivered at the ear drum. The advantages of this approach may be utilized in various situations, ranging from initial hearing aid fitting to troubleshooting. REMs are a trusted method, essential in collecting information to provide excellent results for our clients every time, leading to higher patient satisfaction from the initial fitting and fewer follow-up consultations.
Book an appointment with Expert Hearing Solutions today and start your hearing aid experience on the right path.
References:
- “Real-Ear Measurement: Basic Terminology And Procedures”. Retrieved from audiologyonline.com:
https://www.audiologyonline.com/articles/real-ear-measurement-basic-terminology-1229
- “Verification And Validation Of Hearing Aids: Opportunity Not An Obstacle“. Retrieved from nih.gov:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002586/
- Expert Hearing. “Hearing Aids”.Retrieved from experthearingsolutions.com: https://www.experthearingsolutions.com/locations/memorial-ave-thunder-bay-on/
- Healthy Hearing. “What Is Real Ear Measurement?”Retrieved from healthyhearing.com:
https://www.healthyhearing.com/report/53319-Real-ear-measurement-hearing-aid-fitting
- Hearing Review. “Real-Ear Measurement And Its Impact On Aided Audibility And Patient Loyalty”. Retrieved from hearingreview.com:
