Hearing Assessment of Orchestra and Marching Band Music Students

• Main Authors: Zweigart, Elizabeth, Wines, Jordan
• Format: Others
• Published: Digital Commons @ East Tennessee State University 2020
• Subjects: Hearing; Tinnitus; Music; Student; Audiology; Public Health
• Online Access: https://dc.etsu.edu/asrf/2020/presentations/27; https://dc.etsu.edu/cgi/viewcontent.cgi?article=1497&context=asrf

Musicians are a unique population in the world of audiology. It has been reported that on average, they exceed the recommended daily dose of noise exposure before the middle of their day. This significantly increases the risk of a permanent noise- or music- induced hearing loss. Such a hearing loss may influence their perception of timbre, pitch, and loudness thereby affecting their ability to play and enjoy music. Therefore, early identification of hearing problems is critical to this population. Twelve subjects with a variety of musical backgrounds and experiences were recruited for the study that had three primary purposes. The first was to design and implement a sensitive hearing assessment protocol to identify early signs of hearing loss in young musicians. The second was to determine the presence and significance of hearing loss, tinnitus (perception of sound when no actual external signal is present, commonly referred to as “ringing in the ears”), and hyperacusis (experience of everyday life sounds being perceived as intrusively loud, uncomfortable, or even painful) among musicians. The third was to determine if and when hearing protection devices were used in this population. All subjects completed a thorough case history that included history of noise exposure, musical background, habits and preferences for hearing protection device use, as well as screening for mental and physical health concerns. When indicated by patient responses to the case history, questionnaires about tinnitus, vertigo, hyperacusis, and hearing were administered and scored. The test battery included an evaluation of middle-ear function (otoscopy, tympanometry, and acoustic reflex), cochlear function based on distortion product otoacoustic emissions (DPOAEs), audiometry using conventional test frequencies (0.25-8 kHz) and extended high-frequencies (8-16 kHz), and the Words in Noise (WIN) test which uses monosyllabic words to quantify the loss of speech understanding in adverse listening situations. Results revealed that six subjects experience bothersome tinnitus (four, of whom had WIN scores in the mild range and three of whom reported hyperacusis). One of these seven also had absent DPOAES, absent acoustic reflexes, and a mild to moderate hearing loss from 6 – 16kHz. Case history indicated that the majority of subjects were not using hearing protection devices, suggesting a need for further education and preventative efforts. It also revealed a positive trend between anxiety/depression and tinnitus, hyperacusis, and dizziness severity. In our test protocol the WIN test was the most effective tool for identifying difficulty in adverse listening situations but asking subjects about experiencing tinnitus was a more reliable predictor of functional change to the auditory system (even in patients with thresholdsfrequencies). Together, these assessments could provide clinicians, musicians, and school administrators the value of music students using hearing protection when practicing, performing, or attending live shows.