Hearing Loss: Presbycusis Overview
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Questions and Answers

What is the primary definition of presbycusis?

  • Hearing loss due to environmental factors.
  • Temporary hearing impairment from earwax buildup.
  • Age-related sensorineural hearing impairment. (correct)
  • Hearing loss caused exclusively by genetic factors.
  • Which of the following factors is NOT a risk associated with presbycusis?

  • Sedentary lifestyle. (correct)
  • Use of ototoxic medications.
  • Diabetes mellitus.
  • Long-term exposure to loud music.
  • Which type of presbycusis is associated with the atrophy of nerve cells?

  • Metabolic presbycusis.
  • Neural presbycusis. (correct)
  • Sound-induced presbycusis.
  • Ototoxic presbycusis.
  • What is the general prevalence of hearing loss in individuals over the age of 75?

    <p>About 50%.</p> Signup and view all the answers

    Which of the following is NOT a consequence of diabetes related to presbycusis?

    <p>Improved cochlear blood flow.</p> Signup and view all the answers

    Which statement best describes the onset of presbycusis?

    <p>It usually develops gradually and symmetrically.</p> Signup and view all the answers

    What role does chronic middle ear infection play in presbycusis?

    <p>It can contribute to hearing loss.</p> Signup and view all the answers

    Which factor is associated with diminished perfusion and oxygenation of the cochlea?

    <p>Arteriosclerosis.</p> Signup and view all the answers

    What condition results from epithelial atrophy and loss of sensory hair cells in the cochlea?

    <p>Sensory presbycusis</p> Signup and view all the answers

    Which of the following is NOT a reported symptom of sensory presbycusis?

    <p>Inability to hear low-frequency sounds</p> Signup and view all the answers

    Which test forms the cornerstone of diagnostic testing for presbycusis?

    <p>Audiometric testing</p> Signup and view all the answers

    Patients with presbycusis often find it easier to hear which type of voices?

    <p>Men's voices</p> Signup and view all the answers

    What is a common therapeutic intervention for managing presbycusis?

    <p>Training in speech reading</p> Signup and view all the answers

    What factor is NOT considered when determining treatment for presbycusis?

    <p>Lifestyle of the patient's family</p> Signup and view all the answers

    Which of the following does not represent a recommended way to manage or treat presbycusis?

    <p>Increasing exposure to background noise</p> Signup and view all the answers

    What anatomical changes are associated with sensory presbycusis?

    <p>Thickening of the basilar membrane</p> Signup and view all the answers

    Study Notes

    Presbycusis

    • Age-related hearing loss in elderly individuals.
    • Progressive and symmetrical hearing loss in both ears due to multiple factors.

    Risk Factors for Presbycusis

    • Aging:
      • Arteriosclerosis: Diminished perfusion and oxygenation of the cochlea.
      • Diabetes: Accelerates the process of atherosclerosis, interfering with cochlear perfusion.
    • Stress
    • Genetics
    • Environmental Exposure:
      • Noise exposure
      • Chemicals
      • Ototoxic drugs:
        • Salicylates
        • Loop diuretics
        • Cisplatin
        • Quinine
    • Other Factors:
      • Chronic middle ear infections
      • Chronic cerumen impaction

    Prevalence of Presbycusis

    • 1 in 3 adults over 65 years old experience hearing loss.
    • Almost half of individuals over 75 years old experience hearing loss.
    • Presbycusis occurs gradually and often affects both ears equally.
    • Some individuals may not immediately notice the change.

    Pathophysiology

    • Histologic changes associated with aging occur across the auditory system.
    • These changes affect the cochlear hair cells, supporting cells, and the auditory cortex.
    • Types of Presbycusis:
      • Sensory presbycusis: Epithelial atrophy, loss of sensory hair cells, and supporting cells within the organ of Corti.
      • Neural presbycusis: Atrophy of nerve cells in the cochlea and central neural pathways.
      • Metabolic (strial) presbycusis: Atrophy of the stria vascularis.
      • Mechanical (cochlear conductive) presbycusis: Thickening and stiffening of the basilar membrane in the cochlea.

    Clinical Presentation

    • Patient Reports:
      • Speech sounds mumbled or slurred.
      • Difficulty distinguishing high-pitched sounds like "s" or "th".
      • Difficulty understanding conversations, especially with background noise.
      • Men's voices easier to hear compared to women's voices.
      • Some sounds may be overly loud and annoying.
      • Tinnitus (ringing in the ears) may occur in one or both ears.

    Work-Up of Presbycusis

    • Evaluation may include:
      • Audiometric testing: Pure-tone average and speech discrimination form the basis of diagnosis.
      • Blood tests: To rule out autoimmune-induced hearing loss.
      • CT scan or MRI: To exclude anatomical abnormalities or mass lesions causing hearing loss.
    • Additional testing: Determined based on the audiometric test results.
    • Specific tests:
      • Rinne and Weber tests

    Treatment of Presbycusis

    • Treatment is individualized based on:
      • Age
      • Severity of hearing loss
      • Tolerance for therapies
      • Expected course of the disease.
    • Treatment options include:
      • Avoiding loud noises and reducing noise exposure
      • Wearing earplugs or special fluid-filled earmuffs
      • Hearing aid(s) referral to an audiologist
      • Lip-reading instruction referral
      • Assistive devices:
        • Telephone amplifiers
      • Speech reading training
      • Cochlear implants: For some patients with severe presbycusis.

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    Description

    This quiz explores presbycusis, the age-related hearing loss that affects many elderly individuals. It covers risk factors, prevalence, and the underlying pathophysiology contributing to this condition. Test your knowledge on how aging and other factors impact hearing health.

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