Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Presbycusis also called ‘age-related hearing loss’ is one of the most common sensory changes associated with aging. It is also called ‘old hearing’ or ‘elderly hearing’. When not treated promptly, it can significantly impact communication and social interaction. It would also badly impact overall quality-of-life.
Hearing decline is one among the most prevalent health issues and most common physiological changes occurring among ageing people. It gradually develops over time. Presbycusis is classified as a sensorineural hearing loss. It is an effect of age-related damage occurring within the inner ear or auditory pathways and affecting the same.
Epidemiological data says that approximately one in three adults of age groups between 65 and 74 years of age experience hearing loss to some degree. Nearly half of individuals above the 75 years of age have measurable hearing difficulty.
You can see people suffering from presbycusis experiencing difficulty in understanding the conversations, especially in noisy environments. You can see them frequently increasing the volume of televisions, mobile phones or other devices.
Presbycusis does not have a definitive cure. But, timely evaluation and appropriate use of hearing aids and assistive technologies are seen to greatly improve auditory function and daily communication.
Related Reading – ‘Presbycusis – meaning, causes, symptoms, prognosis, treatment’
Ayurveda Understanding of Presbycusis
Presbycusis – a Vata predominant disorder of hearing – Presbycusis is a disease of old age. Old age is that phase of life wherein there is domination of Vata. Towards old age, dhatu kshaya i.e. depletion and progressive damage of tissues and body structures is common. When dhatu kshaya happens, vata invariably increases. This increased vata causes many health issues in old age and Presbycusis is one such disease.
We can understand from the fundamentals of Ayurveda that Presbycusis not only occurs in the vata phase of one’s life, but the disease itself is caused by vata. Vata dominates the clinical picture of presbycusis. The symptoms, complications and prognosis of the disease can be attributed to the progressive increase of vata in old age.
Presbycusis is a disease which affects the Vata-Predominant Sense Organ and its functions – Shravanendriya i.e. sense organ of sound is one of the predominant seats of Vata. So, vata is invariably present in the ears and is involved in the physiology of hearing and auditory perception. Vata is made up of Vayu (air) and Akasha (space, ether) elements. So, the ear also has the predominance of the same elements. It is the balance of vayu and akasha bhutas in the ear that is responsible for smooth conduction of sound waves and auditory perception. Balance of Vata in the ears helps in hearing, comprehending, understanding sounds, speech, words and voices. This forms the foundation for effective communication. When Vata is put into a state of imbalance with the aging process, all these functions will be put into disarray and the symptoms of presbycusis are manifested.
BADHIRYA
A condition called Badhirya explained in Ayurveda gives us a general picture of all kinds of deafness, impaired hearing or semi or total loss of perception and sensation of hearing. It is a broad umbrella term in which all kinds of deafness shall be included.
Since presbycusis is an age-related hearing loss, it can be considered as Vardhakya Janya Badhirya, though such condition has not been named or described in Ayurveda treatises.
The main pathological event of degeneration of hair cells and nerve endings in the inner ear as occurs in presbycusis can be considered as damage of Shabdavaha Srotas (channels of hearing and related structures involved in perception of sound) and Shravanendriya (sense organ of hearing) by aggravated vata.
Indriya Pradoshaja Vikara
Presbycusis can be classified under Indriya Pradoshaja Vikara, wherein the indriyas and their functioning is afflicted by aggravated doshas, mainly vata in this condition.
Causes of Presbycusis according to Ayurveda
Vata aggravating foods and activities.
Dhatu Kshaya – age related destruction and damage of tissues leading to Vata Aggravation or age related Vata aggravation leading to tissue depletion.
Asatmya Shravana Indriyartha Sannikarsha – Excessive, deficit or perverted contact / exposure of the sense organ of hearing (sound) to different kinds of sounds.
Prajnaparadha – Indulging in conscious mistakes repeatedly in spite of knowing that they are harmful for the sense organ of hearing. Example – Many of us know that too much exposure of ears to sounds of high intensity for long duration of time or continuously exposing ears to the sounds – like always plugging ear or headphones for work or recreation (listening music always) would damage the hearing apparatus in the long run. Still, we keep doing it habitually or obsessively.
All the other causative factors contributory to Badhirya are the etiological factors of Presbycusis.
Samprapti (pathogenesis) of Badhirya
Badhirya or deafness occurs when vata alone or in association with kapha (vata blocked or enveloped by kapha) blocks the passages of sound. (Ma.Ni.57/3)
Ayurveda Treatment Principles of Presbycusis
Nidana Parivarjana – avoiding the causative factors which would cause vata aggravation and or badhirya. One should sensibly use his sense organs, ears in this context, avoiding extremes of exposure (asatmya indriyartha sannikarsha).
Balancing Vata – Treatment of Presbycusis mainly focuses on Vata balancing medicines and foods and lifestyle and habit modifications.
External therapies
Karna Purana & Karna Abhyanga – oil filling in the ears balances vata in the ear, keeps the symptoms in check and prevents the disease from progressing. It is important that Karna Purana should be started as a preventive measure once the person enters the final decades of life or beyond 45-50 years of age or when initial symptoms of presbycusis are traced. Disease awareness and prompt reporting will help prevent irreversible damages. It also reduces hearing loss and tinnitus. Ksheerabala Taila, Bilwa Taila or Tila Taila are commonly used for Karnapurana. Karna Abhyanga with the same medicated oils will also help. The combined effect will contribute towards protecting and shielding the sense organ of hearing, improve blood circulation, balance vata and reduce nerve degeneration.
Internal Therapies
Nasya – nasal instillation of medicines is the best remedy for all diseases affecting the ear, nose, throat and head, so also in presbycusis. Ksheerabala Taila, Anutaila, Shadbindu Taila and Mahamasha Taila are useful.
Virechana and Vasti – Therapeutic purgation and Enema can be administered to combat and balance Vata / Vata-Pitta aggravation. The gross and subtle aggravation of Vata will be addressed when these therapies are skilfully administered.
Nitya Sneha – Medicated ghee or oil shall be consumed every day in small quantities to combat Vata aggravation in old age. Regular consumption of Sneha in food will add on to healthy habits in old age. Similarly, regular / periodic pampering of the body and head with medicated oils in the form of abhyanga, avagaha, dhara (parisheka) should be done. Murdni Taila – oil therapies done on the head will also help in combating stress and will bestow good sleep.
Rasayanas – help in preventing tissue damage and destruction and will rebuild them. Rasayanas are best preventive medicines and also disease modifying in nature. Ashwagandha Rasayana, Amalaki Rasayana, Chyavanaprasha Rasayana, Brahma Rasayana & Agastya Rasayana are the best choices in this condition.
Yoga and Meditation – Yoga practices when done under expert guidance will help in improving overall health and also the health of sense organs. Nadi Shodhana Pranayama and Shavasana are highly beneficial. Meditation not only calms the mind but also will keep the doshas in a state of balance. Bhramari Pranayama, Viparita Karani, Adho Mukha Shvanasana, Matsyasana, Shunya Mudra, Balasana, Paschimottanasana, Uttanasana & Karna Pidasana are the best Asanas to practice in presbycusis.
Badhirya Chikitsa – Presbycusis shall be treated on the lines of treating Badhirya, following the principles laid therein.
Important Ayurveda formulations for Presbycusis
– Triphala Kashaya
– Pathyakshadhatryadi Kashayam
– Dashamula Kashayam
– Maharasnadi Kashayam
– Triphala Ghrta
– Saraswatha Ghrta
– Kalyanaka Ghrta
– Dashamularishta
– Saraswatharishta
– Ashwagandharishta
– Chyavanaprasha Rasayanam
– Brahma Rasayanam
– Agastya Rasayanam
– Ashwagandha Rasayanam
– Sarivadi Vati
– Vilwadi Tailam
– Anu Taila
– Ksheerabala Taila / Ksheerabala Taila 101
