Objectives: Hyperacusis is a disorder that occurs in up to 17% of the general population and is characterized by reduced tolerance to ordinary sounds that would not trouble most people. Between 80 and 90% of people with hyperacusis also experience tinnitus. The severity of hyperacusis and tinnitus symptoms varies from person to person, and both conditions can lead to negative psychosocial consequences, including mental health challenges and social isolation. Despite the high co-occurrence of tinnitus, hearing loss, and hyperacusis, clinicians and researchers have focused to date on hyperacusis in relation to acoustic hearing and have largely overlooked the possibility that a cochlear implant (CI) user might experience hyperacusis. However, preliminary evidence suggests that sound tolerance may improve following cochlear implantation or when a CI is switched on versus off. These findings suggest that it is of clinical and scientific importance to characterize potential hyperacusis symptoms in CI users and determine how they might influence perceptual outcomes and quality of life. In the present study, we sought to determine the prevalence of hyperacusis and its potential relationship with tinnitus and subjective hearing abilities in adults with CIs. Design: Forty adult CI users completed a series of online surveys. We administered the Hyperacusis Questionnaire (HQ), the Tinnitus Handicap Inventory, the Speech, Spatial, and Qualities of Hearing Scale, and the Vanderbilt Fatigue Scale to assess hyperacusis severity, tinnitus severity, subjective hearing difficulties, and listening-related fatigue, respectively. The linear relationships between those variables were quantified using Pearson correlations with Bonferroni adjustments for multiple comparisons. Results: Twenty-two participants (55%) indicated that they are more sensitive to sound than most people. Fourteen participants (35%) indicated that they had both hyperacusis and tinnitus, 8 (20%) had tinnitus only, 8 (20%) had hyperacusis only, and 10 (25%) had neither condition. There was a significant moderate correlation between HQ scores and Tinnitus Handicap Inventory scores ( r = 0.65, p < 0.001), a significant moderate correlation between HQ scores and Speech, Spatial, and Qualities of Hearing Scale scores ( r = 0.55, p < 0.001), and a significant strong correlation between HQ scores and Vanderbilt Fatigue Scale scores ( r = 0.74, p < 0.001). Specifically, CI users with more severe hyperacusis symptoms tended to report more severe tinnitus symptoms, greater hearing difficulties, and greater listening-related fatigue than those with less severe hyperacusis symptoms. Conclusions: Most CI users in the present study reported difficulty tolerating everyday sounds, and the severity of their hyperacusis symptoms was predictive of tinnitus severity, subjective hearing difficulties, and listening-related fatigue. These findings suggest that hyperacusis is prevalent in CI users and that it may be one factor that contributes to hearing difficulties and reduced quality of life in some individuals. Further characterization of hyperacusis in CI users is warranted and will inform the development of clinical protocols to quantify and ameliorate potential adverse effects of decreased sound tolerance in this population.
Jahn et al. (Wed,) studied this question.