HYPERACUSIS: Evaluation & Treatment

The evaluation focuses on evaluating the auditory pathways from the ear canal to the inner ear with subjective and objective measures.

Typically these include:

  • Otoscopy to visualize the ear canal and tympanic membrane (ear drum)
  • Audiometry (subjective hearing test) to evaluate the capability to hear pure tones and speech. This will determine the capabilities of the middle (mechanical portion) and inner (nerve portion) of the ear.
  • Tympanometry is an objective measure of the function of the middle ear and verifies the subjective results of audiometry.
  • Distortion Product Otoacoustic Emissions (DPOAE) is an objective measure of the outer hair cells (nerve cells) of the ear. This also verifies the subjective results of audiometry.
  • Most comfortable (MCL) and Uncomfortable levels (UCL) measurements to determine dynamic range and tolerance levels. Will also serve to verify the diagnosis of hyperacusis vs. misophonia.
  • Hyperacusis Handicap Inventory (HHI) is a subject self analysis of the impact of sound sensitivity on you as the individual.
  • If tinnitus is also present then an evaluation of the specific parameters of pitch, masking levels and reactive tinnitus may also be added to the evaluation.


Treatment for hyperacusis and misophonia differ but have the common goal of reducing the level of reactivity to the offending sounds whether they are based on loudness or type of sound. The severity of the symptoms and longevity of the symptoms with determine the course of treatment. This will be discussed in detail with your audiologist at the time of the evaluation and treatment consultation.