Hyperacusis is present in more than 30% of our tinnitus patients and sometimes the leading symptom causing disability. Therefore it is of vital importance to fit these patients during treatment with technical instruments in the optimal way. Since hyperacusis has to be treated first a decision about how to provide the patient with just the right device has to be made in the very beginning of treatment in each case. The practical experience presented in this study will give a rational basis for implementing technical devices in the treatment of hyperacusis.

During the last three years 141 patients with severe hyperacusis have been treated in the Frankfurt Tinnitus-Hyperacusis Center supplying them with either pink noise generators (noisers), high-freqency amplifiers, common hearing aids, combined devices or other technical instruments including for instance individually designed directional amplifiers.

Severeness and annoyance of hyperacusis were documented step by step throughout the study using the questionnaire developed by Jastreboff. Care was taken to separate and differentiate between the treatment protocols of hyperacusis, malacusis and phonophobia, respectively.Statistical evaluation of our patients shows that in about two thirds of the cases pink noise generators (noisers) were most effective in reducing hyperacusis. Common hearing aides, high frequency amplifiers and combined devices were used in one third of the patients. In addition, the use of bed side noisers, sound protection devices and hearing training was necessary in individual cases. In 72% of our patients hyperacusis was successfully abolished, in 26 % reduced and only three cases ( 2%) showed no improvement of hyperacusis at all.