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

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

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 >>

Prevalence

National Academy on an aging society Hearing loss-A

Growing Problem that effect quality of life.Des 1999

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

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

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

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

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

Audiology Test Diagnostic

Pure tone

Audiometry
Speech Reception

Test (SRT)
Speech

Discrimination
Score (SDS)

Physical examination/ Otoscopy normal

Audiogram : sensory neural hearing loss in

>1000Hz frequency
Speech Audiometric test : Speech
discrimination score decrease

Presbyacusis: sensoris
Atrophy epithel,

hair cell, organ

Corty
Basal chochlea
High frequency
loss.
Steeply sloping
high frequency
hearing loss

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

Presbyacusis metabolic
(strial)
Atrophy stria vascular
Bioelectrika dan

biochemical endolimfa
Flat audiogram
Speech Discrimination
score normal
Aged 30-60 yr
Genetic influence

Presbyacusis mechanic
Thickening basal

membrane cochlea
High frequency
loss, slowly
progressive
Slowly progressive
sloping high
frequency
sensoryneural
hearing loss

Management:
Neurotonic
Avoid loud noise, ototoxic
Annual hearing test
Rehabilitation:

Hearing aid, lip reading & auditory training

Management
Hearing aid
Hearing devices
Lip reading
Implant cochlea
Consultation
Diet
Activities

Prognosis
Progressive
Avoid etiology factors

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

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.

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

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