Evaluation and treatment of severe hyperacusis

Area of Science:

• Audiology
• Otolaryngology
• Neuroscience

Background:

• Hyperacusis, characterized by an abnormal intolerance to everyday sounds, can significantly impact quality of life.
• Sudden onset of hyperacusis, particularly bilateral, presents a diagnostic challenge.
• Previous attempts to manage this patient's hyperacusis with musician earplugs were unsuccessful.

Observation:

• A 52-year-old male presented with sudden onset of severe bilateral hyperacusis (20-34 dB HL loudness discomfort levels) following airplane travel.
• Initial symptoms were unilateral ear fullness, but hyperacusis became bilateral.
• The patient resorted to using gun shop earplugs and earmuffs for relief from environmental sound hypersensitivity.

Findings:

• The patient's hyperacusis was severe, causing discomfort with everyday sounds.
• Standard musician earplugs did not provide adequate relief.
• Custom-selected hearing devices effectively attenuated sound, offering substantial relief from hyperacusis.

Implications:

• This case highlights the importance of considering specialized hearing devices for managing severe hyperacusis.
• Effective sound attenuation can significantly improve the quality of life for individuals with hyperacusis.
• Further research into optimal management strategies for sudden-onset bilateral hyperacusis is warranted.