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HEARING LOSS IN OLDER ADULTS It is estimated that over 6 million people 65 and over have hearing loss. 30-60% of population 65 and older have hearing impairment. Hearing loss is the 3rd most prevalent chronic condition behind HTN and OA. Only 25% of patients who would benefit from hearing aids after testing actually get them. Key Messages • • • • Identify if hearing loss is a problem for our patients 65 and up. Treat any immediately reversible causes (cerumen or effusion). These are usually CONDUCTIVE causes. Refer to Audiology for audiometric testing for hearing aids or to ENT for treatment if any surgical intervention is warranted and feasible for patient. There are some auditory assistance devices we can suggest to patients if they can’t afford hearing aids. Middle Ear Effusion – Perulent Types of Hearing Loss Sensorineural • • Image Middle Ear EffusionSerous • • Most common form in aging for hearing decline over time. Sensorineural hearing loss due to aging is known as “presbycusis” Due to damage to neurons or hair cells transmitting auditory signals to the brain for interpretation. Loud environments, neural tumors, viral insults (acoustic neuritis) Cholesteatoma Conductive • • • Due to mechanical damage or obstruction of the middle ear or external auditory canal. Middle Ear Issues: • Effusions • Trauma to boney structures or tympanic membrane or growths External auditory canal issues: • Foreign body • Inflammation or growths Cerumen Impaction Evaluation of Hearing Loss Weber Test: Place the base of struck tuning fork on bridge of forehead, nose or teeth. Normal: No lateralization of sound Unilateral Conductive Loss : Sound lateralizes towards affected ear. Unilateral Sensorineural Loss: Sound lateralizes to normal or better-hearing side Rinne Test: Place the base of struck tuning fork on the mastoid bone behind the ear. Have patient indicate when sound is no longer heard. Move fork (held at base) beside ear and ask if now audible. Normal: AC > BC; patient can hear fork at ear. Conductive Loss: BC > AC; patient will not hear fork at ear AC = Air Conduction; BC = Bone Conduction Funded by D.W. Reynolds Foundation Tympanosclerosis Chronically Perforated Tympanic Membrane