- Published on 18 August 2016
Understanding, enjoying, practising, and listening to music, rather than just having it in the background, can be a therapeutic method to help overcome specific situations. Medical reports show that music has been used in various approaches to autism patients, as well as those with language disorders, hearing loss, and attention difficulties, among other complaints.Meanwhile, persons with a certain musical sensibility can handle clinical tests with greater ease than those who have little contact with music. This was the conclusion of a research group in otorhinolaryngology and related sciences, backed by the University Health Sciences Foundation, through its study “Correlation between speech discrimation and musical perception in implant patients and normal-hearing persons,” carried out in the Colombian capital, Bogotá.
Vertigo is not the same as dizziness
“Our method was to measure musical qualities in musical tone, melody, and timbre, applying the Clinical Assessment of Music Perception (CAMP) test to patients with a cochlear implant and normal-hearing persons,” explained Adelaida Plaza Ruiz, otorhinolaryngologist and otologist, ex-president of the Colombian Association of Otology and Neurotology.
In this research, tone testing allowed for the identification of patients’ capacity to perceive low and high sounds within a range of 250 to 10,000 millihertz. How easily do they detect changes? This depends on how many semitones the person requires in order to differentiate one tone from another; the idea is that the higher tone in the musical scale should be identified, and four tones were used in the evaluation. The CAMP test evaluates melody in songs, eliminating the rhythm element; the way in which the music is structured comes in a pattern that indicates the musical rhythm, for example: vallenato, salsa, or ballad. By removing the rhythm, the melody is then even and the patient’s ability can be evaluated. In the test, songs without rhythm, i.e. pure melody, are more complex in terms of recognition, even when one is familiar with them, but it is the best way to evaluated how patients perceive sound quality.
Finally, both normal-hearing patients and those with implants were given a timbre test, which consisted of recognising an instrument. In this test, each individual evaluated had to identify what musical instrument they were hearing, e.g. guitar, cello, trumpet, piano, etc.
The results confirm the influence of music
Once the CAMP tests were completed, “we analysed the percentages obtained so as to measure both musical qualities and language results. We found some curious results, for example that patients with implants found it very difficult to identify tone, while those with some prior musical training found this a little easier; normal-hearing patients also had difficulty identifying tone, but they did this more accurately than patients with implants,” pointed out Dr. Plaza (below).
When it came to melody, the pattern was the same as with tone. “Those with normal-hearing did better than patients with implants, but with timbre the results were varied. Implant patients showed greater ability with certain instruments, among them guitar and trumpet; while normal-hearing patients identified piano and guitar with more ease,” said the otologist.
In one specific instance, it was observed that those who had lost their hearing before the age of five-years-old recorded the lowest results in all the musical tests. This is because they went deaf in the prelingual stage, in other words they had not acquired language skills; meanwhile, those who suffered hearing loss when they were older, once they had acquired language, had received stimulation in these areas.
Another great difference was revealed among normal-hearing persons who had prior musical training, and who managed to differentiate between tones very well; something similar occurred among implant patients with some musical perception, and these achieved better results than subjects who lacked this ability.
The big question, then, is: do these results correlate to language or not? For Doctor Adelaida Plaza, they do correlate in implant patients and normal-hearing persons. The study shows that better performance was achieved in speech tests by implant patients who also got high results in musical perception, basically in timbre and melody.
According to another interpretation, people who are not musical may have greater difficulties when it comes to learning a language or discriminating speech. It is noteworthy that patients’ knowledge of music did not need to be of professional level; basic training or having received some classes was considered enough to confer an advantage. Within this panorama, otorhinolaryngologist Plaza Ruiz commented that, according to results, “it could mean that implant patients with a sensibility for music can improve their speech since music awakens other areas of the brain. It would be good for hearing loss patients to be involved in more music training while they are receiving other types of therapy, since musical stimulation is supremely important for interrelating brain areas directly involved with musical perception, as well as speech perception.”
As with all research, new questions arise, and one that the scientific community will have to tackle at some moment is: how do you teach music to a hypoacusic patient when everything is designed for normalhearing patients? There is a new specialty in musical therapy appearing and becoming a profession, with experts now set up in some of the country’s centres who are devoted to teaching patients with special needs how to develop musical abilities.
Endoscopic surgery, another option for specialists
In another area of the profession, Dr. Adelaida Plaza told Audio Infos about one of the procedures that has grown internationally over the past two years and in which Colombia is a leader in the Latin America region. This is the field of endoscopic surgery, part of the evolution from the microscope to the endoscope which has brought so many benefits for patients.
“Bringing in endoscopic surgery in our country offers several advantages that optimise the procedures related to hearing. To begin with, we now have greater visualisation of structures that we could not observe before due to the relatively limited capactiy of the microscope. With the endoscope we have a greater visual field, allowing us to make real-time measurements to assure the success of patient recuperation,” pointed out Dr. Plaza.
Surgery currently using endoscopic techniques in Colombia includes extraction of tumours and tympanoplasty, among other procedures, and this has led to shorter surgery times, and less-invasive and less-painful operations for patients, who need less recuperation time.
One of the specific subjects under investigation by Dr. Plaza is related to blockages in ventilation pathways that are evaluated using endoscopic vision. “We are comparing ventilation pathway blockages in normal ears wtih those in patients suffering from chronic otitis media. This means we are studying blockage cases to get an idea of the prevalence of cases so that if we find a really high percentage we will need to modify the current surgery protocol. Hearing professionals would then be obliged to check the state of the ventilation pathways in procedures and, if they find blockages, immediately take the necessary actions,” explains the otologist.
So far, it is looking like the importance of the presence of blockages could mean that checking them would influence the prevention of future infections and patient relapses. “If, while carrying out surgery, I realise that there is obstruction in the ventilation pathways, I can clear them so that the patient will have no further problems. Until now, this procedure was not possible because there was no tool allowing for it. With the endoscope, we can get to places we never imagined we would reach, so we don’t need to stop at repairing the perforation we were performing; we can also evaluate and prevent chronic infections in the ear,” added Adelaida Plaza.
To sum up, this means a change in concepts and the exploration of procedures that benefit patients’ quality of life, and for this one must advance in training processes not only for experienced professionals but also for those who are on the point of completing their specialty studies. According to Plaza, “teaching endoscopic surgery is more dynamic, everything is on screen, is more attractive to learn, and the results are more effective. So now we have courses and practicals aimed at otorhinolaryngologists and otologists who want to update their knowledge so they can start using endoscopes. People are shy of getting involved in new techniques but we are leading this process in Colombia and in the region with the help of the universities and the Colombian Association of Otology and Neurotology, and because of this we receive visits all year round from professionals who want to train here.”
Read the complete article on Audio Infos Latin America 52 (bilingual):
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Photos: A.P.R., Sergey Galushkoa - Fotolia, M.B.P.