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Real-Ear Measurements (REMs): A Critical Hearing Aid Service
Ensure your hearing aids are operating at peak performance.)
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Aktualisiert am Sep 5, 2024
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When it comes to hearing aids, there is only one guaranteed way to get the volume right, and that is by measuring the volume provided by your hearing aid—deep inside your own ear. Each person has a unique hearing profile and ear canal resonance, and a unique preference for sound.
Real-ear measurements (REMs) are used to verify the “correct” hearing aid volume is provided, while factoring in your unique hearing profile and ear canal resonance. This should be considered the starting point. From there, you may work with your audiologist to make additional tweaks based on your own sound preferences.
REMs are used to verify hearing aid performance. They take a snapshot of the sound coming out of your hearing aid while it sits in the ear canal. Audiologists or hearing healthcare providers place a probe microphone (thin, pliable tube connected to a microphone) in the ear canal and then set the hearing aid over the top of the probe microphone. Once in place, sound is presented through a loudspeaker and the output of the hearing aid is measured. Results are displayed either as a graph or table and help your hearing healthcare provider understand the volume of sound your hearing aid is providing for each pitch.
During a new hearing aid fitting, your hearing healthcare provider will select a prescriptive formula. These prescriptions are calculated from a number of factors including your hearing loss and help your hearing healthcare provider set up the correct amplification for different types and volumes of sounds.
When hearing aids amplify sound, they can provide different amounts of volume depending on your hearing loss, the frequency, and the type of sound coming into the hearing aid. REMs allow your hearing healthcare provider to confirm your hearing aids are applying the right volume for different sounds according to the prescription. Speech, or speech-like sound, is the best signal to use during prescription verification and should be presented at soft, average, and loud intensities.
Your hearing aids are equipped with many features to improve your listening experience. REMs help your hearing healthcare provider ensure the features are doing exactly what they should be doing. Through REMs, we can measure the performance of features like noise reduction, directional microphones, and telecoils.
REMs can help an audiologist or hearing healthcare provider confirm appropriate amplification settings and ensure features in the hearing aid are functioning as they should. REMs are an important tool for fitting hearing aids and diagnosing hearing aid malfunction.
REMs require a probe tube (thin, pliable silicone tube), a microphone at the level of the ear, a loudspeaker, and a quiet room. Your audiologist or hearing care provider will examine your ear canal to ensure it is free of ear wax and/or any other debris. The probe tube is then placed in your ear canal as close to the eardrum as possible with the hearing aid placed over the probe tube. You might feel a tickle or feel a bit of pressure during the probe tube placement. This is normal as the skin in the ear canal is more sensitive closer to the eardrum but the probe tube is very soft and will not damage your ear.
You will likely be facing a loudspeaker once all the pieces are in place. Your hearing healthcare provider will turn on the loudspeaker and play different sounds and measure the sound in your ear canal through the probe tube. Sometimes your hearing aid will be turned on and sometimes it will be turned off, depending on the type of measurement. The sound from the loudspeaker might be speech or some type of speech-like noise and will vary in volume. As a listener, you will just sit quietly during the measurements. You will not need to respond during the measurements.
Want to see how it’s done? Dr. Cliff, AuD has a great 9 minute YouTube video packed with information and demonstration.
As beneficial as REMs are, they are only useful when your hearing healthcare provider understands how to read the results. It is possible for your provider to complete the procedure but not understand how the results impact the hearing aid fitting or feature validation. As a client, there are some key things you can look for to feel confident in your provider.
During a new hearing aid fitting, be on the alert for the following:
During feature validation, be on the alert for the following:
The short answer is REMs should be done for all fittings of new hearing aids, and there are now some states that have licensure laws that require the test to be performed within a specific period of time. However, in simple terms, REMs only verify the output of the hearing aid near the eardrum based on the audiogram's indicated prescription—a prescription that is also based on averages. While REM is extremely useful, what it does not take into account is the patient's perception of sound.
There are some arguments against universally mandating REMs. However, REM should be performed at least on all new fittings and whenever a change in hearing ability is noted in established hearing aid users.
Christopher Frink, AuD, a respected private-practice audiologist based in Salem, Ore, answered the question in HearingTracker's "Expert Answers" with two good points:
Thus, it’s incumbent and essential for consumers to find a provider who uses REMs with every fitting, but is sensitive enough to listen to their preferences.
Some providers will discuss REMs on their website but not all will. Use our Pro Finder to find audiologists who routinely perform REMs during their new hearing aid fittings. If you’re wondering if your current audiologist or hearing healthcare provider offers REMs, it’s worth asking before your new hearing aid fitting.
Elise ist eine leidenschaftliche Audiologin, Dozentin und Content-Marketerin. Sie hält ihre CCC's in Audiologie durch die American Speech-Language-Hearing Association (ASHA) und die New Zealand Audiological Society (NZAS). Sie interessiert sich von Natur aus dafür, Barrieren im Zugang zu Hörheilkunde auf dem globalen Markt zu identifizieren und kreative Wege zu finden, um sich mit Kunden und Gesundheitsdienstleistern zu verbinden, um gesundes Hören zu fördern. Sie hält einen Doctor of Audiology Abschluss von der Vanderbilt University School of Medicine aus dem Jahr 2010.
Dr. Bailey ist ein führender Experte für Verbrauchertechnologie in der Audiologie-Branche. Er ist ein überzeugter Befürworter der patientenzentrierten Hörkommunikation und audiologischen Best Practices und begrüßt jede technologische Innovation, die den Zugang zu qualitativ hochwertigen Hörergebnissen verbessert. Dr. Bailey hält einen Au.D. vom Vanderbilt University Medical Center.
