Presbycusis: Reversible with anesthesia drugs?
Introduction
An unexpected and extraordinary medical event is reported here: a reversal of presbycusis, or age-related high-frequency hearing loss. Experienced in the early stages of recovery from abdominal surgery, this enhancement of hearing is noteworthy because no cure is known for presbycusis and no medications are available for its treatment. The patient is the author, a retired physics professor who has taught university-level courses in the science of sound and hearing.
After presenting some background information, this article describes the restoration of hearing, discusses possible causal connections, and then concludes with speculation about prospects for medication that might be effective for the treatment of presbycusis.
Section snippets
Patient background
Since about age 40, the author/patient has experienced a progressive loss of high-frequency hearing ability. On a tone audiogram this bilateral presbycusis is apparent as a 40 dB decline within the span of an octave, in the frequency range between 2 kHz and 4 kHz. Below 2 kHz the response is essentially flat, at −10 dB, and above 4 kHz it is again flat, at about −50 dB. In simple terms, both ears function well at lower frequencies but suffer about 40 dB of hearing loss at high frequencies. As is
Surgery and post-surgery chronology
The following account, much of it verbatim from the author’s notes, describes the reversal of hearing loss in the context of the surgery and the first 4 days of recovery.
Day of surgery: General anesthesia: 7 h, from 7:10 a.m. to 2:10 p.m. Surgery: 5.5 h. Uneventful, stable initial recovery. Noise in hospital limited sleep to 1 h.
Day 1 of recovery: Discharged from the hospital mid-day; settled comfortably in hotel. Sleep duration 8 h. Note added: the author was unaware of any auditory changes during
Interpretation and hypothesis
Age-related hearing loss is generally attributed to progressive irreversible cochlear or auditory nerve degeneration. In this context it is significant to have an observation of even a temporary reversal in a single case report. This experience suggests that with appropriate medical treatment, presbycusis may be reversible for some patients. Although the nature of the relationship between the events associated with surgery and the restoration of hearing deserves further study, it is meaningful
Searching for a medical treatment
To be viable as a potential treatment for presbycusis, a systemic medication should not produce major non-auditory side effects. In their current form, the intravenous drugs mentioned above would probably not meet this standard. However, formulations might be possible that could more effectively target the auditory nerve pathway or inner ear. Another possibility is that these or similar agents might be effective if introduced locally to the auditory nerve pathway or inner ear. With smaller
Acknowledgements
It is a pleasure to acknowledge insightful correspondence with Professor Alfred L. Nuttall, Director of the Oregon Hearing Research Center, who has outlined three possible scenarios for the pre-surgery hearing loss and its subsequent temporary restoration: (1) the organ of Corti might in fact have been capable of functioning but was somehow turned off. Then some aspect of the anesthesia or surgery could have stimulated efferent nerves, turning it back on. (2) Afferent fibers leading to the
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Bats experience age-related hearing loss (presbycusis)
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