ABSTRACT
In the 1990s a cluster of symptoms was recognised in people working in call centres who had experienced sudden unexpected sounds through their headsets. The commonest symptoms were pain in or around the ear, hyperacusis, tinnitus and hypervigilance. The classification described is in common usage but an international working group has recently published a different set of definitions consisting of loudness hyperacusis, annoyance hyperacusis, fear hyperacusis and pain hyper-acusis. Hyperacusis is seen in all age groups and in a paediatric population a Brazilian study reported a prevalence of 3.2%. There is a strong association between hyperacusis and tinnitus. Several medical conditions include hyperacusis as a symptom. Some of these conditions, particularly those in the peripheral group, involve dysfunction of the facial nerve and hence potential loss of the protective stapedius reflex. Everyone presenting with hyperacusis should have an appropriate hearing test, usually a pure tone audiogram.
