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The Importance of Real Ear Measurements
The goal of a hearing aid fitting is to provide customised sound amplification that compensates for an individual’s hearing loss. The basis for determining this customised amplification is an individual’s audiogram (hearing test).
For most individuals with hearing loss, the degree of their hearing loss varies across the different frequencies (pitches). Consequently, a hearing aid needs to be programmed to provide the correct amount of amplification at each individual sound frequency to precisely compensate for the hearing loss. For example, for age-related hearing loss, hearing will often be worse in the higher frequencies compared to the lower frequencies. In such cases, a hearing aid would need to be programmed to provide more high frequency amplification.
When setting up a hearing aid for the first time, the audiologist will do an initial programming of the hearing aids using the hearing aid manufacturer’s software. This initial programming is called a “first fit” and uses the individual’s hearing thresholds (audiogram) to determine a predicted target amplification response and the hearing aids a programmed to match this target.
As the name suggests the “first Fit” is just the initial set-up. To ensure the hearing aid is providing the correct amount of amplification at the individual’s eardrum, there are additional factors other than the individual’s audiogram that also need to be considered. These factors include the physical characteristics of how the hearing aid is coupled to the individual’s ear (e.g. ear mould), as well as the physical properties of the individual’s ear canal (e.g. shape).
Everybody’s ears are different and both the ear mould and ear canal shape can significantly influence amplified sound. An accurate hearing aid fitting needs to consider all these factors so that the hearing aid provides the exact amount of amplification at the ear drum. To do this an audiologist should conduct real ear measurements (also called probe microphone measurements or insertion gain) and fine-tuning.
Real ear measurement and fine-tuning
Following the “first fit”, audiologists should measure the hearing aid’s amplification in the ear canal close to the ear drum. This involves placing a tube called a probe-tube, deep into the ear canal, approximately 12 mm from the ear drum (tympanic membrane). This tube is connected to a sensitive microphone and has the role of measuring sound levels near the ear drum. With the hearing aid inserted and turned on, the audiologist can then make accurate measurements at the eardrum of how much the hearing aid is amplifying sound across the range of frequencies. Based on these real ear measurements, the audiologist can then fine-tune the hearing aid to provide the optimal amplification response to optimise speech clarity and wearing comfort. Further fine-tuning may also be done based on the individual’s personal sound preferences.
Real ear measurements are an important procedure to ensure that hearing aids are precisely programmed and customised to account for both an individual’s hearing loss and their physical anatomy. Unfortunately to save time, many hearing clinics do not use real ear measures and simply rely on the “first fit” in the hearing aid manufacturer’s software. If you are in the process of getting hearing aids make sure you request your audiologist use real ear measurements.
At Sounds of Life Audiology we quite regularly see clients who have purchased hearing aids elsewhere who are unhappy with their performance. One of the first things we will do is conduct some real ear measurements to see what the hearing aids are doing. Often these measurements reveal that the hearing aids were not programmed properly for the client. By simply reprogramming and fine-tuning the hearing aids based on the real ear measurement results we are often able to solve the client’s problems without them having to invest in a new set of hearing aids.
At Sounds of Life we believe in providing hearing aids that are fully customised and optimised for wearers. We use real ear measurements as a standard procedure for every hearing aid fitting. It is only by doing this can we be sure we are making the most of the impressive hearing aid technology that is available today.
If you feel hearing loss is impacting your life contact Sounds of Life.
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About Sounds of Life
Sounds of Life Audiology is a leading, independent hearing aid specialist. We offer transparent and affordable hearing aid pricing on quality hearing aids (including virtually invisible hearing aid technology) from the world’s leading brands.