title: Pain threshold improvement for chronic hyperacusis patients in a prospective clinical study.
abstract: OBJECTIVE
  The aim of this study was to investigate if laser therapy in combination with pulsed electromagnetic field therapy/repetitive transcranial magnetic stimulation (rTMS) and the control of reactive oxygen species (ROS) would lead to positive treatment results for hyperacusis patients.
  
  
  BACKGROUND
  Eight of the first ten patients treated for tinnitus, who were also suffering from chronic hyperacusis, claimed their hyperacusis improved. Based upon that, a prospective, unblinded, uncontrolled clinical trial was planned and conducted. ROS and hyperacusis pain thresholds were measured.
  
  
  METHODS
  Forty-eight patients were treated twice a week with a combination of therapeutic laser, rTMS, and the control and adjustment of ROS. A magnetic field of no more than 100 microT was oriented behind the outer ear, in the area of the mastoid bone. ROS were measured and controlled by administering different antioxidants. At every treatment session, 177-504 J of laser light of two different wavelengths was administered toward the inner ear via meatus acusticus.
  
  
  RESULTS
  The improvements were significantly better in the verum group than in a placebo group, where 40% of the patients were expected to have a positive treatment effect. The patients in the long-term follow-up group received significantly greater improvements than the patients in the short-term follow-up group.
  
  
  CONCLUSIONS
  The treatment is effective in treating chronic hyperacusis.
authors.affiliation: Audio Laser-Kliniken, Flygeln, Hovmantorp, Sweden. audiolaser@mail.nu
authors.forename: Michael
authors.initials: M
authors.lastname: Zazzio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D012001:Hyperacusis / Q000503:physiopathology* / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold; D011446:Prospective Studies; D017382:Reactive Oxygen Species; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017382:Reactive Oxygen Species