Professional Documents
Culture Documents
Presbycusis 181116131215 PDF
Presbycusis 181116131215 PDF
Moderator-Dr(Prof)Gul Motwani
Co-Moderator-Dr Nihar Topno
VMMC and Safdarjung Hospital ,New Delhi
Noise induced hearing loss
Definition
Reduction in auditory acuity associated with noise
exposure.
Male preponderance
Pathophysiology
Metabolic
Structural
METABOLIC
Acoustic overstimulation
Transduction
Stimulation with sound of moderate intensity increases
cochlear blood flow, whereas sound of high intensity
decreases cochlear blood flow
Such transient noise stimuli are generally less than 0.2 seconds
in duration.
TYPES OF TRANSIENT NOISE
Speech discrimination is
average for the given PTA
INTERMEDIATE
Change in characteristics of the cochlear duct that are
not evident on light microscopy but alter function at
sub microscopic level.
2 specific deletions
mtDNA4834 and mtDNA4977 have been linked to age related
hearing loss in rodents
Han et al and Dai et al have demonstrated mtDNA4977
deletion with archived human temporal bones from patients
with presbycusis
Other causes
Nutritional and anatomic
Berner et al investigated the relation between vitamin B12 and
Folate - not significant relationship
Cigarette smoking
Alcohol use
Systolic BP
Blood hyperviscosity
May all exacerbate age related hearing loss.
Clinical features
Presentation varies
Symmetrical
SPECIFIC
NON SPECIFIC
Hearing aids tend to provide little benefit
• Optimizataion of acoustic environment.
Psychological counselling
practical measures
• Infrared headphones/bluetooth headphones
• Volume controllable telephone.
• Louder doorbells.
• Lip reading classes.
Specific management
Binaural hearing aids.
Tinnitus management.
Tinnnitus retraining therapy
Cognitive directive counselling.
Sound therapy
Future of treatment…
Researchers are proposing treatment underlying genetic
cause(gene therapy)