Senile hearing loss: causes, symptoms, diagnosis, treatment

Elderly hearing loss, or presbybicusis, along with presbyopia, is the most common manifestation of involutional processes in an aging organism, manifested in the withering of all its functions and, above all, metabolic processes in the nervous system. Involution processes concern all parts of the hearing organ - from the auricle to the cortical areas of the auditory analyzer, and it should be emphasized that this process proceeds simultaneously with the aging of all the CNS sections, potentiating the disorders that arise in the auditory system. Classifications of senile hearing loss are based on the mechanisms of its pathogenesis. Among these classifications are the classifications of A.Saxen and N.Fiand (1937), which distinguish two of its forms: ganglionic, caused by involuntary atrophy of the spiral ganglion, and angiosclerotic, associated with sclerosis of the smallest arteries and capillaries snails. HF Schuknecht singled out four forms of senile hearing loss: sensory, neural, metabolic and mechanical. At the heart of each of these forms lie their own pathogenetic mechanisms, and the emerging syndrome - their combination. A major role in the development of senile hearing loss is played by atherosclerotic changes in the vascular stripe of CpO. A number of authors describe the involutionary changes in the sound-conducting apparatus, while singling out the "conductive" presbyacusis, conditioned by degenerative changes in the sound-conducting structures of the middle and inner ear, into an independent form.

Symptoms of senile hearing loss develop gradually, usually from 40-45 years. Many people begin to notice first violations of tonal hearing at high frequencies, then deterioration of speech intelligibility in the perception of children's and women's voices. Then noise immunity of the sound analyzer decreases; this is manifested by the fact that with the simultaneous conversation of several persons or in a noisy environment, the hearer has more and more pronounced difficulties in understanding speech, although the perception of the sound component of it remains at a satisfactory level. Often there is an ear noise, but it is of a non-permanent nature and is not the reason for contacting a doctor. Sometimes there are short-term unexpressed dizziness associated with abrupt movements.

When hearing a hearing, "live" speech reveals a sharp decrease in it when perceiving a whisper speech, especially words containing high-frequency formants ("burn", "stove", "cut"). Speaking (voiced) speech is perceived much better, especially male voices and words containing low-frequency formants ("crow", "leg", "forehead"). The perception of spoken language reflects the presence of FUNG: a small increase in voice is perceived as a loud speech, but most often this phenomenon is absent. With threshold tonal audiometry, a descending type of bone and air conduction curves and their fusion are determined. Speech audiometry reveals a decrease in the percentage of speech intelligibility and a significant decrease in the noise immunity function.

Evolution of senile hearing loss is characterized more or less rapidly by progressive deafness, which is also facilitated by other manifestations of age-related changes in the body and possible co-morbidities.

Treatment is aimed at slowing the involution processes in the nervous system and in the body as a whole. Usually used drugs that improve microcirculation in the brain, antisclerotic and sedatives, multivitamins. It is often useful to correct endocrine systems. These drugs can only stop the progression of senile hearing loss and improve the overall condition of the body, however, once it has arisen, this ailment can not be reversed. The only more or less effective means of improving the sound perception and communication of the patient with other people is hearing care.

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