Everything you need to know about presbycusis
Presbycusis definition can be complicated but simply put it is a slowly progressing sensorineural hearing loss. It always affects both ears to the same degree, and usually starts at the age of 50. One characteristic of presbycusis is that sounds within the high-frequency range are significantly impacted (more so at the start of the illness) more than deeper sounds.
Consequently, speech intelligibility is hampered more severely than the capacity to hear sounds – especially when impaired hearing is subjected to an intensely noisy environment. Doctors use the term “cocktail party effect” to refer to the ability to focus on a single speaker or conversation in a noisy setting. In other words, if a person can hear what someone is saying in a crowded, noisy party, even if they are half way across the room, it is more than likely that he or she is experiencing the cocktail party effect.
To correctly diagnose presbycusis or age-associated hearing loss, and initiate the appropriate treatment with a hearing aid, it is imperative to exclude other causes or illnesses. Among other things, this includes the examination of the ear using a specialist microscope (ear microscopy). In patients suffering from presbycusis, the ENT specialist will usually find a normally structured eardrum (i.e. no tear or hole in the eardrum). A pure-tone and speech audiogram are also performed to ultimately confirm the diagnosis. If all other causes can be excluded, the ENT specialist will usually recommend the provision of a hearing aid. Modern hearing aids can treat presbycusis efficiently and restore near-perfect comprehension of speech, tones and sounds.
During the speech audiometry exam, a certain number of words are presented to the patient via headphones and he/she will have to repeat them. Once the test is complete, the information collected from the exam will help doctor determine if there is a deficit in speech comprehension.
If speech audiometry is performed on a patient with presbycusis, the examination will reveal impaired speech comprehension.
During pure-tone audiometry, patients are subjected to high and low tones at different volumes. The patient is asked to respond to the sounds until they are unable to hear the faintest tone. The results of this exam will consequently yield an auditory threshold curve.
If this examination were to be performed on a patient with presbycusis, a loss in the perception of high tones would become apparent: in such cases, the auditory threshold curve would be inferior, particularly in the high-frequency range.
This type of hearing loss goes beyond the maximum age-associated hearing loss. If the illness has progressed further, deeper tones could also be affected.
Treatment of presbycusis
The use of a hearing aid is recommended as treatment for age-associated hearing loss. (Medicinal treatment leading to complete restoration of hearing capacity is currently unavailable.) The long-term consequences of untreated age-associated hearing loss could include increased social isolation or depression. The use of a hearing aid system can, however, help diminish the debilitating symptoms and return some quality of life back to the afflicted person.
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