Presbycusis, (Age-related hearing loss) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Presbycusis, Diagnosis and Treatment and Related Diseases

"I do not know whether you have encountered this.
I often hear shouting matches between an old patient and his children who are asking the questions to the patient that I am trying to get a history from.
That is due to aged related hearing loss called Presbycusis."

Presbycusis or Age-related hearing loss is the slow loss of hearing that happens as people get older.
Presbycusis is a progressive, normally bilateral, sensorineural hearing loss that happens in older people as they age.
It is a multi-factorial process because of a combination of genetic and environmental factors.
It can range from bothersome to severely disabling in its effects.
In moderate-to-severe cases it can induce the older person to become isolated and depressed, and may considerably become worse as an age-related disability/cognitive impairment and dementia.
It is importantly correctable using rehabilitative measures and its successful treatment can largely improve quality of life for the older patient.
The majority of those who would benefit from hearing aids does not go for evaluation or use them when provided.

Causes
Tiny hair cells inside the inner ear assist the patient to hear.
They pick up sound waves and change them into the nerve signals that the brain interprets as sound.
Hearing loss happens when the tiny hair cells are injured or die.
There is no known sole and specific cause of age-related hearing loss.
Most often, it is produced by changes in the inner ear that happen as the patient grows older.
The genes and loud noise may play a large part.
These factors add to age-related hearing loss:
1.Family history
2.Repeated exposure to loud noises
3.Smoking
4.Certain medical disorders, such as diabetes
5.Certain medicines such as chemotherapy
Intrinsic factors are:
1.Neuronal loss
2.Loss of cochlear outer hair cells
3.Atrophy of the highly vascular stria in the lateral cochlear wall
4.Oxidative stress causing DNA mutation and damage
5.Inflammation
6.Metabolic and systemic disease
Extrinsic factors are:
1.Noise
2.Ototoxic medicine
3.Diet

Symptoms
Loss of hearing often happens slowly over time.
1.Difficulty hearing people around the patient
2.Often asking people to repeat themselves
3.Frustration at not being able to hear
4.Certain sounds seeming overly loud

Diagnosis
The doctor will use an instrument called an otoscope to look in the ears.
Occasionally, earwax can obstruct the ear canals and cause hearing loss.
Hearing tests can help find out the extent of hearing loss
Pure tone audiometry verifies the diagnosis.
Hearing is tested over a variety of pure tones in each ear.
Frequencies differ from low pitches (250 Hz) to high pitches (8,000 Hz).
It assesses the threshold for air and bone conduction and can find out whether it is due to conductive or sensorineural loss, or mixed.

Treatment
There is no cure for age-related hearing loss.
Treatment is directed on improving the everyday function.
These may be helpful:
Hearing aids
1.Telephone amplifiers and other assistive devices
2.Sign language (severe hearing loss)
3.Speech reading (lip reading)
A cochlear implant may be advised for people with severe hearing loss
General treatment
Communication, courtesy and environmental noise manipulation
Reassurance and education
Assistive listening devices
1.Flashing light alarms
2.Vibrating alarm clocks
3.Amplified telephones
4.Teleconnectors for hearing aids
5.Frequency-modulation transmitters
6.Hearing aids -improve quality of life
7.Cochlear implants -Good outcomes reported for cochlear implants in presbycusis
8.Active middle-ear implants -still going through evaluation

TABLE OF CONTENT
Introduction
Chapter 1 Presbycusis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Hearing Loss
Chapter 8 Otosclerosis
Epilogue