Presbycusis (Age-Related Hearing Loss)
What is Presbycusis?
Presbycusis is a type of sensorineural hearing loss that occurs due to damage to the sensory cells in the inner ear as a result of aging. This condition particularly affects the ability to hear high-frequency sounds and may also impact speech discrimination over time.
According to studies conducted in the United States:
- Presbycusis affects 25–30% of individuals aged 65–74,
- and 40–50% of those aged 75 and older.
Age-related hearing loss typically affects both ears and progresses gradually. It may trigger dementia (such as Alzheimer’s disease).
Causes of Presbycusis
Genetic factors play a significant role in the development of presbycusis. However, environmental influences can accelerate the process.
Main causes include:
- Degeneration of hair cells in the inner ear due to aging
- Exposure to loud noise (prolonged time in noisy environments)
- Vascular diseases and circulatory disorders
- Use of ototoxic medications (certain antibiotics and chemotherapy drugs may damage the inner ear)
- Rheumatologic and neurological diseases
Symptoms of Presbycusis
- Gradually progressing hearing loss affecting both ears
- Difficulty hearing high-pitched sounds (such as children’s voices, women’s voices, doorbells)
- Trouble distinguishing words in conversation
- Difficulty hearing in noisy environments (background noise)
- Ringing in the ears (tinnitus)
- Balance issues and dizziness (in some cases)
- Risk of social isolation and depression
How is Presbycusis Diagnosed?
Examination and Hearing Tests:
- Otoscopic examination: Checks for any anatomical issues in the ear.
- Whisper test and tuning fork tests (Rinne and Weber): Determine whether the hearing loss is conductive or sensorineural.
- Pure Tone Audiometry: Determines hearing thresholds between 250 Hz – 8 kHz to confirm the diagnosis.
- Speech discrimination tests: Evaluate impairment in speech recognition.
Imaging methods such as MRI or CT are generally not required but may be ordered if central nervous system-related conditions are suspected.
Treatment of Presbycusis
Presbycusis is not fully curable, but several approaches can help reduce the impact of hearing loss and improve quality of life:
- Hearing aids: Amplify sounds in mild to moderate hearing loss.
- Speechreading (lip-reading) training: Helps in understanding speech when hearing loss becomes advanced.
- Cochlear implants: Can be considered for those with severe hearing loss who do not benefit from hearing aids.
- Audiologic rehabilitation: Includes education and therapy to cope with hearing loss.
Conclusion
Presbycusis is a progressive, age-related hearing loss. With early diagnosis and appropriate rehabilitation methods, individuals can continue to participate actively in social life. Recognizing the signs of hearing loss and consulting an ENT specialist early can lead to better treatment outcomes.
Prof. Dr. Elif Aksoy
ENT Specialist – Age-Related Hearing Loss and Rehabilitation
