Skip to content
HearingTracker
Log in

Your Audiologist is Wrong: Real Ear Measurements are ESSENTIAL for Your Hearing Aids to Work Well

154 replies6.3k viewsLast reply

Jump
Link to this topic
Reply

That’s an important note.

I was trying to understand how compression was helping with loudness for @Bimodal_user for whatever level of sound it was desirable to control.

In reply to @Neville

@Neville said:

Do you have really tiny ears? Or custom tips that are so deep that they basically reach your brain?

Not really. 3 cm deep ear canal (2.8 cm depth of mic probe). Looking at my ear impression, which photo I sent you a few weeks ago - UP receiver should fit with no problem.

Regarding “so deep” part of quote - my power domes from the Sphere were really deep - the tip at 23 mm?

Edited

Perhaps I exaggerated my , based on relatively quiet my laptop speakers.

@user490, interesting that remains the same after , but the comfort of walking on the street increased exponentially - I no longer feel fear of passing vehicles on sound signals, such as the police, ambulance or fire brigade.

There is still a problem with cars that have illegally modified exhaust silencers (mainly old BMWs, at least in Poland).
A former acquaintance of mine with no shame bragged that his motorcycle could produce 120 of sound.
No hearing aid with closed coupling could protect you from that.

In reply to @cvkemp

Okay Chuck, you hit the nail on the head with this statement. You are well respected on this forum. Your statement is prejudice in the fact that no all people had the family life that you have experienced. Your statement really hit me between the eyes about people expecting miracles because that was me when it came to my hearing loss. I did not know that until I read your statement just now. I was diagnosed with hearing loss in 2007 and in 2010 because of an ear infection it became severe and profound hearing loss. Most audiologists do not know how to treat S&P hearing loss as you well know. The private audiologist I was going to from 2010 to 2017 did not know how to treat S&P hearing loss. I was fitted with Phonak Nadia UP 50 in 2014 but did not take the time to get them fitted right. That has mystified until now. I was looking for a miracle and the miracle in 2017. The private hearing aid store was run by the Phonak parent company. From about 2012 to 2017 I had five different audiologists. The last one changed everything when It came to my hearing loss. He fitted me with Phonak audio’s and set them to where they were blaring in my ears. My brain had gotten lazy. I did not think to turn them down during the trial period. When he told me the price I turned him down. I went to Costco because of the price. But again the hearing specialist did not how to deal with S&P hearing loss. Sorry you are getting my hearing journey. Next audiologist came the . They wanted to set my hearing aids to the report, but that was painful so the hearing aids had to be set back a ways. About 2020 I wanted to get the Bluetooth hearing aids. Even with the upgraded hearing aids from the VA 2017 phone conversation was terrible. In 2020 I met a very helpful and informative audiologist even though she was new and had very little experience with S&P hearing loss like I said she was very helpful. To back track here in 2017 I realized that I needed to take responsibility for my hearing loss. She helped me a lot with making adjustments to my hearing aids. Now in 2025 my favorite audiologist in Kansas City only does hearing tests and not adjustments which is disappointing but it is what is, right Chuck? I’m grateful to the VA for providing me with hearing aids. Sorry about the long post but it is about my hearing aid journey.

Your post is welcomed. I am getting ready for my next hearing appointment in early November. While I love my Oticon INTENT1 aids, I am at a crossroads, I am seriously thinking about switching hearing aid brands. Over the last few appointments and a number of emails my audiologist of 7 years has been hinting at switching brands of hearing aids. So I have been researching the different brands of hearing aids. I started my journey with aids and would like to return to ITE aids. But I have come to trust my audiologist so I will listen intently to his guidance. For a couple of months we have been exchanging emails and I have been giving him my thoughts. I am a researcher and have a list of options with the pros and cons of them. If given a choice I am thinking about trying the Phonak Virtio R infinio in the canal aids. But as I said I will not go against my audiologist.

Thanks for your reply, Chuck. A couple of months ago I asked my audiologist for word recognition software and was approved. Word recognition is retraining the brain so to speak. I have very poor word recognition and I have a lot of anxiety about doing the work. I probably ought to say something to her. She does not have an email. If I want to talk to her it has to go through the dept. Which is not a problem but it takes time to reach.

Roy

Real Ear Measurement - yes please. In the UK’s impoverished health system it was applied to me just once, 25 years ago, using as I recall no more than three tone frequencies.

So now I have a question: a very quick way to assess the response of any system - a loudspeaker, room nodes etc - is with multi tones played simultaneously. Up to 30 of them. The response (via microphone or in the clinical situation ear-probe) is then fed to a spectrum analyser (free iPhone app) where you immediately see peaks, troughs, general trend.

As trained sound recordist I have found multi-tone great as a first check. Not highly accurate, you need wobbulated tone for that, but it lets you ‘tweak’ on the fly

You can’t run pure tone on modern aids as they recognise it’s not speech and could be feedback. This is really bad advice.

Even pseudo-random and speech weighted noise yield the wrong results.

You need to use a measured actual speech signal or Live Speech.

Edited
@Hearing_Potential said:

Why is your audiologist using insertion gain rather than speech mapping?

That’s what I call “tradition”. I read a book on that clearly stated that people use in some parts of the world and REAG in others. The equipment was MedRx in my case. I am not sure what do you mean writing “speech mapping”, I have though that ISTS is validated standard of input sound.

I don’t know, why was used instead of REAG or REAR. Maybe because insertion gain is default presentation in Phonak Target Software? :thinking::thinking::thinking:

@Hearing_Potential said:

Were the real-ear measurements performed using the dedicated Phonak measurement mode given it doesn’t appear that speech stimuli were used?

Yes, that was using TargetMatch from Phonak with MedRx software.

@Hearing_Potential said:

Ah, are you self-fitting here?

Yes, that’s a lifesaver. Much better experiences since doing it. For example, I realised that despite my theoretical fitting range is for M receiver, I am better not only with P, but even with UP receiver due to more mid- and high frequency gain.

And I have the best results with no vent despite my near normal low frequency hearing (I feel no occlusion effect):

P receiv Unitron power domes I90 Sphere Zrzut ekranu 2026-07-21 021527 (1)
UP receiv cShell titan no vent I90 Sphere Zrzut ekranu 2026-07-21 021527

I think the best results I would have with Naida SP, but its unavailable in Infinio Sphere generation.

Experimented with simulation with another and theoretically, the best coverage, even in highest frequencies I would have with Virto Infinio SP .

In reply to @tenkan

A thought

Hearing Aids are medical equipment

Yet every prescription is unique.

helps. I’ve experienced the results. Yet this REM isn’t used by many fitters.

And I expect the do-it-yourself programmers don’t use REM with target.

I hope to try RL3 soon

I’d sure like to be able to understand speech. In quiet and noise

DaveL my Paradise P90s as setup by my dispensing fitter certainly aren’t medical equipment.

Related discussions