Tag Archives: ears

acoustic shock

Too Loud, Too Close, Too Long: Musicians Suffer Career Ending Acoustic Shock

acoustic shockIn the symphonic world, a crescendo makes for a dramatic finale, but it can have serious consequences for musicians. Recently, in an unprecedented court ruling, British viola player Chris Goldscheider, 40, won a landmark High Court judgment against Royal Opera House when he suffered career ending hearing loss from a rehearsal of Wagner’s Die Walkure. Seated directly in front of the brass section, he suffered acoustic shock, the result of sound that exceeded 130 decibels.

It’s a story that cellist Janet Horvath knows too well. The former associate principal cello for the Minnesota Orchestra, sustained an acoustic-shock injury to her left ear in 2006 after a one-time concert.

That night, the drum set, piano, electric guitars, keyboard, and conductor were positioned directly in front of her for a pops concert that included Broadway singers. Horvath was wearing musician’s earplugs, but one speaker was no more than two feet from her left ear. Eight speakers blasted music back toward the musicians. She says, “I felt it instantly; it was excruciating. When the concert was over, I took out my earplugs and could not bear to hear anyone talking. It never subsided.” She took a few months off to heal, but she needed to wear her left earplug. She compensated, relying on her right ear, and continued to be exposed to high decibels.

By 2009, her right ear, like the left, could no longer tolerate normal sound. After several doctors, she was diagnosed with hyperacusis, an auditory injury caused by repeated exposure to high decibels or a single acoustic shock. In 2010, she had to leave the orchestra that was her home for nearly 34 years.

She says, “It was characterized by abnormal sensitivity—the total breakdown of tolerance to all sound. I couldn’t leave the house. There was pain in my ear, teeth, tongue, it radiated down my neck. You actually fear sound. Many people with hyperacusis become hermits.”

The problem is prevalent, especially among woodwind players, Horvath says. “There is more awareness of the condition and I was lucky to have found physicians who helped me retrain my brain. I was fitted with special hearing aids, which turned sound down.”

“It was painstaking training that took more than two years of slowly increasing sound. I am aware of limits and decibels,” she says. Today she is mostly cured, but avoids loud restaurants and sports events. She can finally attend concerts and plays chamber music.

Noise-induced hearing loss is a combination of exposure time, noise level, peak level, and proximity to the sound. Being aware of decibel levels is important. Horvath explains, “If you know you will be playing Mahler, it’s not a day to mow your lawn.” Horvath maintains that silence is as critical to musicians as making sound. “It would be smart to have rooms where musicians can go to have silence.”

Minnesota Orchestra has an audiologist come in to offer hearing tests and fit musicians for earplugs. According to Horvath, this could be precedent-setting. No one wants to get sued so they’re now willing to take further steps to protect their musicians’ hearing. She hopes, too, that conductors will begin to alternate the repertoire to give musicians a break.

OSHA limits the number of decibels one can be exposed to per day. The decibel level of an average two-hour concert generally exceeds OSHA’s recommendations. And there are no regulations for intermittent loud blasts. Horvath adds that OSHA only talks about hearing loss as a disability when you can no longer hear speech. 

In the hall where the Minnesota Orchestra regularly performs, they have made modifications. “Our orchestra has always been on the cutting edge, partly because of my work. Their stage manager was one of the first to build a Plexiglass shield,” she says.

Horvath has written a number of books, including Playing Less Hurt: An Injury Prevention Guide for Musicians. She is a recognized authority in the area of medical problems of musicians and a recipient of the Richard J. Lederman Lecture Award presented by the Performing Arts Medicine Association. She conducts seminars across the country and regularly appears on national radio and television.

When the Sound Won’t Stop – 3 Ways to Battle Tinnitus

For musicians, tinnitus is an occupational hazard. Beethoven was famously afflicted. According to Hearing Education and Awareness for Rockers (HEAR), nearly 60% of the Rock and Roll Hall of Fame’s inductees are hearing impaired, many suffering from bouts of tinnitus. Although almost always described as a constant ringing in the ears, there is a litany of sounds that sufferers ascribe to the noise: clicking, humming, hissing, buzzing, piercing, throbbing, roaring, whooshing, or chirping—much like an orchestra of cicadas. 

Following a deafening noise, a car accident, or an especially loud concert, the average person will experience some form of tinnitus, but only a small percentage of the population lives with it. A rare kind, called objective tinnitus, or rhythmic, is associated with circulation and vascular problems because it often keeps time with the person’s heartbeat. A doctor can hear it with a stethoscope which, although still aggravating for the patient, can at least be heard by someone else. Subjective tinnitus, on the other hand, the most common kind, is only heard by the sufferer, but emits a seemingly phantom, yet deafening, noise.

Research shows that hearing loss results in less external sound stimuli reaching the brain. In response, the brain changes how it processes different sound frequencies, called maladaptive neuroplastic changes. Delicate hairs in the inner ear move to the pressure of sound waves, which triggers cells to release an electrical signal through the auditory nerve to the brain. The brain interprets these signals as sound. If the hairs inside the inner ear are bent or broken, they can leak random electrical impulses to the brain, resulting in ear ringing.

The American Tinnitus Association (ATA) estimates that 20 million people have “burdensome” tinnitus, and two million have “extreme and debilitating” cases. Most patients develop tinnitus as a symptom of hearing loss caused by age, long-term damage, or acute trauma to the auditory system. When the ringing occurs on one side of the brain it may be indicative of something more sinister, like a tumor. Ménière’s disease also affects the inner ear, causing vertigo, ringing, and eventual loss of hearing. 

3 Ways to Battle Tinnitus

People with tinnitus can find relief by using hearing aids and other sound-amplification devices. Like a microphone, amplifier, or speaker, hearing aids can supplement the volume of outside noise and increase the amount of sound stimuli received and processed by the body’s auditory system. A good sound therapy plan takes into account individual needs, but the most important factor is to provide background sound in a consistent, systematic way to encourage habituation.

Ear-Level Sound Generators—Ear-level sound therapy devices are worn on the ear, like a hearing aid, and deliver a variety of predetermined or programmable therapeutic sounds. They are appropriate for individuals with minimal hearing loss.

The sounds most commonly available are broadband sounds that many tinnitus patients find tolerable—rainfall or flowing water, for example. Some devices offer preset broadband sounds, and some offer broadband sounds that can be modified.

Any of these devices can deliver a controlled, consistent sound to the ears. This should provide not only some relief but also a feeling of control over tinnitus, which will aid habituation. The volume should be set to a very comfortable level that does not interfere with your ability to concentrate or communicate.

Hearing Aids—Normally intended to improve speech comprehension in a wide range of listening environments, hearing aids can also be programmed in ways that provide therapeutic intervention for tinnitus. The frequency of tinnitus is usually within the range of frequencies included in an individual’s hearing loss. For some people with tinnitus, the use of hearing aids to amplify sound in the range of their hearing loss can also help reduce their perception of their tinnitus.

Combination Units—A combination unit is an ear-level device combining the amplification of a hearing aid with background sound like a sound generator. The devices have an assortment of background noises, including a preset broadband noise, an adjustable broadband noise, and random chime-like tones. Look for a device that allows you to adjust the hearing aid volume and the generated sound volume separately. 

Now that most hearing aids have wireless Bluetooth capability, it is possible to stream additional sounds through hearing aids and combination units. As a result, any Bluetooth-capable device can be made into a customized combination unit.