What is Presbycusis?

Our ears have a very delicate anatomy. Generally, the ear is divided into three segments. The outer ear is made from the ear lobe and the ear canal all the way down to the eardrum. The function of the eardrum is to collect the sound and change it into vibrations that later transmit into the rest of the ear. The middle ear is made of three hearing bones that together transmit the sound waves and amplify the signal to the organ of hearing. The inner ear is the innermost part of the ears and contains the hearing apparatus. The cochlea is the organ of hearing that is housed within the inner ear. This is basically tucked in under the brain on each side.

The cochlea, as we said, is the organ of hearing. It is a microscopic structure that is filled with two different chambers of liquid. As the sound waves hit the liquid, the membrane in between the liquid chambers vibrate and this is translated into a nerve signal. The nerve signal then travels to the brain, and this is translated into sounds that we perceive. Depending on the frequency of the sound coming in, different parts of the membrane vibrate at different rates, and the differential in the vibration tells us about pitch and frequency of the sounds.

As part of the wear and tear of our ears that comes with time, it is believed that some of the reception properties of the hearing membrane deteriorate over time. Possibly, the nerve of the hearing may also weaken. Subsequently, we all perceive some degree of decreased hearing as time goes on. This is called presbycusis.

Although everybody suffers from some degree of hearing loss as time goes on, we do see that in certain families there is a genetic predisposition for this to happen sooner. Some people also have more rapid onset of hearing loss because of prior noise exposure. The kind of noise exposure that leads to hearing loss typically is ongoing exposure for hours every day times a few years. This is more common in certain occupations where there is a lot of noise, and the person has not been wearing protective ear gear.

People with presbycusis usually lose the higher frequencies before they lose the lower frequencies. Therefore, in many social situations, they actually hear the background noise much better than they hear the foreground noise. This could be of special concern if they are trying to communicate with their friends and family; these patients have extra difficulty trying to participate in an ongoing conversation. Many people with presbycusis prefer not to be in loud environments were such communication might be problematic.

In most people, the process of presbycusis is rather slow. It takes years for the degree of hearing loss to finally become problematic. Therefore, many people might not be aware of any significant hearing loss until a hearing test is done. A hearing test in a sound booth with an audiologist can confirm the degree and nature of the hearing loss.

Once presbycusis is diagnosed as opposed to any other cause for hearing loss, there is not a great deal of medical therapy that could be done. The most common solution is to get a hearing aid. Since the range of hearing loss is different in each individual person, the hearing aids need to be programmed for that particular person’s spectrum of hearing deficiency. There have been a lot of advances in the technology concerning hearing aids recently, and many of the newer aids offer superior sound quality. However, keep in mind that no amount of machine generated sound can ever replace the normal hearing that we all used to have when our hearing was fully intact.

The only way to detect any degree of hearing loss that would be compatible with presbycusis is to have a hearing test for evaluation. Most Ear, Nose, and Throat doctors have access to hearing test within their offices. Once the diagnosis is confirmed, treatment and plan can be custom fit for the individual patient’s needs.

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