A Few Things About Deafness in the Elderly

How to prevent and delay deafness in the elderly?

Many elderly people think that "old people have poor hearing" is a normal phenomenon, but it is not entirely correct. In the outpatient clinic, we often encounter elderly patients who have been deaf for a long time. After examination, it is found that it is just because there is too much earwax in the ear, forming earwax embolism. After taking out the earwax, the hearing returns to normal. Therefore, if the elderly find that their hearing has decreased, they should not diagnose themselves easily, but must go to the hospital to find out the cause.

Currently, one in three adults over the age of 65 in the world suffers from hearing impairment, and the proportion of presbycusis among the elderly aged 60 to 74 is as high as 30% to 50%. Among the elderly, deafness is a common chronic disease second only to arthritis and hypertension. Presbycusis is a degenerative phenomenon of aging and there is currently no effective treatment.

Therefore, prevention and early intervention are particularly important, such as paying attention to dietary hygiene, reducing lipid foods, appropriately strengthening physical exercise, quitting smoking and drinking, preventing noise damage, avoiding the use of ototoxic drugs, etc., which are very important for preventing and controlling the development of the disease and delaying premature decline.

When the hearing loss of patients with presbycusis reaches a certain level, the effective way to improve hearing is to choose to wear appropriate hearing aids, which can improve the quality of life of patients with presbycusis. In addition, cochlear implants can also play an important role in patients with severe and profound hearing loss who are ineffective or have poor results with hearing aids.

Do you know how harmful noise is to your ears?

Noise refers to excessively loud and noisy sounds. In our daily lives, we often encounter a lot of noise. Some noises affect the sound quickly, while others affect it slowly. This is related to the nature of the noise and the length of time we are exposed to it.

In clinical practice, we may encounter people who suddenly experience hearing loss after setting off firecrackers. This kind of hearing loss is called blast-induced deafness. It is caused by the damage of impulse noise (or shock wave) to the auditory organ. Impulse noise is strong and often accompanied by shock waves, which often cause acute damage to the auditory organ, such as congestion, bleeding or perforation of the eardrum, fracture of the middle ear ossicles and damage to the inner ear, which can lead to varying degrees of hearing loss or even complete deafness.

Such patients can also be encountered in clinical practice. Their hearing loss is slow and progressive. Some patients suffer from it because they work in a noisy environment for a long time, while some patients feel that they are not exposed to noise. After careful inquiry into their medical history, they often have the habit of wearing headphones for a long time. We call such patients noise-induced hearing loss. The eardrums of such patients are normal.

Pure tone audiometry of these two types of hearing loss shows sensorineural hearing loss, with a V-shaped or U-shaped curve. For blast-induced hearing loss, medications to nourish nerves and improve microcirculation, or hyperbaric oxygen therapy, can be given. The treatment for early noise-induced hearing loss is the same as for blast-induced hearing loss, with the patient leaving the noisy environment. Late-stage treatment mainly involves rehabilitation or hearing aids.

How should elderly people with sudden deafness seek medical treatment?

When the elderly experience sudden hearing loss, their hearing will drop to the lowest point within a few minutes, hours or a day (usually about 12 hours), and in some cases within 3 days. The elderly should bring their previous medical records and go to the ear department of a nearby hospital for treatment in a timely manner, and have their family members accompany them as much as possible.

Patients should explain to the doctor in detail whether they have any other general discomfort before the onset of the disease, whether they have a history of overwork, depression, anxiety, emotional excitement, cold or flu, whether they can recall the exact time and place of the onset of the disease and the activities they were engaged in at the time, whether they have other underlying diseases, such as diabetes, hypertension, arteriosclerosis, autoimmune diseases, etc., their medication status and control status, whether they have a history of trauma, and whether they have other ear symptoms besides sudden hearing loss, such as tinnitus, dizziness, a feeling of blockage and pressure in the ears, and the chronological relationship of the onset of hearing loss. Providing these clues can help doctors make a clear diagnosis as soon as possible.

The doctor will perform a routine ear examination based on the general condition of the elderly patient, observe the external auditory canal and eardrum, and may further perform the following examinations depending on the patient's condition:

① Pure tone audiometry: determines the type of hearing loss (conductive, sensorineural or mixed) and the degree of hearing threshold improvement;

②Re-energization test: This phenomenon is seen in inner ear diseases and can be used as one of the bases for the diagnosis of inner ear diseases;

③ Tympanometry: to understand the functional status of the middle ear and the characteristics of conductive hearing impairment;

④ Electrocochlear electrogram and auditory brainstem evoked potential: qualitative and localized diagnosis of deafness;

⑤ Vestibular function test: usually performed after vertigo is relieved to determine the extent of vestibular dysfunction.

⑥ Fistula test: assists in the identification of Meniere's disease, perilymphatic fistula, labyrinthitis and window membrane rupture;

⑦ Laboratory examination: including blood and urine routine examination and blood rheology examination, etc., to detect viral infection, renal dysfunction and blood viscosity;

⑧Imaging examination: internal auditory canal cisternography, CT and MRI (enhanced if necessary) are used to detect lesions in the internal auditory canal and brain. Knowing this knowledge can help the elderly with the disease get better medical treatment and restore the lost hearing as much as possible.