Abstract
Purpose:
The purpose was to assess the proportion of patients seeking help for tinnitus and/or
hyperacusis who have severe hyperacusis and to examine factors associated with severe
hyperacusis.
Research Design:
This was a retrospective cross-sectional study based on 362 consecutive patients who
attended a National Health Service audiology clinic for tinnitus and/or hyperacusis
rehabilitation and for whom uncomfortable loudness levels (ULLs) had been measured.
The criterion for severe hyperacusis was taken as a ULL of 30 dB HL or less for at
least one of the measured frequencies for at least one ear.
Results:
Thirteen patients had severe hyperacusis, and eight of those had normal hearing. The
lowest average ULL across frequencies was 28 dB HL. The difference in average ULLs
between ears was 5 dB or less for nine patients. The range of ULLs across frequencies
was between 5 and 60 dB, ULLs often being lowest at 8 kHz. Eleven patients had tinnitus,
eight had otological abnormalities, twelve had mental health problems, and six were
taking antidepressants.
Conclusions:
Severe hyperacusis is characterized by low ULLs for specific frequencies and no or
mild hearing loss. Given the high incidence of tinnitus, otological abnormalities,
and mental health problems, the management of patients with severe hyperacusis should
involve otologists and psychiatrists in addition to audiologists.
Key Words
hyperacusis - psychological assessment - tinnitus - uncomfortable loudness levels
