REM and Tinnuitis and Phonak Audeo Sphere Infinio I90

@jpetr48 said:

I get is the technology is advanced that REM is no longer necessary

That’s just flannel; they ‘should’ have the option of using REM specifically with the Spheric Mode engaged to see if it’s reaching a target like Live Speech Mapping, while playing you a background noise source and engaging you in a Q&A.

so there is no confusion the REM is not a fitting formula for tinnuitis. Here is what I found using an ai chat. But ai is not alway right which is why I posted.
Real ear measurements (REM) are extremely important - they’re considered the gold standard for hearing aid fitting. Here’s why:

Critical Importance:

1. Verification vs. Estimation

• Manufacturer settings are based on averages
• Your ear canal’s unique shape/size affects sound delivery
• REM shows exactly what your ear is receiving
• Without REM, it’s like prescribing glasses without checking actual vision correction

2. For Your Specific Audiogram

• Verifies proper amplification across your sloping loss pattern
• Ensures high frequencies (where your tinnitus occurs) are receiving correct amplification
• Confirms low frequencies aren’t over-amplified given your good hearing there

3. Impact on Outcomes

• Studies show significantly higher satisfaction with REM-verified fittings
• Better speech understanding
• More consistent results
• Fewer return visits for adjustments

4. Tinnitus Management

• Critical for ensuring proper amplification at tinnitus frequencies
• Helps verify the hearing aid is providing appropriate sound therapy
• Particularly important given your high-frequency tinnitus

Red Flag: If an audiologist doesn’t offer REM or suggests it’s not necessary, consider finding one who does. It’s that important for optimal fitting.
here are the specifics based on my audiogram:
For your specific audiogram, here are the key REM measurements they should verify:

1. Target Match Points

• 250-1000 Hz: Minimal amplification (within 3-5 dB of target)
• 2000-4000 Hz: Critical match to targets (within 2-3 dB)
• 4000-8000 Hz: Precise match needed for tinnitus frequencies

2. Specific Measurements Needed

• REAR (Real Ear Aided Response)
  • Verifies actual output across frequencies
  • Particularly important at 4-8kHz where your tinnitus occurs
• REUG (Real Ear Unaided Gain)
  • Measures your natural ear canal resonance
  • Important because you have good low frequency hearing
• REIG (Real Ear Insertion Gain)
  • Shows exactly what the hearing aid is adding
  • Should match your sloping loss pattern

3. Speech Mapping

• Soft speech (55 dB) should be audible
• Normal speech (65 dB) should be comfortable
• Loud sounds (85 dB) shouldn’t be uncomfortable

4. Special Attention Areas

• Verify adequate gain at your tinnitus frequency
• Check for any unwanted peaks that might affect comfort
• Ensure the open dome isn’t causing too much sound leakage

Simple statement: it is a best practice. (For a reason). If you can’t get it for some reason (no HCPs in your country use it, or you are really limited to being remote because bed-ridden, etc) then good fitters can get you pretty close but it may be a more iterative process. My first fitting was done with REM and just worked. We did some stuff to add a program for tinnitus masking as a trial which I dropped later when I went with receivers incompatible with the tinnitus masking program. But the initial fitting wasn’t changed until I had another set of testing done.

I’d say get REM done if you can.

WH

From what I can see from the Target 10 documentation, Tinnitus Balance is a separate Global Tuning step.

My experience with my KS9s fitted at Costco, was that the second fitting (different technician) that used REM was way superior to my initial fitting without it.

Yes, REM has importance in fitting verification.

The AI doesn’t ’know’ what it’s trying to explain, but is using many arguments to justify its reasoning.

Proper REM ‘only’ needs to measure the output of the hearing aid at the eardrum (REAR) and show that on the screen. You keep the manufacturer’s software window open at the same time and adjust the aid and observe the change on screen.