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Musicians with Hearing Loss -- Performing with Hearing Impairment -- Bassoon Session 1 Music and Medicine on Monday

Submitted by emolotkova on Mon, 08/12/2024 - 08:22

Music and Medicine on Monday (M+M+M) at the University of Iowa - Schedule of Events and Disclaimer

see also: Hearing Protection for All Musicians - Three Trombone Example -- Music and Medicine on Monday

Protocol page initiated Aug 2024 Evgeniya Molotkova BS, Henry Hoffman MD

Musician with Hearing Loss Adapts to Make it His Super Power (60 seconds):

 

Musicians Hear Music Differently Than the Audience (60 seconds):

Hidden Hearing Loss in Musicians (90 seconds):

Resources for Musicians with Hearing Loss (90 seconds):

 

Full Session with Performance:

 

Definitions

Hearing Threshold: The minimum level of sound that someone can hear (measured in decibels (dB)). In order for a sound to be audible, it must be above this threshold. For reference, a quiet conversation is approximately 20 dB and loud music at a concert is 120 dB (InformedHealth.org).

Hearing Impairment: A condition in which a person is not able to hear as well as someone with normal hearing (defined as a hearing threshold of 20 dB or lower, bilaterally). There are many causes of hearing impairment, and they can cause a sensorineural, conductive, or mixed hearing loss. If not adequately addressed, a hearing impairment may negatively impact communication, cognition (especially in older adults), and the ability to perform daily tasks (World Health Organization, 2024). 

  • Sensorineural Hearing Loss refers to hearing loss that it caused by a defect before the cochlea (ex. the hair cells or brain) (Anastasiadou and Al Khalili, 2023)
  • Conductive Hearing Loss refers to hearing loss that is caused by a defect in a structure after the cochlea (ex. tympanic membrane) (Anastasiadou and Al Khalili, 2023)

    see also: How to Read an Audiogram

  • Pure Tone Average (PTA) is a common way of summarizing audiometric findings. It takes the average of each ear's hearing threshold at 500, 1000, and 2000 Hz. One drawback of PTA is that it does not accurately represent hearing loss at extreme frequencies (Carl et al, 2024)

  • Discrimination is a person's ability to understand and discern speech and includes perception of changes in volume, duration, and frequency of sounds. This type of hearing impairment may be difficult to pick up on audiometry and is often called "hidden hearing loss (Guzek et al, 2023)" 

Hearing Aid: A device that amplifies sound by converting the acoustic energy of sound waves to electrical energy, which is then converted back to acoustic energy that can be projected into the ear. Hearing aids can be further subdivided into non-invasive/non-implanted hearing aids and surgically implanted hearing aids (Schuster-Bruce and Gosnell, 2022)

    see also: Hearing Aid (HA): Pages for HA Users and family

Cochlear Implant: A type of hearing aid that uses electricity to directly stimulate the spiral ganglion cells of the auditory nerve, bypassing "damaged" hearing structures and effectively treating sensorineural hearing loss (Krogmann and Al Khalili, 2023). 

    see also: Cochlear Implant (CI): Pages for CI Users and family

    see also: Cochlear Implant (CI) and Music

Permanent Threshold Shift (PTS) refer to a permanent loss of sensitivity to sound; as per Hertanzo et al (2020) may result from loss of neuronal connections, outer hair cell loss and disruption of the integrity of the organ of Corti. 

Tinnitus is the perception of sound in the absence of an external acoustic stimulus. The word tinnitus arises from Latin word 'tinnire" which means 'to ring'. (Chari and Limb 2018).  Hertzano (2020) affirmed that "all tinnitus are associated wtih some form of hearing loss" and tinnitus is "an early symptom of an underlying auditory injury before measurable audio metric changes.". There are many causes of tinnitus- among the most common are associated with sensorineural hearing loss  attributable to aging, prolonged noise exposure and head injury.

 

Resources

 

Background

see: Musicians Who Use Hearing Aids

see: Musicians With Hearing Aids: Information for Audiologists

see: Hearing Aid (HA) and Music

see: Musicians With Cochlear Implants (CIs): Singing or Playing Instruments While Using Cochlear Implants

see: Musicians With Cochlear Implants (CIs): Singing or Playing Instruments While Using Cochlear Implants: Information for Audiologists

see: Music-Induced Hearing Loss

see: Music and Coping with Hearing Loss

 

Hearing Aids and Music Perception

Hearing aids (HAs) have been demonstrated to improve health-realted, patient quality of life. However, there has been little research (until more recently) that has addressed hearing aids in the context of music perception. HAs have been designed primarily to improve speech perception. Several unique characteristics/mechanisms of hearing aids make speech more intelligble at the expense of being able to perceive music. Several studies have underscored this issue, as many hearing aid users report some degree of their hearing aids interfering with their ability to listen to music. Thus, hearing aids may pose a significant challenge to professional musicians. According to a recent qualitative study by Vaisberg and colleagues, these challenges may be subdivided into categories including difficulty hearing the composer, sound quality of hearing aids, and perception of music with hearing aids (Vaisberg et al, 2019).

 

Hearing Protection

  • Musician earplugs
    • A type of earplug that fits into the ear and reduces noise exposure levels equally across the spectrum of tone and pitch in order to reduce distortion of the overall sound. Generally, musician earplugs attenuate sound less than regular earplugs, as this may contribute to poor perception of music. Overattenuation affects the listening experience and may decrease consistent use (Bockstael et al, 2015)
  • Sound shields
    • Sound shields are large, flat pieces of material placed between musicians to attenuate sound coming from instruments. Several studies have shown that sound shields do offer some degree of attenutation under certain conditions, but this may vary based on the arrangement of musicians and their instruments and the piece being played (Libera, 2010)(O'Brien et al, 2013)

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References

InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Hearing loss and deafness: Normal hearing and impaired hearing. 2008 May 15 [Updated 2017 Nov 30]

“Deafness and Hearing Loss.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss. Accessed 5 Sept. 2024. 

Anastasiadou S, Al Khalili Y. Hearing Loss StatPearls. Treasure Island (FL), 2024.

Carl AC, Hohman MH, Cornejo J. Audiology Pure Tone Evaluation StatPearls. Treasure Island (FL), 2024.

Guzek A, Iwanicka-Pronicka K. Auditory Discrimination-A Missing Piece of Speech and Language Development: A Study on 6-9-Year-Old Children with Auditory Processing Disorder. Brain Sci 2023; 13.

Schuster-Bruce J, Gosnell E. Conventional Hearing Aid Indications and Selection StatPearls. Treasure Island (FL), 2024.

Krogmann RJ, Al Khalili Y. Cochlear Implants StatPearls. Treasure Island (FL), 2024.

Milon B, Shulman ED, So KSet al. A cell-type-specific atlas of the inner ear transcriptional response to acoustic trauma. Cell Rep 2021; 36:109758.

Chari DA, Limb CJ. Tinnitus. Med Clin North Am 2018; 102:1081-1093.

Vaisberg JM, Martindale AT, Folkeard P, Benedict C. A Qualitative Study of the Effects of Hearing Loss and Hearing Aid Use on Music Perception in Performing Musicians. J Am Acad Audiol 2019; 30:856-870.

Bockstael, Annelies; Keppler, Hannah1; Botteldooren, Dick. Musician earplugs: Appreciation and protection. Noise and Health 17(77):p 198-208, Jul–Aug 2015. | DOI: 10.4103/1463-1741.160688 

Libera, Rebecca. "Shielding sound: A study on the effectiveness of acoustic shields." Journal of Band Research 45.2 (2010): 23-41.

O'Brien, Ian, Judy Wood, and Bronwen Ackermann. "ASSESSMENT OF AN ACOUSTIC SCREEN USED FOR SOUND EXPOSURE MANAGEMENT IN A PROFESSIONAL ORCHESTRA." Acoustics Australia 41.2 (2013).