title: [In situ sound pressure measurement in a professional violinist with bilateral tinnitus].
abstract: BACKGROUND
  A case of a professional violinist suffering from a bilateral tinnitus is presented. The musician reported the tinnitus to be louder and more straining when playing his Vuillaume violin (France 1840) as compared with his Carcassi violin (Italy 1763).
  
  
  METHODS
  In the 42-year-old musician, audiometry revealed a normal hearing threshold in the right ear and a slight hearing loss in the left ear of up to 20 dB between 2 kHz and 8 kHz. Transitory evoked otoacoustic emissions could only be measured in the right ear. The tinnitus could be masked (distance type); residual inhibition was only seen in the right ear. By sound intensity measurements in both external auditory canals, the different sound spectra of both violins could be demonstrated. When playing with "forte" intensity, sound pressure reached peaks of over 90 dB. The tinnitus was ameliorated by lidocaine infusions.
  
  
  CONCLUSIONS
  The different sound spectra of both violins may be the reason for the enhancement of the musician's tinnitus. Interference of air and bone-conducted sound could lead to a cochlear overlap and thus influence the tinnitus although such a phenomenon can not be verified. It was previously reported that high-pitched instruments may cause tinnitus sensations in performing musicians. A review of the literature surprisingly reveals that although professional musicians are exposed to sound pressure levels that may cause hearing impairment, only very few do develop one. This fact has to be taken into account whenever an occupational disease is suspected.
authors.affiliation: Abteilung für Phoniatrie und Pädaudiologie, Hals-Nasen-Ohren-Universitätsklinik Erlangen.
authors.forename: F
authors.initials: F
authors.lastname: Rosanowski
authors.forename: U
authors.initials: U
authors.lastname: Eysholdt
mesh_terms: D000328:Adult; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008144:Loudness Perception / Q000502:physiology; D008297:Male; D009146:Music; D009784:Occupational Diseases / Q000175:diagnosis / Q000503:physiopathology*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D010898:Pitch Perception / Q000502:physiology; D011571:Psychoacoustics; D013018:Sound Spectrography; D014012:Tinnitus / Q000175:diagnosis / Q000503:physiopathology*; D000159:Vestibulocochlear Nerve / Q000503:physiopathology