Rehearsal Sound Exposure and Choir Singers' Hearing: A Pilot Field Study.

Exposure to high- and moderate-intensity sound is inevitable for professional singers during their working day, the majority of which is spent in rehearsal, preparing for a performance. The impact of self-produced sound exposure on singers' hearing within the rehearsal setting has not been examined. OBJECTIVES: This original pilot field study investigates the feasibility of data collection and hypothesis testing of singers' hearing within the rehearsal environment. METHODS: 18 professional choir singers are examined for hearing threshold changes following routine rehearsal sound exposure. Pure Tone Audiometry is measured before, immediately after, and approximately 24 hours after rehearsal. RESULTS: This study does not identify definitive Temporary Threshold Shift in this population under these conditions. That said, mean temporary threshold shift was found 3.61 dB higher than the recovery threshold shift in the right ear at 3000 Hz (P = 0.06), and this may be important to look at for future studies. CONCLUSIONS: Methodological challenges of this field study include dynamic experimental conditions intrinsic to the rehearsal process, environmental and musical influence on Pure Tone Audiometry results and estimation of sound intensity exposure.

Audiological findings in professionals exposed to music and their relation with tinnitus.

Professional musicians are at high risk of developing tinnitus due to their over-exposure to music at both occupational and recreational level. This is a 5-year long prospective case series study performed in the Musicians/Performing Arts Medicine Clinic of the 1st Otorhinolaryngology Department of the National and Kapodistrian University of Athens. A total of 274 professional musicians underwent thorough medical history, history of music exposure, assessment of the impact their hearing status has on their professional life (Musicians Hearing Handicap Index), behavioral (Pure Tone Audiometry, standard and extended high frequency) and objective audiometric tests (TEOAE and DPOAE). Standard pure tone audiometry thresholds were correlated with the presence of tinnitus only at high frequencies. Musicians with tinnitus had a clinical and significant higher MHHI score and the incidence of tinnitus was significantly higher in participants suffering from musculoskeletal disease and those with abnormal PTA. Participants' hours of practice were similar in those with tinnitus and those without. The tinnitus group (and in order of descending effect size) had significantly worse thresholds in high frequency audiometry (≥3000Hz) as well as lower signal to noise ratios in DPOAE at almost all frequencies and in TEOAE at high frequencies (2.8 and 4kHz). A subgroup analysis of the musicians with normal PTA, showed that those with tinnitus showed elevated thresholds in the extended high frequency. In conclusion, tinnitus occurrence in musicians with normal audiogram is potentially correlated with high frequency hearing loss and impaired otoacoustic emissions and these two examinations should be considered in this group.

Musicians' Hearing Handicap Index: A New Questionnaire to Assess the Impact of Hearing Impairment in Musicians and Other Music Professionals.

Purpose We aimed to develop and validate the Musicians' Hearing Handicap Index (MHHI), a new self-evaluation tool for quantifying occupation-related auditory difficulties in music professionals. Although pure-tone audiometry is often considered the "gold standard" and is usually employed as the main instrument for hearing assessment, it cannot fully describe the impact of hearing dysfunction. The MHHI is an attempt to complement the hearing impairment assessment toolbox and is based on a unique approach to quantify the effects of hearing-related symptoms or hearing loss on the performance of musicians and other music industry professionals. Method An initial set of 143 questionnaire items was successively refined through a series of critical appraisals, modifications, and suggestions. This yielded an intermediate questionnaire consisting of 43 items, which was administered to 204 musicians and sound engineers. After exploratory factor analysis, the final form of the MHHI questionnaire was obtained, consisting of 29 items. The questionnaire's test-retest reliability, internal consistency, discriminating power, content validity, criterion validity, and aspects of construct validity and inherent conceptual structure were assessed. Results Exploratory factor analysis revealed a combination of four common factors for the 29 validated questionnaire items. They were named "impact on social and working lives," "difficulties in performance and sound perception," "communication difficulties," and "emotional distress." The MHHI was shown to be a valid and reliable instrument to assess musicians' and sound engineers' occupational difficulties due to hearing impairment and related symptoms. Conclusion The ability of the MHHI to discriminate between groups of music professionals with different auditory symptoms or pure-tone audiometry thresholds suggests that auditory symptoms might influence a professional's performance to an extent that cannot be assessed by a pure-tone audiogram.