Spring 08 Week 9

An adult male came in to purchase musicians in-ear monitors with custom earmolds. He reported playing the keyboard in a band at his church. No hearing problems were reported. However, the right tympanic membrane has previously been ruptured twice. The last occurrence was approximately ten years ago. No other outstanding case history information was provided. Since he is exposed to noise often, a hearing evaluation was recommended and conducted.

Clear ear canals and visible, intact tympanic membranes were observed bilaterally. Redness was observed in the right ear canal. Normal, Type A tympanograms were measured bilaterally.
Otoacoustic emissions were not attempted due to the conductive component in behavioral testing. Puretone audiometry revealed a normal sloping to mild loss at 2000 Hz rising again to normal in the high frequencies in the right ear. The left ear had normal sloping to moderate loss at 4000 Hz rising to normal in higher frequencies. In both ears, the low frequencies showed a slight conductive component while the high frequencies were sensorineural. Pure tone averages were in good agreement with the speech recognition thresholds (SRT) bilaterally. SRT for the right and left ear was 30 dB HL. Word recognition testing was not completed at this time.

Musician custom earmolds were made. UM 56 ear pieces and UM 2 dual driver universal fit in-ear musicians’ monitors were ordered through Westone. He was recommended to return for annual evaluations or if changes in hearing are noticed. Due to a slight conductive component, an appointment with an otolaryngologist was recommended. The importance of hearing protection was also discussed.

I found a study that examined the impact that changing on-stage music and crowd noise levels during musical performance had on preferred listening levels and minimum acceptable listening levels across both floor and in-ear monitors. Participants for this study were 23- to 48-year-old musicians, with and without hearing loss, who had 10 years of experience. Preferred levels were found to be lower for floor monitors while acceptable levels were lower for in-ear monitors. However, there were no significant difference between the two kinds of monitors and both had acceptable levels according to OSHA. It was suggested by the authors for those patients at risk for noise exposure to use in-ear monitors to reduce other surrounding noises.

Federman, J. & Ricketts, T. (2008). Preferred and minimum acceptable listening levels for musicians while using floor and in-ear monitors. Journal of Speech, Language, and Hearing Research, 51, 147-159.

http://web.ebscohost.com/ehost/pdf?vid=1&hid=117&sid=e7290bc3-1ebb-49b1-96c7-03828271d116%40sessionmgr107