What is hyperacusis?
Hyperacusis is a disorder of sound processing characterized by an excessive response to sounds that are not normally perceived as unpleasant. In contrast, in phonophobia, another form of hypersensitivity to sound, the fear of specific sounds comes to the fore. Recruitment is the term used when those affected are hard of hearing and perceive sounds as too loud, especially in the damaged hearing range.

Symptoms
People with hyperacusis find everyday sounds such as the sound of the sea, the clattering of dishes in the kitchen, or car noise extremely unpleasant or even painful. Symptoms can be very individual and vary from person to person. Some sufferers are sensitive to only a few specific sounds, while others may be hypersensitive to a wide range of sounds.

Causes
The exact causes of hyperacusis are not yet fully understood. However, it is thought that damage to the inner ear or central auditory nervous system, such as from noise, trauma, viral infections, or certain medications, may play a role.

Diagnosis
The diagnosis of hyperacusis is based on a detailed history, a hearing examination and a hearing test. Another diagnostic method is to measure the discomfort threshold, which is the noise level at which hypersensitivity occurs.

Treatment options
Increasing exposure to disturbing sounds is recommended. In some cases, psychotherapeutic treatment, for example in the form of behavioral therapy, may also be helpful. In this process, patients learn to reduce their fear of certain sounds and to identify a healthy way of processing sounds for themselves. If hyperacusis develops due to ear injury or hearing impairment, a hearing aid that attenuates ambient noise or is specifically designed to meet the needs of the patient may help in the course of the condition.

Distribution
Hyperacusis is a rare condition. In the population, about 1-2% of people suffer from this impairment.