Week 4

On Wednesday, July 4, there was no clinic because of the holiday. On Thursday, I saw a child who came in for a kindergarten re-screening. Otoscopy revealed that the child had a PE tube that was moving out of his right ear. Tympanometry and the air conduction pure tone re-screening were also normal.

In the evening, I saw a recruit who graduated from the Music Education program. The recruit had been a musician since she was very young and had played in marching bands in junior high, high school, and college. She also practices frequently and plays with several performance groups. She was recruited because of her history of noise exposure and also because, previously, she expressed a desire to obtain musicians' earplugs and custom iPod earbuds.

In addition to persistent noise exposure, case history also revealed that the recruit often has tinnitus that sounds like "static;" however, she reported that it wasn't bothersome. The recruit also noted that she has chronic allergies.

Otoscopy revealed a moderate amount of cerumen in the lateral EAM, and I was able to remove a significant amount with the guidance of my supervisor.

Tympanometry and acoustic reflexes were normal. Pure tone AC audiometry, with the 6000 Hz test frequency included, revealed no outstanding findings, so we proceeded to make impressions for her earplugs.

The recruit expressed that she typically sits in front of brass and percussion performers in concert formation, so my supervisor recommended musicians' earplugs with the greatest level of attenuation. She also recommended purchasing counter-sunk filters, which would provide greater stability for the filters. She explained that when filters are not counter-sunk, they often get knocked off and lost. Because of the cost of replacement-filters, the recruit chose to get the musicians' earplugs with counter-sunk filters. The recruit also chose to purchase custom iPod earbuds. Both sets of earplugs were ordered from ProSonic because they offered the most affordable products.

My experiences with my recruit were valuable because I was able to remove cerumen for the first time and also because I learned about a product (musicians' earplugs) that was not familiar to me. I included some links about current studies that emphasized the need to monitor the hearing of musicians. Both studies, Hearing Development in Classical Orchestral Musicians and Hearing Development in Classical Orchestral Musicians: A Follow-up Study, completed by the same authors, Kähäri, Axelsson, Hellström, & Zachau, explored frequency-specific, gender, and individual ear differences. The longitudinal study found that males expressed more significant losses, particularly at 6000 Hz. The studies also found a right-ear advantage. The links to the studies are listed below:

Kähäri, K., Axelsson, A., Hellström, P., & Zachau, G. (Jan2001). Hearing assessment of classical orchestral musicians. Scandinavian Audiology, 30(1), 13-23.
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Kahari, K., Axelsson, A., Hellstrom, P., & Zachau, G. (2001). Hearing development in classical orchestral musicians. A follow-up study. Scandinavian Audiology, 30(3), 141-149.
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