Integrated Real Ear offers the benefit of a real ear measurement system without the burden of additional equipment, cost, and time. In the absence of a real ear measurement, Inspire uses an average RECD to estimate the hearing aid response in the ear (Predicted Real Ear Response). Integrated Real Ear measures the wearer’s real ear response and uses it to calculate a custom RECD. The custom, or Measured RECD, provides a more accurate estimate of the Real Ear Response and thus a more accurate target match. Integrated Real Ear in conjunction with Inspire provides a fast, easy and automatic way to integrate a real ear measurement in the fitting session. Integrated Real Ear results are also used in Speech Mapping and Verify Comfort resulting in more accurate displays.
Integrated Real
Ear can be performed through Auto Path
or by clicking on the Integrated Real Ear
icon
in
the center of most frequency adjustment screens. NOTE:
In order to avoid subjecting the patient to loud feedback, Integrated Real Ear (or Auto Path) should be launched BEFORE
the hearing aid and probe tube are inserted in the patient’s ear. Once
Integrated
Real Ear or Auto Path is launched, the hearing
aid is muted.
The process of obtaining the Measured Real Ear to Coupler Difference (RECD) is quick and easy. The hearing instrument generates a complex tone stimulus. A probe tube routes the resulting sound pressure level in the ear canal to the hearing aid microphone. The stored 2 cc coupler response is subtracted from the measured Real Ear Aided Response to get the RECD. The stimulus generation and measurement takes place in both ears at the same time. The following pictures depict the set-up for standard, custom and RIC products.
Once the Integrated Real Ear process is initiated, an animation will appear demonstrating the appropriate test set up.
Clicking on the Begin
icon 
will initiate the Real
Ear measurement. Once the measurement is complete, the screen will change
and display the RECD responses for the both ears.
The Integrated Real Ear screen provides two options for RECD: Measured RECD and Average RECD. When a measurement is completed, the RECD will default to Measured RECD.
The black dotted line on the graph shows the Average RECD that is used in Inspire in the absence of a measured RECD. The thin, blue line shows the measured RECD. The blue shaded region shows the difference between Average and Measured. In regions where the Measured RECD is above the Average RECD, less gain than average is needed to match target. In regions where the measured RECD is below the Average, more gain will be needed.
Once the Measured RECD is selected, the Target Match
button 
will become enabled and turn green.
When Target Match is selected,
the Real Ear Response will be modified based on the Measured RECD and
a new Target Match will be performed. Target Match differs from Best Fit
in that only gain and maximum output adjustments are made. Features such
as Acoustic Signature, Indicator Tones, and Directionality will not be
reset by Target Match. NOTE: Selecting
Measured RECD will not change the target, as the target is based on the
patient’s hearing loss.
If the real ear measurement cannot be completed, the following message will be displayed. Troubleshooting suggestions include repositioning the probe tube, checking for debris in the probe, and minimizing background noise.
In binaural fittings, individual ear measurements are recommended. In
cases where this is not possible (i.e. blocked canal or blocked probe
tube), Inspire provides an option to copy a measurement from one ear to
the other ear. Two icons, copy from the right ear
to the left 
and
copy from the left ear
to the right 
, are
located in the middle of the screen.
The vertical axis in the Real Ear view will display Measurement-Based Real Ear Response (dB SPL) when the Measured RECD has been selected, and Predicted Real Ear Response (dB SPL) when the Average RECD has been selected.
