What Is Hyperacusis?
Hyperacusis is a condition that affects hearing. The affected person experiences abnormal sounds that others feel are normal. Sounds appear to them as abnormal and unbearable. Their hearing capacity is lowered. This situation is known as decreased sound tolerance (DST).
A normal person generally hears sounds with varying degrees, whereas an individual with hyperacusis may perceive sounds as too high a volume, unpleasant, and painful. The tolerable sounds, like car engine sounds, household electrical sounds, and people chatting, can be intolerable and disturbing for them.
Their experience may affect their mental health. They may become anxious and irritable. They may avoid social situations. Sometimes this condition may be accompanied by tinnitus (hearing loss that involves clicking or ringing sounds).
What Are the Common Symptoms of Hyperacusis?
An individual with hyperacusis may perceive sounds that are normal as louder. This causes mild, annoying sounds to them. Because of these intense sounds, they may experience problems related to their balance. This may further cause seizures.
Symptoms that are experienced by hyperacusis may include:
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Ringing sounds in the ear.
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Pain in the ear.
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Ears may feel fullness or pressure (this experience is somewhat similar to the feeling of ear pain in an airplane).
All these symptoms make a person’s life miserable. Their mental health and social life are affected by the annoying sounds they hear every day. This may further lead to the following:
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Anxiety.
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Relationship issues.
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Social isolation and avoidance.
If an affected person becomes stressed, the symptoms may intensify. Sounds may appear louder in situations where one feels fear for normal sounds.
What Causes Hyperacusis and Who Is at Risk?
There are many reasons for hyperacusis. The most common one is exposure to loud noises. Noise exposure, especially during occupational or recreational activities, is found to be a common risk factor. Musicians, especially those who are exposed to rock or pop music, are at risk of developing hyperacusis. Sudden exposure to loud noises, like a gunshot or fireworks, may also cause hyperacusis.
Researchers thought that the brain may fail to perceive the sound as it is, and it may perceive the normal sound as louder among affected individuals.
Damage to auditory nerves may also cause hyperacusis. It was also noted that facial nerve damage may lead to hyperacusis. The facial nerve controls the stapedius muscle in the ear, which is responsible for regulating sound intensity. A head injury that involves the head, ear, and jaw may cause hyperacusis.
A study has noted that hyperacusis is always associated with hearing loss, but hearing loss need not be a cause for the development of hyperacusis.
Hyperacusis is always accompanied by other health issues. These include:
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Psychological issues like anxiety and depression.
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Bell’s palsy (weakness or paralysis of one side of the face due to dysfunction of the facial nerve).
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Down syndrome (a genetic disorder caused by an extra or partial chromosome 21).
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Ear infections (inflammation in the ear caused by bacteria or viruses).
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Head injury (trauma to the skull, brain, or scalp).
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Lyme disease (a bacterial infection transmitted by infected deer ticks).
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Meniere’s disease (a chronic inner ear disorder causing sudden vertigo, hearing loss, and tinnitus).
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Migraines (a type of headache).
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Post-traumatic stress disorder (persistent mental and emotional stress due to injury or psychological shock).
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Ramsay Hunt syndrome (a viral condition caused by the varicella-zoster virus in the facial nerve).
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Superior canal dehiscence syndrome (a rare condition in which there is a hole in the bone in the inner ear that affects hearing and balance).
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Temporomandibular joint syndrome (a condition causing pain and dysfunction in the jaw joint and muscles surrounding it).
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Tinnitus (a condition in which the sound perceived is like a ringing, buzzing, or roaring when no external sound source is present).
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Williams syndrome (a rare genetic condition that affects different parts of the body).
Some may develop hyperacusis after surgery or due to a reaction to medications. Hyperacusis does not have a single cause, but its causes involve many factors and conditions. Tinnitus was found to accompany hyperacusis (around 86 percent of affected individuals), and Williams syndrome was also noted to be accompanied by hyperacusis (around 90 percent of affected individuals).
How Is Misophonia Different From Hyperacusis?
Misophonia is a condition in which certain sounds can make a person angry. This is often linked with hyperacusis. In fact, hyperacusis can lead to misophonia, as certain sounds are uncomfortable and unpleasant, and can make a person dislike those sounds.
How Is Hyperacusis Diagnosed?
The affected person with hyperacusis must consult an ENT (ear, nose, and throat) specialist.
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They will take medical history that helps to know about other conditions, medications, or any previous injuries.
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They do a physical examination of the ear and head.
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They may ask certain questions to understand exactly what you are experiencing.
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Hearing tests are prescribed to determine the hearing sensitivity. They may do a pure-tone audiometry test.
What Treatment and Management Options Help With Hyperacusis?
The treatment of hyperacusis depends on the cause. The treatments help reduce physical symptoms and psychological burden. There is no cure for this condition. The treatments include:
Sound therapy:
In this therapy, the affected person is exposed to different levels of sound very gradually. First, very low-intensity sound exposure is done, and then gradually, they are exposed to slightly higher frequencies of sound. This makes the person get used to louder sounds without feeling discomfort. This may be done for a few weeks. Within those few weeks, the person may get accustomed to higher-volume sounds.
Cognitive behavioral therapy (CBT):
CBT is considered to be the most effective in treating hyperacusis. This method helps manage emotional reactions to louder sounds. Counseling and education, along with CBT, help manage hyperacusis. It helps in reducing the fear and anxiety that are linked to hyperacusis. Studies have noted that CBT can increase loudness discomfort level (LDL). LDL means it is the point at which the person perceives sound as being uncomfortably loud.
Tinnitus retraining therapy (TRT):
TRT is primarily used for tinnitus. It can also treat hyperacusis. It involves educating affected persons and treating them with counselling and sound therapy. A calming sound called pink sounds is being exposed to the affected individual. These sounds are introduced using special headphones. Pink sounds are those of rain or wind. These noises create a sound environment. This makes the uncomfortable sounds a little pleasant.
Surgery:
In this technique, the doctor makes a round and oval window reinforcement to correct the hyperacusis associated with facial nerve paralysis. The tissue behind your ear is used for this surgery. This tissue supports the ear bones (ossicles), which are responsible for sound intensity regulation. When this surgery is done, it improves LDL.
Conclusion
Hyperacusis is a sound sensitivity disorder. The affected person feels discomfort from normal, occurring sounds such as running water. These sounds may be painful for them, and in the course of avoiding them, they may get isolated. This may precipitate psychological stress, cause related diseases, and make a person’s life miserable. Hence, it becomes important for everyone to address this issue as early as possible in order to manage this condition very well.
Key Takeaway From iCliniq
Hyperacusis is a hearing disorder related to sound sensitivity. If not addressed at the right time, it may lead to complications, and it can be associated with many other conditions.
For more information, you can consult an ENT surgeon at iCliniq.
