Relation of hyperacusis in sensorineural tinnitus patients with normal audiological assessment

Hyperacusis is mainly a consequence of the noise level in the twenty-first century, owing to dramatic changes in people's lifestyles. Of every 100 people with otological complaints (e.g., tinnitus and hyperacusis), 20 are affected by hyperacusis. Because of its high incidence, this symptom has long been the subject of investigation. Nine patients (eight female, one male) with sensorineural tinnitus voluntarily participated in this study. Among the evaluated patients, three were between 25 and 40 years of age and six were between 41 and 60 years. The patients did not report a history of acoustic trauma, use of drugs, or otological diseases. The duration of complaints at the time the study began varied from 3 months to 8 years. The patients answered a questionnaire, submitted to an ear, nose, and throat examination, and were evaluated by pure-tone and speech audiometry and otoacoustic emissions and laboratory tests. In all patients, ear, nose, and throat assessments and audiological tests were within the normal ranges. Of the nine subjects in our study, 100% had tinnitus, and 89% (n = 8) had hyperacusis as an associated symptom. Six subjects (67%) had severe tinnitus; among them, four had moderate hyperacusis, one had severe hyperacusis, and one was not affected by hyperacusis. In two subjects (22%) with moderate tinnitus, one had moderate hyperacusis and the other referred severe symptoms. Another patient (11%) reported mild tinnitus and mild hyperacusis. No patient classified his or her tinnitus as disabling. The findings of the present study led us to conclude that the most affected age range of patients with tinnitus and hyperacusis was 41-60 years and that women are affected significantly more often than men. Tinnitus preceded hyperacusis as a complaint in 78% of the subjects. Hyperacusis was present in eight (89%) of the patients. There was no direct correlation between the severity of tinnitus and of hyperacusis, although we noticed that the discomfort of tinnitus was generally perceived as equal to or worse than that of hyperacusis.