Recruitment vs Hyperacusis/Sound Sensitivity

Discussion in 'Dr. Stephen Nagler (MD)' started by Ilija, Dec 31, 2014.

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    1. Ilija

      Ilija Member

      Jagodina, Serbia
      Tinnitus Since:
      Cause of Tinnitus:
      Loud gig/year of loud headphone usage.
      I have finally figured out why my new sound sensitivity I think came along.
      It seems every time I have friends over and they get really loud it seems to agitate my audio nerve and therefore I get some new sensitivity.
      Now I'm not panicking because I believe that once I let it go, stop the worrying, the monitoring and all other negative emotions attached to it it'll go away, for instance my PC makes an electric sound while it's off, yesterday I left it on as I usually turn it off, and after I let go of the sound the next day I couldn't hear it, but the moment I started listening to it I found it.

      I was just wondering is this ear recruitment or hyperacusis/sound sensitivity, from what you've told me ear recruitment is when I would hear some faint sounds really loud, none of my sounds are loud, I can hear myself and everything else clearly over them, also none of these sounds are distorted nor do they cause me discomfort unless I make it so by listening too much and having anxiety and such.

      I know I shouldn't be bothering you as much and I'm truly sorry if I have become a nag, but you are the only doctor who can give me a solid answer, sure I can post on the forums but then all I get is either get well wishes or some theories for people who are one sided when it comes to Tinnitus.

      Other than that I've been relatively fine, socializing which I believe is what's keeping me together, having laughs and such, trying not to let Tinnitus have any hold over me, but at times I do find myself worrying as to whether my sound sensitivity will go away as it is the only thing bothering me right now, the Tinnitus I have learned to not care about 2 months ago.

      So if it's not too much of a bother please just give me an example or something of the two so that I know what I have.
      Also what do you think about my auditory nerve being sore theory, if it's the case then the month of quiet I will be having for winter breaks should help.

      Thank you.
    2. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Atlanta, Georgia USA
      Tinnitus Since:
      Hyperacusis is a decreased threshold to discomfort from sound mediated primarily via the classical auditory pathways. It can range from a person who is mildly uncomfortable in a restaurant setting wherein all the rest of the people at the table have no discomfort at all ... to a person who has profound discomfort from many of the sounds encountered in daily life.

      Recruitment is the rapid growth of perceived loudness for those sounds located in the pitch region of a hearing loss. My father had a significant hearing loss for several years before his death fifteen years ago at the age of 89. I could say, "Dad." He would hear nothing, and he of course would not respond. So I’d say it a bit louder. Still nothing. A bit louder than that. Still nothing. And then, just a very tiny bit louder. The immediate response: "Stop yelling so loud, Stephen, I hear you just fine. Tone it down a bit, will you!" And THAT'S recruitment - a rapid growth of perceived loudness in a pitch region containing hearing impairment. (And it is very difficult to convey to a person with significant hearing loss that the time he thought I was yelling ... was actually the fourth time I tried to get his attention.) This phenomenon occurs because at some decibel level, the normal hair cells adjacent to the damaged hair cells that correspond to the frequency of a hearing loss are "recruited." At the decibel level at which these normal hair cells "kick in," perceived loudness shoots up rapidly, causing discomfort. Importantly, loudness discomfort levels in recruitment are themselves normal. The problem lies in the rapidity of the growth of the loudness.

      To the best of my understanding, neither hyperacusis nor recruitment has anything to do with soreness of the auditory nerve.

      Dr. Stephen Nagler

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