You do not have permission to edit this page, for the following reasons:

This IP address has been blocked from editing Wikipedia.
This does not affect your ability to read Wikipedia pages.
Most people who see this message have done nothing wrong. Some kinds of blocks restrict editing from specific service providers or telecom companies in response to recent abuse or vandalism, and can sometimes affect other users who are unrelated to that abuse. Review the information below for assistance if you do not believe that you have done anything wrong.

The IP address or range 3.88.0.0/16 has been blocked (disabled) by ‪ST47‬ for the following reason(s):

The IP address that you are currently using has been blocked because it is believed to be a web host provider. To prevent abuse, web hosts may be blocked from editing Wikipedia.
You will not be able to edit Wikipedia using a web host provider because it hides your IP address, much like a proxy or VPN.
We recommend that you attempt to use another connection to edit. For example, if you use a proxy or VPN to connect to the internet, turn it off when editing Wikipedia. If you edit using a mobile connection, try using a Wi-Fi connection, and vice versa. If you are using a corporate internet connection, switch to a different Wi-Fi network. If you have a Wikipedia account, please log in.
If you do not have any other way to edit Wikipedia, you will need to request an IP block exemption.

How to appeal if you are confident that your connection does not use a web host's IP address:
If you are confident that you are not using a web host, you may appeal this block by adding the following text on your talk page: ((unblock|reason=Caught by a web host block but this host or IP is not a web host. My IP address is _______. Place any further information here. ~~~~)). You must fill in the blank with your IP address for this block to be investigated. Your IP address can be determined here. Alternatively, if you wish to keep your IP address private you can use the unblock ticket request system. There are several reasons you might be editing using the IP address of a web host (such as if you are using VPN software or a business network); please use this method of appeal only if you think your IP address is in fact not a web host.

Administrators: The IP block exemption user right should only be applied to allow users to edit using web host in exceptional circumstances, and they should usually be directed to the functionaries team via email. If you intend to give the IPBE user right, a CheckUser needs to take a look at the account. This can be requested most easily at SPI Quick Checkuser Requests. Unblocking an IP or IP range with this template is highly discouraged without at least contacting the blocking administrator.

This block will expire on 06:27, 30 September 2026.

Even when blocked, you will usually still be able to edit your user talk page, as well as email administrators and other editors.

For information on how to proceed, please read the FAQ for blocked users and the guideline on block appeals. The guide to appealing blocks may also be helpful.

Other useful links: Blocking policy · Help:I have been blocked
Your IP address is in a range that has been blocked on all Wikimedia Foundation wikis. The block was made by ‪Tks4Fish‬. The reason given is Open Proxy/Webhost: Contact stewards if you are affected. .
- Start of block: 04:06, 17 February 2021
- Expiry of block: 04:06, 17 February 2024
Your current IP address is 3.88.39.226. The blocked range is 3.88.0.0/16. Please include all above details in any queries you make. If you believe you were blocked by mistake, you can find additional information and instructions in the No open proxies global policy. Otherwise, to discuss the block please post a request for review on Meta-Wiki. You could also send an email to the stewards VRT queue at stewards@wikimedia.org including all above details.

You can view and copy the source of this page:

((more citations needed|date=January 2023))
((Infobox medical condition (new)
| name          = Hyperacusis
| synonyms      = Hyperacousis
| image         = 
| caption       = 
| pronounce     = 
| field         = [[Otolaryngology]], [[neurology]], [[psychiatry]]
| symptoms      = 
| complications = 
| onset         = 
| duration      = 
| types         = 
| causes        = 
| risks         = 
| diagnosis     = 
| differential  = [[Sensory processing disorder]], [[Autism Spectrum Disorder|Autism]]
| prevention    = 
| treatment     = 
| medication    = 
| prognosis     = 
| frequency     = 
| deaths        = 
))
'''Hyperacusis''' is an increased sensitivity to sound and a low tolerance for environmental noise. Definitions of hyperacusis can vary significantly, but it is often categorized into four subtypes: loudness, pain, annoyance, and fear.<ref name="pmid25104073">((cite journal |display-authors=6 |vauthors=Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Dauman N, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC |date=December 2014 |title=A review of hyperacusis and future directions: part I. Definitions and manifestations |journal=American Journal of Audiology |volume=23 |issue=4 |pages=402–419 |doi=10.1044/2014_AJA-14-0010 |pmid=25104073))</ref><ref name="pmid25478787">((cite journal |display-authors=6 |vauthors=Pienkowski M, Tyler RS, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Coelho CB, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC |date=December 2014 |title=A review of hyperacusis and future directions: part II. Measurement, mechanisms, and treatment |journal=American Journal of Audiology |volume=23 |issue=4 |pages=420–436 |pmid=25478787 |s2cid=449625 |url=https://pdfs.semanticscholar.org/a5ed/91aa23c1d830720013b3d2b8e41958345f01.pdf |doi=10.1044/2014_AJA-13-0037 |archive-url=https://web.archive.org/web/20180409233712/https://pdfs.semanticscholar.org/a5ed/91aa23c1d830720013b3d2b8e41958345f01.pdf |archive-date=2018-04-09))</ref> It can be a highly debilitating [[hearing|hearing disorder]].<ref name="pmid24012803">((cite journal |vauthors=Knipper M, Van Dijk P, Nunes I, Rüttiger L, Zimmermann U |date=December 2013 |title=Advances in the neurobiology of hearing disorders: recent developments regarding the basis of tinnitus and hyperacusis |journal=Progress in Neurobiology |volume=111 |pages=17–33 |pmid=24012803 |doi=10.1016/j.pneurobio.2013.08.002 |doi-access=free))</ref>

There are a variety of causes and risk factors, with the most common being exposure to loud noise.<ref name="pmid25104073" /> It is often coincident with [[tinnitus]].<ref name="pmid25104073" /> Proposed mechanisms in the literature involve dysfunction in the brain, inner ear, or middle ear.<ref name="pmid26139435" /><ref name=":7" /><ref name=":8" /><ref name="Noreña 20182"/><ref name=":02" /><ref name=":12" />

Little is known about the [[prevalence]] of hyperacusis, in part due to the degree of variation in the term's definition.<ref name="pmid25104073" /><ref name=":0">((cite journal | vauthors = Rosing SN, Schmidt JH, Wedderkopp N, Baguley DM | title = Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review | journal = BMJ Open | volume = 6 | issue = 6 | pages = e010596 | date = June 2016 | pmid = 27259524 | pmc = 4893873 | doi = 10.1136/bmjopen-2015-010596 ))</ref> Reported prevalence estimates in the literature vary widely, and further research is needed to obtain strong epidemiological data.<ref name=":2">((Cite journal |last1=Musumano |first1=Lucia Belen |last2=Hatzopoulos |first2=Stavros |last3=Fancello |first3=Virginia |last4=Bianchini |first4=Chiara |last5=Bellini |first5=Tiziana |last6=Pelucchi |first6=Stefano |last7=Skarżyński |first7=Piotr Henryk |last8=Skarżyńska |first8=Magdalena B. |last9=Ciorba |first9=Andrea |date=2023-10-21 |title=Hyperacusis: Focus on Gender Differences: A Systematic Review |journal=Life |volume=13 |issue=10 |pages=2092 |doi=10.3390/life13102092 |issn=2075-1729 |pmid=37895473 |pmc=10608418 |bibcode=2023Life...13.2092M |doi-access=free ))</ref> While there are no exact numbers, several people have died by suicide due to the severe consequences of the disease.<ref name=":3">((Cite news|url=https://medium.com/buzzfeed-collections/when-everyday-sound-becomes-torture-1082367f24c0|title= Noise Kills: When Everyday Sound Becomes Torture|access-date=2023-01-17|language=en))((cbignore))</ref>

==Signs and symptoms==
Hyperacusis symptoms can include an increased perception of the loudness of sounds (loudness hyperacusis), pain (noxacusis/pain hyperacusis/sound-induced otalgia), [[annoyance]], and/or fear in response to sounds by which most people are unaffected. It may affect one or both ears.<ref name=":4" /> The majority of patients experience bilateral symptoms but often have one ear that is more affected than the other. Annoyance hyperacusis is often considered synonymous with [[misophonia]]. Fear hyperacusis is often considered synonymous with [[phonophobia]]. Many researchers more narrowly define hyperacusis to only include loudness hyperacusis and pain hyperacusis.<ref name=":4" />

Hyperacusis can also be accompanied by [[tinnitus]]. The latter is more common<ref name="BTA">((cite web |title=Hyperacusis |url=https://www.tinnitus.org.uk/hyperacusis |access-date=9 June 2020 |website=British Tinnitus Association |language=en))</ref> and there are important differences between their involved mechanisms.<ref name="pmid24012803" />

Hyperacusis can result in [[anxiety]] and stress. Avoidant behavior is often a response to prevent the effects of hyperacusis and this can include avoiding social situations.<ref>((Cite journal |last1=Henry |first1=James A. |last2=Theodoroff |first2=Sarah M. |last3=Edmonds |first3=Catherine |last4=Martinez |first4=Idalisse |last5=Myers |first5=Paula J. |last6=Zaugg |first6=Tara L. |last7=Goodworth |first7=Marie-Christine |date=September 2022 |title=Sound Tolerance Conditions (Hyperacusis, Misophonia, Noise Sensitivity, and Phonophobia): Definitions and Clinical Management |url=http://dx.doi.org/10.1044/2022_aja-22-00035 |journal=American Journal of Audiology |volume=31 |issue=3 |pages=513–527 |doi=10.1044/2022_aja-22-00035 |pmid=35858241 |issn=1059-0889))</ref>

=== Loudness hyperacusis ===
Loudness hyperacusis is characterized by an increased perception of the loudness of sounds.<ref name=":4" /> It is often associated with certain volumes and/or frequencies. It can occur in children<ref name=pmid29312994>((Cite journal |last=Potgieter |first=I. |date=June 29, 2020 |title=Hyperacusis in children: a scoping review |journal=BMC Pediatr |volume=20, 319|issue=1 |page=319 |doi=10.1186/s12887-020-02223-5 |pmid=32600446 |pmc=7322835 |doi-access=free ))</ref> and adults,<ref>((Cite journal |last1=Fackrell |first1=Kathryn |last2=Potgieter |first2=Iskra |last3=Shekhawat |first3=Giriraj S. |last4=Baguley |first4=David M. |last5=Sereda |first5=Magdalena |last6=Hoare |first6=Derek J. |date=2017 |title=Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research |journal=BioMed Research International |volume=2017 |pages=1–22 |doi=10.1155/2017/2723715 |pmid=29312994 |pmc=5654244 |doi-access=free |issn=2314-6133 ))</ref> and can be either "short-term" in a duration of weeks to less than a year before recovery, or, less commonly, "long-term," spanning years and in some cases becoming permanent. Sensitivity is often different between ears.<ref name=":1">((Cite journal |last=Pollard |first=Bryan |date=October 2019 |title=Clinical Advancements for Managing Hyperacusis with Pain |journal=The Hearing Journal |volume=72 |issue=10 |pages=10, 12 |s2cid=208398632 |doi=10.1097/01.HJ.0000602900.16223.0e |doi-access=free |url=https://journals.lww.com/thehearingjournal/Fulltext/2019/10000/Clinical_Advancements_for_Managing_Hyperacusis.4.aspx))</ref>

=== Noxacusis (pain hyperacusis) ===
In some instances, hyperacusis is accompanied by pain, which is known as noxacusis.<ref>((Cite web |last=Auerbach |first=Benjamin |date=January 1, 2019 |title=Physiological mechanisms of hyperacusis: an update |url=https://www.entandaudiologynews.com/features/audiology-features/post/physiological-mechanisms-of-hyperacusis-an-update |access-date=May 2, 2022 |website=ENT and Audiology News))</ref> Noxacusis is characterized by pain resulting from sounds, often initiated at certain volumes or frequencies.<ref>((Cite journal |last=Sheldrake |first=Jacqueline |date=May 15, 2015 |title=Audiometric Characteristics of Hyperacusis Patents |journal=Frontiers in Neurology |volume=6 |page=105 |doi=10.3389/fneur.2015.00105 |pmid=26029161 |pmc=4432660 |doi-access=free))</ref> Pain can be immediate or delayed, and it sometimes persists for an extended period of time following exposure.<ref name=":1"/> Pain can be acute or chronic, and is often described as stabbing, burning, throbbing, or aching. In healthy listeners, pain from sound is not typically experienced until the volume exceeds approximately 120 decibels.<ref name=":4" />

Individuals experiencing noxacusis report less improvement over time and fewer benefits from sound therapy compared to individuals with loudness hyperacusis.<ref name=":5">((Cite journal |last1=Williams |first1=Zachary J. |last2=Suzman |first2=Evan |last3=Woynaroski |first3=Tiffany G. |date=2021-06-14 |title=A Phenotypic Comparison of Loudness and Pain Hyperacusis: Symptoms, Comorbidity, and Associated Features in a Multinational Patient Registry |journal=American Journal of Audiology |language=en |volume=30 |issue=2 |pages=341–358 |doi=10.1044/2021_AJA-20-00209 |issn=1059-0889 |pmc=8642094 |pmid=33877881))</ref>

=== Loudness discomfort level (LDL) ===
The threshold of sound at which discomfort is initially experienced; measured in decibels (dB).<ref>((Cite journal |last=Deihl |first=Peter |date=July 15, 2015 |title=Abnormal auditory gain in hyperacusis: investigation with a computational model |journal=Frontiers in Neurology |volume=6|page=157 |doi=10.3389/fneur.2015.00157 |pmid=26236277 |pmc=4502361 |doi-access=free ))</ref>

=== Setback ===
A setback is a temporary exacerbation of symptoms, a worsening of the perception of loudness or pain from sound, often due to a particular noise exposure.<ref name=":4">((Cite journal |last1=Williams |first1=Zachary J. |last2=Suzman |first2=Evan |last3=Woynaroski |first3=Tiffany G. |date=2021-06-14 |title=A Phenotypic Comparison of Loudness and Pain Hyperacusis: Symptoms, Comorbidity, and Associated Features in a Multinational Patient Registry |url=http://dx.doi.org/10.1044/2021_aja-20-00209 |journal=American Journal of Audiology |volume=30 |issue=2 |pages=341–358 |doi=10.1044/2021_aja-20-00209 |pmid=33877881 |pmc=8642094 |issn=1059-0889))</ref> Setback prevention is an important focus among those affected. Efforts to avoid setbacks commonly include using hearing protection and avoiding loud noises.<ref name=":1"/> Pain hyperacusis patients experience setbacks more frequently than patients with loudness hyperacusis.<ref name=":4" />

=== Associated conditions ===
Some conditions that are associated with hyperacusis<ref name="Baguley, 2003"/> include:
((div col|colwidth=35em))
* [[Acoustic shock]]
* [[Adverse drug reaction]]
* [[Anxiety]]
* [[Asperger syndrome]]
* [[Attention deficit hyperactivity disorder]]<ref>((cite journal | vauthors = Ralli M, Romani M, Zodda A, Russo FY, Altissimi G, Orlando MP, Cammeresi MG, Penge R, Turchetta R | display-authors = 6 | title = Hyperacusis in Children with Attention Deficit Hyperactivity Disorder: A Preliminary Study | journal = International Journal of Environmental Research and Public Health | volume = 17 | issue = 9 | pages = 3045 | date = April 2020 | pmid = 32349379 | pmc = 7246428 | doi = 10.3390/ijerph17093045 | doi-access = free ))</ref>
* [[Autism spectrum]]
* [[Bell's palsy]]<ref name="Purves">((cite book | vauthors = Purves D |title=Neuroscience |date=2012 |location=Sunderland, Mass. |isbn=978-0-87893-695-3 |page=283 |edition=5th))</ref>
* [[Depression (mood)|Depression]]
* [[Endolymphatic hydrops]]<ref name="Møller 2011 p. 457">((cite book | vauthors = Møller A | title=Textbook of tinnitus | publisher=Humana Springer distributor | location=Totowa, N.J. London | year=2011 | isbn=978-1-60761-145-5 | page=457))</ref>
* [[Fetal alcohol spectrum disorder]]
* [[Hypothyroidism]]
* [[Lyme disease]]<ref name="Baguley, 2003"/>
* [[Migraine]]<ref name="Baguley, 2003">((cite journal | vauthors = Baguley DM | title = Hyperacusis | journal = Journal of the Royal Society of Medicine | volume = 96 | issue = 12 | pages = 582–585 | date = December 2003 | pmid = 14645606 | pmc = 539655 | doi = 10.1177/014107680309601203 ))</ref>
* [[Ménière's disease]]
* [[Multiple sclerosis]]<ref name="Baguley 2007 p. ">((cite book | vauthors = Baguley D | title=Hyperacusis : mechanisms, diagnosis, and therapies | publisher=Plural Publishing Inc | location=San Diego, CA | year=2007 | isbn=978-1-59756-808-1 | page=59))</ref>
* [[Noise-induced hearing loss]]
* [[Posttraumatic stress disorder]]<ref name="Baguley, 2003"/>
* Severe [[head trauma]]<ref name="Baguley, 2003"/><ref name="Granacher 2008 p. ">((cite book | vauthors = Granacher R | title=Traumatic brain injury: methods for clinical and forensic neuropsychiatric assessment | publisher=CRC Taylor & Francis distributor | location=Boca Raton, Fla. London | year=2008 | isbn=978-0-8493-8139-3 | page=181))</ref>
* [[Sjögren syndrome]]<ref>((cite journal | vauthors = Montoya-Aranda IM, Peñaloza-López YR, Gutiérrez-Tinajero DJ | title = Sjögren's syndrome: Audiological and clinical behaviour in terms of age | journal = Acta Otorrinolaringologica (English Edition) | volume = 61 | issue = 5 | pages = 332–337 | year = 2010 | issn=2173-5735 | doi = 10.1016/S2173-5735(10)70061-2 | pmid = 20678744 | url = https://www.sciencedirect.com/science/article/pii/S2173573510700612 ))</ref>
* [[Superior canal dehiscence syndrome]] (SCDS)
* [[Systemic lupus erythematosus (SLE)]]<ref name="pmid20576373">((cite journal | vauthors = Maciaszczyk K, Durko T, Waszczykowska E, Erkiert-Polguj A, Pajor A | title = Auditory function in patients with systemic lupus erythematosus | journal = Auris, Nasus, Larynx | volume = 38 | issue = 1 | pages = 26–32 | date = February 2011 | pmid = 20576373 | doi = 10.1016/j.anl.2010.04.008 ))</ref>
* [[Tay–Sachs disease]]<ref name="Desnick 2001 p. ">((cite book | vauthors = Desnick R | title=Tay–Sachs disease | url=https://archive.org/details/advancesgenetics00desn | url-access=limited | publisher=Academic | location=San Diego, Calif. London | year=2001 | isbn=978-0-08-049030-4 | page=[https://archive.org/details/advancesgenetics00desn/page/n45 25]))</ref>
* [[Temporomandibular joint disorder]]
* [[Tinnitus]]
* [[Tonic tensor tympani syndrome]]
* [[Trigeminal neuralgia]]
* [[Visual snow]]
* [[Williams syndrome]]<ref name="Baguley, 2003"/><ref name="Zarchi">((cite journal | vauthors = Zarchi O, Attias J, Gothelf D | title = Auditory and visual processing in Williams syndrome | journal = The Israel Journal of Psychiatry and Related Sciences | volume = 47 | issue = 2 | pages = 125–131 | year = 2010 | pmid = 20733255 ))</ref>
((div col end))

==Causes and risk factors==
The most common cause of hyperacusis is overexposure to excessively high [[Decibel#Acoustics|decibel]] ([[sound pressure]]) levels, which can cause [[acoustic trauma]].<ref name="pmid25104073"/> An [[acoustic shock]], which can lead to symptoms such as hyperacusis and ear pain, can also occur after exposure to an unexpected moderately loud to loud noise, even if this does not necessarily result in permanent cochlear damage.<ref name="Noreña 20182">((Cite journal |last=Noreña |first=Arnaud |date=2018 |title=An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock |journal=Trends in Hearing |volume=22 |doi=10.1177/2331216518801725 |pmc=6156190 |pmid=30249168 |s2cid=52815107))</ref>

Some affected people acquire hyperacusis suddenly as a result of taking ototoxic drugs (which can damage the cells responsible for hearing), [[Lyme disease]], [[Ménière's disease]], [[head injury]], or surgery. Others are born with sound sensitivity or develop [[superior canal dehiscence syndrome]].<ref>((Cite journal |date=2023-08-26 |title=Superior canal dehiscence syndrome: A review |url=https://www.sciencedirect.com/science/article/abs/pii/S0385814623001505 |journal=Auris Nasus Larynx |language=en-US |doi=10.1016/j.anl.2023.08.004 |issn=0385-8146 |last1=Suzuki |first1=Mitsuya |last2=Ota |first2=Yasushi |last3=Takanami |first3=Taro |last4=Yoshino |first4=Ryosuke |last5=Masuda |first5=Hiroaki |pmid=37640595 |s2cid=261306199 ))</ref> [[Bell's palsy]] can trigger hyperacusis if the associated flaccid paralysis affects the [[tensor tympani]], and [[stapedius]], two small muscles of the [[middle ear]].<ref name="Purves"/> Paralysis of the stapedius muscle prevents its function in dampening the oscillations of the [[ossicles]], causing sound to be abnormally loud on the affected side.<ref name="Carpenter">((cite book | vauthors = Carpenter MB |title=Core text of neuroanatomy |date=1985 |publisher=Williams & Wilkins |location=Baltimore |isbn=978-0-683-01455-6 |page=151 |edition=3rd))</ref> Age may also be a significant factor, with younger patients exhibiting more severe hyperacusis.<ref name=":2" />

Recently, it has been discovered that individuals with one copy of the GJB2 (Cx26) genetic mutation exhibit hearing that is more sensitive than average, akin to hyperacusis. These individuals appear to be at greater risk for damage from noise.<ref>((Cite journal |last1=Liu |first1=Li-Man |last2=Liang |first2=Chun |last3=Chen |first3=Jin |last4=Fang |first4=Shu |last5=Zhao |first5=Hong-Bo |title=Cx26 heterozygous mutations cause hyperacusis-like hearing oversensitivity and increase susceptibility to noise |journal=Science Advances |date=2023 |volume=9 |issue=6 |pages=eadf4144 |doi=10.1126/sciadv.adf4144 |issn=2375-2548 |pmc=9908021 |pmid=36753545|bibcode=2023SciA....9F4144L ))</ref>

Some [[psychoactive drugs]] such as [[LSD]], [[methaqualone]], [[benzodiazepine]]s, or [[phencyclidine]] can cause hyperacusis.<ref name=":2"/><ref name="Barceloux 2012 p.">((cite book |vauthors=Barceloux D |title=Medical Toxicology of Drug Abuse : Synthesized Chemicals and Psychoactive Plants |publisher=John Wiley & Sons |location=Hoboken, N.J |year=2012 |isbn=978-1-118-10605-1 |pages=457, 507, and 616))</ref> An [[antibiotic]], [[ciprofloxacin]], has also been seen to be a cause, known as ''ciprofloxacin-related hyperacusis''.<ref>((cite web |url=https://www.druginformer.com/search/side_effect_details/Ciprofloxacin/hyperacusis.html |title=Ciprofloxacin Related Hyperacusis | work=FDA Reports |date=2017))</ref> [[Benzodiazepine withdrawal syndrome]] is also a possible cause.<ref>((cite journal |vauthors=Beeley L |title=Benzodiazepines and tinnitus |journal=BMJ |volume=302 |issue=6790 |pages=1465 |date=June 1991 |pmid=2070121 |pmc=1670117 |doi=10.1136/bmj.302.6790.1465))</ref><ref>((cite journal |vauthors=Lader M |title=Anxiolytic drugs: dependence, addiction and abuse |journal=European Neuropsychopharmacology |volume=4 |issue=2 |pages=85–91 |date=June 1994 |pmid=7919947 |doi=10.1016/0924-977x(94)90001-9 |s2cid=44711894))</ref>

== Epidemiology ==
Prevalence estimates for hyperacusis vary widely in the literature, and further epidemiological data is needed. No gender differences have yet been established among hyperacusis patients. Hyperacusis appears to be more severe in younger patients.<ref name=":2" />

== Possible mechanisms ==

=== Loudness hyperacusis ===
As one possible mechanism, adaptation processes in the auditory brain that influence the dynamic range of neural responses are assumed to be distorted by irregular input from the inner ear. This is mainly caused by hearing loss related damage in the inner ear.<ref name="pmid26139435">((cite journal | vauthors = Brotherton H, Plack CJ, Maslin M, Schaette R, Munro KJ | title = Pump up the volume: could excessive neural gain explain tinnitus and hyperacusis? | journal = Audiology & Neuro-Otology | volume = 20 | issue = 4 | pages = 273–282 | year = 2015 | pmid = 26139435 | doi = 10.1159/000430459 | s2cid = 32159259 ))</ref> The mechanism behind hyperacusis is not currently known, but it is suspected to be caused by damage to the inner ear and [[cochlea]].

=== Noxacusis (pain hyperacusis) ===

==== Inner ear theory ====
Type II afferent fibers of the cochlear nerve are not responsible for hearing like the type I afferent fibers. They are thought to be cochlear pain neurons. Gain of function of these type II afferent fibers may be caused by a flood of ATP after hair cell damage.<ref name=":7" /><ref name=":8" /> Now sensitized, they react to the small amount of ATP released during the normal process of hearing. This may result in pain.<ref name=":7">((cite journal | vauthors = Liu C, Glowatzki E, Fuchs PA | title = Unmyelinated type II afferent neurons report cochlear damage | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 112 | issue = 47 | pages = 14723–14727 | date = November 2015 | pmid = 26553995 | pmc = 4664349 | doi = 10.1073/pnas.1515228112 | doi-access = free | bibcode = 2015PNAS..11214723L ))</ref><ref name=":8">((Cite journal |last1=Flores |first1=Emma N. |last2=Duggan |first2=Anne |last3=Madathany |first3=Thomas |last4=Hogan |first4=Ann K. |last5=Márquez |first5=Freddie |last6=Kumar |first6=Gagan |last7=Seal |first7=Rebecca |last8=Edwards |first8=Robert |last9=Liberman |first9=M. Charles |last10=García-Añoveros |first10=Jaime |date=2015-03-02 |title=A Non-canonical Pathway from Cochlea to Brain Signals Tissue-damaging Noise |journal=Current Biology |volume=25 |issue=5 |pages=606–612 |doi=10.1016/j.cub.2015.01.009 |issn=0960-9822 |pmc=4348215 |pmid=25639244))</ref>

==== Middle ear theory ====
Noreña et al. (2018) propose a model that may account for sound-induced pain and a constellation of other symptoms often experienced after an [[acoustic shock]], [[acoustic trauma]], and potentially other mechanisms of auditory damage. Symptoms may include a sense of fullness in the ear, [[tinnitus]], and [[dizziness]].<ref name="Noreña 20182"/><ref name=":02">((Cite journal |last1=Fournier |first1=Philippe |last2=Paleressompoulle |first2=Dany |last3=Esteve Fraysse |first3=Marie-José |last4=Paolino |first4=Fabien |last5=Devèze |first5=Arnaud |last6=Venail |first6=Frédéric |last7=Noreña |first7=Arnaud |date=2022-09-01 |title=Exploring the middle ear function in patients with a cluster of symptoms including tinnitus, hyperacusis, ear fullness and/or pain |journal=Hearing Research |volume=422 |pages=108519 |doi=10.1016/j.heares.2022.108519 |issn=1878-5891 |pmid=35644108|doi-access=free ))</ref>

The model details how symptoms may be initiated by [[tensor tympani muscle]] damage or overload due to acoustic shock or trauma. Hypercontraction or hyperactivity of the muscle may cause an "[[Adenosine triphosphate|ATP]] energy crisis." The muscle is then forced to create energy without sufficient oxygen, which results in the release of lactic acid into the middle ear space. This acidity can activate pain-sensing neurons. Muscle relaxation requires energy in the form of ATP. In the setting of low ATP, it is more difficult for the muscle to relax, which causes the cycle to continue. Via a cascade of events, the activated pain neurons can cause [[neurogenic inflammation]], which may lead to additional pain. In this way, a "vicious circle" is created.<ref name="Noreña 20182" /><ref name=":12">((Cite journal |last1=Fournier |first1=Philippe |last2=Paquette |first2=Sébastien |last3=Paleressompoulle |first3=Dany |last4=Paolino |first4=Fabien |last5=Devèze |first5=Arnaud |last6=Noreña |first6=Arnaud |date=July 2022 |title=Contraction of the stapedius and tensor tympani muscles explored by tympanometry and pressure measurement in the external auditory canal |journal=Hearing Research |volume=420 |pages=108509 |doi=10.1016/j.heares.2022.108509 |issn=1878-5891 |pmid=35568596|doi-access=free ))</ref>

Pain from sound sometimes radiates to the face, scalp, and neck. This may be due to the trigeminocervical complex in the brainstem, which integrates input from and output to various regions of the head and neck, including the middle ear. Of note, the tensor tympani muscle is innervated by the trigeminal nerve. The model also explains how [[Whiplash (medicine)|whiplash]] injuries, [[temporomandibular joint dysfunction]], and other conditions affecting the head and neck regions may influence the function of the tensor tympani muscle and contribute to ear symptoms such as pain hyperacusis.<ref name="Noreña 20182" /><ref name=":02" /><ref name=":12" />

== Diagnosis ==
[[File:LDL-Audiogram.jpg|thumb|upright=1.15|'''Loudness discomfort levels (LDLs)''': group data of hyperacusis patients without hearing loss. Upper line: average hearing thresholds. Lower long line: LDLs of this group. Lower short line: LDLs of a reference group with normal hearing.<ref name="pmid26029161">((cite journal | vauthors = Sheldrake J, Diehl PU, Schaette R | title = Audiometric characteristics of hyperacusis patients | journal = Frontiers in Neurology | volume = 6 | pages = 105 | year = 2015 | pmid = 26029161 | pmc = 4432660 | doi = 10.3389/fneur.2015.00105 | doi-access = free ))</ref>]]
The basic diagnostic test is similar to a normal [[audiogram]]. The difference is that, in addition to the hearing threshold at each test frequency, the lowest uncomfortable sound level is also measured. This level is called ''loudness discomfort level'' (LDL) or ''uncomfortable loudness level'' (ULL). In patients with hyperacusis this level is often considerably lower than in normal subjects, and usually across most parts of the auditory spectrum.<ref name="pmid25104073"/><ref name="pmid26029161"/> However, there is not a consensus regarding what constitutes a normal LDL. The relationship between LDL's and self-reported ability to tolerate sounds in everyday life in unclear.<ref name=":6">((Cite journal |last=Jahn |first=Kelly N. |date=July 2022 |title=Clinical and investigational tools for monitoring noise-induced hyperacusis |url=http://dx.doi.org/10.1121/10.0012684 |journal=The Journal of the Acoustical Society of America |volume=152 |issue=1 |pages=553–566 |doi=10.1121/10.0012684 |pmid=35931527 |pmc=9448410 |issn=0001-4966))</ref>

In addition to self-report questionnaires, audiologists may employ a variety of other techniques to evaluate auditory function in patients experiencing noise sensitivity. When conducting testing that involves the presentation of sounds, which may cause the patient discomfort or pain, it is vital to inform the patient of the volume and duration of sounds to be presented prior to testing. Care should be taken to begin with sounds of low volume, and volume should be increased gradually. The audiologist and patient should both be prepared to stop testing at any time, depending on the patient's symptoms.<ref name=":6" />

==Management and treatment==
There are currently no evidence-based guidelines regarding the treatment of patients with hyperacusis. The majority of audiologists report insufficient formal education in this area, likely due in part to the current lack of consensus in the literature regarding definitions and treatment of hyperacusis.<ref>((Cite journal |last1=Jahn |first1=Kelly N. |last2=Koach |first2=Chelsea E. |date=2023-11-02 |title=Hyperacusis Diagnosis and Management in the United States: Clinical Audiology Practice Patterns |url=http://dx.doi.org/10.1044/2023_aja-23-00118 |journal=American Journal of Audiology |volume=32 |issue=4 |pages=950–961 |doi=10.1044/2023_aja-23-00118 |pmid=37917915 |s2cid=264972147 |issn=1059-0889))</ref>

=== Avoidance and hearing protection ===
Setback prevention and reduction of pain symptoms are high priorities among those with hyperacusis and noxacusis, which is often managed through a combination of controlling the environment so as to avoid loud sounds, [[soundproofing]], and wearing hearing protection, such as [[earplug]]s and safety [[earmuffs]]. Preliminary research has shown that individuals with pain hyperacusis can experience an exacerbation of their symptoms when not adequately protecting themselves against loud sounds.<ref name=":1" />

There are diametrically opposing views on avoiding overuse of hearing protection and silence. Some audiologists may advise against using hearing protection in normal sound environments, claiming it can cause or worsen hyperacusis. This is based on a study in healthy volunteers and not individuals with preexisting loudness or pain hyperacusis.<ref>((Cite journal |last1=Formby |first1=C. |last2=Sherlock |first2=L. P. |last3=Gold |first3=S. L. |date=July 2003 |title=Adaptive plasticity of loudness induced by chronic attenuation and enhancement of the acoustic background |url=https://pubmed.ncbi.nlm.nih.gov/12880017 |journal=The Journal of the Acoustical Society of America |volume=114 |issue=1 |pages=55–58 |doi=10.1121/1.1582860 |issn=0001-4966 |pmid=12880017))</ref>

=== Diet ===
Diet may play a role in symptom management in some cases of hyperacusis, with response to a migraine diet, low-histamine diet, or low sodium diet.<ref>Migraine - More than a Headache.  Adapted from Michael Teixido MD and John Carey MD Edited by: Hamid Djalilian, MD</ref><ref>((Cite web |last=Teixido |first=Michael |date=2014 |title=Migraine - More than a Headache |url=https://www.hopkinsmedicine.org/otolaryngology/_docs/migraine%20patient%20handout.pdf |access-date=May 4, 2022 |website=Johns Hopkins Medicine))</ref>

=== Sound therapy ===
Sound therapy is sometimes recommended for those with hyperacusis, though its application among those with pain (noxacusis) should be used with caution. [[Tinnitus retraining therapy]], a treatment originally used to treat tinnitus, uses broadband noise to treat hyperacusis. [[Pink noise]] can also be used to treat hyperacusis. By listening to broadband noise at soft levels for a disciplined period of time each day, some patients can rebuild (i.e., re-establish) their tolerances to sound.<ref name="pmid25478787"/><ref>((Cite journal| vauthors=Lindsey H |date=August 2014 |title=Help for Hyperacusis: Treatments Turn Down Discomfort |journal=The Hearing Journal |language=en-US |volume=67 |issue=8 |pages=22 |doi=10.1097/01.HJ.0000453391.20357.f7 |issn=0745-7472 |doi-access=free))</ref><ref>((cite journal |vauthors=Formby C, Hawley ML, Sherlock LP, Gold S, Payne J, Brooks R, Parton JM, Juneau R, Desporte EJ, Siegle GR |display-authors=6 |title=A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: A Randomized Placebo-Controlled Clinical Trial |journal=Seminars in Hearing |volume=36 |issue=2 |pages=77–110 |date=May 2015 |pmid=27516711 |pmc=4906300 |doi=10.1055/s-0035-1546958))</ref><ref>((Cite book|title=Hyperacusis and Disorders of Sound Intolerance Clinical and Research Perspectives| vauthors=Fagelson M, Baguley DM |publisher=Plural Publishing |year=2018 |isbn=978-1-94488-328-7 |pages=C15, C16))</ref> More research is needed on the efficacy of sound therapy techniques when hyperacusis is the primary complaint, rather than a secondary symptom, indicating that "no strong conclusions can be made" about its efficacy at this time.<ref name=pmid29312994/> Importantly, individuals with pain hyperacusis are more likely than individuals with loudness hyperacusis to report worsening of their condition after the use of sound therapy.<ref name=":5" />

=== Cognitive behavioral therapy ===
Another possible treatment is [[cognitive behavioral therapy]] (CBT), which may also be combined with sound therapy.<ref name="Baguley, 2003"/><ref>((cite journal |vauthors=Aazh H, Moore BC, Lammaing K, Cropley M |title=Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients' evaluations of the effectiveness of treatments |journal=International Journal of Audiology |volume=55 |issue=9 |pages=514–522 |date=September 2016 |pmid=27195947 |pmc=4950421 |doi=10.1080/14992027.2016.1178400))</ref> However, randomized controlled trials with active control groups are still needed to establish the effectiveness of CBT for hyperacusis<ref>((Cite journal |last1=Aazh |first1=Hashir |last2=Landgrebe |first2=Michael |last3=Danesh |first3=Ali A. |last4=Moore |first4=Brian Cj |date=2019 |title=Cognitive Behavioral Therapy For Alleviating The Distress Caused By Tinnitus, Hyperacusis And Misophonia: Current Perspectives |journal=Psychology Research and Behavior Management |volume=12 |pages=991–1002 |doi=10.2147/PRBM.S179138 |issn=1179-1578 |pmc=6817772 |pmid=31749641 |doi-access=free ))</ref> and the usefulness of CBT for noxacusis is not yet demonstrated in the scientific literature.

=== Surgery ===
Studies have shown improved loudness discomfort levels in patients with hyperacusis after round and oval window reinforcement.<ref name=pmid29312994/>

A case of chronic ear pain associated with hyperacusis after exposure to loud noise at a concert was successfully treated with tympanic neurectomy.<ref>((Cite journal |last1=Ally |first1=Munira |last2=Moinie |first2=Ahmad |last3=Lomas |first3=Joan |last4=Borsetto |first4=Daniele |last5=Mochloulis |first5=George |last6=Bance |first6=Manohar |last7=Boscolo-Rizzo |first7=Paolo |last8=Vijendren |first8=Ananth |date=2022-09-26 |title=Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses |url=http://dx.doi.org/10.1007/s00405-022-07638-7 |journal=European Archives of Oto-Rhino-Laryngology |volume=280 |issue=1 |pages=47–59 |doi=10.1007/s00405-022-07638-7 |pmid=36163556 |s2cid=252541522 |issn=0937-4477|hdl=11368/3030424 |hdl-access=free ))</ref>

=== Treatment for suicidal thoughts ===
Suicidal ideations are a risk factor in hyperacusis patients. Hashir et al. (2019) interviewed 292 patients and found that 15.75% had expressed suicidal ideations in the previous two weeks of the study. They recommend screening for these issues.<ref>((Cite journal |last1=Aazh |first1=Hashir |last2=Landgrebe |first2=Michael |last3=Danesh |first3=Ali |date=2019 |title=Parental Mental Illness in Childhood as a Risk Factor for Suicidal and Self-Harm Ideations in Adults Seeking Help for Tinnitus and/or Hyperacusis |url=https://pubs.asha.org/doi/full/10.1044/2019_AJA-18-0059 |journal=American Journal of Audiology |volume=28 |issue=3 |pages=527–533 |doi=10.1044/2019_AJA-18-0059 |pmid=31184510 |s2cid=184486189 |via=ASHAWIRE))</ref>

==Society and culture==
* Musician Jason DiEmilio, who recorded under the name [[Azusa Plane]], had hyperacusis and ultimately went on to die by suicide due in part to his sensitivity to noise.<ref>((Cite web | vauthors = Cohen J | date = 15 March 2013 | work = Buzz Feed | url=https://www.buzzfeed.com/joycecohen/noise-kills-when-everyday-sound-becomes-torture | title=When Everyday Sound Becomes Torture))</ref>
* Dietrich Hectors, a hyperacusis sufferer in Belgium, took his life in 2009, after years of struggling with catastrophic hyperacusis and tinnitus.<ref name=":3" /><ref>((Cite news |title=Farewell Letter from Dietrich Hectors |language=en |url=https://hyperacusiscentral.blogspot.com/2022/11/farewell-letter-from-dietrich-hectors.html |access-date=2023-01-17))((cbignore))</ref> A local government in Belgium made a [[short film]] based on his life to warn others of the dangers of hyperacusis and tinnitus.<ref>((Cite news |title=Minister Schauvliege stelt kortfilm Ruis voor : gehoorschade |language=nl |url=https://nnieuws.be/artikel/minister-schauvliege-stelt-kortfilm-ruis-voor-gehoorschade |access-date=2023-01-17))((cbignore))</ref>
* Musician [[Stephin Merritt]] has monaural hyperacusis in his left ear, which influences the instrumentation of his band, [[The Magnetic Fields]], leads him to wear earplugs during performances and to cover his affected ear during audience applause.<ref>((cite web |url=https://www.salon.com/2012/03/05/the_return_of_indie_pops_favorite_crank/ |title=The return of indie pop's favorite crank| vauthors = Wilson C |date=2012-03-05 |website=Salon |access-date=2021-07-19))</ref>
* [[Vladimir Lenin]], the Russian [[Communism|communist]] revolutionary, politician, and [[Political theory|political theorist]], was reported seriously ill by the latter half of 1921, having hyperacusis and symptoms such as regular headache and insomnia.<ref>[[Vladimir Lenin#CITEREFShub1966|Shub 1966]], p. 426; [[Vladimir Lenin#CITEREFRice1990|Rice 1990]], p. 187; [[Vladimir Lenin#CITEREFService2000|Service 2000]], p. 435.</ref>
* Musician [[Peter Silberman]] of [[The Antlers (band)|The Antlers]] had hyperacusis and [[tinnitus]] which put his musical career on hold, until the conditions reduced down to a "manageable level".<ref>((Cite news | vauthors = Brodsky R | date = 24 February 2017 |url=https://www.pastemagazine.com/articles/2017/02/how-peter-silberman-lost-his-hearing-and-rediscove.html|title=How Peter Silberman Lost His Hearing, Then Rediscovered Sound|work=pastemagazine.com|access-date=2018-03-27|language=en))</ref>
* Racing driver Wolfgang Reip developed severe hyperacusis after several noise traumas during his racing career.<ref>((Cite web |last=Treworgy |first=David |date=2022-02-24 |title=Champion Racing Driver Wolfgang Reip Announces Battle with Severe Hyperacusis |url=https://hyperacusisresearch.org/champion-racing-driver-wolfgang-reip-announces-battle-with-severe-hyperacusis/ |access-date=2023-01-12 |website=Hyperacusis Research |language=en-US))</ref>
* [[Beethoven]] possibly suffered from hyperacusis alongside his hearing loss. In a letter, he wrote: "As soon as anybody shouts, I can't bear it. Heaven alone knows what is to become of me."<ref name="Beethoven">((Cite journal |last=Huxtable|first=Ryan|date=February 2000 |title=The deafness of Beethoven: A paradigm of hearing problems
|url=https://www.researchgate.net/publication/12269658|journal=Proceedings of the Western Pharmacology Society|volume=43|pages=1–8 |pmid=11056941 ))</ref>
* British writer [[Linda Stratmann]] suffers from hyperacusis and reports noises "cut through her like a scalpel."<ref>((Cite news |url=https://metro.co.uk/2019/08/10/man-does-dishes-for-wife-because-sound-of-it-is-too-painful-for-her-10549473/?fbclid=IwAR2az1izAy1UFfkyXMPquiFnuFOptsjDvZNob8KSk9pXFaqQ5wwZVp3lCA4|title= Man does dishes for wife because sound of it is too painful for her |access-date=2023-01-17|language=en))((cbignore))</ref>

== See also ==
* [[Health effects of noise pollution]]
* [[Tinnitus]] 
* [[Misophonia]]
* [[Otoacoustic emission]]
* [[Safe listening]]
* [[Sensory processing sensitivity]]
* [[Recruitment (medicine)]]
* [[World Hearing Day]]
* [[Hearing Health Foundation]]

== References ==
((Reflist))

== External links ==

* [https://hyperacusisresearch.org Hyperacusis Research, Ltd.] 
* [https://hyperacusiscentral.org Hyperacusis Central Website]
* [https://www.youtube.com/@HyperacusisCentral Hyperacusis Central YouTube]

== Further reading ==
((refbegin))
* ((cite book| vauthors = Baguley DM, Andersson G |title=Hyperacusis : mechanisms, diagnosis, and therapies|date=2007|publisher=Plural Pub.|location=San Diego|isbn=978-1-59756-104-4 ))
* ((cite book | chapter-url = https://books.google.com/books?id=BqEq9Re3L5UC&q=phonophobia&pg=PA8 | chapter = Decreased Sound Tolerance | vauthors = Jastreboff PJ, Jastreboff MJ | title = Tinnitus: theory and management | veditors = Snow JB | date = 2004 | publisher = PMPH-Usa | isbn = 978-1-55009-243-1 ))
((refend))

((Medical resources
| DiseasesDB      = 29099
| ICD10           = ((ICD10|H|93|2|h|90))
| ICD9            = ((ICD9|388.42))
| ICDO            =
| OMIM            =
| MedlinePlus     =
| eMedicineSubj   =
| eMedicineTopic  =
| MeshID          = D012001
| ICD10CM         = ((ICD10CM|H93.23))
))
((Diseases of the ear and mastoid process ))
((Authority control))

[[Category:Psychoacoustics]]
[[Category:Diseases of the ear and mastoid process]]
[[Category:Audiology]]
[[Category:Rare diseases]]
[[Category:Otology]]

Pages transcluded onto the current version of this page (help):

Hyperacusis (edit)
Template:Ambox (view source) (template editor protected)
Template:Authority control (view source) (template editor protected)
Template:Cbignore (view source) (template editor protected)
Template:Cite book (view source) (protected)
Template:Cite journal (view source) (protected)
Template:Cite news (view source) (protected)
Template:Cite web (view source) (protected)
Template:Diseases of the ear and mastoid process (edit)
Template:Div col (view source) (template editor protected)
Template:Div col/styles.css (view source) (template editor protected)
Template:Div col end (view source) (template editor protected)
Template:Find sources mainspace (view source) (template editor protected)
Template:Hlist (view source) (template editor protected)
Template:Hlist/styles.css (view source) (protected)
Template:ICD10 (view source) (template editor protected)
Template:ICD10CM (edit)
Template:ICD9 (view source) (template editor protected)
Template:Infobox (view source) (template editor protected)
Template:Infobox medical condition (view source) (template editor protected)
Template:Infobox medical condition (new) (view source) (template editor protected)
Template:Main other (view source) (protected)
Template:Medical resources (view source) (template editor protected)
Template:More citations needed (view source) (template editor protected)
Template:Navbox (view source) (template editor protected)
Template:Outer and middle ear disease (edit)
Template:Pagetype (view source) (protected)
Template:Refbegin (view source) (template editor protected)
Template:Refbegin/styles.css (view source) (template editor protected)
Template:Refend (view source) (template editor protected)
Template:Reflist (view source) (protected)
Template:Reflist/styles.css (view source) (protected)
Template:SDcat (view source) (template editor protected)
Template:Short description (view source) (protected)
Template:Short description/lowercasecheck (view source) (protected)
Template:Template other (view source) (protected)
Template:Tooltip (view source) (template editor protected)
Template:Tooltip/styles.css (view source) (template editor protected)
Template:Wdib (view source) (template editor protected)
Template:Yesno (view source) (protected)
Template:Yesno-no (view source) (template editor protected)
Template:Yesno-yes (view source) (template editor protected)
Module:Arguments (view source) (protected)
Module:Authority control (view source) (template editor protected)
Module:Authority control/config (view source) (template editor protected)
Module:Category handler (view source) (protected)
Module:Category handler/blacklist (view source) (protected)
Module:Category handler/config (view source) (protected)
Module:Category handler/data (view source) (protected)
Module:Category handler/shared (view source) (protected)
Module:Check for unknown parameters (view source) (protected)
Module:Citation/CS1 (view source) (protected)
Module:Citation/CS1/COinS (view source) (protected)
Module:Citation/CS1/Configuration (view source) (protected)
Module:Citation/CS1/Date validation (view source) (protected)
Module:Citation/CS1/Identifiers (view source) (protected)
Module:Citation/CS1/Utilities (view source) (protected)
Module:Citation/CS1/Whitelist (view source) (protected)
Module:Citation/CS1/styles.css (view source) (protected)
Module:Disambiguation (view source) (protected)
Module:Disambiguation/templates (view source) (protected)
Module:EditAtWikidata (view source) (protected)
Module:Find sources (view source) (template editor protected)
Module:Find sources/config (view source) (template editor protected)
Module:Find sources/links (view source) (template editor protected)
Module:Find sources/templates/Find sources mainspace (view source) (template editor protected)
Module:GetParameters (view source) (template editor protected)
Module:Infobox (view source) (template editor protected)
Module:Infobox/styles.css (view source) (template editor protected)
Module:InfoboxImage (view source) (template editor protected)
Module:List (view source) (protected)
Module:Message box (view source) (protected)
Module:Message box/ambox.css (view source) (protected)
Module:Message box/configuration (view source) (protected)
Module:Namespace detect/config (view source) (protected)
Module:Namespace detect/data (view source) (protected)
Module:Navbar (view source) (protected)
Module:Navbar/configuration (view source) (protected)
Module:Navbar/styles.css (view source) (protected)
Module:Navbox (view source) (template editor protected)
Module:Navbox/configuration (view source) (template editor protected)
Module:Navbox/styles.css (view source) (template editor protected)
Module:Pagetype (view source) (protected)
Module:Pagetype/config (view source) (protected)
Module:Redirect (view source) (protected)
Module:SDcat (view source) (template editor protected)
Module:String (view source) (protected)
Module:String2 (view source) (template editor protected)
Module:TableTools (view source) (protected)
Module:Unsubst (view source) (protected)
Module:WikidataIB (view source) (template editor protected)
Module:WikidataIB/nolinks (view source) (template editor protected)
Module:WikidataIB/titleformats (view source) (template editor protected)
Module:Yesno (view source) (protected)

Return to Hyperacusis.

Retrieved from "https://en.wikipedia.org/wiki/Hyperacusis"