Real Ear Measurements (REM) are a verification of hearing aids to ensure they are correctly programmed according to the user’s hearing loss and ear canal characteristics. This is important because sound travels differently in each individual’s ears. For example, if you have a large ear canal, you might need different adjustments in your hearing aids compared to someone with smaller or narrower ear canals.
When should this test be performed?
Real Ear Measurements (REM) should be performed whenever hearing aids are fitted, at the time of setting up the devices.
What is the procedure?
First, the hearing aid user sits in front of a speaker. The audiologist performs an otoscopy to ensure there is no wax or secretions in the ear, as the canal must be clean and the eardrum visible for the REM.
Then, probe tubes, which are microphones, are placed in the ears near the eardrum without touching it. The unaided ear gain (REUG) is measured to evaluate the ear canal size and ensure the sound pressure is adequate. Afterward, the hearing aids are inserted while turned off, and the occluded ear gain (REOG) is measured to verify that the earmold or dome is correct.
Next, the aided ear gain (REAG) measurement is conducted. Here, the hearing aids are turned on, and various sounds are played to measure performance and ensure it matches the user’s hearing prescription.
During this part, the patient will typically hear three levels of sound (soft, medium, and loud but not uncomfortable). Different stimuli, such as ISTS (International Speech Test Signal), can be used. These stimuli mimic common everyday speech sounds to ensure the hearing aids capture and transmit these sounds clearly and accurately.
Once these tests are completed, the probe tubes are removed, and the hearing aids are adjusted according to the user’s needs and comfort.
What if my Audiologist does not perform Real Ear Measurements?
Although REM tests are essential for correctly fitting a hearing aid, not all clinics or hearing centres may perform them due to equipment limitations or other factors.
It is important to perform REM during the initial fitting of the hearing aids and during follow-ups if the user experiences problems. They should also be performed after an annual hearing test if there are changes in hearing.
The most crucial aspect of hearing aid fitting is ensuring that the person with hearing loss can hear clearly and comfortably. However, this cannot be guaranteed without performing Real Ear Measurements.
