Dr. Erin Rushing, audiologist, performing a hearing aid fitting in Houma, La.

What Are Real-Ear Measures?

Do you or someone you know have hearing aids in a drawer somewhere because they don't help? The main goal of hearing aids is to improve hearing as much as possible.

Do you or someone you know have hearing aids in a drawer somewhere because they don’t help? The main goal of hearing aids is to improve hearing as much as possible. Real-ear measures help determine the proper amount of amplification using actual data instead of “best guess” approaches.

What Are Real-Ear Measures?

Real- Ear Measures (REM) are measurements used to decide how well a hearing aid performs in the wearer’s ear canal. This is done by measuring the hearing aid’s output in the wearer’s ear. An audiologist then uses the measurements to adjust the hearing aid to target responses to help you hear as best as possible.

Methods or Techniques Used to Fit a Hearing Aid

Most hearing care professionals use the proprietary “First Fit” algorithm that each manufacturer has included with their hearing aid software. These algorithms apply a proprietary fitting rationale that the manufacturer either designed or believes to be the best option for determining how much amplification the hearing aid needs to give the wearer. The algorithm uses the person’s hearing test results to determine how much amplification the manufacturer thinks is appropriate for the average ear. It’s a “best guess” approach.

Real-Ear Measures involve inserting a probe microphone into the ear canal and then comparing the measured output to prescriptive targets generated from the person’s hearing loss. After that, the audiologist sets the hearing aid to amplify to certain target levels for soft, medium, and loud sounds across the aid’s usable frequency range. As a result, the hearing aid is adjusted to provide the best possible hearing improvement for the patient.

Fitting Rationales Used

There are several fitting rationales that an audiologist can use. The most common is the National Acoustic Laboratories (NAL) non-linear fitting rationale and DSL (desired sensation level) fitting rationale.

  • NAL NL-1 Fitting Rationale- A theoretically derived formula uses the person’s audiogram to calculate how much amplification is required. NAL NL-2 is an advanced version of this formula that considers the effects of loudness recruitment.

  • DSL Fitting Rationale – This approach is based on research that shows that people with hearing loss have difficulty understanding speech in noise. The DSL fitting rationale attempts to provide the person with enough amplification to overcome this difficulty.


Benefits of Real-Ear Measures

When buying hearing aids, the aim is to get devices that will be comfortable and deliver quality sound. Real-ear measures are essential in achieving this goal. The main benefits of REM include:

1. Customized Fitting

REM considers the anatomy of your ear canal and the type and severity of your hearing loss. There is no guesswork involved as actual data, and a scientific approach to setting levels is used to calibrate the hearing aid to the person’s unique hearing loss.

2. Higher Chances of Success

With real-ear measures, you won’t have to waste your time or money on hearing aids that don’t fit or aren’t calibrated to your ear canal’s acoustics. Instead, the hearing aid custom-fit is based on the test results and considers the person’s unique characteristics. This leads to a higher chance of success with the first pair of hearing aids.


Bottom Line

Unfortunately, Real-Ear Measures is a technique that is not commonly used. However, some hearing care professionals are now using it to give better results to their patients.

Hearing aids can be a significant financial investment, so why wouldn’t you want to find someone who will leave no stone unturned and go the extra mile to get the most out of your money? Comprehensive Hearing Solutions has you covered! So say no to uncomfortable and ill-fitting hearing aids by scheduling an appointment today and get a thorough hearing evaluation to get the best possible fit for you. Contact us now.

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Dr. Erin Rushing
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