Presbycusis

Question 1

what is it?

Answer 1

Presbycusis is a type of sensorineural hearing loss that affects elderly individuals

Question 2

what type of hearing is affected?

Answer 2

high-frequency hearing is affected bilaterally

Question 3

epidemiology

Answer 3

elderly

males

Question 4

causes

Answer 4

The precise cause is unknown however is likely multifactorial

Arteriosclerosis: May cause diminished perfusion and oxygenation of the cochlea, resulting in damage to inner ear structures

Diabetes: Acceleration of arteriosclerosis

Accumulated exposure to noise

Drug exposure (Salicylates, chemotherapy agents etc.)

Stress

Genetic: Certain individuals may be programmed for the early ageing of the auditory system

Question 5

presentation

Answer 5

Speech becoming difficult to understand

Need for increased volume on the television or radio

Difficulty using the telephone

Loss of directionality of sound

Worsening of symptoms in noisy environments

Hyperacusis: Heightened sensitivity to certain frequencies of sound (Less common)

Tinnitus (Uncommon)

Question 6

signs

Answer 6

Possible Weber’s test bone conduction localisation to one side if sensorineural hearing loss not completely bilateral

Question 7

Ix

Answer 7

Otoscopy: Normal, to rule out otosclerosis, cholesteatoma and conductive hearing loss (Foreign body, impacted wax etc.)

Tympanometry: Normal middle ear function with hearing loss (Type A)

Audiometry: Bilateral sensorineural pattern hearing loss

Blood tests including inflammatory markers and specific antibodies: Normal