II. Definitions

  1. Presbycusis
    1. Hearing Loss related to aging

III. Epidemiology

  1. Onset in middle age, and slowly progressive
  2. Most notable over age 65 years
  3. Most common cause of Sensorineural Hearing Loss

IV. Risk Factors

  1. Older Age
  2. Chronic loud noise exposure
    1. See Noise Induced Hearing Loss
  3. Tobacco Abuse
  4. Heavy Alcohol use
  5. Ototoxin exposure

V. Pathophysiology

  1. Slowly progressive Sensorineural Hearing Loss
  2. Typically due to atrophy of Organ of Corti and auditory nerve at basal end of Cochlea
  3. Multifactorial from aging, genetic predisposition, vascular supply to the Cochlea and other risk factors (see above)

VI. Symptoms

  1. Slowly progressive high frequency Hearing Loss
  2. Decreased speech discrimination
    1. See Hearing Impairment Severity Scale
    2. Poor understanding of speech even when loud enough
  3. Recruitment
    1. Abnormal Hypersensitivity to noise

VII. Evaluation

  1. Audiometry displays high pitched Hearing Loss
  2. Acoustic reflex testing

VIII. Management

  1. Audiology
    1. Hearing Aid
  2. Otolaryngology (if Hearing Aid ineffective)
    1. Cochlear Implant

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