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Case Studies in Real Ear Measurement (REM)

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1.  What does the Real-Ear Aided Response (REAR) measure? Insertion gain Frequency response (in dB SPL) in the ear canal in relation to hearing thresholds and prescriptive targets Speed of sound Distance from the eardrum

2.  The Expected Benefits with Amplification (EBA) tool helps clinicians interpret what? Aided SII values Unaided SII values REUR vs REOR SII changed values (Aided – Unaided)

3.  Which is NOT a way of improving the accuracy of your real-ear measurements (REM)? Running speaker equalization Running binaural measurements with large level differences between sides Checking probe tube depth, HA position, patient position, etc. Re-running measurements that are unexpected

4.  What should you do if your simulated gain curves in the hearing aid manufacturers software are way over target when fitting a slight/mild hearing loss? Panic and reset hearing aids to “best fit” Suspect a defect with the hearing aids Choose a different prescriptive target to use Nothing; it is common for simulated gain curves to be over-target when matching REM targets

5.  Why is it essential to run unaided speech at 65 dB in the REAR screen when fitting a slight/mild hearing loss? To give a measured reference point for unaided speech in the ear canal to ensure the hearing aid (when inserted) does not act as an earplug So that insertion gain can be calculated It is not essential; measuring unaided speech is a waste of precious time No one runs REM for slight/mild losses