Search Results (54)

Objective: Children with cleft lip and/or palate (CLP) commonly present with otitis media with effusion (OME), with increased referrals for newborn hearing screening (NHS). Auditory brainstem response (ABR) testing with OME may mimic sensorineural hearing loss. This study evaluated NHS and ABR findings on and optimal timing for ABR reassessment after tympanostomy in patients with CLP. Methods: We conducted a retrospective study reviewing 271 CLP cases at our institution. The data included the cleft type, NHS results, ABR findings, OME incidence, and tympanostomy rate. Subgroup analyses compared ABR results before and after tympanostomy and via postoperative timing. Statistical comparisons were performed using the Mann–Whitney U test and Fisher’s exact test. Results: The NHS referral rate was 14.0%, and the OME incidence was 48.7%. These cases occurred in patients with cleft palate involvement, with an OME prevalence of 73.4%. Tympanostomy was performed in 72.6% of cases. Among 36 ears tested pre- and post-tympanostomy, wave V thresholds improved from 61.67 ± 16.08 to 34.72 ± 6.54 dBnHL (p < 0.0001), and wave I latency decreased from 2.27 ± 0.36 to 1.76 ± 0.12 ms (p < 0.0001). Postoperative wave V thresholds were significantly better in the ≥15-day group (p = 0.037), with 65% (17/26) of ears showing thresholds <40 dBnHL compared to 25% (3/12) in the <15-day group (p = 0.035). No timing-related differences were found regarding wave I latency. Conclusions: Tympanostomy significantly improved the ABR results in children with CLP and OME. Reassessment on or after postoperative day 15 may yield more accurate results and may help to reduce parental anxiety. Full article

Background/Objectives: Potential correlations between the scores of self-report questionnaires and speech perception in noise abilities vary widely among studies and have been little explored in patients with conventional hearing aids (HAs). This study aimed to analyse the interrelations between (1) self-report auditory scales (the 15-item short-form of the Speech Spatial and Qualities of Hearing Scale (15iSSQ) and the Extended Listening Effort Assessment Scale (EEAS); (2) speech perception in cocktail party noise, measured with and without HAs; and (3) a self-assessment of the listening effort perceived during the speech in a noise-perception task (TLE) in hearing-aid wearers. Material and Methods: –Thirty-two patients, aged of 77.5 years (SD = 12) with a mean HA experience of 5.6 years, completed the 15iSSQ and EEAS. Their speech-in-babble-noise perception thresholds (SPIN) were assessed with (HA_SPIN) and without their HAs (UA_SPIN), using a four-alternative forced-choice test in free field, with several fixed Signal to Noise ratios (SNR). They were asked to self-assess their listening effort at each of those SNRs, allowing us to define a task-related listening-effort threshold with (HA_TLE) and without HAs (UA_TLE), i.e., the SNR for which they self-evaluated their listening effort as 5 out of 10. Results: 15iSSQ decreased as both HA_SPIN (r = −0.47, p < 0.01) and HA_TLE increased (r = −0.36, p < 0.05). The relationship between 15iSSQSpeech and UA_SPIN (and UA_TLE) showed a strong moderating influence by HA experience and HA daily wear (HADW), explaining up to 31% of the variance. 15iSSQQuality depended on HA SPIN and HA_TLE (r = −0.50, p < 0.01), and the relationship between 15iSSQQuality and UA_TLE was moderated by HADW. EEAS scores depended on both HA experience and UA_SPIN, with a strong moderating influence by HADW. Conclusions: Relationships between auditory questionnaires and SPIN are strongly moderated by both HA experience and HADW, even in experienced HA users, showing the need to account for these variables when analysing relationships between questionnaires and hearing-in-noise tests in experienced HA wearers. Full article

Background: Meniere’s disease (MD) is a chronic inner ear disorder affecting approximately 0.2% of the population, with 30% of patients remaining refractory to conventional treatments. The pathophysiology involves endolymphatic hydrops, suggesting that agents affecting fluid homeostasis might provide therapeutic benefit. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors, originally developed for diabetes, offer unique mechanisms including natriuresis and osmotic diuresis that may address the underlying fluid imbalance in MD. Methods: We conducted a retrospective observational study at the Korea University Anam Hospital, analyzing the medical records of patients with definite MD (Bárány Society criteria) who received off-label empagliflozin 10 mg daily between January 2023 and December 2023. Six patients (3 men, 3 women; mean age 55.8 years) with treatment-resistant MD were identified who had failed conventional therapy for at least 3 months. Primary outcomes included changes in pure tone threshold average (PTA), low-frequency threshold average (LFA), vertigo episode frequency, and vertigo severity using visual analog scale (VAS) scores, assessed at baseline and after 3 months of treatment. Results: All patients demonstrated clinically significant improvements in both auditory and vestibular symptoms. Mean PTA improved from 31.4 dB to 20.8 dB (improvement of 10.6 dB, p < 0.05). Low-frequency hearing showed more substantial recovery, with LFA improving from 37.2 dB to 15.6 dB (improvement of 21.6 dB, p < 0.01). Vertigo frequency decreased dramatically from 1.6 episodes per month to 0.1 episodes per month, with four patients experiencing a complete resolution of vertigo episodes. VAS scores for vertigo severity decreased from 5.2 to 0.5. Treatment was well-tolerated, with only minor adverse effects reported in two patients: transient polyuria in one patient and 5 kg weight loss in another, both consistent with the known pharmacological profile of SGLT-2 inhibitors. Conclusions: This preliminary study suggests a potential clinical benefit of repurposing SGLT-2 inhibitors for treatment-resistant MD. However, the retrospective design and inherent limitations prevent definitive conclusions about causality. The significant improvements observed in both hearing thresholds and vestibular symptoms warrant further investigation through randomized controlled trials with objective outcome measures to establish the true efficacy of this therapeutic approach. Full article

Background/Objectives: Aminoglycoside antibiotics and loop diuretics are still the main causes of hearing loss in patients, and no specific prevention is available for this drug-induced ototoxicity. The aim of this study was to compare the protective effects of methionine (MET) and glutathione (GLUT) in terms of the reduction in ototoxicity induced by mixtures of amikacin (AMI, an aminoglycoside antibiotic) and furosemide (FUR, a loop diuretic) in a mouse model in which the hearing threshold decreased by 20% and 50%, respectively. Methods: To compare the otoprotective effects of MET and GLUT on AMI- and FUR-induced ototoxicity in mice, an isobolographic transformation of interactions was applied. Results: MET, but not GLUT, mitigated the AMI- and FUR-induced hearing threshold changes in mice. Additionally, MET exerted an antagonistic interaction with a combination of FUR+AMI, as the hearing threshold decreased by 50%, and an additive interaction, with a tendency toward antagonism in the model of hearing threshold decreased by 20%. In contrast, GLUT exerted only additive interactions when combined with FUR+AMI for both variant hearing thresholds decreased by 20% and 50%, respectively. Only MET could be a potential otoprotective drug in further prevention of hearing loss induced by AMI and FUR. Conclusions: MET is superior to GLUT in mitigating AMI- and FUR-induced hearing threshold decreases in mice. MET could be recommended as an otoprotectant in the prevention of hearing loss in patients receiving AMI and FUR. Full article

Background/Objectives: In the early stage of presbycusis, patients experience reduced speech perception in noisy environments despite normal audiometry, normally known as hidden hearing loss. Diagnostic indicators like the reduced amplitude of ABR wave I, elevated extended high-frequency threshold (EHT), and decreased middle ear muscle reflex (MEMR) amplitude aim to identify biomarkers of peripheral auditory pathology but remain inconsistent. Mismatch negativity (MMN) is a cortical auditory evoked potential generated when the brain detects sound changes. This study aimed to assess MMN as a diagnostic tool for hidden hearing loss in adults. Methods: Seventy-three subjects with normal hearing underwent an extended pure-tone audiogram examination ranging from 0.125 to 16 kHz and a subsequent MMN assessment with two different paradigms: a speech (ba/da) and a tone (1/2 kHz) paradigm. The MMN’s amplitude and latency were measured and analyzed. Results: The outcome shows a significant age-related effect on MMN amplitude in the speech condition (χ² = 13.0, p = 0.002). Specifically, the MMN amplitude in the 25–30-year-old group was significantly smaller than in the 20–25-year-old group (p = 0.0015, Cohen’s d = 0.63). Additionally, no further effects of age were observed on the cortical potentials examined. Also, neither tone nor speech paradigms showed a significant influence of EHT on the amplitude or latency of either MMN or P300. Conclusions: The application of MMN as an electrophysiological tool to diagnose hidden hearing loss in normal hearing adults has limitations. However, in contrast to MMN responses to tonal stimuli, the present study reveals that MMN amplitude obtained with speech stimuli may indicate early signs of central auditory deficits. Full article

Cytomegalovirus (CMV) infection in pregnant women is one of the most common causes of congenital infection in children. It is often asymptomatic but can lead to serious complications, including progressive sensorineural hearing loss. Profound hearing loss is an indication for cochlear implantation (CI). Electrode impedance and neural response telemetry (NRT) thresholds can be measured to confirm correct electrode placement and speech processor programming. Background/Objectives: The aim of the study is to evaluate the hearing outcome of children with profound sensorineural hearing loss or deafness due to cCMV infection after CI compared to a control group of children born with other causes of congenital hearing loss and to identify prognostic factors predicting the outcome of patients with hearing loss due to cCMV infection after CI. Methods: A retrospective study was conducted in patients implanted between 2016 and 2023 at the Department of Otolaryngology of the Institute of the Polish Mother’s Memorial Hospital Research Institute in Łódź. Pre- and postoperative hearing levels, electrode impedance and neural response telemetry (NRT) thresholds were compared. The degree of pre-implantation hearing loss was assessed by the level of the recorded V-wave in the ABR test. Post-implantation hearing assessment was based on the last available free-field tonal audiometry measurement. Impedance measurements were included: intraoperative, 1, 6, 12 months after CI, respectively, and NRT thresholds. Results: The final analysis included 84 patients with profound sensorineural hearing loss and complete audiological follow-up data: 13 patients with congenital CMV (cCMV) infection and 71 patients with other causes of deafnes. The analysis included 175 implanted ears: 17 in the CMV group and 158 in the control group. The age at implantation ranged from 1 to 11 years in the CMV and from 1 to 13 years in the control group. Mean preoperative hearing thresholds were 94.54 dB in the CMV group and 97.04 dB in the control group. At the most recent postoperative evaluation, mean thresholds improved to 33.83 dB and 36.42 dB, respectively. No statistically significant differences were observed between the groups. Mean intraoperative NRT values were 79.74 in the CMV group and 86.90 in the non-CMV group. Final NRT values were 129.77 and 130.76, respectively. Mean impedance values measured intraoperatively and at 1, 6 and 12 months postoperatively were 11.09 kOhm, 13.40 kOhm, 8.35 kOhm and 8.25 kOhm in the CMV group; and 12.28 kOhm, 14.06 kOhm, 9.60 kOhm and 8.00 kOhm in the control group, respectively. Conclusions: CI in children with deafness caused by cCMV infection is an effective treatment option. Initial electrical impedance values of the electrodes increase after implant activation and decrease in subsequent months of follow-up, suggesting the absence of active adhesion processes in the cochlea. Full article

Background: When speaking while wearing a face mask, sound transmission is attenuated, and visual cues are lost due to the covered facial movements of the speaker. In this study, we investigated the extent to which different face masks alter speech intelligibility in individuals with different degrees of hearing impairment. Methods: A total of fifty participants were divided into four hearing status groups according to the degree of hearing loss: normal levels (16), mild (13), moderate (11), and severe (10). A modified version of the Audiovisual German Matrix Sentence Test (AV-OLSA) was used to assess speech perception in noise in five conditions (audiovisual, audio-only, visual-only, surgical mask, and FFP2 mask). Results: Our results show that acoustic attenuations of face masks cause a small but similar decrease in speech reception thresholds (SRTs) in listeners of different hearing statuses. The effect of visual cues (visual benefit) on SRTs was stronger than the effect of acoustic attenuation but also did not differ significantly between the different hearing status groups, with a median difference of 1.5 dB for mild hearing loss, 2.9 dB for moderate hearing loss, and 2.7 dB for severe hearing loss. The best-aided hearing status did not correlate with visual benefit. Conclusions: Our research confirms the importance of providing visual cues for speech reception in noisy environments, especially for individuals with impaired hearing, regardless of their degree of hearing loss. Full article

Aural rehabilitation with hearing aids can decrease the attentional requirements of cognitive resources by amplifying deteriorated-frequency sound in hearing loss patients and improving auditory discrimination ability like speech-in-noise perception. As aural rehabilitation with an intelligible-hearing sound also can be hopeful, the aim of this study was to evaluate the effectiveness of aural rehabilitation with intelligible-hearing sound for hearing loss patients. Adult native Japanese speakers (17 males and 23 females, 68.43 ± 9.23 years) with hearing thresholds exceeding 30 dB at any of the following frequencies: 125, 250, 500, 1000, 2000, 3000, 4000, 8000, 10,000, and 12,000 Hz in either ear, were recruited. on any side were recruited and underwent the Mini-Mental State Examination Japanese. We conducted a self-evaluation questionnaire for hearing problems of voice, a gap detection test, a fast speech test, a speech-in-noise test, a pure tone audiogram, and a speech perception test using a Japanese 67-S, cortical auditory-evoked fields, and magnetic mismatch negativity before and after the non-intelligible-hearing (N = 20) and intelligible-hearing (N = 20) sound therapy, which involved listening to music for one hour a day for 35 days. The better hearing ear was defined using a four-frequency pure-tone average at the thresholds of 500, 1000, 2000, and 4000 Hz. After the sound therapy, the speech-in-noise test with a signal-to-noise ratio +10 in the better hearing ear showed significant improvement (p < 0.05), and N1m-P2m amplitudes showed a significant increase in the Lt superior temporal gyrus in response to the stimulus from the better hearing ear (p < 0.05). A significant enhancement of the magnetic mismatch negativity amplitude at the Lt superior temporal gyrus was exhibited after the sound therapy (p < 0.01). Intelligible-hearing sound therapy can improve the ability of speech-in-noise perception in the better hearing ear and enhancement of central cortex response, which reflects the ability of working memory, was proved by cortical auditory-evoked fields and magnetic mismatch negativity. Intelligible-hearing sound therapy can be a valuable aural rehabilitation method for sensory neural hearing loss, the same as hearing aids. Full article

Objectives: we aim to assess the contribution of the EarPopper device to hearing in children with middle ear effusion (MEE). Methods: The study has three parts, including 1. tympanometry and audiometry before and six weeks after using the EarPopper to evaluate the treatment’s effect over time compared to a control group; 2. tympanometry before and immediately after using the EarPopper to evaluate immediate changes in middle ear pressure (MEP); 3. length of effect 90 min after use to assess pressure fluctuations over time. Results: Part 1 was a follow-up six weeks after using the device, and the patients in the study group that completed the study showed a significant improvement in hearing threshold. The average gain in hearing threshold ranged from 9.1 dB to 14 dB compared to the control group’s max improvement of 1.1 dB. In addition, MEP was significantly improved in the study group, as most Type Bs improved to Type A and C. Part 2 was the tympanometry immediately after using EarPopper and showed the majority of Type Cs turned into Type As. The majority of Type Bs remained unchanged. Part 3 was a follow-up 90 min after use; Type Cs that had improved to Type A demonstrated a decrease in pressure and return to negative pressure. Conclusions: use of the EarPopper device for six weeks is associated with an improved hearing threshold and middle ear status. Full article

Objectives: The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. Methods: The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Results: Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year (p = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière’s disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. Conclusions: The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment. Full article

Objective: To examine the surgical, audiological and patient-reported outcomes of the Osia 2 implant. Methods: Data from 14 consecutive subjects undergoing implantation between April 2022 and November 2023 were reviewed. Ten subjects had conductive hearing loss, three had mixed hearing loss and one had single-sided deafness (SSD). Warble tone thresholds, Pure Tone Average (PTA₄) and Speech Discrimination Score (SDS) in quiet and in noise were determined unaided and aided. The subjective outcome was determined from two standardized questionnaires: (1) International Outcome Inventory for Hearing Aids (IOI-HA) and (2) Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12b). Results: Unexpected postoperative pain was found in four cases. The warble tone thresholds exhibited a consistent reduction across all frequencies, contributing to a mean decrease of 27 dB in the aided PTA₄. SDS demonstrated notable improvements, with a 57.3% increase at 50 dB and a 55.6% increase at 65 dB. In noise, SDS exhibited a 43.9% improvement. The mean IOI-HA Score was 3.8, and the mean overall score for SSQ12b was 6.6, with consistent findings across the subgroups. Conclusions: The Osia device emerges as a promising recommendation for individuals with conductive or mixed hearing loss, possibly also for those with SSD. Its safety and efficacy profile aligns with the broader category of active transcutaneous devices, demonstrating a reduced risk of wound infection compared to percutaneous alternatives. Both audiological assessments and subjective evaluations revealed positive outcomes. Full article

Noise-induced hearing loss (NIHL) is a prevalent form of adult hearing impairment, characterized by oxidative damage to auditory sensory hair cells. Although certain dihydropyridines, the L-type calcium channel blockers, exhibit protective properties against such damage, the ability of third-generation dihydropryidines like lercanidipine to mitigate NIHL remains unclear.We utilized glucose oxidase (GO)-treated OC1 cell lines and cochlear explants to evaluate the protective influence of lercanidipine on hair cells. To further investigate its effectiveness, we exposed noise-stimulated mice in vivo and analyzed their hearing thresholds. Additionally, we assessed the antioxidative capabilities of lercanidipine by examining oxidation-related enzyme expression and levels of oxidative stress markers, including 3-nitrotyrosine (3NT) and 4-hydroxynonenal (4HNE). Our findings demonstrate that lercanidipine significantly reduces the adverse impacts of GO on both OC-1 cell viability (0.3 to 2.5 µM) and outer hair cell (OHC) survival in basal turn cochlear explants (7 µM). These results are associated with increased mRNA expression of antioxidant enzyme genes (HO-1, SOD1/2, and Txnrd1), along with decreased expression of oxidase genes (COX-2, iNOS). Crucially, lercanidipine administration prior to, and following, noise exposure effectively ameliorates NIHL, as evidenced by lowered hearing thresholds and preserved OHC populations in the basal turn, 14 days post-noise stimulation at 110 dB SPL. Moreover, our observations indicate that lercanidipine’s antioxidative action persists even three days after simultaneous drug and noise treatments, based on 3-nitrotyrosine and 4-hydroxynonenal immunostaining in the basal turn. Based on these findings, we propose that lercanidipine has the capacity to alleviate NIHL and safeguard OHC survival in the basal turn, potentially via its antioxidative mechanism. These results suggest that lercanidipine holds promise as a clinically viable option for preventing NIHL in affected individuals. Full article

Long-term exposure to noise can cause irreversible hearing loss. Considering that there is no effective drug treatment, it is important to seek preventive treatment for noise-induced hearing loss (NIHL). Although astragaloside IV (AS-IV) protects against NIHL by reducing serum inflammatory factors, there is scarce information on the regulation of inflammatory factors by AS-IV to prevent NIHL. We investigated the hearing thresholds and relationship between the serum levels of inflammatory cytokines and intestinal microbiota of c57bl/6j mice exposed to noise (103 dB SPL 4 h·d⁻¹) for 7 days, treated with or without AS-IV. Our results revealed a lower hearing threshold and lower serum levels of TNF-α, TNF-γ, IL-6, IL-1β, and IFN-γ in the mice treated with AS-IV. Additionally, AS-IV increased the abundance levels of the phylum Firmicutes, class Bacillus, order Lactobacillus, and family Lactobacillus (p < 0.05), and decreased those of the phylum Bacteroidetes and order Bacteroidales (p < 0.05). Lactobacillus and Bacilli negatively correlated with TNF-α, TNF-γ, and IL-1β; Erysipelotrichaceae negatively correlated with INF-γ; and Clostridiales positively correlated with IL-1β. In conclusion, AS-IV reduces the elevation of hearing thresholds in mice, preventing hearing loss in mice exposed to noise, and under the intervention of AS-IV, changes in the levels of inflammatory factors correlate with intestinal flora. We suggest that AS-IV improves intestinal flora and reduces inflammation levels in c57bl/6j mice exposed to noise. Full article

Cholesterol is a risk factor for age-related hearing loss (ARHL). However, the effect of cholesterol on the organ of Corti during the onset of ARHL is unclear. We established a mouse model for the ARHL group (24 months, n = 12) and a young group (6 months, n = 12). Auditory thresholds were measured in both groups using auditory brainstem response (ABR) at frequencies of 8, 16, and 32 kHz. Subsequently, mice were sacrificed and subjected to histological analyses, including transmission electron microscopy (TEM), H&E, Sudan Black B (SBB), and Filipin staining, as well as biochemical assays such as IHC, enzymatic analysis, and immunoblotting. Additionally, mRNA extracted from both young and aged cochlea underwent RNA sequencing. To identify the mechanism, in vitro studies utilizing HEI-OC1 cells were also performed. RNA sequencing showed a positive correlation with increased expression of genes related to metabolic diseases, cholesterol homeostasis, and target of rapamycin complex 1 (mTORC1) signaling in the ARHL group as compared to the younger group. In addition, ARHL tissues exhibited increased cholesterol and lipofuscin aggregates in the organ of Corti, lateral walls, and spiral ganglion neurons. Autophagic flux was inhibited by the accumulation of damaged lysosomes and autolysosomes. Subsequently, we observed a decrease in the level of transcription factor EB (TFEB) protein, which regulates lysosomal biosynthesis and autophagy, together with increased mTORC1 activity in ARHL tissues. These changes in TFEB and mTORC1 expression were observed in a cholesterol-dependent manner. Treatment of ARHL mice with atorvastatin, a cholesterol synthesis inhibitor, delayed hearing loss by reducing the cholesterol level and maintaining lysosomal function and autophagy by inhibiting mTORC1 and activating TFEB. The above findings were confirmed using stress-induced premature senescent House Ear Institute organ of Corti 1 (HEI-OC1) cells. The findings implicate cholesterol in the pathogenesis of ARHL. We propose that atorvastatin could prevent ARHL by maintaining lysosomal function and autophagy by inhibiting mTORC1 and activating TFEB during the aging process. Full article

Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. The aim of the study was to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and to evaluate its psychometric properties. The study sample consisted of 106 adult patients with hyperacusis and tinnitus with a mean age of 45.2 years. A medical interview, an audiological examination, and several questionnaires (the Tinnitus Handicap Inventory, the Hyperacusis Questionnaire, the State–Trait Anxiety Inventory, and Visual Analog Scales) were applied. The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure with 70.5% of the variance explained. Convergent and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. The internal consistency assessed with Cronbach’s alpha was excellent (α = 0.91), as was reproducibility (intraclass correlation, ICC = 0.96). The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool assessing the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus. Full article