“60-80% of them present clinically significant hearing and balance problems, which – together with the accompanying diseases of this age – bring a huge burden on the health system. In the Greek area, the management of this problem is even more difficult”, says Mr Mr. Yiannis Epitropou, Assistant Director of Otorhinolaryngology Metropolitan Hospital.

OR embassy is the term that describes hearing loss from the 6th decade of life onwards, as a result of old age combined with lifelong exposure to non-occupational noise, ototoxic agents, unhealthy diet, diseases with ototoxic influence (infections, diabetes etc. .) medicinal substances as well as with genetic and other “idiopathic” (that is, unknown to modern science) factors. A more concise definition could describe her as the genetically predisposed hearing loss with age.

Like the auditory system, the balance system gradually degenerates over time. But unlike hearing, balance is a dynamic state that is the result of many factors, often unrelated to the preeminent organ of balance, the inner ear or labyrinth, and therefore extremely difficult to measure on an objective scale.

When the patient comes with the symptom of vertigo or chronic instabilitythe first automatic conclusion drawn is that we are dealing with a disorder of the seamless cooperation of the responsible systems (vestibular organs = 2 labyrinths, eyes, musculoskeletal, proprioceptive and central nervous system). Therefore, most age-related symptoms of instability involve multiorgan “dysfunction” of these systems. When orthostatic hypotension is also present, the cardiovascular and endocrine systems are additionally related to the problem.

A series of newer diagnostic tests allow the quantitative assessment of balance disorders (EMG, VEMP, VNG, posturography) to a certain extent, but in no case with the precision that audiological tests allow for the measurement of hearing acuity.

Evidence of epidemiology of rabies

In the latest studies, the participation of genetic factors in a percentage of 55-61% in the final development of presbyacusis is reported (which is the same with diseases such as arterial hypertension and dyslipidemia).

Worthy of special mention is a study conducted among the Mabaans, an isolated African tribe living on the banks of the White Nile in Sudan, where noise levels less than ten times that of a household refrigerator were measured in the center of the camp. The members of the tribe are characterized by the sharpest hearing on record worldwide, with this impressive difference increasing from the sixth to the ninth decade of life!

Apart from the complete lack of noise, gunfire, etc., the Mabaans live with minimal stress, no salt in their diet and a very low fat diet. At the same time, they present an almost zero incidence of cardiovascular diseases. Those members of the tribe who migrate to Khartoum, the capital of the country, leave behind the “eternal youth” and “climb” on the “train of decay” of the residents of the big city.

Epidemiology of balance disorders

As early as 1953, Droller and Pemberton found that 50% of otherwise “productive” Britons aged 60-70 had at least one symptom of “dizziness”. Similarly, in another study it was found that up to 50% of the reasons for admitting patients to a geriatric clinic were “dizziness”. As we know, as the years go by, balance disorders become more common and this is evident because when patients over 75 are asked, “dizziness” is the most common symptom.

“Although specific causes of vertigo are sometimes diagnosed, most elderly patients – up to 80% – suffer from a more general impairment of balance subsystems. All this, combined with the increase in the aging population, explains the ever-increasing frequency of falls, hip fractures, and fatal fall injuries in people over 65 years of age,” emphasizes Mr. Commissioner.

Interesting evidence from human and animal studies

As in other areas of the hyper-specialized nervous system, in the labyrinth, the organ of hearing and balance, the sensory cells unfortunately do not regenerate after their death (due to e.g. trauma or their apoptosis over time). age).

Fortunately for us, the central nervous system possesses the so-called “plasticity”, the ability to modify and adapt its function in response to the impairment of the function of the above sensory organs, so that the remaining system functions as efficiently as possible, but always in as much as possible.

Dealing with embassy

Starting with the fact that the problems of the outer ear (pinna, external auditory canal) and middle ear (tympanic membrane, ossicles) have been diagnosed and resolved, and, at the same time, the other health problems (arterial hypertension, diabetes mellitus, dyslipidemia) are treated effectively, the best available treatment remains the hearing aid (hearing aid). But even though many could benefit from a hearing aid, they end up not using it for a variety of reasons, including cost, stigmatization as a “disability” and “evidence” of advanced age, and poor performance in noisy environments.

But the progress of technology (digital headphones instead of analog ones), combined with the improvement of application techniques, have given a great boost to the degree of satisfaction, comfort, ease of use as well as the aesthetic result. The truth boils down to the fact that every hearing-impaired person deserves and should be considered as a potential candidate for hearing aid use.

In cases where bilateral hearing loss is severe and not satisfactorily served by hearing aids, cochlear implants, as well as their combination with hearing aids, appear as the final solutions, with encouraging results regardless of age.

Balance disorders – treatment

The first objective that is initially set is to assess the patient’s degree of risk of falling, in order to provide the appropriate assistance, e.g. admission to a hospital, support from the environment, use of a wheelchair, cane, etc. Then, a detailed history is a necessary condition for finding neurological or other diseases that affect the synergy of movements, muscle strength and balance. Cardiovascular problems are considered, including the standing test (orthostatic hypotension). When indicated, brain imaging (axial and/or magnetic brain) and triplex carotid and vertebral arteries are useful tools in the diagnostic approach. Also, an eye examination is often deemed necessary. Orthopedic issues (arthritis of the hip, knee, spine) are considered and if possible treated.

The control of the medication is always necessary, while during its duration it is often required the immediate discontinuation of labyrinthine depressantssince patients receive them incorrectly on a chronic basis.

“In the event that a thorough ENT examination does not reveal a specific cause of the vertigo (benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, perilymphatic fistula, etc.), in which case special treatment and treatment are also qualified, the patient must immediately join a program vestibular rehabilitation therapywith referral to a dedicated team of physical therapists experienced in implementing ‘balance recovery’ protocols, thereby reducing the likelihood of falls and improving the patient’s safety, mobility and by extension self-confidence and quality of life,” he concludes Mr. Commissioner.

*The Metropolitan Hospital having a model, fully equipped and organized Otorhinolaryngology Clinic staffed with excellent medical and nursing staff, it is at all times available to patients for the diagnosis and treatment of hearing and balance disorders.

In particular, the highly trained and specialized medical and nursing staff of the Hospital provide reliable diagnostic and therapeutic services, in accordance with modern views and the latest developments in science, while, being equipped with the latest technology, the Audiology-Neurology and Endoscopic Laboratory provide the necessary modern means for every diagnostic approach and therapeutic treatment.