Tinnitus vs. Hyperacusis: What’s the Difference?

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Tinnitus and hyperacusis are two symptoms of hearing disorders, sometimes seen together. In tinnitus, patients hear a buzzing or buzzing sound without a sound stimulus, while hyperacusis involves heightened sensitivity to sound. One or both ears may be involved, and the most common cause of both conditions is routine exposure to very high volumes of noise, often experienced by industrial and construction workers, as well as some musicians. Treatment options vary depending on the cause and may include therapy with an audiologist and treatment with a neurologist.

In tinnitus, patients experience a sensation of ringing in their ears even though no sound is being produced. Most commonly, this manifests itself in the form of a ringing noise which can vary in intensity. People with hyperacusis also experience very loud small sounds, essentially as if someone had turned up all the volume knobs in their natural setting. Both problems are symptoms of hearing loss, rather than conditions in their own right.

Ear damage can cause tinnitus and hyperacusis and can also be associated with neurological problems such as brain damage from accidents and degenerative diseases. Most commonly, tinnitus and hyperacusis are associated with noise-induced hearing loss. People develop noise-induced hearing loss from exposure to very loud noise without wearing adequate hearing protection.

Hyperacusis can also be accompanied by balance disorders, also known as vestibular disorders. In addition to being used for hearing, the delicate structures inside the ear are involved in the sense of balance. If they are damaged, a patient may experience balance issues and may experience nausea, vomiting, and other problems as the body struggles to navigate without a functioning vestibular system.

Patients with tinnitus and hyperacusis can be examined by neurologists and audiologists. A detailed patient interview will be conducted to gather information about the patient’s medical history, and this information will be combined with test results to determine why the patient is experiencing hearing loss. Treatments may include providing ear protectors to prevent further damage and treatment with an audiologist.

Increased awareness of conditions such as tinnitus and hyperacusis has led to a number of measures to prevent hearing loss whenever possible. These include mandating hearing protection in loud noise environments and developing more effective and more comfortable hearing protection. Musicians in particular have been heavily involved in promoting hearing protection.

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