presbycusis
Jump to navigation
Jump to search
Introduction
High-frequency (3000-8000 Hz) sensorineural hearing loss associated with aging.
Etiology
- controversial
- accumulated effect of life-long exposure to noise
- possible genetic predisposition
- systolic hypertension may be risk factor[5]
Epidemiology
- the most common cause of hearing loss
- 40-50% of elderly (>= 75 years of age)
Pathology
- pathologic changes in temporal bone[5]
- atrophy of hair cells in the organ of Corti
- loss of neurons in the basal part of the spiral ganglion
- patchy atrophy of the stria vascularis over middle & apical regions of the cochlea, restricting blood supply to neurosensory receptors
- degeneration of the stria vascularis at the base & apex of the cochlea is the most prominent manifestation
- changes in motion mechanics of the cochlear duct[5]
- degenerative changes in the brainstem & auditory cortex of temporal lobe
- hearing loss is associated with saccular dysfunction*
* hearing loss is not associated with utricle dysfunction
Clinical manifestations
- bilateral symmetrical hearing loss
- tends to be gradual in onset & mild-moderate in severity
- irreversible
- tinnitus
- unable to hear high frequency sounds
- great difficulty hearing a whisper
- unable to hear consonant (non-vowel) sounds
- may hear people speak, but not be able to make out words
- may complain that other people mumble
- Weber test: response is midline
- Rinne test: air conduction better than bone conduction
Diagnostic procedures
- hand-held audioscope
- audiometer
- sensorineural hearing loss more pronounced at higher frequencies[9]
Differential diagnosis
Management
- amplification (hearing aid)
- only 14% of patients with hearing loss use hearing aids[5] cites[6][7][8]
- use increases with age (from 4.3% among adults 50-59 years, 22% among adults >= 80 years)[5]
- cochlear implant
More general terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 43
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 392, 407
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Mangione C. in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 6.0 6.1 Chien W, Lin FR. Prevalence of hearing aid use among older adults in the United States. Arch Intern Med. 2012 Feb 13;172(3):292-3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22332170 Free PMC Article
- ↑ 7.0 7.1 Gopinath B, Schneider J, Hartley D et al Incidence and predictors of hearing aid use and ownership among older adults with hearing loss. Ann Epidemiol. 2011 Jul;21(7):497-506. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21514179
- ↑ 8.0 8.1 Mizutari K, Michikawa T, Saito H et al Age-related hearing loss and the factors determining continued usage of hearing aids among elderly community- dwelling residents. PLoS One. 2013 Sep 23;8(9):e73622. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24086287 Free PMC Article
- ↑ 9.0 9.1 NEJM Knowledge+ Otolaryngology
- ↑ Presbycusis ( Age-Related Hearing Loss) http://www.nidcd.nih.gov/health/hearing/presbycusis.asp