Hyperacusis and Recruitment

[ASD]

Dear Sir,

i have T from Aug 2014.. In Right Ear..due to ear infection..which was a resultant of severe persistent(2 months+) allergic cold..I had also developed sudden hearing loss measuring -65db at 4khz and -55db at 8khz.

Along with T ,I Had also developed, Hyperacusis and Recruitment . Normal sounds were felt uncomfortable and louder than what they were. Today My hearing has improved . 4khz is at -25Dbs and 8khz is at -45Dbs.
During this period Hyperacusis has reduced...and only some sounds feel uncomfortable( Which i assume are of the frequencies where i have considerable loss yet) the recruitment is almost gone as I do not feel any sounds louder than what they are..Also my T seems Thinner and Less Intrusive.

I have following question regarding my condition

1) Is it possible that H and R( Recruitment) to improve without hearing loss improving? and if H & R improve along with Improvement in Hearing what does that signify?
2) I was diagnosed with Sensorineural Hearing loss...It had typical Notch at 4khz...but now it has become more of a sloping curve...now it looks more like conductive hearing loss....( The hearing thresholds are mentioned above)...i also feel that my right ear(one with T) is clogged a bit ( about 20%)...is it advisable to get test like OAE..Impedance Audiometry done to confirm what kinda hearing loss it is?

Kindly reply
regards

 

[Dr. Nagler]

1) Is it possible that H and R( Recruitment) to improve without hearing loss improving?

Hyperacusis can most definitely improve without hearing loss improvement. We see that sort of thing all the time using desensitization approaches such as pink noise hyperacusis protocols or TRT. Recruitment is an almost unavoidable byproduct of hearing loss and cannot improve unless hair cells are regenerated, which with current technology cannot be accomplished in humans.

2) I was diagnosed with Sensorineural Hearing loss...It had typical Notch at 4khz...but now it has become more of a sloping curve...now it looks more like conductive hearing loss....( The hearing thresholds are mentioned above)...i also feel that my right ear(one with T) is clogged a bit ( about 20%)...is it advisable to get test like OAE..Impedance Audiometry done to confirm what kinda hearing loss it is?

This question would be better answered by an audiologist, but to the best of my knowledge all you need is tympanometry and pure tone air-conduction and bone-conduction audiometry to make that sort of determination.

Dr. Stephen Nagler