Real Ear Measurement: Importance & What is it | Meenakshi

Real Ear Measurement (REM)

Real ear measurement is the measurement of sound pressure level in a patient’s ear canal developed when a hearing aid is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for a patient’s hearing loss. Real ear measurement (REM) is critical when fitting patients with hearing aids because it verifies the gain (volume) provided by the hearing aids based on the pitch and volume of the sound they pick up. Research consistently indicates that without REM being performed, patients will not achieve the level of amplification that is needed to meet their hearing loss prescription. Visit once Speech and Hearing Aid CentreReal ear measurement

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Why is REM important?

Only an estimated 30% of audiologists and hearing aid dispensers use REM when fitting hearing aids. REM is recommended by both the American Speech-Language-Hearing Association (ASHA), and the American Academy of Audiology (AAA), as the preferred method of verifying the performance of hearing aids.
REM are the most reliable and efficient method for assessing the benefit provided by the hearing aid.
Real ear measures involve positioning a probe tube in the patient’s ear canal approximately 6mm from the patient’s eardrum. Then, after testing to make sure that the probe tube is appropriately positioned, the hearing aid is also placed in the patient’s ear and the verification process commences. real ear measurement

REUR (Real-Ear Unaided Response)

The SPL, across frequencies, measured in the open (unaided) ear canal for a given input signal.

REAR (Real-Ear Aided Response)

The SPL, across frequencies, measured in the open (unaided) ear canal for a given input signal.

REIG (Real-Ear Insertion Gain)

The amount of gain provided by the hearing instrument alone calculated by subtracting the REUG from the REAG across frequencies or by subtracting the REUR from the REAR across frequencies.  Facebook Page

REOR (Real-Ear Occluded Response)

The SPL across frequencies, measured in the ear canal, with the hearing aid in place and turned off. An REAR with the hearing aid turned off.

RECD (Real-Ear-to-Coupler Difference)

Difference in dB across frequencies, between the SPL measured in the real-ear and in a 2cc coupler, produced by a transducer generating the same input signal.

Why should you do it? RECD

The RECD is a powerful tool that can assist the clinician throughout the various stages of the amplification process. For instance, the RECD allows you to accurately convert assessment information collected with insert phones from dB HL to dB SPL (Scollie et al., 1998b) by, in effect; adjusting the 2cc coupler calibration values used with insert phones. This is helpful when using hearing instrument fitting methods that use the SPL-O-GRAM format (e.g., DSL). RECD values can also be used to convert real-ear targets to 2cc coupler targets to assist with selection of hearing instruments via manufacturers’ specification sheets. real ear measurement

Arguably the most useful application of the RECD is in the prediction of real-ear output when measuring hearing instruments in the 2cc coupler. Given that the RECD allows us to know the difference between output in the real-ear and the 2cc coupler, real-ear hearing aid output (e.g., REAR, RESR) can be accurately predicted to within approximately 2 dB (Seewald et al, 1999).

The ability to predict hearing instrument output offers a number of advantages, which, as described by Seewald (1997) include the following:

1. The audiologist will know the levels of amplified sound delivered into the patient’s ear canal. real ear measurement

2. The unique acoustic properties of the ear and earmold coupling (if the RECD is conducted with the earmold) will be accounted for. This helps avoid errors that can occur when using average values in the fitting process. real ear measurement

3. All hearing instrument response shaping can be performed in the hearing aid test chamber, under highly controlled acoustic conditions.

4. The degree of cooperation and amount of time required from the patient in the fitting process is greatly reduced. real ear measurement

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