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Transcript
HEARING LOSS IN OLDER ADULTS It is estimated that over 6 million people 65 and over have hearing loss. 30 – 60% of the 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. TYPES OF HEARING LOSS Sensorineural Due to damage to neurons or hair cells transmitting auditory signals to the brain for interpretation. Loud environments, neural tumors, viral insults (acoustic neuritis) Most common form in aging for hearing decline over time. Sensorineural hearing loss due to aging is known as “presbycusis” Conductive Due to mechanical damage or obstruction of the middle ear or external auditory canal Examples of middle ear issues would be effusions (purulent – otitis media, serous – eustachian tube dysfunction) , trauma to the boney structures or tympanic membrane (scarring –tympanosclerosis), or growths such as cholesteotomas or otosclerosis. Examples of external auditory canal issues would be foreign body (cerumen, insect, crayon), inflammation (otitis externa), or growth (polyp, malignancy) EVALUATION OF HEARING LOSS Rinne Test: Place the base of struck tuning fork on the mastoid Weber Test: Place the base of struck tuning fork on bridge of 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. o Normal: AC > BC; patient can hear fork at ear. o Conductive Loss: BC > AC; patient will not hear fork at ear AC = Air Conduction; BC = Bone Conduction forehead, nose or teeth. o Normal: No lateralization of sound o Unilateral Conductive Loss : Sound lateralizes towards affected ear. o Unilateral Sensorineural Loss: Sound lateralizes to normal or better-hearing side Funded by D.W. Reynolds Foundation