Could anyone provide me a solution on what test to be used to differentiate between hyperacusis (with hearing loss) and recruitment, from an audiological point of view.
Hyperacusis is usually associated with hearing loss.Recruitment is a cochlear pathology and abnormal loudness growth in individuals with hearing loss is usually hyper-recruitment.
There is a valuable clinical tool which can be used to quantify hyperacusis called - Johnson Hyperacusis quotient published in Hearing Journal (please find the attachment) which can be used.
Determining pure tone UCLs, determining OAE (which can be abnormal) and being careful in doing Immittance as even probe tone can be intolerable and use ascending method while testing reflexes. Also try to rule out phonophobia through appropriate psychological assessment.
Hope the answer is useful.
Regards,
Prashanth
In our clinical practise , we use Fowler and Sisi test for recruitment analysis.
They are valuable and very common test and can differentiate easily both recruitment and hyperacusis symptoms.
If you interested on reviews and treatment take a look on those new articles and reviews.
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Descriptive case history and the use of Audiological Tests can help diagnose of hypercusis. In particular, the LDL Test (loudness discomfort test) is of critical importance in determining the degree of hyperacusis. Normal LDL levels in most human ears tend to fall at 90 dB or greater at various pitches or frequencies. Again, there is very little normative data on LDL results in normal hearng populations for comparison.
" Hyperacusis is usually associated with hearing loss.Recruitment is a cochlear pathology and abnormal loudness growth in individuals with hearing loss is usually hyper-recruitment."
- Audiosensitivity ('hyperacusis') is often present in those with normal PTA. It is diagnostic of Meniere Spectrum Disorder (endolymphatic hydrops), a condition of inner ear hypersensitivity, at least in its early stages. It is detected by abnormalities of stapedial reflexes. I found LDL tests to be useless.
- Recruitment indicates normal cochlear function once loud sounds are presented. Hyper-recruitment is surely audiosensitivity, a totally different phenomenon.
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