Presbycusis

Definition

Presbycusis is gradual hearing loss in both ears that commonly occurs as people age. This form of gradual hearing loss can be mild, moderate, or severe. Presbycusis that leads to permanent hearing loss may be referred to as nerve deafness.

The Ear
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Causes

There are several causes of presbycusis including:

  • Gradual degeneration of the inner ear
  • Changes the bone structure of the ear, a condition called otosclerosis
  • Changes in the hearing nerve pathways in the ear leading to the brain
  • Repeated exposure to loud sounds, music, or equipment which can damage the fragile hair cells within the inner ear involved in hearing
  • Hereditary or genetic influences

Risk Factors

Presbycusis is more common in men, and in people over 75 years old. Other factors that may increase your chance of presbycusis include:

  • Family history of gradual hearing loss with advancing age
  • Noise exposure
  • Smoking
  • Having certain health conditions, such as:
    • Cardiovascular disease, high blood pressure , or other circulatory problems
    • Diabetes
    • Otosclerosis
    • Thyroid diseases
    • Trauma
    • Vestibular schwannoma
    • Infection
    • Paget disease of bone

Symptoms

Presbycusis may cause:

  • Noticeable loss of hearing of higher-pitched sounds, such as female voices, telephone ringing, or bird calls
  • Sounds that appear less clear and sharp
  • Difficulty understanding conversations, particularly in noisy places or while speaking on the telephone
  • Ringing in one or both ears, a condition called tinnitus
  • Background sounds appear overly loud or bothersome
  • Ear fullness with or without vertigo

With presbycusis, hearing loss is usually very gradual, affecting both ears equally.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will perform a visual exam of your ear canal and eardrum with a lighted instrument called an otoscope.

Tests may include the following:

  • Rinne test—to test if hearing loss the hearing loss is nerve related
  • Weber test—to determine if the hearing loss is one-sided
  • Audiometry —to determine level and extent of hearing loss

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Hearing Aids and Assistive Listening Devices

If it is determined that a hearing aid may be useful, the audiologist will conduct several tests to determine the type of hearing aid that will best improve hearing of speech. The extent of benefit varies according to the cause and degree of hearing loss. Sometimes hearing aids will need to be replaced with other models if hearing loss progresses. Some people with presbycusis may benefit from telephone amplifiers that help hear speech on the telephone.

Cochlear Implants

For certain people with very severe hearing loss that is not improved by a simple hearing aid, a cochlear implant device may improve sound generation to the brain. It may provide partial hearing to the profoundly deaf.

Prevention

To help reduce your chance of developing presbycusis, take the following steps:

  • Follow treatment plans that help manage health conditions that may cause hearing loss.
  • Avoid repeated exposure to loud noises and sounds of any type, including those at work, home, and during recreation.
  • When working with loud machinery or in loud environments, wear protective ear plugs or ear muffs.
  • If you smoke, talk to your doctor about how you can quit.

Revisions

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