Hyperacusis: Intolerance to sound

Hyperacusis is a condition characterized by over-sensitivity to everyday environmental sounds which may be unpleasant or painful to the ear as a result of damage sustained to the Auditory system. Hyperacusis can be due to damage to the brain or the neurological system, In these cases, there is processing problem specific to how the brain perceives sound. .

Individuals with hyperacusis have difficulty tolerating normal sounds which are not loud to others such as sound from running water in the kitchen sink, ringing phones, shutting doors, shuffling paper, placing dishes on table, TV sound etc.

40% of patients with tinnitus complain of mild Hyperacusis and around 86% of Hyperacusis sufferers have tinnitus.

Tinnitus is the perception of sound within the human ear such as ringing sensation, when no external sound is present.

Hearing Loss with low tolerance to sound is different term known as recruitment, In Hyperacusis usually hearing is normal.

Hyperacusis may be caused by overexposure to excessively high loudness levels, head injury, stress, and genetic differences or by abnormal responses in the ear muscles, which protects the ear from loud sounds. Other causes may include adverse reactions to medicine or surgeries, chronic ear infections, autoimmune disorders, migraine and some forms of epilepsy.

In cochlear Hyperacusis, the symptoms are ear pain, annoyance and general intolerance to everyday sounds.

In some conditions, wherein the vestibular system is involved is called as Vestibular Hyperacusis. In this condition, the sufferer may experience feelings of dizziness, nausea or a loss of balance when sounds of certain pitches are present at certain level.

AnxietyStress and Phonophobia (fear of loud sounds) may be present in Hyperacusis. Sufferer may result in developing avoidant behavior in order to avoid a stressful sound situation or to avoid embarrassing themselves in a social situation which involves noise. This might lead the sufferer stay away from the society.

Understanding the mechanism of Hyperacusis is often challenging. People who develop Hyperacusis should have a thorough Evaluation by otorhinolaryngologist (Ear, Nose and Throat doctor) and a detail Audiological evaluation to determine the state of the Auditory- Vestibular system.

Although a corrective medical or surgical approach for treating Hyperacusis is not available at this time, there are therapies that can help sufferer to reduce fears and anxieties towards sensitivity of sounds under guidance of an ENT Specialist and supervision by a Clinical Audiologist.

Antidepressant medicines and treating migraine may help.

Retraining Therapy

Retraining therapy consists of counseling and acoustic therapy. The aim is to reduce the patient’s reactions to Hyperacusis. Counseling is designed to help a patient better cope, while acoustic therapy is used to decrease a patient’s sensitivity to sounds and to teach them to view the sound in a positive manner.

Sound Generators

This treatment approach uses the sound of music or broadband noise or music produced via a body-worn system or a small device that looks like a hearing aid, which produces steady and gentle sounds. The theory is that, by listening to a sound at a low level for a certain amount of time each day, the auditory nerves and brain centers will become desensitized and able to tolerate normal environmental sounds again.

Constant use of earplugs/ earmuffs is not recommended because constant or frequent blocking of the ears may further alter the brain’s calibration of loudness which may lead the brain to further restrict its comfort range for sounds.

What to do in hyperacusis ?

1 .Avoid exposure to loud noise

  1. Avoid caffeine, chocolate, smoking , alcohol, MSG
  2. Avoid ototoxic medicines (medicines that might damage ear) such as aspirin, quinine)
  3. Daily exercise
  4. Adequate rest
  5. ENT & Audiological evaluation

Read more about Hyperacusis  http://www.tinnitus.org.uk/hyperacusis

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