Abnormal sensitivity to sound and disorders in loudness perception is defined as Hyperacusis. It is a condition that comes from a problem in the way noise is perceived by the brain, that is, the central auditory processing center of the brain.
It can often lead to pain and discomfort. It usually brings along pain and difficulty. Between 2% and 8% of the world’s population is said to have this condition. More specifically it affects one in 50,000 people.
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How to know if you have a Hyperacusis?
It is important to distinguish between people sensible to sound and people experiencing real Hyperacusis. People with Hyperacusis define it as broken tolerance to otherwise normal sounds.
These sounds become painful and extremely loud. It is not the condition where loud noises are unbearable, it is the condition where all noises cannot be tolerated. Pain in the ear and the feeling of pressure are also accompanied by this problem.
A person suffering from this condition can easily develop and have difficulties at work, at home, and in social communication.
What causes Hyperacusis or sensitive hearing?
There is no one known cause of Hyperacusis, but doctors think it can be related to the way sound enters your brain and triggers responses in your body.
The most common cause of Hyperacusis is damaging the cochlea when a person is exposed to loud noises at work, music concerts, fireworks, gun shootings, and the improper functions of airbags.
Other causes which can lead to Hyperacusis
- Head wound
- Usage of certain medications
- Lyme illness
- Airbag consecution
- Virus infections affecting inner ear and face nerves
- Down Syndrome
- Inner ear
- Temporomandibular Joint Syndrome (TMJ)
- 8th Nerve
- Psychological (alert and compulsive people)
Usually, people first acquire hyperacusis in one ear, but consequently, both ears get it. The speed of this disease varies from person to person, leading to the conclusion that some get it quickly and suddenly, while others develop it more slowly.
Diagnosis of the Hyperacusis
If a person suspects the possibility of having hyperacusis an evaluation and analysis by a doctor specialist is recommended.
A specialist for ear, nose, and throat is called an otolaryngologist, but an otologist or a neurotologist are also specialists in this area.
The first examination will most probably be an audiology test, which includes hearing testing, a physical evaluation, and checking medical history.
Medical history questions are mostly about the beginning of the symptoms and their severity, but migraines are also questioned.
“Persons with migraines often have small white matter lesions that may be seen on the MRI. In addition to hyperacusis, persons with migraines often have photophobia (sensitivity to bright light), motion intolerance, sensitivity to strong smells, and sometimes even unusual cutaneous sensitivity (allodynia). The treatment approach for migraine is completely different than that for other types of hyperacusis.” (Timothy C. Hain, MD)
A hearing test includes an audiogram which is a graph that shows a persons’ hearing possibilities at different frequencies.
An important note is that people suffering from hyperacusis mostly do not show results of normal hearing losses that can be seen on the audiogram. A doctor may also advise and talk with the patient about the results shortly.
Read More: What to Expect at the Audiologist >
Lifestyle changes to prevent Hyperacusis
It becomes extremely difficult for a person to live in a world where all noises are too loud. Everyday situations are stressful and a person may become asocial due to these circumstances.
It is recommended for people with this problem to start wearing earplugs and similar devices in all environments that seem to be dangerous.
Certain activities or hobbies like singing, dancing or sports represent a great danger and must therefore be eliminated forever.
Even ear protection in these cases becomes insufficient, thus forcing people to say goodbye to certain interests forever. Normal everyday activities, that most people take for granted, become unbearable and very challenging.
Phone conversations, watching television, listening to the radio, driving a car, traffic jams, walking through crowded streets, having lunch in restaurants, going out to a café or a bar, participating in group activities, cleaning the house, and many more represent a major obstacle to people suffering from Hyperacusis.
In some cases because of loud noises at work, people are forced to find new jobs or claim disability with the help and diagnosis of a specialist.
The reason is that loud noises at work may worsen the state of the problem by worsening the tinnitus a person almost always has combined with hyperacusis. The tinnitus may size up in value or there may also be some problems to the inner ear if the problem is not treated properly.
This diagnosis may go so deep in severity where people report problems listening to their own voice and therefore changing it to an acceptable level of intensity.
Read More: Noise-Induced Hearing Loss and Tinnitus >
Measures of Caution
If a person suspects the diagnosis of Hyperacusis the following should be avoided:
- Loud sounds and noises.
- Migraine producers like alcohol, chocolate, junk food, cigarettes, and coffee.
- A person is recommended to exercise and rest more.
Treatment of the Hyperacusis
Hyperacusis can be treated in various ways. Medication, surgery, hearing devices, and also therapy.
Medications are used for treatment but specialists and scientists are not very impressed with the results. Additionally, medications can cause some side effects also.
For the psychological distress associated with tinnitus, cognitive-behavioral therapy (CBT) has been identified as the treatment of choice, and this seems a reasonable strategy to counter the anxiety and stress associated with hyperacusis, together with information counseling, relaxation therapy, and sound therapy.
Devices mostly used for healing and helping bad hearing are earplugs and sound generators.
Read More: How to prevent Hearing Loss? >
1. Sound therapy
Sound therapy can also be used to reteach the auditory processing center of the brain to easily handle sound from the environment.
The sound-generating device should be worn on one or both ears, depending on which is affected. If sound were to be directly placed in the ear, patients experiencing hyperacusis would feel unpleasant and therefore the produced sound is static and gentle to the ear or ears.
Binaural sound therapy, from ear-level wide-band generators, is undertaken even when the symptoms are unilateral. Treatment is based on the notion of desensitization, and the sound intensity is increased from a low level gradually over time.
Noise therapy cannot be performed and finished in less than one year. Results show that intolerance to various sounds is decreased, but along the way patients become more socially isolated from the community and depression is likely to occur also.
There has been no corrective surgical procedure specifically for the treatment of hyperacusis. However, surgical intervention was found to improve hyperacusis.
Silverstein et. al. found round window reinforcement to be an effective and minimally invasive surgical option to reduce the symptoms of hyperacusis.
Nikkar-Esfahani et al. found an improvement in noise tolerance in patients with hyperacusis and successfully underwent complete occlusion of round window niche.
In a case report by Dang et al., a patient with unilateral posterior and superior canal dehiscence underwent trans-mastoid plugging of both defects, resulting in complete resolution of hyperacusis.
Silverstein et al. reported the first successful surgical treatment of hyperacusis using temporalis fascia to reinforce the round and oval window.