Cause Of Deafness Research Articles

Anatomical Consideration of Dhamani Marma with SpecialReference to Vidhur Marma in Ayurveda

Marma sharira is known as the science of traumatological anatomy. Injuries to various structures of the body such as arteries, muscles, nerves, bones, and visceral organs may result in fatal injuries and death. Marmas in Ayurvedic classics are illustrated as the vital points in human body injury of which leads to termination of life. Acharya Sushruta has presented five types of marmas on structural basis, that is, Mansa-marma, Sira-marma, Snayu-marma, Asthi-marma, and Sandhi marma. Whereas according to acharya Vaghbhatt, there are six types of marmas. He has enumerated a sixth group of marma known as Dhamani Marma. Under the Dhamani Marmas which are nine in number he has presented Vidhur marma. The injury to which leads to deafness. The possible cause of deafness may be due to injury of an arterial structure that is Dhamani or snayu, that is, nerves. This article focuses on co-relating various anatomical structures such as arteries and nerves with Dhamani Marma explained by acharya Vagbhatt with special reference to Vidhur marma injury.

Trick or teeth? A peculiar cause of deafness

Abnormal development of specific first pharyngeal arch derivatives can result in ectopic teeth which can develop inside the middle ear causing hearing loss. This case is about an 11-year-old patient with hearing loss in the left ear caused by an ectopic tooth in the middle ear.

Changing Management of Intravestibular Schwannomas in the Era of Cochlear Implantation for Single-Sided Deafness.

Intralabyrinthine schwannomas (ILSs) are a rare cause of deafness. Patients with ILS confined to the semicircular canals and the vestibule (intravestibular schwannomas) are potential candidates for cochlear implantation for hearing rehabilitation, a new option for patients with unilateral hearing loss since the 2019 FDA approval of cochlear implant (CI) for single-sided deafness. In this report, we describe an evolving management approach for ILSs causing hearing loss. Adults (≥18 years) who underwent simultaneous ILS resection and CI between January 2019 and June 2023 (n = 3). Transmastoid labyrinthectomy with simultaneous cochlear implantation. Hearing performance with cochlear implantation measured as CNC Word Recognition scores and AzBio Sentence scores. Three patients with ILS confined to the semicircular canals and vestibule underwent simultaneous tumor resection via labyrinthectomy with CI placement. In all cases, complete tumor resection and full CI insertion were achieved. No patients experienced postoperative complications. Patients 1 and 2 underwent 6- and 9-month postactivation testing, respectively, with CNC scores 64% to 80% and AzBio 81% to 99% in the implanted ears. Patient 3 scored 0% on CNC and AzBio testing at 3 months and deferred her 6-month audiometry. Patients with ILS confined to the vestibule and semicircular canals can be considered for simultaneous tumor resection and CI placement.

Risk factors and management strategies of inadvertent facial nerve stimulation in cochlear implant recipients: A systematic review.

To systematically review the prevalence and risk factors of inadvertent facial nerve stimulation (FNS) after cochlear implant (CI) surgery. And to report the different management strategies used for reducing and resolving FNS. Web of Science, Scopus, PubMed, Cochrane Library, and Virtual Health Library (VHL) of the World Health Organization (WHO). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) on studies that reported FNS as a complication after CI. A comprehensive electronic search strategy was used to identify the relevant articles. We extracted the data on the prevalence of FNS after CI activation, the reported grades, and the management strategies. The number of associated electrodes; cause of deafness; co-anomalies; and duration of hearing loss and their relationships with FNS were also studied. Twenty-one relevant articles were included in this review. The prevalence of FNS among the CI populations was 5.29% (175/3306 patients). Among those whose ages were reported, 58.3% (95/163) were adults, and 41.7% (68/163) were pediatrics. Modifying the different fitting parameters was the most used strategy, as it successfully resolved FNS in 85.5% of the patients (142/166). The second commonly used management strategy was surgical intervention (reimplantation or explantation), which was reported in seven studies for 23 patients. FNS after CI activation could be controlled and resolved with many advances that range from readjusting the fitting parameters to surgical intervention. However, further studies are required to validate the efficacy of each management strategy and its impact on patients' performance. Our findings demonstrate that CI recipients with FNS could still benefit from the CI devices and their FNS could be controlled.

Investigation of GJB2 and SLC26A4 genes related to pendred syndrome genetic deafness patients

Deafness can occur due to damage to the ear, especially the inner ear. In other cases, the cause is a heterogeneous genetic abnormality and is caused by the changes that occur in the genes involved in the hearing process. Mutations in GJB2 and SLC26A4 genes are one of the most important causes of deafness in the world, which causes syndromic and non-syndromic hereditary hearing loss. The purpose of this study is to investigate GJB2 and SLC26A4 genes related to genetic syndromes of deafness and bioinformatic analysis at the genome and proteome level and to evaluate and compare the expression of these genes in different tissues of the human body. For this purpose, tools related to bioinformatics analysis such as UCSC and OMIM databases were used. One of the common genetic syndromes caused by mutations in these genes is pendred syndrome. The clinical symptoms of this disease are weight gain, constipation, dry skin, and hair, decreased energy, sleepiness, bulging belly, decreased body temperature, and slow growth. This disease does not currently have a specific treatment, so it is very important and fundamental to investigate the genetic factors affecting this disease. The results of this research showed that the transfer of potassium, sodium, and chlorine ions as well as the mutation in the SLC26A4 gene, which is responsible for the synthesis of pendrin protein, is very effective in the occurrence of pendred syndrome. To diagnose pendred syndrome more accurately, molecular methods should be used in genetic tests. The results of comparing the expression profiles of these two genes showed that the difference in the expression of these two genes is very high and, in general, the expression of the SLC26A4 gene in the body is very low. Because people with hearing loss have other problems including damage to other parts of the body such as the heart, kidneys, or eyes. Knowing the genetic cause in these cases allows the doctor to be aware of problems in other systems as well.

TRIM71 reactivation enhances the mitotic and hair cell-forming potential of cochlear supporting cells.

Cochlear hair cell loss is a leading cause of deafness in humans. Neighboring supporting cells have some capacity to regenerate hair cells. However, their regenerative potential sharply declines as supporting cells undergo maturation (postnatal day 5 in mice). We recently reported that reactivation of the RNA-binding protein LIN28B restores the hair cell-regenerative potential of P5 cochlear supporting cells. Here, we identify the LIN28B target Trim71 as a novel and equally potent enhancer of supporting cell plasticity. TRIM71 is a critical regulator of stem cell behavior and cell reprogramming; however, its role in cell regeneration is poorly understood. Employing an organoid-based assay, we show that TRIM71 re-expression increases the mitotic and hair cell-forming potential of P5 cochlear supporting cells by facilitating their de-differentiation into progenitor-like cells. Our mechanistic work indicates that TRIM71's RNA-binding activity is essential for such ability, and our transcriptomic analysis identifies gene modules that are linked to TRIM71 and LIN28B-mediated supporting cell reprogramming. Furthermore, our study uncovers that the TRIM71-LIN28B target Hmga2 is essential for supporting cell self-renewal and hair cell formation.

Validating the ORACollect for the detection of cytomegalovirus

Targeted screening for Cytomegalovirus (CMV) in Deaf and Hard of Hearing (DHH) children is now internationally recommended. With newborn genomic screening for DHH children a future possibility, the commercially-available human genomic DNA collection kit (ORACollect, Oragene OCR-100) could enable one single sample to screen for CMV and genetic causes of deafness at scale with minimal additional costs. Our pilot study validated ORACollect against Copan FLOQswabs® (gold standard clinical procedure) for detecting CMV using 15 sets of saliva samples from 14 infants/children, comparing CMV PCR results using different testing protocols. ORACollect stored at room temperature had high sensitivity (up to 89%), specificity (up to 80%) and percent agreement (up to 86%) in detecting CMV DNA compared to FLOQswabs®. This suggests that ORACollect is an appropriate alternative to FLOQswabs® for collecting viral CMV DNA for PCR testing, independent of the DNA extraction approach. This could be revolutionary in facilitating dual genomic and viral screening in newborns and would enable CMV screening in non-tertiary hospital settings where laboratory facilities are not available.

A clinical case of a patient with an anomaly in the development of the inner ear and refractory stimulation of the facial nerve after a coronavirus infection and meningitis

Background. Thanks to the development of technology and new surgical approaches, it has become possible to perform cochlear implantation (CI) in patients with malformations of the inner ear. The experience of this type of rehabilitation has more than 15 years in Russian practice and more than 20 years in the world. Unfortunately, the COVID-19 pandemic has added not only one more cause of deafness, but also etiological factor of the complications. The purpose of this paper is to describe a clinical case of facial nerve stimulation (FNS) in a CI user with an inner ear malformation and a coronavirus infection complicated by meningitis. A clinical case demonstrating a combination of all these etiological factors of FNS has not been previously described in the scientific literature.
 Aim. To describe a clinical case of FNS in a CI user with an inner ear malformation and a coronavirus infection complicated by meningitis.
 Materials and methods. In 2017 4 years old patient underwent cochlear implantation on her right ear in Saint Petersburg Research Institute of Ear, Throat, Nose and Speech. In May 2022 the patient was admitted to the infectious diseases department of the medical institution with the diagnosis: coronavirus infection (confirmed), severe course; complication: purulent meningoencephalitis. After recovery, the patient complained of facial muscles twitching when using the speech processor of the cochlear implant. In order to correct the non-hearing sensation, the patient was sent to the Saint Petersburg Research Institute of Ear, Throat, Nose and Speech for rehabilitation in June 2022. During repeated fitting, it was possible to improve the reactions to sounds. Phoneme discrimination has improved. Positive dynamics was registered against the background of the changed settings. The average hearing thresholds using 3-phase stimulation were 42.5 dB. However, it was not possible to completely eliminate the FNS, and the compulsory settings of the speech processor did not allow the patient to achieve sufficient speech intelligibility.
 Conclusion. Meningitis after CI can cause an increase in the transmittance of the inner ear tissues to electric current and, as a consequence, the development of the FNS. Modern technologies make it possible to rehabilitate such patients, including those with abnormalities of the inner ear. To increase the effecacy of rehabilitation, special coding strategies are used including the 3-phase stimulation.

Analysis of GJB2 gene mutations spectrum and the characteristics of individuals with c.109G>A in Western Guangdong.

GJB2 mutations are among the most important causes of deafness, and their prevalence varies greatly among different countries and ethnic groups. This study aimed to determine the pathogenic mutation spectrum of GJB2 in patients with nonsyndromic hearing loss (NSHL) in Western Guangdong and to explore the pathogenic characteristics of the c.109G>A locus. In total, 97 NSHL patients and 212 normal controls (NC) were included in this study. Genetic sequencing analyses were performed on GJB2. In the NSHL group, the main pathogenic mutations in GJB2 were as follows: c.109G>A, c.235delC, and c.299_300delAT with allele frequencies of 9.28%, 4.12%, and 2.06%, respectively. c.109G>A was the most frequently detected pathogenic mutation in this region. In the NC group, the allele frequency of c.109G>A among 30-50 years old subjects was markedly lower than that among 0-30 years old subjects (5.31% vs. 11.11%, p < 0.05). We found the pathogenic mutation spectrum of GJB2 in this region and showed that c.109G>A was the most common GJB2 mutation with unique characteristics, such as clinical phenotypic heterogeneity and delayed onset. Therefore, the c.109G>A mutation should be considered as an essential marker for routine genetic assessment of deafness, which can also be beneficial for preventing deafness.

Cochlear Implantation in Adults with Post-lingual Hearing Loss: Clinico-Demographical Study and Outcomes in the Current Times.

To describe clinico-demographical profile for post-lingual hearing loss in the adults undergoing cochlear implantation and their outcomes. A retrospective chart review was conducted including adult patients (> 18 years) with bilateral post-lingual severe to profound hearing loss who underwent cochlear implantation in a tertiary care hospital of north India. The clinico-demographical details were collected and the outcomes of the procedure were assessed in terms of speech intelligibility scores, usage and satisfaction scores. Twenty-one patients were included with a mean age of 38.6 years with 15 males and 6 females. The major cause of deafness was infections followed by ototoxicity. The complication rate was 4.8%. Preoperative SDS was not recordable in any of the patients. The mean postoperative SDS was 74%, with no issue of device malfunction in a mean follow-up of 44 months. Cochlear implantation is a safe surgery with good outcomes in post-lingually deafened adults with the major cause for deafness being infections.

AAV-Net1 facilitates the trans-differentiation of supporting cells into hair cells in the murine cochlea.

Mechanosensitive hair cells (HCs) in the cochlear sensory epithelium are critical for sound detection and transduction. Mammalian HCs in the cochlea undergo cytogenesis during embryonic development, and irreversible damage to hair cells postnatally is a major cause of deafness. During the development of the organ of Corti, HCs and supporting cells (SCs) originate from the same precursors. In the neonatal cochlea, damage to HCs activates adjacent SCs to act as HC precursors and to differentiate into new HCs. However, the plasticity of SCs to produce new HCs is gradually lost with cochlear development. Here, we delineate an essential role for the guanine nucleotide exchange factor Net1 in SC trans-differentiation into HCs. Net1 overexpression mediated by AAV-ie in SCs promoted cochlear organoid formation and HC differentiation under two and three-dimensional culture conditions. Also, AAV-Net1 enhanced SC proliferation in Lgr5-EGFPCreERT2 mice and HC generation as indicated by lineage tracing of HCs in the cochleae of Lgr5-EGFPCreERT2/Rosa26-tdTomatoloxp/loxp mice. We further found that the up-regulation of Wnt/β-catenin and Notch signaling in AAV-Net1-transduced cochleae might be responsible for the SC proliferation and HC differentiation. Also, Net1 overexpression in SCs enhanced SC proliferation and HC regeneration and survival after HC damage by neomycin. Taken together, our study suggests that Net1 might serve as a potential target for HC regeneration and that AAV-mediated gene regulation may be a promising approach in stem cell-based therapy in hearing restoration.

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians

IntroductionSensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low. Methods and materialA questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests. ResultsOne hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group. ConclusionFew Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group.

Wildervanck syndrome: Case report

Abstract BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is composed by the oculo-cervico-acoustic triad, which may be more or less complete. MATERIAL AND METHODS. We present a 5-year-old girl diagnosed with Wildervanck syndrome, exhibiting: Klippel-Feil anomaly (fused cervical vertebrae), Duane Stilling Turk syndrome (bilateral abducens palsy) and congenital bilateral cophosis indicated by ABR. RESULTS. The CT scan revealed major malformations of the brain and calvarium including the petrous part of both temporal bones. Despite all these brain malformations, the psychological development of the child was nearly normal. As it was previously reported in other cases, the child also presented spina bifida cervicalis and cleft palate. The cause of deafness was bilateral lack of cochleae, making impossible the insertion of the cochlear electrode for hearing rehabilitation. When the patients are discovered late (after 3 years of age), the management of hearing loss is by being taught sign language and lip reading. CONCLUSION. Any cranio-facial malformation and any delay in speech production impose early attention of the otorhinolaryngologist or audiologist for timely diagnosis and rehabilitation of hearing loss. The imaging examination, especially the high-resolution temporal bone CT-scan, is of paramount importance to be performed in all profound congenital deaf children to evaluate the candidacy to cochlear implantation.

Conservative Otosclerosis Treatment With Sodium Fluoride and Other Modern Formulations: A Systematic Review.

Otosclerosis, also known as otospongiosis, is a primary osteodystrophy of the otic capsule of the inner ear and one of the leading causes of deafness in adults. The rationale for medical therapy for otospongiosis is to slow down and eventually stop the phase of bone resorption. Conservative treatments includesodium fluoride (NaF), bisphosphonates, and other modern medicines. A systematic review of the existing and published articles and books until April 2021 has been conducted in Medscape, Google Scholar, PubMed, and other databasesusing appropriate terms.According to the results of the research, the administration of NaF for a period of at least six months stabilizes hearing thresholds (HTs), improves vestibular symptoms, and delays the worsening of tinnitus. The administration of bisphosphonates for a period of at least six months showed significant percentage differences in the improvement of hearing loss, dizziness, and tinnitus remission.In the already existing double-blind studies that were evaluated, groups of patients treated with bisphosphonates for at least 24 months showed greater stabilization of the mean air and bone conduction thresholds than groups of patients treated with a placebo. The new modern medications have not yet been widely administered clinically to draw useful conclusions, although the test results of some of their use are quite encouraging.

Dépistage et diagnostic de la surdité chez le chien

Screening and diagnosis of deafness in dogs is based on Brainstem Auditory Evoked Response or BAER recording. Deafness is usually classified according to five criteria : determinism, onset, severity, symmetry, and anatomical-functional stage reached. In breeds at risk for hereditary deafness, with white or piebald robes (Dalmatian Dogo argentino, Bull terrier, Australian cattle dog, etc.) or merle (Border collie, Australian shepherd, etc.), screening of breeding animals and newborns should be encouraged to reduce the prevalence of deafness in these breeds. In dogs with acute deafness, hearing impairment should be confirmed by BAERs recording and lesions should be in-vestigated by medical imaging (CT-scan and/or magnetic resonance imaging). Acquired causes of deafness are nu-merous : inflammatory (especially otitis media), toxic (or ototoxicity), traumatic, degenerative (or presbycusis). In acute deafness in dogs, total bilateral deafness is most often irreversible.

THE DIAGNOSTIC AND ETIOLOGICAL CONTRIBUTION OF SECTIONAL IMAGING IN DEAFNESS (ABOUT 80 CASES)

Introduction: Deafness is defined as hearing impairments that can occur at any age and can be of genetic or idiopathic origin. They can occur both abruptly and gradually. The aim of this work is to underline the diagnostic and above all etiological contribution of spiral CT and MRI during deafness, which makes it possible to orient the therapeutic conduct. Materials and methods: We conducted a prospective work on patients explored in the radiology department of August 20 Hospital in Casablanca for deafness apart from chronic otitis media and post-traumatic deafness, between March 2012 and December 2013. 43 patients were explored by computed tomography (CT) of the rocks with multiplanar reconstructions (16 strips) and 37 patients were explored by magnetic resonance imaging (MRI) 1.5 Tesla. Results: There were 80 patients with an average age of 42 years. There was a female predominance (55 women for 25 men). Hearing loss was bilateral (75%), usually symmetrical 3 times greater than unilateral involvement (25%). This deafness was sudden in 30 patients (37.5%) and progressive installation in 50 patients (62.5%). Conductive hearing loss was found in 22 cases (27.5%), sensorineural hearing loss in 22 cases (27.5%) and mixed hearing loss in 36 cases (45%). The etiological diagnoses were as follows: 18 cases of otosclerosis (22.5%), 7 cases of CSL agenesis (8.75%), 10 cases of cerebellopontine angle tumor (12.5%), 12 cases of paraganglioma jugulo - tympanic (15%), 7 cases of vasculo-nervous crossing (8.75%) and 26 cases which turned out to be normal (32.5%). Conclusion: The determination of the causes of deafness has greatly benefited from the development of medical imaging. They benefit from medical and/or surgical treatment essentially depending on their mechanism, their severity and the results of imaging based on the CT-MRI pair.

Full etiologic spectrum of pediatric severe to profound hearing loss of consecutive 119 cases

Determining the etiology of severe-to-profound sensorineural hearing loss (SP-SNHL) in pediatric subjects is particularly important in aiding the decision for auditory rehabilitation. We aimed to update the etiologic spectrum of pediatric SP-SNHL by combining internal auditory canal (IAC)-MRI with comprehensive and state-of-the-art genetic testings. From May 2013 to September 2020, 119 cochlear implantees under the age of 15 years with SP-SNHL were all prospectively recruited. They were subjected to genetic tests, including exome sequencing, and IAC-MRI for etiologic diagnosis. Strict interpretation of results were made based on ACMG/AMP guidelines and by an experienced neuroradiologist. The etiology was determined in of 65.5% (78/119) of our cohort. If only one of the two tests was done, the etiologic diagnostic rate would be reduced by at least 21.8%. Notably, cochlear nerve deficiency (n = 20) detected by IAC-MRI topped the etiology list of our cohort, followed by DFNB4 (n = 18), DFNB1 (n = 10), DFNB9 (n = 10) and periventricular leukomalacia associated with congenital CMV infection (n = 8). Simultaneous application of state-of-the-art genetic tests and IAC-MRI is essential for etiologic diagnosis, and if lesions of the auditory nerve or central nerve system are carefully examined on an MRI, we can identify the cause of deafness in more than 65% of pediatric SP-SNHL cases.

Noise Mapping, Prevalence and Risk Factors of Noise-Induced Hearing Loss among Workers at Muscat International Airport.

Noise-induced hearing loss (NIHL) is a common occupational hazard and a major cause of deafness among airport workers. However, few studies have been conducted to investigate the various risk factors related to hearing loss. Purpose: the purpose of this study was to measure the prevalence and risk factors of NIHL among Muscat International Airport airside workers. Method: Their daily noise exposure level at the airport was measured, and the time-weighted average (TWA) was calculated for each airside department. A cross-sectional study design involving 312 workers from the eight departments of the airport was chosen and the prevalence of NIHL among workers was assessed. The study participants then completed a self-administered questionnaire that covered their socio-demographic characteristics, occupational exposure history and the health-related risk factors of NIHL. Results: The TWA recorded for the workers was above the accepted limit in some departments, namely, cabin appearance, ramp, line maintenance and hangar. The prevalence of NIHL among participants was 21.79% (n = 68). Of these 68 participants with NIHL, 22.30% were exposed to job-related high noise levels. NIHL was common among participants aged 40 or above (57.35%, n = 39) and high school degree holders (29.60%, n = 29), as well as those who were exposed to higher noise levels (84.89%, n = 191) or who did not wear their hearing protection devices (HPDs) regularly (53.65%, n = 125). Conclusion: around a quarter of our study participants who were exposed to high noise levels suffer from NIHL.

The protective effects of systemic dexamethasone on sensory epithelial damage and hearing loss in targeted Cx26-null mice

Mutations in the GJB2 gene (encoding Connexin26(Cx26)) are the most common cause of hereditary deafness, accounting for about a quarter of all cases. Sensory epithelial damage is considered to be one of the main causes of deafness caused by GJB2 gene mutation. Dexamethasone (DEX) is widely used in the treatment of a variety of inner ear diseases including sudden sensorineural hearing loss (SSNHL), noise-induced hearing loss (NIHL), and deafness caused by ototoxic drugs. Whether DEX has a direct therapeutic effect on hereditary deafness, especially GJB2-related deafness, remains unclear. In this study, we revealed that DEX can effectively prevent hair cell death caused by oxidative stress in cochlear explants. Additionally, two distinct Cx26-null mouse models were established to investigate whether systemic administration of DEX alleviate the cochlear sensory epithelial injury or deafness in these models. In a specific longitudinally Cx26-null model that does not cause deafness, systemic administration of DEX prevents the degeneration of outer hair cells (OHCs) induced by Cx26 knockout. Similarly, in a targeted-Deiter’s cells (DCs) Cx26-null mouse model that causes deafness, treatment with DEX can almost completely prevent OHCs loss and alleviates auditory threshold shifts at some frequencies. Additionally, we observed that DEX inhibited the recruitment of CD45-positive cells in the targeted-DCs Cx26-null mice. Taken together, our results suggest that the protective effect of dexamethasone on cochlear sensory epithelial damage and partially rescue auditory function may be related to the regulation of inner ear immune response in Cx26 deficiency mouse models.

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians

IntroductionSensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low. Methods and materialA questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests. ResultsOne hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group. ConclusionFew Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group.