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Diagnosis Presbyacusis

Diagnosis Presbyacusis. Jenny Bashiruddin Departemen THT FKUI-RSCM Jakarta. Introduction. Presbyacusis : sensory neural hearing loss, gradually ,in elderly, degeneration disorders, bilateral, symmetric, start in high frequencies Limitation in communication Isolated.

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Diagnosis Presbyacusis

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  1. Diagnosis Presbyacusis Jenny Bashiruddin Departemen THT FKUI-RSCM Jakarta

  2. Introduction • Presbyacusis : sensory neural hearing loss, gradually ,in elderly, degeneration disorders, bilateral, symmetric, start in high frequencies • Limitation in communication • Isolated

  3. Epidemiology demography • 1990, >65 yr : 6,7 million people • 2020 estimation :18,8 million people Prevalence presbyacusis • >65 yr : 30 % • >75 yr : 50% Presbyacusis in Indonesia : 9,3 million people US census Bureau International Data Base th 2004

  4. Epidemiology • 1 off 3 American, age 65-75 yr suffer hearing loss The National Institute on Deafness & other Communication Disorders (NIDCD) • 8,58 million England suffer hearing loss : 75% age >60 yr The UK National Study of Hearing Disorder 1995 • Industrial population >>

  5. Prevalence National Academy on an aging society Hearing loss-A Growing Problem that effect quality of life.Des 1999

  6. Etiologi • Atherosclerosis /cardiovascular diseases • Diet and metabolism • Accumulation noise induced • Drugs/ toxic substances • Stress • Genetic

  7. DIAGNOSIS • Screening • Anamnesis • Otoscopy • Tuning fork tes • Pure tone Audiometri • Speech Reception Test (SRT) • Speech discrimination scor (SDS)

  8. Diagnosis • Anamnesis : • Aged >60 years • Hearing impaired slowly, progressive,& symmetries, • Tinnitus • Difficulties hearing in noise (Cocktail party deafness) • Pain in hearing loud sound(recruitment)

  9. Symptom • Slowly • Impaired in high frequencies • Women and children voice difficult to hear • Tinnitus • Recruitment

  10. Sign and Symptom • High frequency hearing loss. • Gradually, bilateral and symetric • Difficulty in differentiated the consonant s, r, n, c , h, ch. • Coctail party deafness. • Recruitment : over increasing sensitivity

  11. Audiology Test Diagnostic • Pure tone Audiometry • Speech Reception Test (SRT) • Speech Discrimination Score (SDS)

  12. Physical examination/ Otoscopy normal • Audiogram : sensory neural hearing loss in >1000Hz frequency • Speech Audiometric test : Speech discrimination score decrease

  13. Presbyacusis: sensoris • Atrophy epithel, hair cell, organ Corty • Basal chochlea • High frequency loss. • Steeply sloping high frequency hearing loss

  14. Presbyacusis Neural • Atrophy neuron cell in cochlea • Spiral gangglion, in auditory central pathway • 2100 neuron loss every decade • Speech Discrimination score loss unproporsional • Regresi fonem • Sloping audiogram

  15. Presbyacusis metabolic (strial) • Atrophy stria vascular • Bioelectrika dan biochemical endolimfa • Flat audiogram • Speech Discrimination score normal • Aged 30-60 yr • Genetic influence

  16. Presbyacusis mechanic • Thickening basal membrane cochlea • High frequency loss, slowly progressive • Slowly progressive sloping high frequency sensoryneural hearing loss

  17. Management: • Neurotonic • Avoid loud noise, ototoxic • Annual hearing test • Rehabilitation: • Hearing aid, lip reading & auditory training

  18. Management • Hearing aid • Hearing devices • Lip reading • Implant cochlea • Consultation • Diet • Activities

  19. Prognosis • Progressive • Avoid etiology factors

  20. Impact of life • Quality of life • Social isolated • Less activities • Depression • emotional problem • Frustrated others • Less Interpersonal relationship • Lonely

  21. Quality of life Hearing problem could impact function and psichosocial life such as : • Daily comunication • Phone comunication (social and emergency) • Social attitude • Family relationship, activity and time leisure • Safety • Independent living.

  22. Summary • Changes in Presbyacusis : • Changes cochlea structures and audit0ry nerves • Atrophy and hair cell degeneration in organ Corty • Changes vascularisation and decreasing volume and size of nerves

  23. Summary • Presbyacusis could managed properly • Need early identification • Psychosocial impact should be consider • Try to identification of etiology and specific problem. • Need support from family, friends and surrounding

  24. Thanks for attention

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