presbycusis
Introduction
Introduction to senile deafness Senile deafness refers to a kind of senile disease in which progressive hearing loss gradually occurs with age. Usually, the incidence rate of the elderly aged 65 to 75 years can be as high as 60%. Bilateral symmetry, progressive progressive neurotic deafness, the hearing curve is mostly slope-shaped with high frequency drop, sometimes flat, in addition to hearing loss, often accompanied by dizziness, lethargy, tinnitus, temper more paranoid Wait. basic knowledge The proportion of illness: 90% Susceptible people: good for the elderly aged 65-75 Mode of infection: non-infectious complication:
Cause
Causes of senile deafness
Long-term exposure noise (25%):
According to Rosen, the hearing of remote tribes in the Sudan is better than that of urban residents, especially those over the age of 65, who can maintain good high-frequency hearing. Weston (1964) investigated the incidence of senile sputum in urban residents earlier than in rural areas. The reasons are manifold, but long-term noise damage is one of the main reasons.
Effects of different eating habits (15%):
According to the hearings of the Soviet Union (1976) census Moscow and Georgia, the latter region eats more vegetarian food, the incidence of coronary heart disease is less, the elderly have better hearing, while the Moscow residents are mainly meat, blood cholesterol is high. The incidence of cardiovascular disease is high, and the hearing of the elderly is also poor. Rosen (1962) found that the average blood cholesterol of the elderly who ate a low-saturated fat diet was 5.2 mmol/L, while the blood cholesterol of a saturated fat diet increased by 6.76 mmol/ L, Weston (1964) investigated 70% of senile deafness with atherosclerosis, and the severity of deafness was positively correlated with the degree of arteriosclerosis.
Genetic factors (10%):
Lowell (1977) divided the patients with deafness into two groups according to age. There is a history of family deafness under 65 years old. It is a flat or basin-type hearing curve. There is no history of family deafness over 65 years old. It is a downhill type hearing curve and language recognition rate. Low, genetics predominates, genetically, men and women are different, women's tissue tolerance is stronger than men's, and men are more likely to suffer from harsh environments and noise than women, smoking and drinking more than women, so Older deafness is twice as many as female.
Senile deafness is the manifestation of human aging process in the auditory organs. The pathogenesis of senile deafness is complicated. It is still unclear. There are data showing that the incidence of senile deafness is significantly higher in elderly patients with hyperlipidemia. In the normal blood lipid group, hyperlipidemia promotes senile sputum, in addition to degeneration of outer hair cells and vascular streak due to lipid deposition, platelet aggregation and erythrocyte stasis, microcirculatory disorders, and may also interact with peroxidative lipids in biosensors and hairs in auditory receptors. The direct damage of the cells, the cochlear end of the weekend end of the spiral and related nerve atrophy, it is characterized by slow progress of bilateral, high frequency decline of the main sensorineural hearing loss, in addition, the elderly due to hyperosteogeny and deposition In order to narrow or occlude the inner ear canal and nearby bone pores and tubules, the corresponding nerve fibers, spiral ganglion atrophy, and nerve cells are reduced, which may be another cause of senile sputum. It should be acknowledged that senile sputum It is manifested in the aging phenomenon of hearing, which basically conforms to the metabolic law, and any treatment can not change this law and trend.
Prevention
Senile deafness prevention
First, with the growth of the elderly population, the prevention of senile deafness is an urgent need. If you want to enter the old age and still keep your ears clear, you must first have a healthy body and mind, create a good living environment, and go to a happy mood every day. In the face of everything, but also pay attention to diet, daily life, reduce fat foods, quit smoking and alcohol, proper physical exercise, try to avoid the use of ototoxic drugs, more interaction with others, more brains, more hands, this can delay aging arrival.
1, middle-aged and elderly people should adhere to physical exercise, such as walking, jogging, doing exercises, playing Tai Chi, etc., to enhance physical fitness, improve the body's blood circulation, slow down the process of aging.
2, reasonable arrangements for diet, middle-aged and elderly people do not consume too much fat and sweets, should eat more vegetables, fruits, beans and other light foods, to prevent high blood pressure, arteriosclerosis, diabetes and other systemic diseases, and affect the ear The auditory function.
3, clinical application of streptomycin, neomycin, gentamicin, kanamycin, polymyxin and other ototoxic drugs, should strictly control its indications, even if it is necessary to apply, it should be used with the least effective The dose should be treated with short-term treatment as much as possible.
4. Once the middle-aged and elderly people find hearing loss, they should go to the hospital for examination, find out the cause, determine the nature of the disease, and treat it as soon as possible to prevent the aggravation of deafness.
Second, the experts suggest that if the following typical symptoms of senile deafness should be checked accordingly:
1. Over 60 years of age, there is a bilateral symmetry hearing loss of unknown cause, which is mainly due to the decline of old age hearing.
2, hearing loss is a slow progressive increase, often not noticed at the beginning, with the decline of high-frequency hearing, the ability to distinguish the language, at this time the patient has a audible sound, can not hear the content, It is often necessary for others to repeat. Later, as the frequency of the language is impaired, the speaker is asked to raise his voice to talk to him.
3, there is often a phenomenon of auditory resilience, that is, the patient often said, "When others whisper, they can't hear it, but when they are loud, they feel too noisy."
4, the language resolution is not proportional to pure tone hearing, which is called "phoneme decline". In most cases, pure tone hearing loss is not as serious as language hearing. The older the age, the more obvious the phenomenon is that in many elderly people, although pure tone hearing is basically normal, Still can't understand the content of the speech.
5. There is an age-related "additional" hearing loss among the elderly, which leads to a worse speech function than the younger ones at the same threshold level, and there is also a tendency to underestimate their own hearing loss.
6. In a noisy environment, the elderly have a poorer understanding of language. Even if the elderly suffer little loss in hearing sensitivity, in a noisy reverberant environment, the difficulty of understanding speech is better than that of normal hearing. Young people are much larger, and it is more difficult for older people with hearing impairment to understand speech.
7, some patients with senile sputum can be accompanied by tinnitus, often high-frequency sound, initially intermittent, appear in the dead of night, gradually change to persist, can be heard during the day, tinnitus often begins at 30-40 years old, its appearance The rate increases with age, reaching its peak at 60-70 years old, and then rapidly declines. Most patients with tinnitus feel "habit" with tinnitus as they get older, and tinnitus can disappear automatically afterwards.
Complication
Senile deafness complications Complication
Deafness is the ultimate result of this disease, and generally no other special complications.
Symptom
Senile deafness symptoms Common symptoms Deaf hearing loss Tinnitus vertigo tone rhythm abnormal sleepiness
Bilateral symmetry, progressive progressive neurotic deafness, the hearing curve is mostly slope-shaped with high frequency drop, sometimes flat, in addition to hearing loss, often accompanied by dizziness, lethargy, tinnitus, temper more paranoid Wait.
The tympanic membrane is normal. After middle age, the two ears undergo sexual sympathetic hearing deafness, accompanied by high-pitched tinnitus. It begins to fall from 3000Hz, gradually affects the intermediate frequency of 4000-6000Hz, and the high-frequency sound is suddenly lost due to the rupture of the basement membrane. Men's voice is easier to understand than women's and children's language. Pure tone audiometry is based on four pathological changes: sensory, neurological, vascular (metabolic) and cochlear (mechanical). Different sensory deafness curves such as decline, poor language recognition rate, and sound decay.
Examine
Examination of senile deafness
Detailed ear and nose examinations, strict hearing function, vestibular function and eustachian tube function testing, necessary imaging and whole body examinations are the basis for diagnosis and differential diagnosis.
Diagnosis
Diagnosis and diagnosis of senile deafness
Differential diagnosis
Some of the symptoms of ear disease have the characteristics of secret development, easy to be confused with senile deafness, and must be distinguished from the following ear diseases:
1, chronic inflammation: chronic suppurative otitis media, often can cause small bone dissolution and shedding, mastoiditis and tympanosclerosis, chronic exudative otitis media, repeated authors can cause mucosal degeneration and obstruction in the middle ear cavity and eustachian tube Chain adhesion hardening, especially chronic catarrhal otitis media, because there is no typical symptom in normal times, only in the sense of sensation, excessive alcohol and tobacco, fatigue, etc., there are dull pain, tinnitus and other symptoms in the ear, the posterior segment of the external auditory canal can be seen during the examination. Congestion and swelling, eardrum inversion, hearing loss and other symptoms, occult development, often do not attract people's attention in the early and middle stages, once the impact of hearing, conventional treatment is difficult to achieve results, the above several diseases can already have electric otoscope, acoustic impedance And X-ray examination to confirm the diagnosis.
2, metabolic diseases caused by deafness: such as diabetes, hyperlipidemia, inner ear sclerosis, specialist examination can be ruled out.
3, drug-induced deafness: the history of application of ototoxic drugs, there is an exact time limit of onset, once the disease is formed, it rarely fluctuates.
4, noise deafness: related to occupational noise and unscientific living noise environment, early and mid-term performance has a typical symptom of increased symptoms after noise stimulation, symptoms after the break.
