Share this article on:

Interest in Hyperacusis on the Rise

Tyler, Richard S. PhD

doi: 10.1097/01.HJ.0000480889.17591.b4
Journal Club

Dr. Tyler is professor of otolaryngology–head and neck surgery and of communication sciences and disorders at the University of Iowa.

Figure 1.

Figure 1.

Many of the hyperacusis patients I see are much more distressed than the average tinnitus patient. Fortunately, there is now a greater interest from researchers and clinicians to explore mechanisms and provide treatment for this population.

Figure.

Figure.

There is a wide variety of symptoms associated with hyperacusis, and the terminology is often difficult to understand for clinicians and the general public (Phillips. J Am Acad Audiol1998;9[5]:371-379http://www.audiology.org/sites/default/files/journal/JAAA_09_05_06.pdf). This is not a good thing. The term “hyper” means excessive, and “acusis” involves sound. The different forms of hyperacusis can be simply and clearly distinguished with the terms loudness, annoyance, fear, and pain. These categories distinguish hyperacusis symptoms in a meaningful fashion.

Figure 2.

Figure 2.

The primary functions affected by hyperacusis include emotional well-being, hearing, sleep, and concentration (Tyler. Handbook of Clinical Audiology, Sixth Edition. Baltimore: Lippincott Williams and Wilkins, 2009). These can have secondary effects on socialization, physical health, work performance, education, and finances.

A Review of Hyperacusis and Future Directions:Part I. Definitions and Manifestations

Tyler, Richard S, Pienkowski, M, Roncancio, Eveling R, et al

Am J Audiol

2014;23(4):402-419http://aja.pubs.asha.org/article.aspx?articleid=1896739

A Review of Hyperacusis and Future Directions: Part II. Measurement, Mechanisms, and Treatment

Pienkowski, M, Tyler, Richard S, Roncancio, Eveling R, et al

Am J Audiol

2014;23(4):420-436http://aja.pubs.asha.org/article.aspx?articleid=1896738

At present, there are no cures for hyperacusis. There are, however, several approaches that many patients find successful. The progressive evaluation and treatment of hyperacusis parallels that for tinnitus (Tyler. Prog Brain Res2007;166:425-434https://www.icts.uiowa.edu/Loki/publications/browsePublication.jsp?id=17956807). Many, but not all, will have hearing loss and benefit from hearing aids. Care must be taken; typically decreasing the gain for moderate and high level inputs, and decreasing the maximum output. Eventually, it is desirable to return to typical appropriate gain settings (Searchfield. Tinnitus Treatment, Clinical Protocols. New York: Thieme Medical Publishers, 2006).

It is also important to note that because it is difficult for those without hyperacusis to really appreciate the devastating nature counseling can include partners, family members, and friends (Hallberg. Scand J Caring Sci2005;19[4]: 410-418http://onlinelibrary.wiley.com/doi/10.1111/j.1471-6712.2005.00361.x/abstract).

At least five sound therapy approaches have been used for hyperacusis, including continuous low-level broadband noise (Hazell. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications, 1992; Formby. J Acoust Soc Am 2008;123:37http://scitation.aip.org/content/asa/journal/jasa/133/5/10.1121/1.4805833), successive approximations to high-levels of noise (Vernon. Tinnitus Treatment and Relief. Boston, MA: Allyn & Bacon, 1998), successive approximations to troublesome sounds (Tyler. Handbook of Clinical Audiology, Sixth Edition. Baltimore: Lippincott Williams and Wilkins, 2009), partial masking with a variety of sounds, including music, and the gradual increase of the maximum output of hearing aids (Searchfield. Tinnitus Treatment, Clinical Protocols. New York: Thieme Medical Publishers, 2006; Sammeth. Scand Audiol 2000;29[1]:28-36http://www.tandfonline.com/doi/abs/10.1080/010503900424570?journalCode=iaud20). No matter what approach is used, progress can be slow for some patients. (Dauman. Acta Otolaryngol125[5]: 503-509http://www.tandfonline.com/doi/abs/10.1080/00016480510027565?journalCode=ioto20).

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.