Presbycusis (age-associated hearing loss) is the most common cause of sensorineural hearing loss in adults. In the early stages, it is characterized by symmetric, gentle to sharply sloping high-frequency hearing loss. With progression, the hearing loss involves all frequencies. More importantly, the hearing impairment is associated with significant loss in clarity. There is a loss of discrimination for phonemes, recruitment (abnormal growth of loudness), and particular difficulty in understanding speech in noisy environments. Hearing aids may provide limited rehabilitation once the word recognition score deteriorates below 50%. Cochlear implants are the treatment of choice when hearing aids prove inadequate, even when. | Chapter 030. Disorders of Smell Taste and Hearing Part 10 Presbycusis age-associated hearing loss is the most common cause of sensorineural hearing loss in adults. In the early stages it is characterized by symmetric gentle to sharply sloping high-frequency hearing loss. With progression the hearing loss involves all frequencies. More importantly the hearing impairment is associated with significant loss in clarity. There is a loss of discrimination for phonemes recruitment abnormal growth of loudness and particular difficulty in understanding speech in noisy environments. Hearing aids may provide limited rehabilitation once the word recognition score deteriorates below 50 . Cochlear implants are the treatment of choice when hearing aids prove inadequate even when hearing loss is incomplete. Meniere s disease is characterized by episodic vertigo fluctuating sensorineural hearing loss tinnitus and aural fullness. Tinnitus and or deafness may be absent during the initial attacks of vertigo but invariably appear as the disease progresses and increase in severity during acute attacks. The annual incidence of Meniere s disease is per 1000 onset is most frequently in the fifth decade of life but may also occur in young adults or the elderly. Histologically there is distention of the endolymphatic system endolymphatic hydrops leading to degeneration of vestibular and cochlear hair cells. This may result from endolymphatic sac dysfunction secondary to infection trauma autoimmune disease inflammatory causes or tumor an idiopathic etiology constitutes the largest category and is most accurately referred to as Meniere s disease. Although any pattern of hearing loss can be observed typically low-frequency unilateral sensorineural hearing impairment is present. MRI should be obtained to exclude retrocochlear pathology such as a cerebellopontine angle tumor or demyelinating disorder. Therapy is directed towards the control of vertigo. A low-salt diet is the mainstay of .
