Senile hearing loss: causes, symptoms, diagnosis, treatment

Senile deafness, or presbycusis, along with presbyopia, is the most common manifestation of involutional processes in the aging organism, manifested in the withering of all its functions and, above all, metabolic processes in the nervous system. Involutional processes concern all parts of the organ of hearing - from the auricle to the cortical zones of the auditory analyzer, while it should be emphasized that this process occurs simultaneously with the aging of all parts of the central nervous system, potentiating those disorders that occur in the auditory system. Classifications of senile deafness are based on the mechanisms of its pathogenesis. Among these classifications, it is necessary to note the classifications of A. Saxen and N. Fiand (1937), who distinguish two of its forms: ganglionic, caused by involutional atrophy of the spiral ganglion, and angiosclerotic, associated with sclerosis of the smallest arteries and capillaries of the cochlea. H.F. Schuknecht identified four forms of senile hearing loss: sensory, neural, metabolic and mechanical. Each of these forms is based on its own pathogenetic mechanisms, and the resulting syndrome is a combination of them. Atherosclerotic changes in the vascular strip of the SpO play a major role in the development of senile hearing loss. A number of authors describe involutional changes in the sound-conducting apparatus, while distinguishing "conductive" presbycusis as an independent form, caused by degenerative changes in the sound-conducting structures of the middle and inner ear.

Symptoms of senile hearing loss develop gradually, usually starting at the age of 40-45. Many people begin to notice first a disturbance of tonal hearing at high frequencies, then a deterioration in speech intelligibility when perceiving children's and women's voices. Then the noise immunity of the sound analyzer decreases; this is manifested by the fact that when several people talk at the same time or in a noisy environment, the listener experiences increasingly pronounced difficulties in understanding speech, although the perception of its sound component remains at a satisfactory level. Tinnitus often occurs, but it is intermittent and is not a reason to visit a doctor. Sometimes short-term, unexpressed dizziness occurs, associated with sudden movements.

When examining hearing with "live" speech, a sharp decrease in its perception of whispered speech is revealed, especially words containing high-frequency formants ("to burn", "to bake", "to cut"). Conversational (voiced) speech is perceived much better, especially male voices and words containing low-frequency formants ("raven", "leg", "forehead"). The presence of FUNG affects the perception of spoken speech: a slight increase in the voice is perceived as loud speech, but most often this phenomenon is absent. Threshold tonal audiometry determines the descending type of bone and air conduction curves and their fusion. Speech audiometry reveals a decrease in the percentage of speech intelligibility and a significant decrease in the noise immunity function.

The evolution of senile deafness is characterized by more or less rapidly progressing deafness, which is also facilitated by other manifestations of age-related changes in the body and possible concomitant diseases.

Treatment is aimed at slowing down involutional processes in the nervous system and in the body as a whole. Usually, drugs are used that improve microcirculation in the brain, anti-sclerotic and sedative agents, and multivitamins. Correction of endocrine systems is often useful. These agents can only slightly slow down the progression of senile hearing loss and improve the general condition of the body, but once this disease has arisen, it cannot be reversed. The only more or less effective means of improving sound perception and communication of the patient with other people is hearing aids.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ]