Presbycusis Treatment & Management

Updated: Mar 29, 2021
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Treatment

Medical Care

Presbycusis is not curable, but the effects of the disease on patients’ lives can be mitigated.

Amplification devices

Properly fitted hearing aids may contribute to the rehabilitation of a patient with presbycusis. Older patients with arthritis in their fingers and visual difficulties need extra help in learning to use hearing aids. Patients using hearing aids may still experience difficulties with speech discrimination in noisy situations. It is important that hearing aids are tested and fitted appropriately by an audiologist to optimize sound quality. Well-fitted hearing aids may also decrease tinnitus experienced by some patients. [28]  Unfortunately, only a minority of patients with presbycusis (10-20%) are ultimately treated with amplification devices, and many who have hearing aids do not utilize the device effectively. [29]

Lip reading

Lip reading may help patients with diminished speech discrimination and may help hearing aid users who have difficulty in noisy environments. [3]

Assistive listening devices

These range from a simple amplification of the telephone signal to a device on the television that sends a signal across the room to a headset worn by a patient with hearing loss. The patient can amplify the sound without disturbing other people with normal hearing who are in the same room.

Cochlear implants

Some patients with presbycusis benefit from cochlear implants. Patients with cochlear changes and relatively intact spiral ganglia and central pathways appear to be the best candidates. Cochlear implantation is reserved for patients who have hearing loss that is refractory to hearing aids.

Other treatments

These measures are aimed at rehabilitating patients who already experience presbycusis. However, efforts are underway to develop therapies that treat the potential underlying causes of presbycusis, as well as mechanisms to actually prevent the disease altogether. With new studies showing possible genetic and nutritional causes of presbycusis, researchers are proposing treatments that address these underlying causes. For example, medications that block the production of reactive oxygen metabolites may lead to a treatment of presbycusis at the molecular level. Alternatively, a study by Derin et al showed that treatment with I-carnitine resulted in improvement in the ABR results of rats experiencing age-related hearing loss. [30] Unfortunately, most of these therapies are still in the investigational stages.

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Consultations

Rehabilitation of a patient with presbycusis takes time and patience. Specialists in the fields of otolaryngology, audiology, neurology, and psychology may all be involved.

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Diet

No well-established dietary restrictions are prescribed for patients with presbycusis. However, some researchers have recently suggested that a 30% caloric dietary restriction and the use of antioxidant dietary supplements may reduce the production of reactive oxygen metabolites that can harm the inner ear and lead to age-related hearing loss.

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Activity

No activity restrictions are prescribed for patients with presbycusis. However, patients should be warned that exposure to loud sounds can exacerbate sensorineural hearing loss.

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