Tribute to the Flute: A Literature Review of Playing-Related Problems in Flautists

References

• O’Brien I, Wilson W, Bradley A. Nature of orchestral noise. J Acoust Soc Am. 2008;124(2):926–939. doi:10.1121/1.2940589
   PubMed Web of Science ®Google Scholar
• Steinmetz A, Zeh A, Delank KS, Peroz I. Symptoms of craniomandibular dysfunction in professional orchestra musicians. Occup Med. 2014;64(1):17–22. doi:10.1093/occmed/kqt148
   Google Scholar
• Burkholder KR, Brandfonbrener AG. Performance-related injuries among student musicians at a specialty clinic. Med Probl Perform Art. 2004;19(3):116–122. doi:10.21091/mppa.2004.3020
   Web of Science ®Google Scholar
• Fishbein M, Middlestadt S, Ottati V, Straus S, Ellis A. Medical problems among ICSOM musicians: overview of a national survey. Med Probl Perform Art. 1988;3:1–8.
   Web of Science ®Google Scholar
• Stanhope J, Milanese S, Grimmer K. University woodwind students experiences with playing-related injuries and their management: a pilot study. J Pain Res. 2014;7:133–148. doi:10.2147/JPR.S49620
   PubMed Web of Science ®Google Scholar
• Guptill C. The lived experience of working as a musician with an injury. Work. 2011;40(3):269–280. doi:10.3233/WOR-2011-1230
   PubMedGoogle Scholar
• Lonsdale K, Laakso EL, Tomlinson V. Contributing factors, prevention, and management of playing-related musculoskeletal disorders among flute players internationally. Med Probl Perform Art. 2014;29(3):155–162. doi:10.21091/mppa.2014.3032
   PubMed Web of Science ®Google Scholar
• Cruder C, Soldini E, Gleeson N, Barbero M. Factors associated with increased risk of playing-related disorders among classical music students within the risk of music students (RISMUS) longitudinal study. Sci Rep. 2023;13(1):22939. doi:10.1038/s41598-023-49965-7
   PubMed Web of Science ®Google Scholar
• van Selms MKA, Wiegers JW, Meer HA, Ahlberg J, Lobbezoo F, Visscher CM. Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians. J Oral Rehabil. 2020;47(2):132–142. doi:10.1111/joor.12886
   PubMed Web of Science ®Google Scholar
• Jang JY, Kwon JS, Lee DH, Bae JH, Kim ST. Clinical signs and subjective symptoms of temporomandibular disorders in instrumentalists. Yonsei Med J. 2016;57(6):1500. doi:10.3349/ymj.2016.57.6.1500
   PubMed Web of Science ®Google Scholar
• Roset-Llobet J, Rosinés-Cubells D, Saló-Orfila JM. Identification of risk factors for musicians in Catalonia (Spain). Med Probl Perform Art. 2000;15(4):167–174. doi:10.21091/mppa.2000.4032
   Web of Science ®Google Scholar
• Rodríguez-Gude C, Taboada-Iglesias Y, Pino-Juste M. Musculoskeletal pain in musicians: prevalence and risk factors – a systematic review. Int J Occup Saf Ergon. 2023;29(2):883–901. doi:10.1080/10803548.2022.2086742
   PubMed Web of Science ®Google Scholar
• Fry HJ. Incidence of overuse syndrome in the symphony orchestra. Med Probl Perform Art. 1986;1(2):51–55.
   Web of Science ®Google Scholar
• Yang N, Fufa DT, Wolff AL. A musician-centered approach to management of performance-related upper musculoskeletal injuries. J Hand Ther. 2021;34(2):208–216. doi:10.1016/j.jht.2021.04.006
   PubMed Web of Science ®Google Scholar
• Hausen B, Beinhauer A. Cocobolo-Holzallergie bei einer Flötenlehrerin. Akt Dermatol. 2004;30(11):489–492. doi:10.1055/s-2004-825987
   Google Scholar
• Wainapel S, Cole J. The not-so-magic flute: two cases of distal ulnar nerve entrapment. Med Probl Perform Art. 1988;3(2):63–65.
   Web of Science ®Google Scholar
• Cynamon KB. Flutist’s neuropathy. N Engl J Med. 1981;305(16):961.
   PubMed Web of Science ®Google Scholar
• Charness ME, Parry GJ, Markison RE, Rosegay H, Barbaro NM. Entrapment neuropathies in musicians. Neurology. 1985;35(4 Suppl 1):1.
   PubMedGoogle Scholar
• Lederman RJ. Thoracic outlet syndromes. Med Probl Perform Art. 1987;2(3):87–91.
   Web of Science ®Google Scholar
• Brandfonbrener AG. Musicians with focal dystonia: a report of 58 cases seen during a ten-year period at a performing arts medicine clinic. Med Probl Perform Art. 1995;10:121–127.
   Web of Science ®Google Scholar
• Lederman RJ. Occupational cramp in instrumental musicians. Med Probl Perform Art. 1988;3:45–51.
   Web of Science ®Google Scholar
• Brandfonbrener AG, Robson C. A review of 111 musicians with focal dystonia seen at a performing artist’s clinic 1985–2002. Mov Disord. 2002;17(5):1135. doi:10.1002/mds.10319
   Google Scholar
• Frucht SJ. Embouchure dystonia: a video guide to diagnosis and evaluation. J Clin Mov Disord. 2016;3(1):10. doi:10.1186/s40734-016-0035-x
   PubMedGoogle Scholar
• Wilson FR, Wagner C, Hömberg V. Biomechanical abnormalities in musicians with occupational cramp/focal dystonia. J Hand Ther. 1993;6(4):298–307. doi:10.1016/S0894-1130(12)80331-0
   PubMedGoogle Scholar
• Charness ME, Ross MH, Shefner JM. Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: clinical correlation in musicians. Muscle Nerve. 1996;19(4):431–437. doi:10.1002/mus.880190403
   PubMed Web of Science ®Google Scholar
• Altenmüller E, Baur V, Hofmann A, Lim VK, Jabusch HC. Musician’s cramp as manifestation of maladaptive brain plasticity: arguments from instrumental differences. Ann N Y Acad Sci. 2012;1252(1):259–265. doi:10.1111/j.1749-6632.2012.06456.x
   PubMedGoogle Scholar
• Frucht SJ, Fahn S, Greene PE, et al. The natural history of embouchure Dystonia. Mov Disord. 2001;16(5):899–906. doi:10.1002/mds.1167
   PubMed Web of Science ®Google Scholar
• Frucht SJ. Embouchure dystonia: portrait of a task-specific cranial dystonia. Mov Disord. 2009;24(12):1752–1762. doi:10.1002/mds.22550
   PubMed Web of Science ®Google Scholar
• Lederman RJ. Focal dystonia in instrumentalists: clinical features. Med Probl Perform Art. 1991;6:132–136.
   Web of Science ®Google Scholar
• Glória JC, Balestra AA, Iasbik NS, Douglas-de-Oliveira DW, Flecha OD, Gonçalves PF. Prevalence of orofacial changes in wind instrumentalists: a cross-sectional pilot study in Brazil. Med Probl Perform Art. 2018;33(1):1–5. doi:10.21091/mppa.2018.1002
   PubMed Web of Science ®Google Scholar
• Rodrigues M, Freitas M, Neves M, Silva M. Evaluation of the noise exposure of symphonic orchestra musicians. Noise Health. 2014;16(68):40. doi:10.4103/1463-1741.127854
   PubMed Web of Science ®Google Scholar
• Wahlström Edling C W, Fjellman-Wiklund A. Musculoskeletal Disorders and asymmetric playing postures of the upper extremity and back in music teachers: a pilot study. Med Probl Perform Art. 2009;24(3):113–118. doi:10.21091/mppa.2009.3025
   Web of Science ®Google Scholar
• Guptill C, Zaza C, Paul S. An occupational study of physical playing-related injuries in college music students. Med Probl Perform Art. 2000;15(2):86–90. doi:10.21091/mppa.2000.2018
   Web of Science ®Google Scholar
• Bird HA. Overuse syndrome in musicians. Clin Rheumatol. 2013;32(4):475–479. doi:10.1007/s10067-013-2198-2
   PubMed Web of Science ®Google Scholar
• Gasenzer E, Klumpp M, Pieper D, Neugebauer E. The prevalence of chronic pain in orchestra musicians. Ger Med Sci. 2017;15:Doc01.
   PubMedGoogle Scholar
• Stanhope J, Weinstein P. Should musicians play in pain? Br J Pain. 2021;15(1):82–90. doi:10.1177/2049463720911399
   PubMed Web of Science ®Google Scholar
• Fry HJH. Patterns of over-use seen in 658 affected instrumental musicians. Int J Music Educ. 1988;os-11(1):3–16. doi:10.1177/025576148801100101
   Google Scholar
• Cammarota G, Masala G, Cianci R, et al. Reflux symptoms in wind instrument players. Aliment Pharmacol Ther. 2010;31(5):593–600. doi:10.1111/j.1365-2036.2009.04208.x
   PubMed Web of Science ®Google Scholar
• SIGN grading system 1999–2012 Edinburgh: Scottish intercollegiate guidelines network; 2023. Available from: https://www.sign.ac.uk/assets/sign_grading_system_1999_2012.pdf. Accessed March 31, 2023.
   Google Scholar
• Ackermann BJ, Kenny DT, Fortune J. Incidence of injury and attitudes to injury management in skilled flute players. Work. 2011;40(3):255–259. doi:10.3233/WOR-2011-1227
   PubMedGoogle Scholar
• Fortune J, Kenny DT, Ackermann BJ. Performance-related musculoskeletal disorders in tertiary-level flute players and relationships with muscle tension and music performance anxiety. Med Probl Perform Art. 2007;22:175–176.
   Google Scholar
• Spence C S. Prevalence rates for medical problems among flautists: a comparison of the UNT-musician health survey and the flute health survey. Med Probl Perform Art. 2001;16(3):99–101. doi:10.21091/mppa.2001.3017
   Web of Science ®Google Scholar
• Artigues-Cano I, Bird H. Hypermobility and proprioception in the finger joints of flautists. J Clin Rheumatol. 2014;20(4):203–208. doi:10.1097/RHU.0000000000000109
   PubMed Web of Science ®Google Scholar
• Patrone NA, Hoppmann RA, Whaley J, Chauncey B. Benign hypermobility in a flutist. Med Probl Perform Art. 1988;3:158–161.
   Web of Science ®Google Scholar
• Ramella M, Fronte F, Converti R. Postural disorders in conservatory students: the diesis project. Med Probl Perform Art. 2014;29(1):19–22. doi:10.21091/mppa.2014.1005
   PubMed Web of Science ®Google Scholar
• Larsson L, Baum J, Mudholkar G, Kollia G. Benefits and disadvantages of joint hypermobility among musicians. N Engl J Med. 1993;329(15):1079–1082. doi:10.1056/NEJM199310073291504
   PubMed Web of Science ®Google Scholar
• Dawson WJ. Upper-extremity Problems Caused by Playing Specific Instruments. Med Probl Perform Art. 2002;17(3):135–140. doi:10.21091/mppa.2002.3022
   Web of Science ®Google Scholar
• Shoup D. Survey of performance-related problems among high school and junior high school musicians. Med Probl Perform Art. 1995;10:100–105.
   Web of Science ®Google Scholar
• Kok LM, Groenewegen KA, Huisstede BMA, Nelissen RJ, Rietveld ABM, Haitjema S. The high prevalence of playing-related musculoskeletal disorders (PRMDs) and its associated factors in amateur musicians playing in student orchestras: a cross-sectional study. PLoS One. 2018;13(2):e0191772. doi:10.1371/journal.pone.0191772
   PubMed Web of Science ®Google Scholar
• Kok LM, Vlieland TPV, Fiocco M, Nelissen RG. A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians. BMC Musculoskelet Disord. 2013;14(1):9. doi:10.1186/1471-2474-14-9
   PubMedGoogle Scholar
• Manchester RA. The incidence of hand problems in music students. Med Probl Perform Art. 1988;3:15–18.
   Web of Science ®Google Scholar
• Bengtson KA, Schutt AH. Upper extremity musculoskeletal problems in musicians: a follow up survey. Med Probl Perform Art. 1992;7:44–47.
   Web of Science ®Google Scholar
• Knishkowy B, Lederman RJ. Instrumental musicians with upper extremity disorders: a follow-up study. Med Probl Perform Art. 1986;1:85–89.
   Web of Science ®Google Scholar
• Hochberg FH, Leffert RD, Heller MD, Merriman L. Hand difficulties among musicians. JAMA. 1983;249(14):1869–1872. doi:10.1001/jama.1983.03330380057027
   PubMed Web of Science ®Google Scholar
• Cayea D, Manchester RA. Instrument-specific rates of upper-extremity injuries in music students. Med Probl Perform Art. 1998;13:19–25.
   Web of Science ®Google Scholar
• Manchester RA, Flieder D. Further observations on the epidemiology of hand injuries in music students. Med Probl Perform Art. 1991;6:11–14.
   Web of Science ®Google Scholar
• Wolff AL, Ling DI, Casey EK, Toresdahl BG, Gellhorn AC. Feasibility and impact of a musculoskeletal health for musicians (MHM) program for musician students: a randomized controlled pilot study. J Hand Ther. 2021;34(2):159–165. doi:10.1016/j.jht.2021.04.001
   PubMed Web of Science ®Google Scholar
• Brandfonbrener AG. Joint laxity and arm pain in a large clinical sample of musicians. Med Probl Perform Art. 2002;17(3):113–115. doi:10.21091/mppa.2002.3017
   Web of Science ®Google Scholar
• Britsch L. Investigating performance-related problems of young musicians. Med Probl Perform Art. 2005;20(1):40–47. doi:10.21091/mppa.2005.1007
   Web of Science ®Google Scholar
• Steinmetz A, Möller H, Seidel W, Rigotti T. Playing-related musculoskeletal disorders in music students-associated musculoskeletal signs. Eur J Phys Rehabil Med. 2012;48(4):625–633.
   PubMed Web of Science ®Google Scholar
• Sousa CM, Machado JP, Greten HJ, Coimbra D. Occupational diseases of professional orchestra musicians from northern Portugal: a descriptive study. Med Probl Perform Art. 2016;31(1):8–12. doi:10.21091/mppa.2016.1002
   PubMed Web of Science ®Google Scholar
• Ackermann B, Driscoll T, Kenny DT. Musculoskeletal pain and injury in professional orchestral musicians in Australia. Med Probl Perform Art. 2012;27(4):181–187. doi:10.21091/mppa.2012.4034
   PubMed Web of Science ®Google Scholar
• Steinmetz A, Seidel W, Muche B. Impairment of postural stabilization systems in musicians with playing-related musculoskeletal disorders. J Manipulative Physiol Ther. 2010;33(8):603–611. doi:10.1016/j.jmpt.2010.08.006
   PubMed Web of Science ®Google Scholar
• Nemoto K, Arino H. Hand and upper extremity problems in wind instrument players in military bands. Med Probl Perform Art. 2007;22(2):67–69. doi:10.21091/mppa.2007.2014
   Web of Science ®Google Scholar
• Nyman T, Wiktorin C, Mulder M, Johansson YL. Work postures and neck–shoulder pain among orchestra musicians. Am J Ind Med. 2007;50(5):370–376. doi:10.1002/ajim.20454
   PubMed Web of Science ®Google Scholar
• Stanek JL, Komes KD, Murdock FA. A cross-sectional study of pain among U.S. college music students and faculty. Med Probl Perform Art. 2017;32(1):20–26. doi:10.21091/mppa.2017.1005
   PubMed Web of Science ®Google Scholar
• Ranelli S, Straker L, Smith A. Playing-related musculoskeletal problems in children learning instrumental music: the association between problem location and gender, age, and music exposure factors. Med Probl Perform Art. 2011;26(3):123–139. doi:10.21091/mppa.2011.3021
   PubMed Web of Science ®Google Scholar
• Paarup HM, Baelum J, Holm JW, Manniche C, Wedderkopp N. Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: a cross-sectional study. BMC Musculoskelet Disord. 2011;12(1):223. doi:10.1186/1471-2474-12-223
   PubMedGoogle Scholar
• Kok LM, Haitjema S, Groenewegen KA, Rietveld ABM. The influence of a sudden increase in playing time on playing-related musculoskeletal complaints in high-level amateur musicians in a longitudinal cohort study. PLoS One. 2016;11(9):e0163472. doi:10.1371/journal.pone.0163472
   PubMed Web of Science ®Google Scholar
• Fry HJ, Rowley GL. Music related upper limb pain in schoolchildren. Ann Rheum Dis. 1989;48(12):998–1002. doi:10.1136/ard.48.12.998
   PubMed Web of Science ®Google Scholar
• Newmark J, Lederman RJ. Practice doesn’t necessarily make perfect: incidence of overuse syndromes in amateur instrumentalists. Med Probl Perform Art. 1987;2(4):142–144.
   Web of Science ®Google Scholar
• Hartsell HD, Tata GE. A retrospective survey of music-related musculoskeletal problems occurring in undergraduate music students. Physiother Can. 1991;43(1):13–18.
   Google Scholar
• Newmark J, Hochberg FH. Isolated painless manual incoordination in 57 musicians. J Neurol Neurosurg Psychiatry. 1987;50(3):291–295. doi:10.1136/jnnp.50.3.291
   PubMed Web of Science ®Google Scholar
• Lederman RJ. Tremor in instrumentalists: influence of tremor type on performance. Med Probl Perform Art. 2007;22(2):70–73. doi:10.21091/mppa.2007.2105
   Web of Science ®Google Scholar
• Dahl MG. Flautist’s chin: a companion to fiddler’s neck. BMJ. 1978;2(6143):1023. doi:10.1136/bmj.2.6143.1023
   PubMedGoogle Scholar
• Inoue A, Shoji A, Fujita T. Flautist’s chin. Br J Dermatol. 1997;136:147. doi:10.1111/j.1365-2133.1997.tb08778.x
   PubMed Web of Science ®Google Scholar
• Freeman S, Stephens R. Cheilitis: analysis of 75 cases referred to a contact dermatitis clinic. Am J Contact Dermat. 1999;10(4):198–200.
   PubMedGoogle Scholar
• Jansen EJM, Helleman HW, Dreschler WA, de Laat JAPM. Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras. Int Arch Occup Environ Health. 2009;82(2):153–164. doi:10.1007/s00420-008-0317-1
   PubMed Web of Science ®Google Scholar
• Laitinen HM, Toppila EM, Olkinuora PS, Kuisma K. Sound exposure among the Finnish national opera personnel. Appl Occup Environ Hyg. 2003;18(3):177–182. doi:10.1080/10473220301356
   PubMedGoogle Scholar
• Lee J, Behar A, Kunov H, Wong W. Musicians’ noise exposure in orchestra pit. Appl Acoust. 2005;66(8):919–931. doi:10.1016/j.apacoust.2004.11.009
   Web of Science ®Google Scholar
• Qian C, Behar A, Wong W. Noise exposure of musicians of a ballet orchestra. Noise Health. 2011;13(50):51. doi:10.4103/1463-1741.74000
   PubMed Web of Science ®Google Scholar
• Schmidt JH, Pedersen ER, Juhl PM, et al. Sound exposure of symphony orchestra musicians. Ann Occup Hyg. 2011;55(8):893–905. doi:10.1093/annhyg/mer055
   PubMed Web of Science ®Google Scholar
• Royster DJ, Royster LH, Killion MC. Sound exposure and hearing thresholds of symphony orchestra musicians. J Acoust Soc Am. 1991;89(6):2793–2803. doi:10.1121/1.400719
   PubMed Web of Science ®Google Scholar
• Sabesky IJ, Korczynski RE. Noise exposure of symphony orchestra musicians. Appl Occup Environ Hyg. 1995;10(2):131–135. doi:10.1080/1047322X.1995.10389295
   Google Scholar
• Axelsson A, Lindgren F. Hearing in classical musicians. Acta Otolaryngol. 1981;91(sup377):1–100. doi:10.3109/00016488109108191
   Google Scholar
• Chesky K, Henoch MA. Instrument-specific reports of hearing loss: differences between classical and nonclassical musicians. Med Probl Perform Art. 2000;15(1):35–38. doi:10.21091/mppa.2000.1007
   Web of Science ®Google Scholar
• Emmerich E, Rudel L, Richter F. Is the audiologic status of professional musicians a reflection of the noise exposure in classical orchestral music? Eur Arch Otorhinolaryngol. 2008;265(7):753–758. doi:10.1007/s00405-007-0538-z
   PubMed Web of Science ®Google Scholar
• Ostri B, Eller N, Dahlin E, Skylv G. Hearing impairment in orchestral musicians. Scand Audiol. 1989;18(4):243–249. doi:10.3109/01050398909042202
   PubMed Web of Science ®Google Scholar
• McBride D, Gill F, Proops D, Harrington M, Gardiner K, Attwell C. Noise and the classical musician. BMJ. 1992;305(6868):1561–1563. doi:10.1136/bmj.305.6868.1561
   PubMedGoogle Scholar
• Kähäri KR, Axelsson A, Hellström PA, Zachau G. Hearing assessment of classical orchestral musicians. Scand Audiol. 2001;30(1):13–23. doi:10.1080/010503901750069536
   PubMed Web of Science ®Google Scholar
• Toppila E, Koskinen H, Pyykkö I. Hearing loss among classical-orchestra musicians. Noise Health. 2011;13(50):45. doi:10.4103/1463-1741.74001
   PubMed Web of Science ®Google Scholar
• Cramp JE, Horstman SW. Musician sound exposure during performance of wagner’s ring cycle. Med Probl Perform Art. 1992;7:37–39.
   Web of Science ®Google Scholar
• Folprechtová A, Mikšovská O. Akustické podmínky v symfonickém orchestru. Prac Lék. 1976;28(1–2):1.
   Google Scholar
• Jahto K, Hellmann H. Zur Frage des Lärm- und Klangtraumas des Orchestermusikers. HNO. 1972;20(1):21–29.
   PubMedGoogle Scholar
• Flach M, Aschoff E. Zur Frage berufsbedingter Schwerhörigkeit beim Musiker. Laryngologie. 1966;43:595–605.
   Google Scholar
• Schwab B, Schultze-Florey A. Velopharyngeal insufficiency in woodwind and brass players. Med Probl Perform Art. 2004;19(1):21–25. doi:10.21091/mppa.2004.1004
   Web of Science ®Google Scholar
• Malick D, Moon J, Canady J. Stress velopharyngeal incompetence: prevalence, treatment, and management practices. Cleft Palate Craniofac J. 2007;44(4):424–433. doi:10.1597/06-176.1
   PubMed Web of Science ®Google Scholar
• Costa MMB, Alvite FL. Lateral laryngopharyngeal diverticula: a videofluoroscopic study of laryngopharyngeal wall in wind instrumentalists. Arq Gastroenterol. 2012;49(2):99–106. doi:10.1590/S0004-28032012000200002
   PubMedGoogle Scholar
• Cappellaro J, Beber BC. Vocal tract discomfort and voice-related quality of life in wind instrumentalists. J Voice. 2018;32(3):314–318. doi:10.1016/j.jvoice.2017.05.011
   PubMed Web of Science ®Google Scholar
• Trollinger V, Alnouri G, Sataloff RT. LEMG findings of vocal fold paresis in voice patients who play or played wind instruments. J Voice. 2021;S0892–1997(21):356–358. doi:10.1016/j.jvoice.2021.10.018
   Google Scholar
• Plamenac P, Nikulin A. Atypia of the bronchial epithelium in wind instrument players and in singers: a cyto pathologic study. Acta Cytol. 1969;13(5):274–278.
   PubMed Web of Science ®Google Scholar
• Deniz O, Savci S, Tozkoparan E, Ince DI, Ucar M, Ciftci F. Reduced pulmonary function in wind instrument players. Arch Med Res. 2006;37(4):506–510. doi:10.1016/j.arcmed.2005.09.015
   PubMed Web of Science ®Google Scholar
• Bourne D, Hallaran A, Mackie J. The lived experience of orchestral string musicians with playing related pain. Med Probl Perform Art. 2019;34(4):198–204. doi:10.21091/mppa.2019.4031
   PubMed Web of Science ®Google Scholar
• Merkblatt zu der Berufskrankheit Nr. 2301 der Anlage zur Berufskrankheiten-Verordnung: lärmschwerhörigkeit [Fact sheet on occupational disease No. 2301 of the Annex to the Regulation on Occupational Diseases: Noise-induced hearing loss]; 2008. Available from: https://www.baua.de/DE/Themen/Praevention/Koerperliche-Gesundheit/Berufskrankheiten/pdf/Merkblatt-2301.pdf. Accessed September 17, 2023.
   Google Scholar
• Empfehlung für die Begutachtung der Lärmschwerhörigkeit (BK-Nr. 2301) – königsteiner Empfehlung [Recommendation for the assessment of noise-induced hearing loss (occupational disease no. 2301) - Königstein recommendation]; 2020. Available from: https://publikationen.dguv.de/widgets/pdf/download/article/2559. Accessed September 17, 2023.
   Google Scholar
• Notified and recognized occupational diseases in the field of the Berufsgenossenschaften. Classification: years, region, sex, type of occupational disease. Available from: https://www.gbe-bund.de/gbe/pkg_isgbe5.prc_menu_olap?p_uid=gast&p_aid=9921866&p_sprache=E&p_help=0&p_indnr=842&p_indsp=&p_ityp=H&p_fid=. Accessed September 17, 2023.
   Google Scholar
• Bächinger D, Jecker R, Hannig JC, et al. The professional ear user-implications for the prevention, diagnosis, and treatment of ear diseases. HNO. 2022;70(12):891–902. doi:10.1007/s00106-022-01235-0
   PubMed Web of Science ®Google Scholar
• Tikka C, Verbeek JH, Kateman E, Morata TC, Dreschler WA, Ferrite S. Interventions to prevent occupational noise-induced hearing loss. Cochrane Database Syst Rev. 2017;7(7):CD006396. doi:10.1002/14651858.CD006396.pub4
   PubMedGoogle Scholar
• Richter B, Zander M, Hohmann B, Spahn C. Hearing protectors in musicians. HNO. 2011;59(6):538–546. doi:10.1007/s00106-011-2306-z
   PubMed Web of Science ®Google Scholar
• Teie PU. Noise-induced hearing loss and symphony orchestra musicians: risk factors, effects, and management. Md Med J. 1998;47(1):13–18.
   PubMedGoogle Scholar
• Koppejan S, Snijders CJ, Kooiman T, Van Bemmel B. Hand and arm problems in flautists and a design for prevention. Ergonomics. 2006;49(3):316–322. doi:10.1080/00140130500436213
   PubMed Web of Science ®Google Scholar
• Lee SH, Carey S, Dubey R, Matz R. Intervention program in college instrumental musicians, with kinematics analysis of cello and flute playing: a combined program of yogic breathing and muscle strengthening-flexibility exercises. Med Probl Perform Art. 2012;27(2):85–94. doi:10.21091/mppa.2012.2016
   PubMed Web of Science ®Google Scholar
• Visser A, Van Der Biezen JJ. Inferior-based pharyngeal flap for correction of stress velopharyngeal incompetence in musicians: case reports and review of the literature. J Plast Reconstr Aesthet Surg. 2012;65(7):960–962. doi:10.1016/j.bjps.2011.11.049
   PubMed Web of Science ®Google Scholar
• Clemente M, Mendes J, Moreira A, Vardasca R, Ferreira A, Amarante J. Wind Instrumentalists and temporomandibular disorder: from diagnosis to treatment. Dent J. 2018;6(3):41. doi:10.3390/dj6030041
   Google Scholar
• Kenny DT, Fortune JM, Ackermann B. Predictors of music performance anxiety during skilled performance in tertiary flute players. Psychol Music. 2013;41(3):306–328. doi:10.1177/0305735611425904
   Web of Science ®Google Scholar