The Art and Science of Hearing Aid Fitting
Understanding the Real Ear Measurement Process
The Art and Science of Hearing Aid Fitting: Understanding the Real Ear Measurement Process
Living with hearing loss can be challenging, but modern hearing aids have the potential to dramatically improve quality of life. I have been wearing hearing aids for more than 15 years and have come to depend on them every day. Without them, I miss parts of every conversation. With them, I hear normally. One of the most important pearls I can share with people thinking about hearing aids is to find an experienced audiologist who has the tools to fit and expertly program hearing aids for each user. This is often the key difference that takes hearing aids from being helpful to being indispensable. In this post, we'll explore the hearing aid fitting process, with a special focus on Real Ear Measurement (REM), a gold standard technique used during a hearing aid fitting that can significantly enhance your hearing experience.
The Basics of Hearing Aid Fitting
Hearing aid fitting is a multi-step process that aims to customize the device to your unique hearing needs. Here's an overview of what you can expect:
1. Hearing Evaluation: Before any fitting takes place, a comprehensive hearing test is conducted to determine the type and severity of your hearing loss.
2. Hearing Aid Selection: Based on your test results, lifestyle, and preferences, your audiologist will recommend suitable hearing aid options. Any audiologist you visit should have a choice of different hearing aids made by multiple major manufacturers. My favorite hearing aid manufacturers are Phonak and Oticon, although other major brands work well too. The key here is to be able to try different aids to see what works best for you.
3. Custom Ear Impressions: If you opt for in-the-ear styles, impressions of your ear canals are taken to ensure a perfect fit. Most people will benefit far more from hearing aids that sit behind-the-ear, with a very small wire that (almost invisibly) places a small speaker in the ear canal. These do not require impressions.
4. Initial Programming: The hearing aid is programmed based on your audiogram (hearing test results) and the manufacturer's fitting software.
5. Fine-tuning: The settings are adjusted based on your feedback and objective measurements.
6. Follow-up Appointments: Regular check-ups ensure the hearing aids continue to meet your needs over time. Most people need small adjustment to be made in the first weeks and months that enhance their experience.
While this process forms the foundation of hearing aid fitting, there's one crucial step that can make a significant difference in your hearing experience: Real Ear Measurement.
Introducing Real Ear Measurement
Real Ear Measurement, also known as probe microphone measurement, is a fitting technique that allows audiologists to objectively verify and adjust hearing aid performance while the device is in your ear. This method provides a precise, individualized fit that accounts for the unique characteristics of your ear canal.
How Real Ear Measurement Works
During a Real Ear Measurement, a thin probe microphone is inserted into your ear canal alongside your hearing aid. This probe measures the actual sound levels reaching your eardrum when the hearing aid is in place. Here's the step-by-step process:
1. Calibration: The system is calibrated to ensure accurate measurements.
2. Unaided Response: The natural acoustics of your ear canal are measured without the hearing aid.
3. Aided Response: With the hearing aid in place, the probe microphone measures the amplified sound reaching your eardrum.
4. Target Matching: The audiologist compares the measured response to prescriptive targets based on your hearing loss and makes adjustments to match these targets.
5. Fine-tuning: Further adjustments are made based on your feedback and comfort level.
The Importance of Proper Hearing Aid Fitting
You might wonder why such a detailed fitting process is necessary. After all, can't hearing aids be pre-programmed based on your hearing test results? While pre-programming can provide a starting point, it often falls short of delivering optimal results. Here's why proper fitting, especially using Real Ear Measurement, is crucial:
The advantages of Real Ear Measurement translate into tangible benefits in your daily life:
1. Improved Speech Clarity: By ensuring that speech frequencies are appropriately amplified, REM can significantly enhance your ability to understand conversations, even in challenging environments.
2. Reduced Listening Effort: A properly fitted hearing aid requires less mental effort to process sounds, reducing listening fatigue.
3. Better Sound Quality: REM helps in achieving a more natural sound quality, making music and environmental sounds more enjoyable.
4. Increased Comfort: By avoiding over-amplification, REM reduces the likelihood of sound-related discomfort or pain.
5. Faster Adaptation: Many users report quicker adaptation to their hearing aids when fitted using REM, allowing them to experience the benefits sooner.
6. Long-term Satisfaction: The precise, personalized fit achieved through REM often leads to higher long-term satisfaction with hearing aids.
Overcoming Common Misconceptions
Despite its benefits, some misconceptions about Real Ear Measurement persist:
1. "It's time-consuming": While REM does add some time to the fitting process, the improved outcomes are well worth the extra minutes.
2. "It's uncomfortable": The probe tube used in REM is extremely thin and flexible, causing minimal discomfort.
3. "It's not necessary for all fittings": While simpler cases might achieve satisfactory results without REM, using it consistently ensures the best possible outcomes for all patients.
4. "The results aren't that different": Studies consistently show significant improvements in hearing aid performance and user satisfaction with REM-based fittings.
The Future of Hearing Aid Fitting
As technology advances, we're seeing exciting developments in the field of hearing aid fitting. Some newer hearing aids now incorporate built-in real ear measurement capabilities, allowing for ongoing adjustments based on your listening environments. Additionally, artificial intelligence and machine learning are being integrated into fitting processes, promising even more personalized and adaptive solutions in the future.
However, these technological advancements don't diminish the importance of professional expertise. Your audiologist's skills in interpreting results, making appropriate adjustments, and considering your individual needs remain crucial to achieving the best outcomes.
Conclusion
Hearing aid technology has come a long way, offering tremendous potential to improve the lives of those with hearing loss. However, the sophisticated technology in modern hearing aids can only reach its full potential when properly fitted to your individual needs. Real Ear Measurement represents the pinnacle of current fitting techniques, offering a level of precision and personalization that can significantly enhance your hearing experience. I have experimented with my own hearing aids and found Real Ear Measurement to make an immediate improvement in my hearing, when compared to programming done without REM
If you're considering hearing aids or are unsatisfied with your current devices, don't underestimate the importance of the fitting process. Consider a visit with an ENT specialist in Frisco and about about Real Ear Measurement and how it can be used to optimize your hearing aids. Remember, investing time in a proper fitting can make all the difference in your journey to better hearing.