Hyperacusis When sounds become agony

Bird chirping, the sound of water or voices can be felt by people with sensitivity to noise, the so-called hyperacusis, as unpleasant or even threatening. More than one million people suffer from it and often fear hearing damage. That is why most of them try to protect themselves from noise by keeping their ears, earplugs or headphones. In addition, many deliberately avoid situations in which unpleasant sounds could occur. This increases the problem, however, the noise hypersensitivity continues to increase. This is indicated by HNOnet-NRW, an association of established ENT doctors.

Hypersensitivity to noise may occur in one or both ears. The limit to sound sensitivity is exceeded when even everyday noises become uncomfortable and trigger stress reactions in the body. "However, hearing does not show any damage in most patients with hyperacusis," emphasizes Dr. med. Uso Walter, Chairman of the HNOnet-NRW. Rather, the error lies in the neurological processing of the sounds in the brain. "As with an amplifier, which is set wrong, in the central acoustic processing unimportant noise no longer suppressed, but unfiltered forwarded or even amplified. Although causes are not fully understood, the phenomenon often occurs with acoustic overload or stress. Therefore, hyperacusis may also be associated with mental health problems such as anxiety disorders, depression, or a post-traumatic stress disorder. In about 40 percent of the patients, there are additional ear noises, ie tinnitus. "Tinnitus is neither the cause of the hypersensitivity nor, conversely, the hypersensitivity of the cause of the tinnitus," explains Dr. med. Walter. "Both symptoms can develop independently in the hearing system and then occur individually or together."

In audiometric examinations by the otolaryngologist or hearing care professional, hyperacusis is characterized by a markedly reduced discomfort threshold (UBS). Thus, the test tones are already experienced as unpleasant at 50 or 60 dB - this corresponds to normal conversation volume or a quiet radio. The therapy of the noise hypersensitivity consists of a hearing training, in which the affected person is confronted with pleasant noises of increasing volume. This activates the suppression mechanisms in the area of ​​central hearing processing, and over time, even unpleasant noises become bearable. Conversely, a conscious isolation of acoustic stimuli increases the noise hypersensitivity more and more. Any silence should therefore be avoided. "A hearing training almost always leads to a quick improvement of the symptoms", emphasizes Dr. med. Walter. "After two months, 90 percent of those affected are free of symptoms again." The hyperacusis must be differentiated from the so-called phonophobia, in which only certain sounds are perceived as unpleasant. Here is a behavioral therapy promising. (Pm)