Categories of Hyperacusis

Category 1

Patients are significantly affected by tinnitus, but do not have hyperacusis or subjective hearing loss.

Category 2

Patients are affected by tinnitus and have significant hearing loss, but no hyperacusis.

Category 3

Patients have hyperacusis, but no prolonged ear discomfort or exacerbation of tinnitus when exposed to noise. Exacerbation of ear discomfort and/or tinnitus is usually brief, and, if present, resets itself by the next morning. Hearing loss, if present, is irrelevant because hyperacusis must be addressed first. Amplification may be considered after the hyperacusis problem is resolved.

Category 4

Patients have tinnitus and hyperacusis but have prolonged (day or weeks) worsening of ear discomfort and/or exacerbation of tinnitus after being exposed to noise. This category must be treated very cautiously and requires careful monitoring.

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