How will the audiologist determine if I suffer from hyperacusis / recruitment ?
The audiologist will gradually increase the intensity of sounds and noises in order to determine the levels at which each auditory stimulus becomes either uncomfortable and/or worsens your tinnitus. The type and the number of stimuli depend one how much the client wishes to document the reported severity of sensitivity to daily environmental sounds/noises. The term hyperacusis refers to a reduced tolerance to sounds despite normal hearing whereas the term recruitment is used in the presence of a hearing impairment.
My philosophy while selecting the electroacoustic aids
Hyperacusis/recruitment may cause an otalgia which becomes a stressor, thereby aggravating the tinnitus. The more severe is the recruitment, the more important this symptom needs to be considered in the choice of the circuitry (e.g.: gain) of the hearing aid, as some circuitries are more appropriate than others. For hyperacusis cases, Dr Jastreboff's Tinnitus Retraining Therapy and other techniques for noise and tinnitus desensitization training suggest using white noise generators. Another technique consists in choosing a more pleasant noise to replace the tinnitus. This noise can then be integrated into an aid called a masker. It is usually adjusted to offer the best level of masking with the least amount of speech interference. If this masking noise is used all day long, it is important to adjust the volume to a soft intensity to avoid yielding to an auditory fatigue which could, in turn, aggravate the tinnitus.