Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research

Table 3

Charting population and outcome data according to management strategy: devices. RCT = Randomised Controlled Trial; NRCT = Nonrandomised Controlled Trial. Retro = retrospective study; LDLs = Loudness Discomfort Levels; LGOB = loudness growth in one-half octave band; MCL = Most Comfortable Loudness; HQ = Hyperacusis Questionnaire; SHQ = Sound Hypersensitivity Questionnaire; MASH = Multiple Activities Scale for Hyperacusis.

Intervention	Ref	Study design	Sample size	Hyperacusis complaint	Aimed at treating hy	Outcome measures		Main findings
						Primary	Secondary
Acoustic training	Noreña and Chery-Croze [39]	Cohort	8	Primary	Yes	MASH, HQ, LGOB	LDLs	All participants reported a significant decrease in both MASH and HQ scores over the course of the treatment. Following the enriched acoustic environment treatment, auditory sensitivity significantly decreased at all frequency bands and all loudness categories (soft to too loud).
Acoustic training	Miani et al. [40]	Case report	1	Within symptom set	Yes	Discomfort levels	Not specified	The treatment produced notable improvement in the symptoms. No discomfort levels were registered in a free acoustic environment; discomfort levels were only observed with headphones at high frequencies that are not normally present in environmental noises. Clinical situation remained stable after 1 year.
Desensitisation program with tinnitus maskers	Vernon [41]	Case report	3	Primary	Yes	Self-report	Not stated	One patient was able to travel daily without ear protectors after 2 years of treatment. Another patient self-reported an improvement in condition after 3 months. Another reported improvement of at least 50% after 6 months of treatment.
Desensitisation program with tinnitus maskers	Gabriels [42]	Case series	2	Primary/within symptom set	Yes	MCLs and LDLs	Not specified	The patient self-reported noticeable improvements in hyperacusis with improved ability to manage life without the limitations associated with hyperacusis. LDLs and MCLs improved after four months. The patient reported ear plugs as being considerably beneficial.
Desensitisation program with tinnitus maskers	Hudson [43]	Case series	20	Primary	Yes	Self-report	Not stated	Patients self-reported improvements in hyperacusis after using tape. Some were afraid to use them.
Cochlear implant	Ramos Macías et al. [44]	Cohort	16	Within symptom set	No	SHQ	Not specified	Cochlear implant surgery resulted in improved sound intolerance, with a reduction in SHQ score for six patients (out of 7).
Cochlear implant	Mertens et al. [45]	Retro	23	Within symptom set	No	HQ	Not specified	Cochlear implants were found to significantly reduce hyperacusis for the single-sided deafness group, with significant differences observed in HQ total and attentional subscale scores between the cochlear implant ON and the cochlear implant OFF condition.
Hearing aids	Saglier et al. [46]	Cohort	177	Secondary	No	HQ	Not specified	Hyperacusis scores prior to fitting hardly differed between patients without a family history of hearing impairment and patients with family history. At 6 months after hearing aid fitting, patients without family history reported lower hyperacusis scores than those with a family history.
Wave laser TinniTool	Teggi et al. [47]	RCT	54	Within symptom set	No	LDLs	Not specified	Laser therapy led to a decrease in hyperacusis severity. LDLs for five patients (out of 7) improved in soft laser group, whilst only two patients in the dummy control group showed LDLs of more than 80 dB. Four patients presenting hyperacusis in the soft laser group also suffered from migraine compared to only 2 in the dummy group.
Phase-shift treatment device	Meeus et al. [48]	NRCT	21	Secondary	No	HQ	Not specified	No significant differences were found on hyperacusis questionnaire or audiometric data between pure tone tinnitus group and narrow band noise tinnitus group.
Suppression device and pharma	Valente et al. [49]	Case report	1	Within symptom set	Yes	Self-report	Not stated	The patient reported that the Micro Tech® Refuge-hyperacusic hearing instruments are very helpful and provided a level of protection that was at least as good as what he achieved with the plugs and muffs. The patient still reported an inability to listen to music, attend concerts, restaurants, movies, and events, or hear others when eating.