What is presbycusis ?

Presbycusis results from the natural aging of the ear.

Presbycusis affects everyone from a certain age and genetic and environmental factors (noise) can aggravate or hasten its importance.

Presbycusis is to hearing what presbyopia is to sight. However, there is a major difference: presbycusis affects the sensory organ, i.e. the auditory cells, which deteriorate over the years and do not regenerate, whereas presbyopia affects the eyeball, without damage to the sensory organ (optic nerve). Thus, the presbyopic person will be able to regain perfect vision with an adapted pair of glasses, whereas the presbyacousic person will only be imperfectly corrected by an amplification on the damaged frequencies.

It is important to specify this notion so that the patient is not disappointed. However, the current quality of hearing aids should satisfy the majority of patients who seek help.

8 out of 10 cases of hearing loss are due to the aging of the ear.

Men are affected earlier than women, but the average age is between 50 and 70 years for 75% of them.

The hearing impairment is progressive and slow to develop, affecting mainly the high frequencies (2000 Hz, 4000 Hz and 8000 Hz). It is a perceptive deafness (affecting the sensory organ), bilateral and symmetrical. It is the ENT who will make the diagnosis by performing a tonal and vocal audiometry.

This high-frequency impairment causes discomfort that is essentially perceptible in a noisy environment, which often leads to sincere denial on the part of the subject. “I can’t hear my wife talking to me from the kitchen with her back to me, with the hood on”.

The indications for fitting a hearing aid are based on this and should be proposed as soon as the patient encounters discomfort in social life, particularly in conditions of environmental noise where he/she repeats or hears sounds close to him/her. As a rule, an average deficit of 35 dB is an indication for fitting a hearing aid, especially since the earlier the fitting, the better the benefit for the user, slowing down the appearance of cognitive problems.

Trends

Our current world and its noise pollution have unfortunately aggravated presbycusis or advanced its age of onset. In addition to these earlier attacks, there are pure hearing lesions linked to noise or pressure attacks which are independent of age but which produce hearing curves very similar to those of presbycusis sufferers.

Noise aggression remains the prerogative of high-risk professions, but fortunately protective helmets have existed in the workplace for decades (work on forges, ironworkers, presses, jackhammers, etc.). Young people remain the targets of choice for these sound aggressions nowadays: walkmans, concerts, night clubs…

It can be about sound and pressure aggressions: shooting, fireworks, firecrackers, explosions…

Or pure pressure aggressions: scuba diving, parachuting, but especially free diving. These sports often involve young subjects and the hearing damage that can result is very close to presbycusis damage.

In 2016, four million French people with mild or moderate hearing loss were affected. Among them, 80% are not fitted with hearing aids despite the technical evolution and discretion of current prostheses. Once the ENT has explained to his patient what he can expect from a hearing aid, when these become invisible or almost invisible, when the price becomes totally accessible with the generation of ready-to-wear aids that are suitable for these mild or moderate impairments, is denial still possible ?

Check out the article “Can we prevent hearing loss ?“

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