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PresbycusisTreatment&Management

Author:PeterSRoland,MDChiefEditor:ArlenDMeyers,MD,MBAmore...
Updated:Feb27,2014

MedicalCare
Presbycusisisnotcurable,buttheeffectsofthediseaseonpatientslivescanbemitigated.
Amplificationdevices:Properlyfittedhearingaidsmaycontributetotherehabilitationofapatientwith
presbycusis.Olderpatientswitharthritisintheirfingersandvisualdifficultiesneedextrahelpinlearningto
usehearingaids.Patientsusinghearingaidsmaystillexperiencedifficultieswithspeechdiscriminationin
noisysituations.
Lipreading:Lipreadingmayhelppatientswithdiminishedspeechdiscriminationandmayhelphearingaid
userswhohavedifficultyinnoisyenvironments.
Assistivelisteningdevices:Theserangefromasimpleamplificationofthetelephonesignaltoadeviceon
thetelevisionthatsendsasignalacrosstheroomtoaheadsetwornbyapatientwithhearingloss.The
patientcanamplifythesoundwithoutdisturbingotherpeoplewithnormalhearingwhoareinthesameroom.
Cochlearimplants:Somepatientswithpresbycusisbenefitfromcochlearimplants.Patientswithcochlear
changesandrelativelyintactspiralgangliaandcentralpathwaysappeartobethebestcandidates.
Thesemeasuresareaimedatrehabilitatingpatientswhoalreadyexperiencepresbycusis.However,effortsare
underwaytodeveloptherapiesthattreatthepotentialunderlyingcausesofpresbycusis,aswellasmechanismsto
actuallypreventthediseasealtogether.Withnewstudiesshowingpossiblegeneticandnutritionalcausesof
presbycusis,researchersareproposingtreatmentsthataddresstheseunderlyingcauses.Forexample,medications
thatblocktheproductionofreactiveoxygenmetabolitesmayleadtoatreatmentofpresbycusisatthemolecular
level.Alternatively,astudybyDerinetalshowedthattreatmentwithIcarnitineresultedinimprovementintheABR
resultsofratsexperiencingagerelatedhearingloss. [15]Unfortunately,mostofthesetherapiesarestillinthe
investigationalstages.

Consultations
Rehabilitationofapatientwithpresbycusistakestimeandpatience.Specialistsinthefieldsofotolaryngology,
audiology,neurology,andpsychologymayallbeinvolved.

Diet
Nowellestablisheddietaryrestrictionsareprescribedforpatientswithpresbycusis.However,someresearchers
haverecentlysuggestedthata30%caloricdietaryrestrictionandtheuseofantioxidantdietarysupplementsmay
reducetheproductionofreactiveoxygenmetabolitesthatcanharmtheinnerearandleadtoagerelatedhearing
loss.

Activity
Noactivityrestrictionsareprescribedforpatientswithpresbycusis.However,patientsshouldbewarnedthat
exposuretoloudsoundscanexacerbatesensorineuralhearingloss.

ContributorInformationandDisclosures
Author
PeterSRoland,MDProfessor,DepartmentofNeurologicalSurgery,ProfessorandChairman,Departmentof
OtolaryngologyHeadandNeckSurgery,Director,ClinicalCenterforAuditory,Vestibular,andFacialNerve
Disorders,ChiefofPediatricOtology,UniversityofTexasSouthwesternMedicalCenterChiefofPediatric
Otology,Children'sMedicalCenterofDallasPresidentofMedicalStaff,ParklandMemorialHospitalAdjunct
ProfessorofCommunicativeDisorders,SchoolofBehavioralandBrainSciences,ChiefofMedicalService,
CallierCenterforCommunicativeDisorders,UniversityofTexasSchoolofHumanDevelopment
PeterSRoland,MDisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,AmericanAcademyof
OtolaryngicAllergy,AmericanAcademyofOtolaryngologyHeadandNeckSurgery,AmericanAuditorySociety,
AmericanLaryngologicalRhinologicalandOtologicalSociety,AmericanNeurotologySociety,American
OtologicalSociety,NorthAmericanSkullBaseSociety,andSocietyofUniversityOtolaryngologistsHeadand
NeckSurgeons
Disclosure:AlconLabsHonorariaConsultingAdvancedBionicsHonorariaBoardmembershipCochlearCorp
HonorariaBoardmembershipMedElCorptravelgrantsConsulting
Coauthor(s)
JoeWalterKutzJr,MD,FACSAssistantProfessor,AssociateResidencyDirector,NeurotologyFellowship
Director,DepartmentofOtolaryngologyHeadandNeckSurgery,UniversityofTexasSouthwesternMedical
School
JoeWalterKutzJr,MD,FACSisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,American
AcademyofOtolaryngologyHeadandNeckSurgery,AmericanNeurotologySociety,OtosclerosisStudyGroup,
TexasMedicalAssociation,andTriologicalSociety
Disclosure:PurduePharmaConsultingfeeConsultingMedtronicInc.ConsultingfeeConsulting
MichelleCMarcincuk,MDClinicalAssistantProfessorofOtolaryngology,UniversityofTexasSouthwestern
MedicalCenterConsultingStaff,DepartmentofSurgery,DivisionofOtolaryngology,TexasHealthCare,PLLC
MichelleCMarcincuk,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofOtolaryngology
HeadandNeckSurgery,AmericanMedicalAssociation,TexasMedicalAssociation,andTriologicalSociety
Disclosure:Nothingtodisclose.
SpecialtyEditorBoard

JackAShohet,MDPresident,ShohetEarAssociatesMedicalGroup,IncAssociateClinicalProfessor,
DepartmentofOtolaryngologyHeadandNeckSurgery,UniversityofCalifornia,Irvine,SchoolofMedicine
JackAShohet,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofOtolaryngologyHead
andNeckSurgery,AmericanMedicalAssociation,AmericanNeurotologySociety,andCaliforniaMedical
Association
Disclosure:EnvoyMedicalConsultingfeeMedicalAdvisoryBoardMember
FranciscoTalavera,PharmD,PhDAdjunctAssistantProfessor,UniversityofNebraskaMedicalCenter
CollegeofPharmacyEditorinChief,MedscapeDrugReference
Disclosure:MedscapeSalaryEmployment
GerardJGianoli,MDClinicalAssociateProfessor,DepartmentofOtolaryngologyHeadandNeckSurgery,
TulaneUniversitySchoolofMedicineVicePresident,TheEarandBalanceInstituteChiefExecutiveOfficer,
PonchartrainSurgeryCenter
GerardJGianoli,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofOtolaryngology
HeadandNeckSurgery,AmericanCollegeofSurgeons,AmericanNeurotologySociety,AmericanOtological
Society,SocietyofUniversityOtolaryngologistsHeadandNeckSurgeons,andTriologicalSociety
Disclosure:Vesticon,Inc.NoneBoardmembership
ChristopherLSlack,MDPrivatePracticeinOtolaryngologyandFacialPlasticSurgery,AssociatedCoastal
ENTMedicalDirector,TreasureCoastSleepDisorders
ChristopherLSlack,MDisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,American
AcademyofFacialPlasticandReconstructiveSurgery,AmericanAcademyofOtolaryngologyHeadandNeck
Surgery,andAmericanMedicalAssociation
Disclosure:Nothingtodisclose.
ChiefEditor
ArlenDMeyers,MD,MBAProfessorofOtolaryngology,Dentistry,andEngineering,UniversityofColorado
SchoolofMedicine
ArlenDMeyers,MD,MBAisamemberofthefollowingmedicalsocieties:AmericanAcademyofFacialPlastic
andReconstructiveSurgery,AmericanAcademyofOtolaryngologyHeadandNeckSurgery,andAmericanHead
andNeckSociety
Disclosure:MedvoyOwnershipinterestManagementpositionCerescanImagingHonorariaConsulting

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