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{{AFC submission|d|v|declinets=20140311022602|decliner=RadioFan|ts=20140206184038|u=Cstokesrees|ns=5}}
{{AFC submission|d|mergeto|3=Hearing aid|declinets=20140328061951|decliner=AdventurousSquirrel|ts=20140311194304|u=Cstokesrees|ns=5|small=yes}}{{AFC submission|d|v|declinets=20140311022602|decliner=RadioFan|ts=20140206184038|u=Cstokesrees|ns=5}}
{{afc comment|1=Please verify URLs in references and resubmit [[User:RadioFan|RadioFan]] ([[User talk:RadioFan|talk]]) 02:26, 11 March 2014 (UTC)}}
{{afc comment|1=Please verify URLs in references and resubmit [[User:RadioFan|RadioFan]] ([[User talk:RadioFan|talk]]) 02:26, 11 March 2014 (UTC)}}


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[[File:RealEarMeasurement.png|thumb |header=Real Ear Measurement |alt=Ear with RIC hearing aid and real ear probe tube in place. |Real ear measurement showing probe microphone in place and RIC hearing aid.]]
[[File:RealEarMeasurement.png|thumb |header=Real Ear Measurement |alt=Ear with RIC hearing aid and real ear probe tube in place. |Real ear measurement showing probe microphone in place and RIC hearing aid.]]
'''Real Ear Measurement''' (REM, also known as insitu- or probe microphone measurement)<ref>{{cite book|last=Stach|first=Brad|title=Comprehensive Dictionary of Audiology|date=2003|publisher=Thompson Delmar Learning|location=Clifton Park NY|isbn=1-4018-4826-5|page=167|edition=2nd Ed.}}</ref> is the measurement of sound pressure level in a patient's ear canal developed when a [[hearing aid]] is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for an patient's hearing loss.<ref name=strategies>{{cite book|last=Valente|first=Michael|title=Strategies for Selecting and Verifying Hearing Aid Fittings|date=1994|publisher=Thieme Medical Publishers|location=NY|isbn=0-86577-500-1|page=88|coauthor=John E. Tecca|chapter=Chapter 5}}</ref> The [[American Speech–Language–Hearing Association]] (ASHA) and [http://www.audiology.org/ American Academy of Audiology] (AAA) recommend real ear measures as the preferred method of verifying the performance of hearing aids.<ref name=ASHA>{{cite journal|last=ASHA Ad Hoc Committee on Hearing Aid Selection and Fitting|title=Guidelines for Hearing Aid Fitting for Adults|journal=American Journal of Audiology|date=1998|volume=7|issue=5-13|doi=10.1044/1059-0889.0701.05}}</ref> <ref name=AAA>{{cite web|last=American Academy of Audiology|title=Guidelines for the Audiologic Management of Adult Hearing Impairment|url=http://audiology.com/haguidelines 2007.pdf|accessdate=3 February 2014|first=Michael |last=Valente |coauthors=Harvey Abrams, Darcy Benson, Theresa Chisolm, Dave Citron, Dennis Hampton, Angela Loavenbruck, Todd Ricketts, Helena Solodar, Robert Sweetow|year=2007}}{{dead link|date=March 2014}}</ref>
'''Real Ear Measurement''' (REM, also known as insitu- or probe microphone measurement)<ref>{{cite book|last=Stach|first=Brad|title=Comprehensive Dictionary of Audiology|date=2003|publisher=Thompson Delmar Learning|location=Clifton Park NY|isbn=1-4018-4826-5|page=167|edition=2nd}}</ref> is the measurement of sound pressure level in a patient's ear canal developed when a [[hearing aid]] is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for an patient's hearing loss.<ref name=strategies>{{cite book|last=Valente|first=Michael|title=Strategies for Selecting and Verifying Hearing Aid Fittings|date=1994|publisher=Thieme Medical Publishers|location=NY|isbn=0-86577-500-1|page=88|coauthor=John E. Tecca|chapter=Chapter 5}}</ref> The [[American Speech–Language–Hearing Association]] (ASHA) and [http://www.audiology.org/ American Academy of Audiology] (AAA) recommend real ear measures as the preferred method of verifying the performance of hearing aids.<ref name=ASHA>{{cite journal|last=ASHA Ad Hoc Committee on Hearing Aid Selection and Fitting|title=Guidelines for Hearing Aid Fitting for Adults|journal=American Journal of Audiology|date=1998|volume=7|url=http://aja.pubs.asha.org/article.aspx?articleid=1773808|issue=5–13|doi=10.1044/1059-0889.0701.05|doi_brokendate=2014-03-28}}</ref> <ref name=AAA>{{cite web|DUPLICATE_last=American Academy of Audiology|title=Guidelines for the Audiologic Management of Adult Hearing Impairment|url=http://audiology.com/haguidelines%202007.pdf|accessdate=3 February 2014|first=Michael |last=Valente |coauthors=Harvey Abrams, Darcy Benson, Theresa Chisolm, Dave Citron, Dennis Hampton, Angela Loavenbruck, Todd Ricketts, Helena Solodar, Robert Sweetow|year=2007}}{{dead link|date=March 2014}}</ref>
Used by [[audiologists]] and other hearing healthcare practitioners in the process of hearing aid fitting, real ear measures are the most reliable and efficient method for assessing the benefit provided by the amplification.<ref>{{cite book|title=Handbook of Clinical Audiology|date=2009|publisher=Lippincott Williams & Wilkins|location=Baltimore MD|isbn=978-0-7817-8106-0|page=858|edition=6th|author=Jack Katz |coauthors=Larry Medwetsky, Robert Burkard, Linda Hood|chapter=Chapter 38, Hearing Aid Fitting for Adults: Selection, Fitting, Verification, and Validation}}</ref> Measurement of the sound level in the ear canal allows the clinician to make informed judgements on audibility of sound in the ear and the effectiveness of hearing aid treatment.
Used by [[audiologists]] and other hearing healthcare practitioners in the process of hearing aid fitting, real ear measures are the most reliable and efficient method for assessing the benefit provided by the amplification.<ref>{{cite book|title=Handbook of Clinical Audiology|date=2009|publisher=Lippincott Williams & Wilkins|location=Baltimore MD|isbn=978-0-7817-8106-0|page=858|edition=6th|author=Jack Katz |coauthors=Larry Medwetsky, Robert Burkard, Linda Hood|chapter=Chapter 38, Hearing Aid Fitting for Adults: Selection, Fitting, Verification, and Validation}}</ref> Measurement of the sound level in the ear canal allows the clinician to make informed judgements on audibility of sound in the ear and the effectiveness of hearing aid treatment.


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[[File:RealEarProbeTubes.png|thumb |alt=Probe tubes used in real ear measurement. |Silicone probe tubes used for real ear measurement.]]
[[File:RealEarProbeTubes.png|thumb |alt=Probe tubes used in real ear measurement. |Silicone probe tubes used for real ear measurement.]]
First, the clinician will examine the ear canal with the use of an [[otoscope]] to ensure no wax or other debris will interfere with the positioning of the probe tube. The probe tube is placed with the tip approximately 6mm from the [[tympanic membrane]]. Next the hearing aid is put in place. The REM system will typically produce a test stimulus from a loudspeaker situated 12-15 inches from the patient's head and simultaneously measure the output in the ear canal to determine how much amplification the hearing aid is providing.<ref name=strategies2>{{cite book|last=Valente|first=Michael|title=Strategies for Selecting and Verifying Hearing Aid Fittings|date=1994|publisher=Thieme Medical Publishers|location=NY|isbn=0-86577-500-1|page=93-95|coauthor=John E. Tecca|chapter=5. Use of Real-Ear Measurements To Verify Hearing Aid Fittings}}</ref>
First, the clinician will examine the ear canal with the use of an [[otoscope]] to ensure no wax or other debris will interfere with the positioning of the probe tube. The probe tube is placed with the tip approximately 6mm from the [[tympanic membrane]]. Next the hearing aid is put in place. The REM system will typically produce a test stimulus from a loudspeaker situated 12-15 inches from the patient's head and simultaneously measure the output in the ear canal to determine how much amplification the hearing aid is providing.<ref name=strategies2>{{cite book|last=Valente|first=Michael|title=Strategies for Selecting and Verifying Hearing Aid Fittings|date=1994|publisher=Thieme Medical Publishers|location=NY|isbn=0-86577-500-1|page=93–95|coauthor=John E. Tecca|chapter=5. Use of Real-Ear Measurements To Verify Hearing Aid Fittings}}</ref>
== Insertion Gain ==
== Insertion Gain ==


Revision as of 06:19, 28 March 2014

  • Comment: Please verify URLs in references and resubmit RadioFan (talk) 02:26, 11 March 2014 (UTC)
Ear with RIC hearing aid and real ear probe tube in place.
Real ear measurement showing probe microphone in place and RIC hearing aid.

Real Ear Measurement (REM, also known as insitu- or probe microphone measurement)[1] is the measurement of sound pressure level in a patient's ear canal developed when a hearing aid is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for an patient's hearing loss.[2] The American Speech–Language–Hearing Association (ASHA) and American Academy of Audiology (AAA) recommend real ear measures as the preferred method of verifying the performance of hearing aids.[3] [4] Used by audiologists and other hearing healthcare practitioners in the process of hearing aid fitting, real ear measures are the most reliable and efficient method for assessing the benefit provided by the amplification.[5] Measurement of the sound level in the ear canal allows the clinician to make informed judgements on audibility of sound in the ear and the effectiveness of hearing aid treatment.

The use of real ear measurement to assess the performance of hearing aids is covered in the ANSI specification Methods of Measurement of Real-Ear Performance Characteristics of Hearing Aids, ANSI S3.46-2013 (a revision of ANSI S3.46-1997).[6]

Method

Probe tubes used in real ear measurement.
Silicone probe tubes used for real ear measurement.

First, the clinician will examine the ear canal with the use of an otoscope to ensure no wax or other debris will interfere with the positioning of the probe tube. The probe tube is placed with the tip approximately 6mm from the tympanic membrane. Next the hearing aid is put in place. The REM system will typically produce a test stimulus from a loudspeaker situated 12-15 inches from the patient's head and simultaneously measure the output in the ear canal to determine how much amplification the hearing aid is providing.[7]

Insertion Gain

The traditional method of real ear measurement is known as insertion gain, which is the difference between the sound pressure level measured near the ear drum with a hearing aid in place, and the sound pressure level measured without. First a measurement is made with the probe tube in the open ear, then a second one is made using the same test signal with the hearing aid in place and turned on. The difference between these two results is the insertion gain. This gain can be matched to targets produced by various prescriptive formula based on the patient's audiogram or individual hearing loss.[8]

Speech Mapping

Speech mapping (also known as output-based measures) involves testing with a speech or speech-like signal, with the goal being to amplify it to the approximate middle of the patient's residual auditory area (the amplitude range between the patient's hearing threshold and upper limit of comfort). This allows the clinician to adjust the hearing aid to optimize speech audibility while avoiding loudness discomfort.[9]This approach to hearing aid testing is implemented in most current real ear systems and there has been a significant increase in audiologists selecting to verify using the output method.[10]Using an authentic speech signal to test a hearing aid gives the advantage that the hearing aid can be tested with all its special features operative. The impact of those features can be viewed just as they would normally affect speech in everyday life.[11]

See also

References

  1. ^ Stach, Brad (2003). Comprehensive Dictionary of Audiology (2nd ed.). Clifton Park NY: Thompson Delmar Learning. p. 167. ISBN 1-4018-4826-5.
  2. ^ Valente, Michael (1994). "Chapter 5". Strategies for Selecting and Verifying Hearing Aid Fittings. NY: Thieme Medical Publishers. p. 88. ISBN 0-86577-500-1. {{cite book}}: Unknown parameter |coauthor= ignored (|author= suggested) (help)
  3. ^ ASHA Ad Hoc Committee on Hearing Aid Selection and Fitting (1998). "Guidelines for Hearing Aid Fitting for Adults". American Journal of Audiology. 7 (5–13). doi:10.1044/1059-0889.0701.05. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help)
  4. ^ Valente, Michael (2007). "Guidelines for the Audiologic Management of Adult Hearing Impairment" (PDF). Retrieved 3 February 2014. {{cite web}}: Unknown parameter |DUPLICATE_last= ignored (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)[dead link]
  5. ^ Jack Katz (2009). "Chapter 38, Hearing Aid Fitting for Adults: Selection, Fitting, Verification, and Validation". Handbook of Clinical Audiology (6th ed.). Baltimore MD: Lippincott Williams & Wilkins. p. 858. ISBN 978-0-7817-8106-0. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  6. ^ ANSI/ASA Standard S3.46-2013 "Methods of Measurement of Real-Ear Performance Characteristics of Hearing Aids," Acoustical Society of America, Melville, New York, http://acousticalsociety.org/
  7. ^ Valente, Michael (1994). "5. Use of Real-Ear Measurements To Verify Hearing Aid Fittings". Strategies for Selecting and Verifying Hearing Aid Fittings. NY: Thieme Medical Publishers. p. 93–95. ISBN 0-86577-500-1. {{cite book}}: Unknown parameter |coauthor= ignored (|author= suggested) (help)
  8. ^ Valente, Michael (1994). "13. Aural Rehabilitation for Individuals with Severe and Profound Hearing Impairment: Hearing Aids, Cochlear Implants, Counseling, and Training". Strategies for Selecting and Verifying Hearing Aid Fittings. NY: Thieme Medical Publishers. p. 277. ISBN 0-86577-500-1. {{cite book}}: Unknown parameter |coauthor= ignored (|author= suggested) (help)
  9. ^ Moore, Brian C.J. (August 2006). "Speech mapping is a valuable tool for fitting and counseling patients". Hearing Journal. Vol 59 (8): 26, 28, 30. doi:10.1097/01.HJ.0000286371.07550.5b. Retrieved 6 February 2014. {{cite journal}}: |volume= has extra text (help)
  10. ^ Jack Katz (2009). "Chapter 38, Hearing Aid Fitting for Adults: Selection, Fitting, Verification, and Validation". Handbook of Clinical Audiology (6th ed.). Baltimore MD: Lippincott Williams & Wilkins. p. 859. ISBN 978-0-7817-8106-0. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  11. ^ Ross, Mark (2007). "Evaluating the Performance of a Hearing Aid in the Real-Ear". Rehabilitation Engineering Research Center on Hearing Enhancement. Gallaudet University. Retrieved 6 February 2014.

Category:Hearing Category:Health sciences Category:Ear procedures

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