Hyperacusis

Q:  I would like information on hyperacusis. My son has this, and he really suffers from loud noises. He also has a hearing problem but can’t wear a hearing aid. Is there a surgery that would correct it or a medication that can be taken?

A:  People with hyperacusis are a small, very rare group of "sound sensitive" individuals. They are usually not born with it, but develop a narrow tolerance to sound, most commonly from noise trauma (sudden or cumulative over time). Other common causes include head injury, ear damage from toxins or medication, Lyme disease, air bag deployment, viral infections involving the inner ear or facial nerve, and temporomandibular joint (TMJ) syndrome. Some people with hyperacusis have such a severe intolerance to sound, that it is difficult and sometimes impossible for them to function in our everyday environment with all its ambient noise. All sounds may be perceived as too loud, although for most patients with hyperacusis, the high frequencies are particularly troublesome.

According to Phillip A. Wackym, MD, John C. Koss Professor and Chairman of the Department of Otolaryngology and Communication Sciences at the Medical College of Wisconsin, there is no specific corrective surgery or medication for hyperacusis. Surprisingly there is little or no detectable hearing loss with hyperacusis and usually, hearing tests show that the hearing function is normal. Many people with hyperacusis, in fact, have audiograms (hearing tests) that show hearing sensitivity at minus decibel levels. Because of this, hyperacusis patients may feel as though, in addition to having less tolerance to sound, they can hear even better than those with normal ears.

Dr. Wackym says that most hyperacusis individuals eventually develop tinnitus (ringing sounds in the ears). Perhaps this is your son's "hearing problem" that you allude to in your letter? Tinnitus is a very common ear disorder affecting approximately 50 million people. Treatment is usually individualized and sometimes several strategies are implemented together. Using ear plugs may be helpful, but frustrating as it results in hearing loss. Tinnitus retraining therapy is a method by which barely audible sound is delivered to the ear for defined periods of time each day. A third approach is the use of a tinnitus masking device, which looks like a hearing aid, but delivers white noise to the ear.

This may be more information than you asked for, but the bottom line is that your son has a rare hearing disorder which is difficult to live with and treat, and he could benefit from seeing an ear, nose and throat physician who specializes in hearing problems.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.