Hyperacusis in children: A clinical profile.

OBJECTIVE: Hyperacusis is commonly seen in clinical paediatric practice and can be distressing for the children and their families. This paper looks at the clinical profile of children seen for hyperacusis in a paediatric audiology service and reviews the possible underlying mechanisms.
METHODS: Retrospective study of case notes of 61 children with troublesome hyperacusis seen in the paediatric audiology service, looking at their clinical presentation and presence of other medical conditions.
RESULTS: Hyperacusis was the main presenting complaint in more than half of the cases (n = 31, 51%). The commonest age at presentation with this problem was 3-4 years (n = 33, 54%). Hearing was normal in the majority of these children (n = 41, 67%). An active middle ear problem was observed in nearly half (n = 29, 48%) of all the children, of which glue ear (otitis media with effusion, OME) was the commonest. Presence of a neurodevelopmental condition was found in almost half (n = 28, 46%) of these patients of which autistic spectrum disorder was the commonest (8/61, 13%). In nearly one-fourth of the children (23%), presence of both middle ear problems and neurodevelopmental was noted. Tinnitus was an accompanying symptom reported in 11% of all the patients.
CONCLUSION: Hyperacusis may commonly present at a very young age. Awareness of different clinical presentations, presence of other medical conditions and possible underlying pathomechanisms in children with hyperacusis can be helpful for clinicians in informing prognosis, counselling and in individualising management plan.