In my case, it is clear that the "sound discomfort" is a consequence of the so-called TTTS. And I think a lot of people, when they talk about hyperacusis, they are referring to TTTS.
I have already said in this thread that I don't know if this also applies to the so-called "pain hyperacusis", but TTTS "specialists", like Myriam Westcott, thinks that even stabbing and burning pain are possible symptoms of TTTS. Norena seems to share the same line of thought.
I remember that in 2015, when I was new to this, there was one poster in a forum who suggested that hyperacusis didn't exist. I thought that was not possible, because I had an increased loudest perception of ambient sounds, from certain level. It was like I had a distorted dynamic range sensation. And I thought THAT was hyperacusis. But then I realized that that was a consequence of using earplugs to "protect" my ears. And when I quitted earplugs gradually, the dynamics returned to normal.
So, after that, it only remained TTTS, which in my case was mainly a sensation of fullness or pressure. And also clicks, thumps and sometimes spasms in my left ear and a bit of pain. And this sensation of fullness was responsible of certain "sound intolerance" especially of sounds with rapid attack and certain texture, not necessarily loud ones. And the dynamics of "hyperacusis" are the dynamics of this "TTTS". The comings and goings, the setbacks, are only explained by the particularities of this mechanism in an abnormal state.
How would you explain comings and goings of hyperacusis as a neurological damage? How do you explain the discomfort hearing certain sounds with fast attack, like the sound of dishes, strong or high pitched voices, or sounds with a certain harsh texture like intercoms or ambulances? How do you think that the sensation of fullness can appear just thinking about it? How can someone who heard a couple of sounds not too strong but near to the ear and someone who got punched in the face end up with this "hyperacusis"?
Now, about cutting the tensor tympani, what I know is that there are different results. And that people like Myriam Westcott don't recommend cutting the muscle, because the results are uncertain. And you are cutting the muscle, which sounds a bit barbaric, and that doesn't eliminate the whole system, I don't know what would happen. But you mentioned a case of "pain hyperacusis", and in this case it is clearer that cutting the muscle won't eliminate the "pain hyperacusis", because this pain would originate in a nerve or tissue around the middle ear, not in the muscle itself and only there.
I read the available literature, but because there is only speculation, I had to think about the problem based on my direct experience. The most common sense is found in texts about acoustic shocks and TTTS.
When I began learning about this, in 2015, the concept of "hyperacusis" was mainly a part of the TRT theory. "Hyperacusis" didn't exist for the classical ENT. But TRT doesn't know the etiology of "hyperacusis", it is just an abstract concept for them, which is linked to tinnitus somehow. And it is diagnosed by a ridiculous LDL test and a ludicrous questionnaire. And for Jastreboff, TTTS is a consequence of misophonia
Then there is the cochlea-gang: Pollard, Liberman, Fuchs… which seems to say that "pain hyperacusis" is a different thing. I have already written about this in this thread.
And about TTTS, I have already said it, but I say it again. Klockhoff presented the concept in 1979 in an obscure article without mentioning any link to strong sounds. Only in 1996, Australian physiologist Robert Patuzzi was responsible for linking acoustics shocks to TTTS, because the symptoms related by the sufferers were the same ones described by Klockhoff. And then some audiologists also from Australia, like Janice Milhinch, Janet Doyle and Myriam Westcott contributed to the topic.
I didn't say "positive thinking". What I wrote is that for TTTS the most defining factor is the attention you give to the problem.
But of course this could be linked to depression. If you are depressed, generally you are thinking over negative things instead of being active and thinking positively. So, if the negative thing is the ear issue, you are going to be thinking about that. As a consequence, you are creating a vicious circle.
And even if you are depressed about other things, thinking negatively about other things could affect TTTS because you are tensed, not relaxed, and also the body tends to somatize (I don't know if this is the right word in English).
And then again, if you haven't noticed this psychosomatic aspect, probably you have something different from me. And if you are not sure, I propose to think about what I am saying in the next days, weeks, months. You are not going to realize right now, when you are reading this, you need time to elaborate this idea.
Of course, if you confirm that what I say applies to your case, you will understand that reading continuously about the problem and participating in forums frequently is not recommended, for obvious reasons. You should be as intellectually disconnected as possibly from the topic and keep busy.
I don't see any establishment in the field of hyperacusis. The closest to an establishment would be TRT. And TRT doesn't believe hyperacusis is psychosomatic. Well, it is more complex than that because they overlap "hyperacusis", "phonophobia" and "misophonia". They don't understand the problem and they keep it all abstract. They think that the ear is an empty tube. The only important thing for them is to exalt The Model. TRT says TTTS is a consequence of "misophonia".
Usually the word "psychosomatic" is not welcomed in the pharma-medical establishment, because it means anti-materialism, anti-drugs, anti-business.
By the way, I repeat that my recommendations are based on my experience and were directed to the OP who asked me about it. But the OP has disappeared, so it was useless for the moment.
I think my recommendations are very conservative, and it takes into account what people feel, it never goes against that. I remember that years ago some people in forums recommended taking out earplugs abruptly, not gradually. By doing that, and not respecting my sensations, I began to hear a tinnitus in one ear. But then I quit earplugs gradually, respecting my sensations, and I was OK.
That is a fragment of a text that in the introduction says clearly that it is based on my experience and on what is called "TTTS". So, if you consider that you don't have TTTS, you shouldn´t follow the guide.
I think that if members want to tell about a different case, which is different in nature from the one of the OP, they should create another thread. The OP doesn't have "noxacusis".
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