Minimally invasive surgery for hyperacusis-enhanced round and oval window reinforcement procedure

Hyperacusis is an audiological disorder in which patients become persistently sensitive and intolerant to everyday environmental sounds. Patients suffering from hyperacusis not only experience pain and discomfort, but also undergo impairments in social, occupational, recreational, and day-to-day activities, resulting in poor quality of life. Previously, a senior author (HS) reported a minimally invasive surgical technique to help hyperacusis patients via reinforcement of the oval and round windows with temporalis fascia (Silverstein, 2015). In a recent publication (Young, 2024), patients with (Loudness Discomfort Level) LDLs above 70 dB had an 80.1 % satisfaction with the round and oval window reinforcement and would recommend the surgery. However, in the group of patients whose LDLs were below 70 dB indicating extreme hyperacusis only 49 % were satisfied and would recommend the surgery. To improve the results, a modification of the original technique was used by enhancing the reinforcement in patients with severe hyperacusis. Enhanced reinforcement of the oval and round windows and tympanic membrane resulted in a superior reduction in hyperacusis symptoms.