Why Real Ear Measurement is Important in Hearing Aid Fittings

When you’re diagnosed with hearing loss, most audiologists will recommend hearing aids to improve your quality of life. These devices come in a variety of styles and sizes, so it’s important you select the best one for your needs. The selection process is critical to providing you with most natural listening experience possible, so your audiologist will likely walk through the varying styles with you and recommend one based on your hearing loss profile. The most common hearing aid styles include:

• Behind the ear (BTE): This style is worn with a piece that holds the technology and main body of the hearing aid behind or on top of the ear, connected to a receiver located in the canal. This is suitable for individuals with mild-to-profound hearing loss.
• In the ear (ITE): A medium-sized device worn in the outer bowl of the ear in either half- or full-shell modes. This hearing aid is ideal for individuals with mild-to-moderately-severe hearing loss.
• Canal worn: Canal hearing aids are the most discreet available and come in other sub varieties like completely in canal (CIC) and invisible in canal (IIC). These hearing aids are recommended for individuals with mild-to-moderate hearing loss.

Once you have completed the hearing aid selection process, your devices will be ordered and you will schedule a fitting appointment. The hearing aid appointment will be the chance for you to learn about your devices, check the physical fit of them and program them to your specific hearing loss.

Real ear measurements (REM) may be performed to evaluate how well your devices are working and how fine-tuned they are to your degree of hearing loss. REM is commonly performed during the hearing aid fitting since it helps to ensure that you have the greatest possible fit and listening experience possible with your devices. Because it is based on the individual acoustic properties of your ears, it allows for a more exact and personalized fit.

What is REM and How Does it Work?

Following the configuration and placement of your new hearing devices, your audiologist will complete REM by inserting a small probe into your ear canal, close to the eardrum. This probe uses a microphone to monitor the sound delivered to your eardrum through your hearing aids. REM verifies the hearing device is delivering the recommended gain across all frequency ranges. This is an important step and can help them to alter the settings if needed.

Live speech mapping can be utilized during this process to measure the levels and pitches of speech reaching your auditory system. The hearing aid is adjusted so that speech is amplified in line with predefined targets that are helpful in boosting audibility. An audiologist adjusts each frequency channel and loudness level as the client listens to a real-time spectrum representation of the speech supplied through the ear canal.

What are the Advantages of REM?

REM benefits hearing aid wearers by providing the audiologist with a more accurate and customized fitting of the devices. When performed by audiologists during the fitting process of hearing aids, real ear measurements appear to be the most reliable and effective method of measuring the benefit delivered by the devices.

This improvement is most likely due to improved audibility, as well as increased contentment with the overall fitting experience. REMs have been shown to not only improve the patient’s experience, but also to result in a higher overall level of satisfaction.

Why is REM Testing Vital to a Good Fit?

The American Speech-Language-Hearing Association and the American Academy of Audiology (AAA) both advocate for using real ear measurements to evaluate hearing aid effectiveness whenever possible. When REM measurements are unavailable, the audiologist must rely on fitting software provided by the hearing aid manufacturer to predict the amount of gain that should be administered at certain frequencies. Using REM measurement helps them to do this more successfully and to a higher standard.

When the device is installed and turned on, the software calculates gain settings based on the audiogram and the fitting rule that has been defined, rather of taking an actual sound measurement at the eardrum. The software or factory settings are only based on the usual sound levels that most people perceive when listening to music in their regular ear canal. These are only “best guesses” for the time being till real measurements are taken.

Several recent investigations found that less than 12% of the targets displayed on the fitting software screen corresponded to the actual measurements collected in the ear canal. Hearing aid fitting software, particularly at lower and higher frequencies, has a tendency to overstate the true gain of the hearing aids being utilized.

If you want to learn more about how we can help you find the best hearing aid for your needs, reach out to the The Hearing Clinic team by calling (612) 246-4868.