AES 2018 International Conference On Music Induced Hearing Disorders
Music for Brain Health
Northwestern University, Evanston, IL
Although it is all around us all of the time, we rarely give much thought to our invisible yet powerful companion, sound. It shapes our brains for better and worse. Learning a second language or playing a musical instrument sharpens our brains. Lack of exposure to meaningful sound and overexposure to meaningless sound blunts our brains and stunts our development. There are ways to capture the imprint that sounds leave on our nervous systems, empowering us to learn more and more about this invisible ally and enemy of brain health.
Making sense of sound engages our entire brain: there is a wide activation of sensorimotor, cognitive, and reward circuitry. Active and repeated engagement with sounds that activate all these circuits, therefore, is a route to honing our brain function. Playing music is like hitting the jackpot for the brain because it requires the motor system, deeply engages our emotions, and absolutely gives us a cognitive workout. We have employed a biological approach to reveal the integrity of sound processing in the brain and how these brain processes are shaped by music training. We have found that music works in synergistic partnerships with language skills and the ability to make sense of speech in noisy, everyday listening environments. We have found that music brings about a “speeding” of auditory system development, and a tendency toward a reversal of the biological impact of poverty-induced linguistic deprivation. The generalization from music to everyday communication illustrates both that these auditory brain mechanisms have a profound potential for plasticity and that sound processing is biologically intertwined with listening and language skills. Playing music gives the brain the tools to make sense of sound. These findings have the potential to inform health care, education, and social policy by lending a neurobiological perspective to the efficacy of music for improving auditory communication skills.
Hearing Protection Goes Digital
Tron Vedul Tronstad, PhD, (Murdock University)
Hearing loss is one of the most common occupational health issues in the world. Despite much focus on noise abatement and hearing conservation programs, still many workers suffer from noise-induced hearing loss (NIHL).
One of the challenges with many hearing conservation programs is that they are based on performing tests only once every three years, which means that a hearing loss might go undetected for long periods. Additionally, there is quite a large uncertainty in the standard hearing threshold measurement method, which leads to that a threshold shift of at least 15 dB is required to reliably conclude that NIHL might be present. Together this leads to a very reactive hearing test regime, where large hearing threshold shifts must be present before any counteractions are initiated.
The presentation will present a new hearing monitoring regime, using much more frequent hearing measurements and statistical process control, that can detect small (<5 dB) hearing threshold shifts. This new regime could be used to initiate individual counteractions that aim at preventing further negative developments.
Disorders of Sound Tolerance
East Tennessee State University; Department of Audiology and Speech Language Pathology; Johnson City, TN
James H. Quillen
Mountain Home VA Medical Center; Johnson City, TN
A variety of unusual and challenging auditory events may affect musicians and recording engineers, particularly when associated with perceptions of excessive loudness, pitch anomalies, aversions to specific sounds, and the sensation of pain in the ears. This presentation will review mechanisms associated with disordered sound tolerance (DST), including exposure characteristics, and the many physiologic changes that result in unusual auditory symptoms such as tinnitus, hyperacusis, diplacusis, and auditory nociception, or the sensation of pain in the ears triggered by sound. Consensus regarding terminology of symptoms of DST is lacking among hearing health care professionals; labeling schemes related to elements of DST will be reviewed. Relations between audiometric status and DST will be reviewed.
Musicians and the Prevention of Hearing Loss
Musicians’ Clinics of Canada, Toronto, Ontario, Canada
Music exposure can pose a problem, especially with the advent of “portable” music. Despite the complexity of the human auditory system, it does not know the difference between industrial noise and music. Indeed, many of the factors can equally affect music exposure as well as industrial exposure. This talk is an overview of those factors affecting hearing for musicians as well as environmental strategies and hearing protection to minimize the potential damaging effects of music.
Otoacoustic Emissions in Band Musicians with Music Overexposure
S. Krishnamurti, K. Mecaskey, R. Thaxton, S. Peeler
Auburn University, Auburn, Alabama, USA
Otoacoustic emissions (OAEs) were recorded in participants from three groups: 1) non-band students, 2) marching band students 2) band directors. OAE results were compared across 190 ears of non-band students, 320 of band musicians, and 128 ears of band directors. There were highly significant differences between participants in terms of OAE amplitude. The greatest OAE amplitudes were found for non-band student musicians, followed by student band musicians, and the least amplitudes were found in band directors.
Hidden Hearing Loss from Sound Overexposure
Sharon G. Kujawa, PhD
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Exposure to high-level sound can damage the sensory hair cells of the cochlea, producing overt threshold sensitivity losses revealed on the clinical audiogram. Recent studies in our laboratories have shown, however, that well before the audiogram provides evidence for this loss, a more insidious process is occurring that doesn’t kill hair cells, but instead, permanently interrupts their communication (synapses) with cochlear neurons. This cochlear synaptic loss can be dramatic, even when thresholds return to normal after exposure, where it has been called ‘hidden hearing loss.’ The injury changes the way ears and hearing age, long after the exposure has stopped, and likely contributes to difficulties hearing in more challenging listening environments, for example, in noise and reverberation. It may be an important instigator of changes that result in tinnitus, the sensation of phantom sounds, and hyperacusis, a reduced tolerance to moderate-level sounds. These sobering findings have important implications for musicians and others involved in music recording and production activities, as they are at high risk for these consequences of sound overexposure.
Work supported by grants from the National Institutes of Health (NIH/NIDCD), Department of Defense and Office of Naval Research.
Computational Models to Predict Safety Limits for Aided Music Listening
GN Advanced Science, Glenview, Illinois
Earl E. Johnson
James H. Quillen VA Medical Center, Mountain Home, TN, USA
Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN, USA
At equal sound exposure levels, listeners with a pre-existing hearing loss are less vulnerable to music-induced hearing damage than listeners with no hearing loss. But such listeners require and often prefer to listen to music with additional amplification. But how much gain and to what output levels (in dB) are safe is somewhat unknown at this time. In this study, we use computational models to predict hearing threshold shifts from amplified music exposure. We estimate safe output limits and corresponding free-field exposure limits for listening to music with hearing amplification by minimizing permanent and temporary threshold shifts.
Investigating the Use of Sound Level Management Software in Live Indoor Music Venues
Elizabeth Francis Beach1,4
1 The HEARing Cooperative Research Centre, Melbourne, Australia
2 Department of Audiology & Speech Pathology, the University of Melbourne, Australia
3 Murdoch University, Perth, Australia
4 the National Acoustic Laboratories, Sydney, Australia
Risks to the hearing health of patrons and staff in the music industry have been documented for decades, yet there has been little progress in terms of effectively managing sound levels to mitigate the risk. This study aimed to investigate whether the use of sound level management software (10EaZy) could have a positive impact on the sound level exposure of patrons and staff within indoor live music venues of the City of Melbourne. The study included surveys of patrons and staff, which asked about hearing health, use of hearing protection and their impression of the sound levels within the venue.
Hidden Hearing Loss Effects of Recreational Sound Exposure on Auditory Function
Colleen G. Le Prell and Edward Lobarinas
University of Texas at Dallas
University of Mississippi Medical Center, Jackson, Mississippi
Our recent studies assessing young-adult college student cohorts from diverse geographic regions have failed to detect statistically significant relationships between various audiometric measures and self-reported recreational noise exposure history. All studies collected retrospective cross-sectional data; in addition, a subset of subjects were followed prospectively to assess potential auditory effects of new loud recreational activities. Testing has included tympanometry, pure-tone detection thresholds, word-in-noise identification tests, distortion product otoacoustic emission (DPOAE) amplitude, and auditory brainstem response (ABR) amplitude measurements. There have been no reliable relationships between self-reported recreational noise history and auditory function in young adult populations from Nashville (Tennessee), Gainesville (Florida), and Dallas (Texas). In a single study assessing changes in function following loud recreational event exposures, temporary word-in-noise deficits were detected as a function of increasing noise exposure dose, but ABR amplitude was unchanged. Taken together, temporary changes in function have largely been restricted to changes on the word-in-noise test and no permanent deficits have been observed in association with recreational sound exposure.
Music and Hearing Aids
Musicians’ Clinics of Canada, Toronto, Ontario, Canada
Given the limitations of most modern digital hearing aids to handle the more intense inputs that are characteristic of many forms of music, there are a number of clinical strategies and technologies that an audiologist may use to alter the electro-acoustic characteristics of hearing aids that otherwise work quite well for their clientele for speech.
Best Practices for Fitting, Dispensing, and Verifying Hearing Protection Devices for Musicians
Cory D.F. Portnuff
UCHealth Hearing and Balance Clinic, University of Colorado Hospital, Aurora, CO
Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
Several types of hearing protection devices (HPDs) are marketed to musicians. Some types, theoretically, provide better sound quality which is more desirable to a musician. Unfortunately, there is presently little guidance on choosing appropriate HPDs for musicians and on clinical methods of measuring attenuation of HPDs. This paper reports on study data evaluating different procedures for HPD measurement to determine the most effective and efficient clinical verification protocols using several different methods. This paper discusses recommendations and best use of these in clinical practice derived from this data. The paper then presents a series of best practices for audiologists in choosing, fitting, dispensing, and verifying hearing protection for musicians.
Development of Guidelines for Protecting the Hearing of Patrons at Music Venues: Practicalities, Pitfalls, and Making Progress
Elizabeth Francis Beach
The HEARing CRC, Melbourne, Australia
National Acoustic Laboratories, Macquarie University, Australia
Murdoch University, Perth, Australia
Queensland Conservatorium of Music, Griffith University, Brisbane, Australia
This paper will describe the efforts of an Australian-based multidisciplinary working group to develop guidelines for protecting the hearing of patrons at music venues. As a starting point, the group considered the various European standards and regulations that require venue operators to limit the sound levels emitted at venues, provide hearing protection, information for patrons, and sound level monitoring. Following an iterative drafting process which incorporated feedback from group members, a consensus document was produced which included agreed requirements relating to hearing protection, information for patrons, and sound level monitoring. The most challenging aspect was reaching agreement on sound level limits, where a number of different views needed to be accommodated.
The Lantos 3D Scanning System and Computer Aided Design of Musicians Earplugs
Brian Fligor, PhD, PASC (Lantos Technologies)
Musicians EarplugsTM (MEPs) are custom-fitted passive hearing protection devices that are intended to maintain the relative loudness of sound across frequencies, while providing a modest amount of attenuation. To achieve the intended performance, the earplug must be sufficiently long (past the ear canal’s 2nd bend) and the earplug’s hollow sound bore must have acoustic mass that falls within manufacturer specifications. Herein, we report the performance of MEPs made from Lantos ear scans and digitally manufactured to correct acoustic specifications for a cohort of ears. Data showing the uniformity of attenuation and occlusion effect magnitude will be presented for earplugs manufactured to specification, as well as earplugs purposely deviating from specification, to demonstrate the control in the manufacturing process.