Clinical interventions for hyperacusis in adults: A scoping review to assess the current position and determine priorities for research

Background. There is no universally accepted definition for hyperacusis, but in general it is characterised by decreased sound tolerance to ordinary environmental sounds.Despite hyperacusis being prevalent and having significant clinical implications,much remains unknown about current management strategies. Purpose. To establish the current position of research on hyperacusis and identify research gaps to direct future research. Design and Sample. Using an established methodological framework, electronic and manual searches of databases and journals identified 43 records that met our inclusion criteria. Incorporating content and thematic analysis approaches, the definitions of hyperacusis, management strategies, and outcome measures were catalogued. Results. Only 67% of the studies provided a definition of hyperacusis, such as "reduced tolerance" or "oversensitivity to sound." Assessments and outcomemeasures included LoudnessDiscomfort Levels, theHyperacusis Questionnaire, andTinnitusRetraining Therapy (TRT) interview. Management strategies reported were Cognitive Behavioural Therapy, TRT, devices, pharmacological therapy, and surgery. Conclusions.Management strategies were typically evaluated in patients reporting hyperacusis as a secondary complaint or as part of a symptom set. As such the outcomes reported only provided an indication of their effectiveness for hyperacusis. Randomised Controlled Trials are needed to evaluate the effectiveness of management strategies for patients experiencing hyperacusis.