Presbyacusis

Question 1

The hearing loss is related to…

Answer 1

Age

Question 2

Is the hearing loss sensorineural or conductive?

Answer 2

Sensorineural

Question 3

Is it unilateral or bilateral hearing loss?

Answer 3

Bilateral

Question 4

What type of frequency is affected?

Answer 4

High frequency sensorineural- can lead to conversational difficulties particularly in noisy environments

Question 5

Does it progress slowly or suddenly?

Answer 5

Slowly as sensory hair cells and neurons in cochlea atrophy over time.
Typically starts before 30 and progresses

Question 6

Hearing is mostly affected in the presence of…

Answer 6

Background noise

Question 7

Are men or women more affected?

Answer 7

Slightly more men

Question 8

What causes presbyacusis?

Answer 8

Precise cause unknown - likely multifactorial
Arteriosclerosis may cause diminished perfusion and oxygenation of cochlea
DM
Accumulated exposure to noise
Drug exposure
Stress
Genetic

Question 9

How do patients typically present with presbycusis?

Answer 9

Chronic, slowly progressing history of:
Speech becoming difficult to understand 
Need to increase volume on TV or radio
Difficulty using telephone
Loss of directionality of sound
Worsening of symptoms in noisy environment

Question 10

What is found on investigations?

Answer 10

Otoscopy- normal, to rule out otosclerosis, cholesteatoma, conductive hearing loss e.g impacted wax, foreign body
Tympanometry - normal middle ear function with hearing loss (type A)
Audiometry - bilateral sensorineural pattern hearing loss
Blood tests including inflammatory markers - normal

Question 11

How is it managed?

Answer 11

Hearing aids