INTRODUCTIONAssociation between advanced age and high tone deafness was first discovered by ZWAARDEMAKER in 1899.

Presbycusis is the most common otolaryngologic problem of elderly.

It involves bilateral high frequency hearing loss associated with difficulty in speech discrimination and central auditory processing of information.

DEFNITIONPresbycusis is a sensorineural hearing disorder. It is most commonly caused by gradual changes in the inner ear.

The cumulative effects of repeated exposure to daily traffic sounds or construction work, noisy offices, equipment that produces noise and loud music can cause sensorineural hearing loss.

TYPES OF PRESBYCUSIS

SensoryNeuralStrialCochlear conductiveMixed presbycusisIntermediate presbycusis

CLINICAL FEATURES

Insiduous onsetSymmetric SNHLProgressive loss with ageNo other otologic diseases Normal ear examination

IMPACT OF PRESBYCUSISNo visible infirmityThose interacting with him/her may not take helpful measuresForces him to continuously ask for helpFosters a sense of disabilityVoluntarily remainIn isolation at partiesMay eventually withdraw from social situations

CAUSESAtherosclerosisDiet and metabolismAccumulated exposure to noiseDrug and environmental chemical exposureGeneticsstress

PREVENTION AND TREATMENT

Prevention:CounselingPeriodic otologic examinationAnnual audiograms in high risk patternsCareer or life style change

Treatment:No effective surgical or medical treatment

ALTERNATIVE MEDICINE

30% dietary caloric restrictionAntioxidant therapy- vitamin A supplementsControl diabetes/hyperlipidemia

PROGNOSISMajority:

Slow deterioration

Neural presbycusis:

Worsen more rapidly

REHABILITATION

Precise hearing aid fittingHearing assistive devicesLip reading classesPossible cohlear implantation