Clinical Features Of Hyperacusis And Evaluation

BackgroundTinnitus is one of the most common symptoms in Otology outpatient, clinicalstudy of tinnitus found that some tinnitus patents not only was disturbed by ringing inears,but also frequently complained of “sensitivity to common sound in normalenvironment”. Jastreboff reported that60%tinnitus patients untoleranced theeveryday sound in tinnitus treatment center showed abnormal reaction,such asdiscomfort,irritable,nevous,fear and other negative reactions. As early as1938,Perlman put forward “hyperacusis” to describe the symptoms. Clinicalcharacteristic of hyperacusis manifested that patients complained of decreasedtolerance to normal sound, also suffered from psychiatric disorders, it has beenreported that serious hyperacusis patients exhibit significantly more psychiatricsymptoms and neurotic personality traits.Epidemiological survey reported that the prevalence for hyperacusis increasedgradually, but the aetiology of hyperacusis are largely unknown, and in the greatmajority of affected patients no underlying medical condition can befound.Evaluation methods of hyperacusis mainly include hyperacusis questionnaireinvestigation and audiological tests. Due to differences of culture and language between different countries, there is no unified hyperacusis questionnaire.Inaddition,very few scholars in our country have attempted to assess hyperacusis usingquestionnaires.Hyperacusis often associated with the presence of tinnitus,clinicians oftenfocus on the symptoms of tinnitus,ignore hyperacusis,leading to bad effection fortreatment of tinnitus.Hyperacusis have more serious negative impact onpatients`lives than other hearing disorders. However, clinician make wrong diagnosisand treatments, due to less know of hyperacusis symptoms and evaluation methods.ObjectiveTo explore the clinical characteristics of hyperacusis and investigate hyperacusismeasurement tools in order to identify the effective diagnostic methods forhyperscusis, providing help for clinical diagnosis and treatment.MethodsThe study group comprised60patients complaining of hyperacusis with orwithout tinnitus,including21cases of men and women39cases,aged13to71years,mean age38.82±14.15years. The control group comprised20normal hearing ageand gender matched individuals, including10cases of men and women10cases,aged13to70years, mean age37.15±13.24years. All participants were interviewed bythe same investigator, using the same medical history questionnaire and hyperacusisquestionnaire (Chinese version) and were subjected to pure tone audiometry, loudnessdiscomfort level assessment and distortion product otoacoustic emissions test withand without contralateral suppression of white noise. Data were collected andanalysed.ResultsIn60hyperacusis patients,49cases (81.67%) had tinnitus,14cases (23.33%) had headache. The most common sound that patients untoleranced was child crying,screaming, sudden sounds and traffic noise. Hyperacusis patients had higher means oftotal scores on the Chinese version of hyperacusis questionnaire compared to thecontrol group(P<0.05),the emotional dimension scores were affected bygender(P<0.05).The loudness discomfort levels indicated a markedly contracteddynamic range in hyperacusis patients, comparing with control group(P<0.05), nostatiscally significant differences could be found between the scores of the individualscales on the hyperacusis questionnaire and the LDL figures. There was nodifferences in DPOAEs amplitudes between DPOAEs test with and withoutcontralateral white noise stimulation in hyeracusis patients (P>0.05).ConclusionHyperacusis is a kind of individual physical and mental combined clinicalsymptoms. Clinical evaluations include hyperacusis questionnaire survey andaudiological examinations. The Chinese version of hyperacusis questionnaire is aneffective tool for the assessment of hyperacusis patients. It is valuable to evaluatecochlear function of hyperacusis patients using distortion product otoacousticemissions test.