In elderly subjects suffering from presbycusis a clinical picture of sudden hearing loss, tinnitus and vertigo may be precipitated by a superimposed serous otitis media. Such an abrupt and dramatic sensory deficiency may be erroneously ascribed to an acute cochlear lesion and given grave prognostication. This situation was observed in 12 patients during a period of 2 years. Appropriate diagnostic evaluation revealed the true nature of the disease and simple therapeutic measures promptly restored the auditory function to its previous level.
Second Clinical College, Hunan Medical University , Changsha , 410011.
To study the clinical features of the sudden sensorineural hearing loss (SSHL) in the elderly, forty-five cases with SSHL, in the age more than 60 years, and fifty-seven young cases with SSHL as controls were investigated. The results showed that: 1. there was a higher incidence of the cardiovascular disease in the elderly group than in the young group (P < 0.05), 2. prognosis of hearing in elderly patients was worse than that in the controls (P < 0.05).
Any disease affecting the ear canal (external ear), ear drum, middle ear space or the three small ear bones may cause a conductive sudden hearing loss in the elderly by interfering with the transmission of sound to the inner ear. Such a conductive hearing impairment may be due to a perforation (hole) in the ear drum, partial destruction or fixation of one or all of the three little ear bones, or scar tissue around the ear bones or in the ear drum. Other causes of conductive hearing losses include wax in the ear canal, middle ear fluid or infection or any other process that would prevent sound from reaching the inner ear .
Perhaps the most common theory to explain sudden hearing loss in the elderly is a viral infection. Evidence of viral infections have been found by researchers in patients who have had sudden SNHL, leading to this being proposed cause. A viral infection can cause inflammation of the inner ear or auditory nerve. This inflammation of the inner ear structure and associated blood vessels can cause hearing loss. No pain, fever, muscle cramps or other signs of a viral illness are usually encountered. Occasionally, signs of an upper respiratory infection may precede the onset of sudden SNHL.