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2016 ; 37
(10
): 1482-1488
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Minimally Invasive Surgery for the Treatment of Hyperacusis
#MMPMID27668792
Silverstein H
; Ojo R
; Daugherty J
; Nazarian R
; Wazen J
Otol Neurotol
2016[Dec]; 37
(10
): 1482-1488
PMID27668792
show ga
OBJECTIVE: To evaluate the efficacy of a minimally invasive surgical procedure in
patients with severe hyperacusis. STUDY DESIGN: Prospective, longitudinal design.
SETTING: Tertiary referral center. PATIENTS: Adult patients with history of
severe hyperacusis. INTERVENTION: Using a transcanal approach, the round and oval
window was reinforced with temporalis fascia or tragal perichondrium in six
subjects (nine ears) and was subdivided into two groups (unilateral or bilateral
reinforcement procedure). MAIN OUTCOME MEASURES: Pre- and postoperative noise
tolerance was measured using uncomfortable loudness level (ULL) test scores. In
addition, a self-report hyperacusis questionnaire (HQ) was used to assess
hypersensitivity to sound before and after the intervention. RESULTS: Analysis of
the data reveals improved postoperative mean ULL test scores of 14?dB (confidence
interval [CI], 70-98?dB) in the unilateral group. For the bilateral group,
improved mean scores were 13?dB (CI, 63-88?dB) in the first ear and 8?dB (CI,
71-86?dB) for the second ear. Further, a negative linear trend was observed in
the mean subjective scores for the HQ when both groups measures were analyzed
together decreasing from a mean score of 32.0 (standard deviation [SD]?=?3.32)
preoperative to a mean score of 11.5 (SD?=?7.42) after surgery. Postoperatively,
the patients reported no change in hearing and improved quality of life after the
procedure. CONCLUSION: The results suggest that reinforcement of the round and
oval window with temporalis fascia or tragal perichondrium may offer significant
benefit for individuals with severe hyperacusis that has not responded to
traditional therapy. ULL scores and self-report measures postoperatively
demonstrate improved noise tolerance, high patient satisfaction, and enhanced
quality of life.