by Neil Bauman, Ph.D.
A mother asked:
My daughter has bilateral LVAS and is begging to play an instrument. Do you have any advice or experience with what instruments are safe for children with LVAS to play?
Some people with LVAS (Large Vestibular Aqueduct Syndrome, sometimes called EVAS—Enlarged Vestibular Aqueduct Syndrome) are very sensitive to changes in air pressure. For them, even blowing on a brass instrument (trumpet, trombone, tuba, etc.) can result in further hearing loss. For these people, any musical instrument that does not require them to blow is safe in that regard.
As far as I know, hearing loss from people with LVAS playing musical instruments is quite rare. Therefore, playing a woodwind or brass instrument probably won’t affect her hearing.
Fortunately, there is a way you can figure this out. It is simply this. If your daughter’s hearing is affected by changes in air pressure (low or high pressure systems moving in rapidly, by going up or down hills in vehicles, by flying, or exerting or straining herself—running very hard, pressing weights, etc.) then the exertion needed to blow a brass instrument will also likely cause a hearing loss.
However, if the above things do not affect her hearing, then it is highly unlikely that playing a woodwind or brass instrument would affect her hearing either.
In short, if you’ve watched what activities have caused hearing loss in your daughter in the past, then those and similar activities will likely cause more hearing loss in the future if she takes part in them. Other than that, you shouldn’t unduly restrict her activities. You should be able to make a good judgment call on this issue by applying the above to her situation.
Finally, one caution, and this is for everyone, not just people with LVAS, the volume of sounds in bands and orchestras can be dangerous to your hearing. Therefore, it is wise to use ear protectors to keep the sounds down to an acceptable level and thus preserve your hearing. There are special musicians’ ear protectors that reduce the volume without affecting how you hear pitch. Many professional musicians wear them. You would do well to do the same.
What about playing flute? One blows and directs the air into the tone hole of the mouthpiece, but a lot of the air “escapes” so it’s not as intense, I would think, as blowing into a brass instrument and definitely not as intense as an oboe! My daughter REALLY wants to play flute.
Hi Cindy:
Personally, I don’t think playing a flute will cause any problems if you have LVAS because it is the “back pressure” that is the problem. Think how much pressure you need to play a tuba or sousaphone. Look at how the plyer’s cheeks puff out. In contrast playing a flute is more like breathing than forcefully blowing. You are not creating much if any back pressure.
Of course, there are no guarantees, especially if your daughter is very sensitive to pressure changes. I’d certainly let her play the flute, but watch her. If it causes hearing loss, stop it. But I’ll bet she doesn’t have any problems.
Cordially,
Neil