A variety of unusual and challenging auditory events may affect musicians and recording engineers, particularly when associated with perceptions of excessive loudness, pitch anomalies, aversions to specific sounds, and the sensation of pain in the ears. This presentation will review mechanisms associated with disordered sound tolerance (DST), including exposure characteristics, and the many physiologic changes that result in unusual auditory symptoms such as tinnitus, hyperacusis, diplacusis, and auditory nociception, or the sensation of pain in the ears triggered by sound. Consensus regarding terminology of symptoms of DST is lacking among hearing health care professionals; labeling schemes related to elements of DST will be reviewed, as will the relation between audiometric status and DST.
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