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Updated: Aug 7, 2026

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
The influence of RECD transducer when deriving real-ear sound pressure level
Kevin J Munro1, Kerri E Millward
1School of Psychological Sciences, University of Manchester, United Kingdom. kevin.munro@manchester.ac.uk
Objective:
The main aim of the present study was to compare the derived and directly measured real-ear hearing instrument performance for a range of commonly used hearing instruments. A secondary aim was to compare the real-ear to coupler difference (RECD) measured using the ER-3A insert earphone and a selection of hearing instruments.
Design:
The real-ear SPL was measured for four models of hearing instrument in 20 adult participants using an Audioscan RM500 real-ear system. This was compared with the derived real-ear SPL obtained by adding the RECD (measured using the ER-3A insert earphone) to the 2-cc coupler response of each hearing instrument. Measurements were made at 1/12 octave intervals from 0.2 to 6 kHz, using both the HA1 and HA2 2-cc coupler. In addition, the RECD was measured using four models of hearing instrument for comparison with the ER-3A insert earphone values.
Results:
The procedures were very reliable with mean differences on retest of less than 1 dB. Repeated-measures analysis of variance revealed statistically significant differences between the measured and derived real-ear SPL (p < 0.001) for several models of hearing instrument. The derived responses using the HA1 coupler yielded good accuracy, whereas the HA2 yielded less accuracy. For three models of hearing instrument, the maximum difference was between 5 and 10 dB when using the HA2 coupler. The mean RECD measured with the ER-3A insert earphone and HA2 coupler was not always equivalent to the RECD measured with the hearing instruments.
Conclusions:
The accuracy of the derived real-ear response obtained using an RECD, measured with an ER-3A insert earphone, is very good when an HA1 is used for the coupler component of the RECD. The accuracy diminishes somewhat with the HA2 coupler, especially for undamped hearing instruments. The accuracy of the derived real-ear response is very good when the RECD is measured using the hearing instrument and the HA1 or the HA2 coupler.
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