Creating an Ear and Hearing Health Culture for Professional Ear Users: Current Perspectives on Challenges, Management, and Recommendations.

Professional ear users (PEUs), including musicians, instrument makers, or sound engineers, depend on highly trained auditory abilities for occupational performance. Given these demands, PEUs may benefit from tailored prevention, diagnostics, and treatment. Ear and hearing disorders are common and potentially career-ending in these populations, yet PEU-specific care pathways remain underdeveloped. This narrative review synthesizes the clinical experience of the authors with current evidence, recommendations, and challenges to advance an interdisciplinary framework for PEU ear and hearing health care: prevention of music- and noise-induced disorders, attention to non-noise risk factors, advanced diagnostics beyond standard audiometry, allied-health collaboration, and individualized treatment addressing professional consequences. Although most evidence comes from musicians and, to a lesser extent, other PEUs, the framework applies broadly to auditory-dependent professions. Drawing on the Capability-Opportunity-Motivation model and analogous cultures in performing arts and elite sports, we propose concrete anchors for behavioral and institutional change, advocating an interdisciplinary culture integrating education, monitoring, and specialized care across medical, occupational, educational, and regulatory stakeholders. Empirical evaluation of comprehensive PEU-specific protocols has yet to be conducted. Therefore, the recommendations presented here are also intended as a basis for future studies testing their effectiveness.