The criterion for the definition of diplacusis used here, an interaural difference of more than 1%, could have been too strict. It is difficult to find evidence on this matter, but in at least one study (Markides 1981) interaural differences of more than 2% are still considered click here to

be normal. Diplacusis did not seem to cause real problems for musicians, as just a few indicated to struggle with it. On the other hand, musicians with diplacusis had increased average threshold levels while the average age for the groups did not differ, indicating that diplacusis is related to other forms of hearing impairment, possibly NIHL. 12% of men between 65 and 74 of age experience some kind of tinnitus and its prevalence increases with age (Lockwood et al. 2002). In musicians, however, it seems to be far more common. About half of the musicians tested mentioned tinnitus as a complaint. In other studies tinnitus has been reported in 2–20% (Lockwood et al. 2002; Axelsson et al. 1989; Coles 1984; Skarzyński et al. 2000). The tinnitus reported in this study usually had a temporary character, but some participants reported very loud and continuous tinnitus. In these cases the

tinnitus could cause a serious handicap. Tinnitus was more often pitched in the higher frequency area (i.e. higher than 4 kHz), which strongly suggests that tinnitus is related to intensive exposure H 89 in vivo to loud sounds. Tinnitus was more often localized

utmost left and this could not be related to the instrument type (e.g. in the HS group) or to the position in the orchestra. As with diplacusis, musicians with tinnitus showed increased hearing thresholds, while no difference in age could be found mafosfamide with musicians who did not report tinnitus. Most musicians scored within normal limits on the speech-in-noise test. The musicians’ subjective assessment did not show any severe problems with understanding speech in a noisy environment, or in music. As the third main theme, we included OAE measurements in order to asses the added value in detection of NIHL and to assess the relations between measurements of hearing acuity (i.e. PTA, OAE) and self-reports on noise-induced hearing problems. In both TEOAEs and DPOAEs large inter-individual differences were found. No relation to individual audiometric patterns could be determined. On group level however, we found clear differences between the average OAE responses of different audiometric subgroups: in general, more intense OAEs were found for groups with better average pure-tone thresholds. The OAEs of the normal hearing musicians were clearly distinguishable from the OAEs of the musicians in the other audiometric categories, suggesting a signalling function for early detection of NIHL. A firm statement on this issue can, however, only be made on the basis of a longitudinal study.