2B_Hyperacusis Flashcards
What is hyperacusis?
Reduced tolerance for everyday sound
- response of discomfort (physical and/or emotional)
- unilateral or bilateral
What functional limitations might someone with tinnitus and/or hyperacusis experience?
Difficulty: - concentrating - following conversation - working - resting/relaxing - sleeping Also: - emotional issues - perceived hearing difficulty - relationship problems - social isolation and avoidance
What are some conditions that are associated with or co-occur with hyperacusis?
- hearing loss
- tinnitus
- otosclerosis
- Meniere’s Disease
- viral infections of the inner ear or facial nerve
- migraines
- head trauma
- autism
- Williams syndrome
- OCD
- depression
- anxiety
- PTSD
What are the 3 types of disorders that may co-occur with hyperacusis?
- hearing loss disorders
- neuro-developmental disorders
- psychiatric and chronic pain disorders
Besides hyperacusis, what are 2 other sound perception disorders?
Phonophobia - fear of sounds
Misophonia - extreme dislike of sounds
What are the 4 types of hyperacusis proposed by Dr. Tyler?
- Annoyance hyperacusis
- Fear hyperacusis
- Loudness hyperacusis
- Pain hyperacusis
Name 2 suspected underlying mechanisms of hyperacusis
- plasticity and distortion of neural gain mechanisms in CANS
- dysfunction of Type II auditory afferents
What is an audiologist’s role regarding assessing and treating hyperacusis?
- identify significant hyperacusis
- evaluate
- refer to other professionals to facilitate access to services
- hearing aid evaluation, fitting, orientation
- recommendations for sound therapy
- counselling
- multidisciplinary team consultation
What things might a case history specific to hyperacusis include?
- results from other health professionals (e.g. neurology, psychiatry)
- patient description of symptoms and functional impct
- associated otolgic/vestibular concerns, such as hearing loss, balance, tinnitus, noise exposure, exaggerated startle response
- family history
- medications
- PTSD
- Autism
What other concerns might be associated with hyperacusis (quality of life)?
- anxiety
- depression
- difficulty concentrating
- pain
What difficulties might we encounter while completing an audiological assessment on someone with hyperacusis?
- pain, discomfort, or fear when exposed to ordinary sounds
- inability to tolerate acoustic immitance, UCL
What UCL results might we expect with hyperacusis?
- abnormal UCL (reduced sound tolerance range)
- hyperacusis might fluctuate
- testing may be difficult d/t intolerance
What are subjective patient questionnaires used for, regarding hyperacusis?
- used for identification, assessment and management of hyperacusis
- disability
- functional impact
- psychological factors
- quality of life
What are two types of therapy for treating hyperacusis?
Cognitive Behavioural Therapy (CBT)
- referral
- focuses on modifying problem emotions, thoughts, and behaviours
- treatment of depression, anxiety and insomnia
Tinnitus Retraining Therapy (TRT)
- may also be used successfully in management of hyperacusis
- gradual increased exposure to broadband noise
- counselling
What is sound therapy?
- patient habituated to low-level sounds for long periods of time
- gradual increase of level and/or duration, plus positive reinforcement
- options: low-level broadband, music, environmental sound, high-level broadband, troublesome sounds, gradual increase to max HA output
