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Hiperacusia o mayor sensibilidad a los sonidos

¿Qué es la hiperacusia?

La hiperacusia o algiacusia consiste en una mayor sensibilidad a los sonidos ambientales, por lo que muchos de ellos pueden llegar a ser molestos e insoportables para la persona causando molestia o incluso dolor de oídos.

¿Cuando existe hiperacusia?

Una persona con audición normal obtiene un umbral de molestia superior a los 120 dB siendo menor en los casos de hipercusia, que se diagnostica cuando el umbral se encuentra por debajo de los 100 dB produciendo que sonidos inferiores a esa intensidad ya son molestos o dolorosos. Muchas de las actividades como asistir a conciertos, el ruído del tráfico en una ciudad, la televisión o simplemente una voz a un volumen normal, 55-60dB (en casos más severos) … son perturbadas y alteran la calidad de vida de manera considerable.

Hiperacusia en oido derecho

La hiperacusia es un fenómeno que se muestra en mayor o menor grado en todas lashipoacusias neurosensoriales donde el rango dinámico (desde cuando empieza a oír hasta el punto en el que son molestos los sonidos) de la persona es inferior a un normoyente, situándose en menos de 70 dB de rángo dinámico, fenómeno conocido como reclutamiento.

En la imagen de la derecha podemos ver una audiometría de oído derecho con hipoacusia neurosensorial. Aparentemente el umbral de molestia no perturbará demasiadas actividades con ruídos fuertes ya que se sitúa entorno a los 100 dB, pero aún así, al corregir la pérdida auditiva con audífono sería beneficioso ampliar el rango dinámico que como podemos ver en los puntos más situados a la derecha es escaso y como consecuencia la audición tendrá una naturalidad limitada debido a que tenemos que incluir en ese rango dinámico estrecho todos los sonidos de las diferentes intensidades comprimiéndolos y como consecuencia perdiendo naturalidad y la capacidad de distinguir diferencias de intensidades.

Hiperacusia en oido izquierdo

En la muchas  de las hipoacusias neurosensoriales ésto no produce un trastorno notable en la calidad de vida ya que el umbral de molestia aparece a intensidades aún muy elevadas, alrededor de los 100 dB aunque si éstos valores son inferiores podemos decir que puede afectar en diversas actividades cotidianas o de ocio como se las que se han nombrado al principio de este artículo. Aún así cabe destacar que es muy frecuente que una persona que tenga hiperacusia con audición normal como podemos ver en la imagen de la izquierda.

Ante la aparición de molestias con sonidos que antes eran totalmente normales y no molestos, se debe de acudir al otorrinolaringólogo para diagnosticar la posible causa y de ser posible un tratamiento para solucionarlo. En los casos en los que no haya solución farmacológica podríamos actuar de diferentes formas.

Solución de la hiperacusia

En el caso de que la medicación no sea efectiva, el uso de audífonos y terapias auditivassobre todo en los casos de una hiperacusia causada por una hipoacusia neurosensorial puede beneficiar a aumentar el rango dinámico de la persona paulatinamente mediante la estimulación de las células ciliadas (células auditivas) deterioradas y en los casos más acentuados una reeducación o reentrenamiento auditivo de forma que la estimulación se lleva a cabo mediante sesiones de terapias programadas para la estimulación de las células ciliadas.

En los casos en el que la hiperacusia sea causada por un trauma acústico “espontánea” o de forma continuada pero con atención médica inmediata, será más facil que exista solución farmacológica prescrita por el otorrinolaringólogo, aunque de no ser así sería últil el uso de audífonos ante la presencia de hipoacusia o la realización de sesiones de reentrenamiento auditivo. Se conocen casos de hiperacusia atendidos de forma inmediata en los que con un reposo auditivo total y la pertinente medicación durante varias semanas, realizando una introducción paulatina y progresiva al mundo ambiental, se consiguen buenos resultados.

Con audífonos o terapias auditivas podemos conseguir resultados muy satisfactorios mejorando el rango dinámico entre 20-40 dB, con lo que una persona que tan solo el volumen de la televisión alta(60dB) o el claxon de un coche(80dB) resultaba molesto se puede ampliar el punto o umbral de molestia hasta unos 100-120 dB consiguiendo una notable mejora en la calidad de vida. En el caso de que la persona sea usuaria de audífono por tener pérdida auditiva, los audífonos pueden programarse de forma que se limita la salida máxima impidiendo que los sonidos alcancen el umbral de molestia.

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