[Acute hearing loss in the orchestral musician : Noise trauma or idiopathic sudden deafness?].

During an orchestral performance musicians are exposed to high noise levels, which may exceed the intensity which could evoke hearing impairment after many years of exposure. From experience the degree of hearing loss in musicians is in general less than would be expected from the levels of exposure. The likelihood that an orchestral musician would develop a noise-induced hearing loss is much lower than for an industrial worker in a noise-intense factory. On the other hand it has to be considered that it is imperative for musicians to have non-impaired hearing to practise their profession. In some cases a sudden onset of hearing loss is traced to the noise stress of a loud performance. In such cases, the high noise levels predominantly produced by brass instruments or drums were assumed to be the cause. This publication presents five cases of expert opinions, where previous expert opinions had assumed noise or a blast trauma as the cause for the hearing loss. By careful analysis, a noise or a blast trauma was not regarded as probable in any of the cases. Interestingly, three of the five musicians had a normal contralateral hearing. In one case normal bilateral hearing was observed without the typical c(5) notch although the musician had been subject to noise stress in an orchestra for years.