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How real-ear measurement (REM) improved a hearing aid user's life

On a recent trip to Beijing, Dennis Mistry, Audiologist and Clinical Product Manager, Interacoustics, was asked to help fit the hearing aids of a client who had experienced issues with his prior fitting.

- Initially, my visit to the clinic [Clear World] was to educate its staff on real-ear measurement (REM). Being presented with a client was a unique opportunity to demonstrate the true benefit of REM and I think it was a good exercise for the clinic’s staff to see how easy it is to do, Dennis comments.

The client whom Dennis received was called Cheng Shiqi. Cheng went to the clinic for finetuning of his pair of Opn2 mini RITE 85, as his left hearing aid was whistling. Before the fitting appointment, Cheng had felt he could not hear sound clearly.

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Hearing struggles during family dinners

Dennis first asked for a repeat audiogram, as this could have changed since Cheng first attended or may not have been properly reflected within his hearing aid programming.

- This came back the same as it was found during his initial assessment, which was a relief, Dennis notes and continues:

- Looking into his ears, everything looked fine. However, Cheng informed me of the situations he was struggling with. Family dinners were particularly difficult, as he had difficulty listening past louder family members.


Moving onto real-ear measurement (REM)

- Before reprogramming anything, I wanted to see what his hearing aids were doing for him. So, we moved onto REM, where I opted for an Aided Response method, as I feel this is easier for the client to follow, Dennis says.

The first measurements showed that the amplification of the left hearing aid gave no amplified sound above his hearing thresholds, which basically confirmed Cheng’s suspicions as this was not helping him at all. The right aid was giving amplification, but it was not enough to give proper stimulation of the lower intensity sounds.


Hearing aid amplification without feedback

- Through REM and visible speech mapping (VSPM), Dennis found that the left ear receiver was too limited to listen to sounds in daily life. So, he changed the receiver from 85 to 100, according to Mrs. Ai from Clear World.

Dennis adds:

- I also opted to switch to a closed dome. After making these changes, I ran the feedback cancellation process within Oticon Genie 2. These changes made a great difference and allowed me to give him more amplification without feedback.


Thorough counseling

Dennis elaborates on the counseling process of the fitting appointment:

- Following, we achieved a nice match to target, using a NAL-NL2 algorithm with a tonal language input, as his main language was Mandarin. However, I didn’t want to stop there. I was keen to understand Cheng’s views of this sound.

Ultimately, Dennis’ counseling efforts led to applying a frequency-lowering special feature of Cheng’s left hearing aid. He liked this and was happy for Dennis to store these changes. Mrs. Ai was impressed:

- Dennis did an excellent job at using visible speech mapping to counsel Cheng regarding his audibility, comfort and clarity.


The life-changing value of real-ear measurement (REM)

Mrs. Ai speaks on behalf of a satisfied client:

- Cheng felt that his ears were more balanced, comfortable and audible than before. Dennis demonstrated the life changing value of REM and visible speech mapping to increase client satisfaction.


Related resources


About the authors

Shane Seiger-Eatwell is a Master of Linguistics and Communication (cand.ling.merc.), having graduated from Aarhus University in 2018. He joined Interacoustics in January 2019 as a Marketing Communications Specialist.

Dennis Mistry, BSc (Hons) Audiology, graduated from Aston University in 2011. Since November 2013, Dennis has served as a Clinical Product Manager at Interacoustics, as part of its Hearing Aid Fitting product management team.
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