Evaluation and Treatment of Severe Hyperacusis

 

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Abstract

A 52-year-old male was evaluated by the authors after initially reporting fullness in his left ear while traveling on an airplane. A unique feature of the patient's complaint was the development of severe bilateral hyperacusis (loudness discomfort levels of between 20–34 dB HL) in spite of the fact that the hearing loss was initially reported in the left ear. To achieve loudness comfort, the patient was initially fit with ER-25 musician earplugs that proved to be unsuccessful. The patient next purchased earplugs and earmuffs from a gun shop in order to obtain relief from the pain and discomfort caused by his exposure to everyday environmental sounds. This paper describes the use of hearing devices that proved to be effective in providing attenuation sufficient that the patient rarely needs to rely on earplugs and ear-muffs for relief from his hyperacusis.

Abbreviations: CBC = complete blood count, ESR = erythrocyte sedimentation rate, LDL= loudness discomfort level

Publication History

Article published online:
08 April 2022

© 2000. American Academy of Audiology. This article is published by Thieme.

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• REFERENCES

• American National Standards Institute. (1996). American National Standard for Specification of Hearing Aid Characteristic. (ANSI S3.22–1996). New York: ANSI.
• Axelsson A, Hamernik R. (1987). Acute acoustic trauma. Acta Otolaryngol (Stockh) 225–233.
• Byrne D, Dirks D. (1996). Effects of acclimatization and deprivation on non-speech auditory abilities. Ear Hear 17:29S-37S.
• Byl F, Adour K. (1976). Auditory symptoms associated with herpes zoster or idiopathic facial paralysis. Laryngoscope 56:372–379.
• Ceranic B, Praher D, Ragian E, Luxon L. (1998). Tinnitus after head injury: evidence from otoacoustic emissions. J Neurol Neurosurg Psychiatry 65:523–529.
• Citron D, Adour K. (1978). Acoustic reflex and loudness discomfort in acute facial paralysis. Arch Otolaryngol 6:303–306.
• Fukaya T, Nomura Y. (1988). Audiological aspects of idiopathic perilymphatic fistula. Acta Otolaryngol (Stockh) 456:68–73.
• Gascon G, Ozand P, Erwin R. (1992). G_ml gangliosidosis type 2 in two siblings. J Child Neurol (Suppl) 7:S41–S50.
• Gavilan C, Gavilan J, Rashad M, Gavilan M. (1988). Discriminant analysis in predicting prognosis of Bell's palsy. Acta Otolaryngol (Stockh) 106:276–280.
• Hadj-Djlani A, Gerster J. (1984). Meniere's disease and fibrositis syndrome (psychogenic rheumatism). Acta Otolaryngol (Stockh) 406:67–71.
• Hazell J, Sheldrake J. (1991). Hyperacusis and tinnitus. In: Aran J, Dauman R, eds, Proceedings IV International Seminar. Amsterdam: Ghedini Publications, 245–248.
• Jastreboff P, Gray W, Gold S. (1996). Neurophysiological approach to tinnitus patients. Am J Otol 17:236–240.
• Klein A, Armstrong B, Greer M, Brown F. (1990). Hyperacusis and otitis media in individuals with Williams syndrome. J Speech Hear Disord 55:339–344.
• Marriage J, Barnes N. (1995). Is central hyperacusis a symptom of 5–hydroxytryptamine (5–HT) dysfunction? J Laryngol Otol 109:915–921.
• Nields J, Fallon B, Jastreboff P. (1999). Carbamazepine in the treatment of lyme disease-induced hyperacusis. J Neuropsychiatry Clin Neurosci 11:97–99.
• Nigam A, Samuel P. (1994). Hyperacusis and Williams syndrome. J Laryngol Otol 108:494–496.
• Phillips D, Carr M. (1998). Disturbances in loudness perception. J Am AcadAudiol 9:371–379.
• Sandlin R, Olsson R. (1999). Evaluation and selection of maskers and other devices used in the treatment of tinnitus and hyperacusis. Trends Ampi 4(l):6–26.
• Vernon J. (1987). Pathophysiology of tinnitus: a special case—hyperacusis and a proposed treatment. Am J Otol 8:201–202.
• Wayman D, Pham H, Byl F, Adour K. (1990). Audiological manifestations of Ramsay Hunt syndome. J Laryngol Otol 104:104–108.