Hyperacusis surgery: The lifechanging effects of round and oval window reinforcement using a patient reported outcome analysis

Objective To evaluate patient-reported outcomes following round and oval window reinforcement (RWR/OWR) surgery for hyperacusis using a concise disease-specific outcome instrument incorporating sound tolerance, pain hyperacusis, psychological well-being, and global quality-of-life measures. Study design Retrospective cohort study. Setting Tertiary referral neurotology practice. Patients Eighty-nine patients with debilitating hyperacusis who underwent round and oval window reinforcement surgery from 2014 to 2026. Intervention Round and oval window reinforcement surgery. Main outcome measures A novel hyperacusis surgery outcome survey incorporating hyperacusis severity, pain hyperacusis, functional sound tolerance, psychological distress, and global improvement. Results 71.8% of patients reported that their hyperacusis was better or much better following surgery. Respondents reported a significant improvement in hyperacusis severity, pain tolerance, sound tolerance, psychologic distress, and global parameters. Overall, 68% (26/38) of respondents would recommend the surgery to someone who has failed conservative therapy for hyperacusis. Conclusions Round and oval window reinforcement surgery demonstrated meaningful improvements in sound tolerance, pain perception, and quality of life among appropriately selected patients with hyperacusis.