Age-Related Hearing Loss (Presbycusis)

This is the name given to hearing loss that develops in both ears as we get older. It mainly results from sound reaching the inner ear structures but not being perceived adequately (sensorineural hearing loss, nerve-related loss). High-frequency sounds (high-pitched, thin sounds) are particularly affected, and it becomes harder to make out what is being said.

What are the symptoms of presbycusis:

People have difficulty hearing the doorbell or the telephone ringing and want to turn up the TV volume. At first, they say they can hear sounds but cannot understand them. They may feel uncomfortable in noisy environments. Gradually, hearing loss and communication problems increase. This leads to additional problems such as social isolation, depression and dementia. In addition to hearing loss, tinnitus and balance problems may occur.

How is presbycusis diagnosed:

After taking a history of the condition, an examination is performed. If there is earwax buildup (impacted cerumen) in the ear canals, it is cleaned out. Audiometric tests determine the level of hearing and speech understanding. Although not necessary for diagnosing presbycusis, if a significant difference in hearing is found between the two ears, tests such as a CT scan or MRI may be performed to look for other possible causes.

How is presbycusis treated:

It is not possible to cure the hearing loss that has developed or restore hearing to its former state. Assistive devices called hearing aids are used to improve patients’ quality of life.

Hearing aids collect surrounding sounds through a built-in microphone, amplify them with an amplifier powered by a battery, and deliver them to the ear through a speaker. The device’s physical design and settings are tailored to the individual and cannot be used by anyone else.

If the hearing in the patient’s two ears is similar, ideally hearing aids should be used in both ears. If hearing in one ear is relatively preserved, it is appropriate to use a device in the poorer-hearing ear. However, in hearing loss affecting both ears, if the hearing loss in one ear is too severe to benefit from a device, the device should be used in the better-hearing ear.

Thanks to advances in computer technology, hearing aids have become quite small today, and in-the-ear models cannot be seen from the outside. In addition, because they can process many different sound tones separately and automatically adjust their settings to the environment, adjustment problems have steadily decreased.

Degrees of hearing loss and hearing aid use:

Hearing level is measured in decibels (dB). The lower this value, the better the hearing; the higher the value, the more hearing is reduced. Normal hearing is between 0 and 20 decibels.

Very mild hearing loss: The measured hearing level is between 20 and 45 dB. Sounds such as a clock ticking or a dripping faucet may not be heard. One-on-one conversation is comfortable, but some words may be missed in noisy environments. These people communicate more comfortably with a hearing aid.

Mild hearing loss: The measured hearing level is between 46 and 55 dB. These people understand speech easily up close but have difficulty with speech from a distance or in crowds. They often cannot hear the doorbell or the telephone ringing. They benefit greatly from a hearing aid.

Moderate hearing loss: The measured hearing level is between 56 and 70 dB. Understanding and following normal conversation is generally not possible. However, they can hear loud speech. They have great difficulty understanding in noisy environments. This is the group that benefits most from hearing aids.

Severe hearing loss: The measured hearing level is between 71 and 90 dB. They can understand only what is said very close to them and shouted. They benefit from using a suitable hearing aid.

Profound hearing loss: The measured hearing level is above 90 dB. In addition to hearing aids, supportive methods such as lip reading should be taught.