Silverstein H, et al. - Given that a significant improvement in sound tolerance after surgery has previously been reported for a minimally invasive surgery developed by the senior author, researchers performed this prospective, IRB approved clinical research trial at a single institution, to compare the new vs original surgical technique employed as well as long-term outcomes of all patients who have undergone minimally invasive surgery for hyperacusis. This study included 40 people who met inclusion criteria. Oval and round window reinforcement was performed in all participants. A total of 20 individuals had surgery prior to 2017 with the original technique of round window reinforcement. New technique with additional oval window and stapes reinforcement was used to treat 20 individuals. According to the findings, the use of the most recent, newer technique seemed to offer an 80% success rate in improving sound tolerance with small alterations to hearing. A significant improvement was seen in hyperacusis symptoms following surgery, and the improvement was now found to be sustainable with a mean follow-up of 2 years post-initial surgery. With the use of the newer technique, significant improvement in psychological measures of anxiety and depression was noted after surgery.