Musical pitches

I have bilateral sensorineural hearing loss and have been wearing aids since 2017.
I am a musician and play piano everyday ( well I did!)
Two and a half years ago I had ear wax removed by microsuction and from that day I have had all sorts of sound problems including the piano sounding like a fuzzy mess.
About a year ago three of the higher notes ( E6,F6 & F#6 ) became badly out of tune, rather I was hearing them out of tune. This is incredibly annoying when listening and playing music but as they are quite high notes and aren’t played all the time it’s just about bearable.
Then inexplicably the other day I started hearing G5 and A5 as G# and A#. This is right in the normal music range and has pretty much ended my playing and listening, music is simply not worth listening to if it’s full of WRONG notes.

I was just wondering if this has happened to anyone else and is there any solution ( I think I know the answer to the solution question)
Thanks

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Yes I experience something similar. Under certain conditions and songs I hear them playing in the wrong key so consequently the melody and harmonies are perceived as incorrect. This happens with songs I am extreme familiar with and know the key and chord structure very well ( am a guitar player). When this happens I have to force my brain to rethink what I am hearing to get it back to the right key.
There are some setting on most modern HAs that lower the frequency of some some sounds so that it enhances speech understanding depending on your audio gram. I have a Music program with it turned off and other tweaks like reducing feedback suppression. This makes some improvement but does not eliminate the problem.
I have rationalized this by assuming I hear some harmonics or overtones preferentially over the dominant frequency, and my brain does it’s best to make sense of the music and sometimes gets it wrong.

Thankfully it does not happen all the time, but it has certainly reduced my music listening habits unfortunately.

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I believe this is a fairly common consequence of SN loss in some people, but not necessarily noticed by all of those affected by it. I have a mixed loss in both ears and if I play a pure sine wave, say middle C, into one ear and then the other, I can hear a significant difference of pitch between my two ears. I can tell that it’s the ear with the greater hearing loss that is “out of tune” There is nothing to be done about it unfortunately, except to turn that ear down a bit when listening to music.

Incidentally I think it is more noticeable if you listen through one ear at a time. With both ears hearing, the brain seems to defer to the better ear. It’s very annoying and life-affecting, but it is also interesting from a technical point of view.

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Thanks Hooby and David, in a way it’s nice to know I’m not the only one except I’m sorry you are suffering too.
I will have a go at your suggestions but it does seem like I’m on a downward spiral and i should probably get my head set to accept that this is it now. Bugger.

Lots of things you can do. #1 is to learn to tune your own hearing aids and tune your own piano.

Also read - Marshall Chasin
Hearing Loss in Musicians: Prevention and Management

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You are far from alone. Probably many hard of hearing people have this issue, but not being trained musicians, don’t notice it. I am an amateur musician, and play the French horn and I sing in a choir. In both cases I have to hit a note by muscle memory and tune by ear. However, many octaves sound nearly a semitone short. That makes it hard to play in tune!

Interestingly, when using double domes to occlude the sound, the further they are inserted into the ear canal, the better octaves sound in tune. This I don’t understand.

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You can’t “tune” your hearing aids. You can certainly learn to adjust the fit, but that is about sound levels and not the frequency or pitch of individual notes!

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This is interesting.

To clarify, are you suggesting that with focussed attention you can convince your brain to make it perceive the correct note again?

Pushing the double domes in deeper with increase the volume overall but also particularly the volume of the lower frequencies.

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To clarify, are you suggesting that with focussed attention you can convince your brain to make it perceive the correct note again?

@Neville
Yes - it takes concentration but at some point the perceived key will “flip” to the correct one (but can also flip back again). I think it only works with music I am familiar with or know for sure what key it is in. I can’t do this with completely new music as I have no frame of reference - so I am likely to dislike the music as it make little sense and sounds wrong to me.

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This is all very interesting. I notice that if I am streaming to my hearing aids, I perceive a tone as being about a semitone out if I play to one ear and then the other. If I stream music to both ears and mute my right ear, immediately the music in my left ear sounds out of tune, all over the place, not just a semitone flat or sharp. If I turn my better ear’s stream on again, my less good ear seems now to play in tune. Listening to a concert playing on an expensive HiFi just now as I type, I have no sense of it being out of tune in one ear.

I think this must be a similar effect to when a better eye leads the brain and something can look sharply in focus, but if you shut the better focused eye, the softer focus from the less good eye becomes apparent.

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Thank you. This is not wildly surprising, given neural plasticity, but definitely interesting to hear. So if one were to propose a sort of therapy for others in the same situation I might imagine that you could make a play list of songs that you know very well and do some close listening. Or do you find that it is easier when playing (as long as you are sure your instrument is in tune)? Do you have one ear that hears things in tune that can support the other ear, and if so would you focus your attention towards the good ear or the bad ear? One might imagine that it could take a long time to get it to “flip” in the first place, but might be faster later, once managed.

I would imagine that successful musical therapy for CI users would similarly start out by focussing on music that is very well-known.

Interesting, and also makes sense for the good ear to lead the bad. Although, given right-ear advantage I wonder if you are better off because your left ear is the poorer one.

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Thanks for all these replies and suggestions.

All very interesting. I have also found if I play G4 & G5 together , G5 sounds in tune but immediately sharpens a semitone if then play it on its own, same with the A. What is this, overtones . So all I need to do is also play the octave below evertime I play G or A !!!

Re playing the Horn, I am an ex trumpet player, really can’t imagine trying to play the G and A ( would be A and B on a trumpet ) if I was hearing Bb and C.

I agree and disagree. I agree that the post you are referring to is recommending self-adjustment of the aids as far as EQ, compression, etc. However, with new aids offering to pitch shift some content (using one marketing name or another), we also have to be aware to either shut this off, or if it’s even possible, pitch shift it by something musically acceptable (like an octave).

I don’t have aids that provide this function, but I am overdue for a new pair. My audiologist had mentioned this feature to me several times, but I don’t think I would want any pitch shifting and just deal with what hearing I can get using the more classical approaches (Eq, compression, etc).

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I’m afraid it just doesn’t work that way. You do have to shut frequency shifting/compression off for music, for sure. In any case you can’t tune individual frequencies and the pitch shift that we are discussing varies with frequency.

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I had/have a similar problem. I was playing bass in an amplified acoustic duo. My partner’s wedge monitor seemed to blare at me into my left ear with what seemed like an atonal roar. I would lean my right ear down toward my own monitor and things would clear up and I could hear the key again.

It turned out that I had an acoustic neuroma developing in my left ear. I’m not suggesting that everyone with diplacusis (hearing the same actual tone differently in each ear) has an acoustic neuroma, but you might want to visit an audiologist and have the audi conduct a word recognition test. If your word recognition score is poorer than would be predicted by your pure tone audiometry score you might want to go to an ENT and have an MRI to rule out an acoustic neuroma.

As for dealing with your problem, you could set up some kind of monitoring system that would pick up the piano sound and amplify it and then direct the amplified piano sound into your good, accurate ear. That way you would be hearing the sound louder in your good ear and your bad ear would tend to adjust.

Or you could buy a bi-CROS HA system to use only for playing piano. With a bi-CROS system, the HA on your bad ear is just a microphone that picks up the sound and re-routes the sound to the HA on your good ear. The the system then combines the signal from the microphone on the bad ear side with the signal from the HA microphone on the good ear, and then sends the combined sound into your good ear for processing to your brain

It’s an expensive solution but it might allow you to continue enjoying playing piano. Good luck.

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That’s crazy, Even for someone that doesn’t listen to or play music that has to be awful. I could see downshifting a range by an octave, but if it’s pretty much anything but that the results will drive one insane in short order.

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I’m curious what your audiogram looks like. I have notched bilateral sn loss, although peaking in different bands between ears. Similar experience. I was blessed (or cursed) with perfect pitch from birth and I’ve since lost it at only ~30 years of age due to this loss, feels like I’ve lost a vital sense and it drives me mad. I’ve contemplated suicide a lot over the last years just having experienced this loss and dealing with it. I finally decided to stop being so stubborn and giving headphones w/ EQ a shot, and now hearing aids a go again, just for the sake of enjoying music (I can manage conversations at regular volumes decently well unaided). As much as a medical marvel modern HAs are, I feel in my case very basic 1/X parametric shaping of my loss “pattern” at certain key points at a fixed SPL is the key, with “features” like compression and such that affect the spectrum in various ways not being present to cause further problems. But I don’t know if any modern HA are capable of this behaviour, and I’m sure certain people could benefit from transposition but my intuition tells me it of course depends on the nature of the loss and the bands affected. I plan on making a thread talking about my experiences and how I’ve been dealing with it.

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Well this has opened a minefield to me. I do not have access to my audiogram and I’m in the dark about anything to do with that. I have been trying a few things however. Using headphones I tried playing just using the headphone on one ear at a time. My left ear (worst ear) sounds like one of those little transister radios from 50 years ago, almost no bass, also all notes from about C5 up sound very much the same. My right ear sounds normal except the G5,G#5,A5 and the E6,F6,F#6 which are either sharp or flat, some as much as a semitone. Trying things out just now I dont seem to have a way of playing G5 or anything near it ( to my ears anyway). Basically I dont have a ‘good’ ear to work with.
I very much appreciate all the suggestions but to say I am despondent would be an understatement.

Seems very similar to my experience from the words you describe although I would consider my left ear my “good” one simply because the losses I have there are in a less significant band. If you click on my audiogram under my username you can see a little of what I am describing. If you look at the audiograms of many other people, especially those with age or chronic-exposure hearing loss, usually you will see a relatively broadband loss that’s either relatively even across the audible spectrum, or more of a gentle sloping loss with bias towards the higher frequencies, as they are most vulnerable to loss. This is because they are concentrated at the apex of the cochlea, being the most vulnerable due to being exposed to the most sound, while also simultaneously having less concentration of hair cells responsible for those frequencies. This is more or less an inevitable thing and product of life like cancer- the longer you live the less of these cells you will likely have and the worse your hearing will be, just like how if you live long enough some cells in your body will simply mutate to a point where your immune system cannot deal with it and they will proliferate in the body. I think this is the “best” situation one can be in terms of hearing loss, because it is more of a gradual loss of function that can usually be remedied quite well through simple broadband amplification, all the “mechanisms” of hearing are still there are more or less working relatively well as a unit, and there is more or less equal or at least progressive deficiency across the board, so it is more predictable to fix and yields better results. The hearing loss I have is the antithesis to this more or less- my hearing prior to the loss was extremely good, and even now I hear very high and very low frequencies completely fine. Great in fact. But important low/mid bands are completely scooped and carved out randomly, which makes mine an atypical case.

When I first found out about my hearing loss, it was tough. Through a battery of tests, MRIs etc I never got closure on how it happened and they found “nothing wrong”, and I have no idea whether is was really due to some acute noise exposure, some medications I was on, a vascular or immune problem or something of that nature. Seeing as how I’m young and can still manage conversations at regular volume (around 50-60 dB) with minor issue, but as a great music lover having it so impacted I figured “hey I will just use my audiogram as a template for applying parametric eq to my music in each ear so I can hear what I am actually missing”, but soon realised it is much more complicated than that. Luckily (or not), I have a very broad scientific knowledge and love for music and music reproduction, and while I am not an audiologist or ENT, I’m also a graduate of medicine and have been involved with medical research, I have a strong background in biochemistry and engineering, so I quickly found out a lot about my loss through not only my experience of dealing with this loss/running informal experiments on my function, but also through reading numerous books and medical papers on the subject. What I was never told by my ENT or my audiologist is that, based on the massive sudden drop of notches I have in each ear, these are actually likely very “dead” cochlear regions where essentially, the cochlear function in terms of the signal transduction process is essentially wiped out due to one or more mechanisms, which I won’t describe for the sake of making the post too long.

One thing that is misleading or not intuitive is that- if my audiogram is showing my thresholds are ~50 dB down at 500hz, I’m still hearing something, right? So why can’t that be amplified or corrected like I’ve seen done successfully in elderly populations? Well it seems most people, and I think even many hearing professionals and doctors in the field don’t understand (at least conceptually) is that, in a case where thresholds like this are past a certain point (especially if the rest of the hearing is relatively OK and there are sudden or random drops), the “threshold” I am hearing at 500hz is not a 500hz tone at all, but rather is more accurately a “false positive” noisy tone. The noise I am hearing at -50dB is NOT what any respectable musician would consider a pure continuous tone but it is a result of other non-dead regions of the cochlea (and maybe even the other ear) being stimulated at low levels giving the impression there is something being heard. A simple audiogram obviously does not reflect this, and no audiologist or hearing care professional has ever asked me if the pure or modulating tones I am hearing in an audiogram seem odd, different, ringing, sharp/flat etc. Speech in noise/word intelligibility tests can give clues, but it can easily be missed or overlooked. So for example in my case, my loss that is shown to be peaking at around 500hz should technically be virtually down to the bottom of the audiogram, that is something that can never be amplified for me (and in fact, amplifying it will just cause more problems and more distortion as it will have psychoacoustic effects due to stimulating other areas of “good” hearing). If I play tones or notes in one ear at regular volumes near the regions where the loss is the most, it just sounds massively wrong and distorted, multiple cents or semitones off, since I am relying on my acuity and brain to sort through the harmonics that I can actually still hear. And since it is non-linear as you described, there’s no real predictable signal processing I’ve tried when running subjective experiments on myself that can compensate gracefully for the issue, since it is very dynamic and can change completely even shifting down a few hz.

I’m entertaining the idea of octave transposition, although, I don’t know how well that would actually work in practice for true fidelity of music in my case specifically, which is/was my MAIN goal for hearing aids, and 90% of the reason I am considering to give them a try again. Many hearing aid algorithms mostly focus on reasonably correcting losses that are correctable, and on top of that providing some other “enhancements” (perhaps in the harmonic octave of your hearing loss or key bands for speech intelligibility, namely in higher frequencies where consonant formant frequencies are critical) that will definitely help with things like speech intelligibility but in my opinion disfavourably imbalance the tonal balance of music. For example with my loss at ~400-1200hz in my right ear, an octave up would be 800-2400hz. You can immediately see the problem, since the loss falls in multiple octaves, pushing everything up would still not account for my unfixable/less fixable issues within 800-1200hz region, but may help some things like speech or localisation/awareness. Similarly pushing everything down to 200-600 would also have some overlap. Maybe a compromise in my case could be had pushing 400-800hz down to 200-400hz and then pushing 800-1200 up to 1600-2400 which would essentially be the “best” of both words- but from my understanding hearing aids don’t necessarily have the functionality to do this arbitrarily for any frequencies and it’s typically only really use to transpose much higher frequencies to lower ones in the case of that typical sloping loss you usually see for the sake of speech intelligibility (which is not a massive problem for me). You also have to factor in, moving stimulus from one frequency region to another “good” one through transposition is also going to hurt tonality and one’s intelligibility at regions where your hearing is actually “good”, since all of this transposition is going to mask fundamentals that occur in those bands, so it is a trade off. I can see this trade off being reasonable if someone has massive problems with conversation and communication- but since I don’t have this issue yet, why would I want to needlessly use these “features” when they are not conductive to my goal of maximising fidelity? I think there are some other solutions to this, like crossfeed or cross hearing aids where they transform and play the band in the opposite ear- but I am conveniently cursed with a loss in my “good” opposite ear that have a harmonic overlap with the losses in my bad ear! Argh! If I lower the frequencies in my better left ear, it falls into critical region of 400-1200 which is already working on overdrive to compensate for the deficiencies in my right! I have no idea what to do, and pray for a cure or solution.

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This is very interesting and if you do find an answer then I am sure there are others here who would benefit.

One other effect I notice is that the level needed to kick a less sensitive region of my cochlear into working, is higher than listening to the tones at a higher level would suggest. Or to put it another way, I have a non-linear response to pure tones. The just-audible to loud ratio in dB is different than for areas where I have less loss.

So in practical terms, my initial fit is always too loud at the frequencies that I can still hear above 1 kHz. That means that I always need the midrange turning down a bit (several dB). It’s particularly true in my left ear, which besides the cochlear damage (caused by calcification as a result of otosclerosis), had for many years a 40dB conductive loss which meant that my brain wasn’t getting to play with much in the way of signals from my left cochlear. In the last year I had this corrected by stapedectomy and there is a real sense that my brain is having to learn again to process stuff from my left cochlear, with some success I believe.

Anyway listening to music, I adjust the fitting so that the midrange and what lower treble I can hear sounds about the same level as it does in my right ear. My audiologist is rather bemused by this, but less so now that I do all my tweaking myself at home instead of going in and asking her for “take another 2dB off at 2kHz in my left ear please!”

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