Otologic Changes and Disorders

Normal aging affects all parts of the ear and represents a major health concern in geriatric medicine. As a result, otologic complaints are increasingly common with age. In fact, hearing loss, external ear disorders, tinnitus, Eustachian tube dysfunction, and vestibular disorders represent the top 5 most common complaints that patients over the age of 65 present to an otolaryngologist. Presbycusis, or age-related hearing loss, is the most common age-associated otologic dysfunction and affects half of people aged 75 and older in the United States. Presbystasis, or the disequilibrium of aging, is a group of disorders that primarily affects mobility and affects over 75% of those 70 years and older. As a result, presbycusis and presbystasis result in everyday challenges that affect both the aging patient and treating provider. Furthermore, management of aging otologic sequela is expensive and contributes significantly to health care expenditures. However, recognition of these aging otologic diseases may help improve access to proper care and treatment while improving overall quality of life. Here we review the basic physiology of the vestibulocochlear system, the pathogenesis and risk factors for presbycusis and presbystasis, and diagnostic and treatment considerations for the general practitioner.