ENT - Presbycusis

Question 1

Type of hearing loss in presbycusis

Presentation of presbycusis

Answer 1

Sensorineural hearing loss

Gradual onset

Tends to affect high-pitched sounds first - female voices may be harder to understand

Tinnitus may be present

Question 2

Mechanism of the hearing loss

Answer 2

There are several different mechanisms, including loss of the hair cells in the cochlea, loss of neurones in the cochlea, atrophy of the stria vascularis and reduced endolymphatic potential.

Question 3

Risk factors

Answer 3

Age
Male gender
Family history
Loud noise exposure
Diabetes
Hypertension
Ototoxic medications
Smoking

Question 4

Diagnosis is made with

Answer 4

Audiometry - this will show sensorineural problem with near-normal hearing at lower frequencies and worsening hearing loss at higher frequencies

Question 5

Management of presbycusis

Answer 5

Optimising environment - reducing ambient noise during conversations

Hearing aids

Cochlear implants - where hearing aids arent sufficient