What is the Difference Between Tinnitus and Hyperacusis?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 02 March 2020
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Tinnitus and hyperacusis are two symptoms of hearing disorders, sometimes observed together. In tinnitus, patients hear a ringing or buzzing noise without a sound stimulus, while hyperacusis involves an increased 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 can include therapy with an audiologist and treatment from a neurologist.

In tinnitus, patients experience the sensation of sound in their ears even though no sound is being produced. Most commonly, this manifests in the form of a ringing noise that can vary in intensity. People with hyperacusis experience even small sounds as very loud, essentially as though someone has turned up all the volume knobs on the natural environment. Both issues are symptoms of hearing loss, rather than being standalone conditions.

Damage to the ear can cause tinnitus and hyperacusis, and it can also be associated with neurological problems like brain damage caused by accidents and degenerative diseases. Most commonly, tinnitus and hyperacusis are associated with noise-induced hearing loss. People develop noise-induced hearing loss as a result being exposed to very loud noise without wearing adequate hearing protection.


Hyperacusis can also be accompanied with 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 can have trouble balancing and may experience nausea, vomiting, and other problems as the body struggles to orient itself 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 can include provision of ear protection to prevent further damage and therapy with an audiologist.

Increased awareness of conditions like tinnitus and hyperacusis has led to a number of measures to prevent hearing loss when possible. These include mandating ear protection in environments where loud noise is present and developing more effective and more comfortable hearing protection. Musicians in particular have been heavily involved in the promotion of hearing protection.


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