Hyperacusis - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Hyperacusis makes it difficult to hear every day sounds. The patient is sensitive to sounds that he/she hears every day. It is a problem with the way the brain’s central auditory processing center perceives noise. The patient will have pain and discomfort while hearing every day sounds like water running from a tap, sounds from traffic, walking on dry leaves, shuffling papers, and more. Even though all the sounds are perceived as loud, high-frequency sounds will be more troublesome.

Hyperacusis is a rare condition and may affect one in 50,000. Along with hyperacusis, the patients will have tinnitus, which is a buzzing or ringing sound in the ear. Even though hyperacusis is a hearing disorder, many people who have this disorder have normal hearing. Hyperacusis conditions can have a large impact on the quality of life. For people with severe intolerance to sound, it will be difficult for them to go outside and have a social life. Because of this, the patients will avoid going out and avoid socializing.

What Causes Hyperacusis?

People are usually born with hyperacusis, and in some cases, it may be acquired in later stages of life. The exact cause of hyperacusis is unknown, but there are some possible causes. They are:

• Head injury.

• Exposure to loud noise.

• Damage to the ear from medications and toxins.

• Viral infections affect the inner ear or the facial nerve.

• Lyme disease.

• Temporomandibular (TMJ) syndrome.

• Tay- Sachs disease.

• Meniere’s disease.

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• Williams syndrome.

• Bell’s palsy.

There are some neurological conditions that can be associated with hyperacusis; they are:

• Chronic fatigue syndrome.

• Post-traumatic stress syndrome (PTSD).

• Sometimes of epilepsy.

• Migraine.

• Depression.

• Anxiety, mood swings with increased heart rate, and sweating.

• Valium (a type of drug used to treat anxiety and other conditions) dependence.

Hyperacusis is seen in some children with brain injuries, autistic children, and some children with cerebral palsy.

What Are the Symptoms of Hyperacusis?

The symptoms of this condition can be troublesome and can affect one's day-to-day living like:

• Difficulty when hearing every day sounds, which start in one and then progresses to the other ear gradually.

• Isolation.

• Depression and anxiety.

• Pain or discomfort with sounds.

• Difficulty in tolerating a normal environment and sounds.

• Phonophobia (fear of sound).

How Is Hyperacusis Diagnosed?

Hyperacusis is diagnosed by an audiologist or ENT (ear, nose, and throat) specialist. They will begin by taking a detailed medical history about the duration and severity of the disease, followed by a thorough physical examination.

A hearing test or an audiogram will be taken, which is a graph that shows a person's ability to hear sound at different pitches. A patient with hyperacusis does not have hearing loss as recorded on an audiogram. They may have difficulty hearing a conversation when there is background noise or in poor hearing conditions, even when there is no hearing loss. This is called obscure auditory dysfunction or auditory processing difficulty.

What Are the Treatment Options for Hyperacusis?

There are no surgical or correcting treatments for this condition till now, but there are certain therapies available that can help reduce patient's fear and anxieties about the condition, and they are:

• Retraining therapy.

• Sound generators.

1) Retraining Therapy:

Retraining therapy includes counseling and acoustic therapy. The aim of this therapy is to reduce the sensitivity of the patient to this condition and better adapt to the disease. Counseling targets the patient to better cope with the situation, and acoustic therapy helps the patient cope with the sounds and teaches the patient to view the sound in a positive manner.

2) Sound Generators:

This treatment approach uses gentle sounds like the sound of music or a body-worn system, or small device that looks like a hearing aid. The aim of this therapy is that listening to gentle sounds like this will help the auditory nerves and brain centers to become desensitized and able to tolerate normal sounds again. The success rate of this treatment is good, but it may take time; like, it may take six months for some and two years for some other people.

It is not recommended to use earplugs or devices that will block hearing as constant or frequent use of this will alter the brain center's calibration to loud sound and may teach the brain to further reduce the range of sound in the comfort zone.

What Are the Other Types of Hearing Sensitivity?

• When some sounds lead to anger, the individual may have misophonia.

• When some sounds lead to anxiety, then an individual may have phonophobia.

• When an individual has trouble adjusting to quiet and loud sounds, they may have recruitment.

How to Check Hyperacusis?

When one has hyperacusis every day, one seems to get disturbed by every day life sounds. It can sometimes be painful and cause discomfort. These sounds are otherwise not very loud for a person with normal hearing. People generally have a threshold before it starts to cause any trouble. This threshold varies from person to person and also depends on other factors, such as a person's mood and the context of the sound.

A person with hyperacusis can be affected by sounds like:

• Jingling sounds.

• A dog barking.

• Sound of a car engine.

• Sound of chewing.

• Sound of the vacuum cleaner.

One's sensitivity to noise can affect relationships, school, work, and general well-being.

Hyperacusis can affect one or both ears. It can come on suddenly or develop over time.

Conclusion

Hyperacusis is a condition affecting the way one perceives sound. This condition affects the tolerance of a person to sounds. The human ear has an extraordinary range of hearing. One can hear even very mild sounds like the gentle rustling of leaves to very loud sounds as from the music in a club. There is a level of sound that can cause pain and discomfort in a person with normal hearing, but this is not the same with a person having hyperacusis. If the person thinks that he has hyperacusis, he can get a consultation from a specialist, and the doctor will be able to guide them in managing this condition.