90 ayurvedic management and rehabilitation therapy for ...from presbycusis 2. as per ayurveda,...

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ISSN No: 2456

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Ayurvedic Management Vardhakyajanya

Dr. Ashwini Kumbar

1,3Department of Shalakya Tantra, S.Hospital & Research Centre, Vijayapur, Karnataka, India

2Department of Panchakarma, SDM College

ABSTRACT Karna is one among the important panchgyanendriya which perceives shabdha. These gyanendriya are acts like bridge for communication in sociais a disease affecting Karna. Impairment in hearing mechanism is termed as badhirya when it affects elder age group it is called as Vardhakyajanya Badhirya. It is most common socio-medical disability. In modern it correlates to Presbyacusis –it is condition where there is progressive sensory hearing loss in bilateral and unilateral ear as the age progresses, which is associated with poor speech discrimination. It hampers the quality of life in elderly individual and leads to psychological disorders, depression, social isolation and loss of self-esteem. Karna poorana is the main treatment modality which is explained in classics for karna rogas. Use of Balya(Nervine tonic) dravya in the form of sneha will alleviates the doshas and Rasayana chikitsa in older age group helps in prevention of rasadi dhatu kshaya. Allied science contributed aural rehabilitationHearing aids, Speech therapy etc which is not suitable for all and even some cannot offer those because of financial issues. Presbycusis is most common old age problem in developing countries after Arthritis and HTN. There is need of prevention, rehabilitation and Ayurveda chikitsa to overcome disability. Keywords: Vardhakyajanya Bhadhirya, Presbyacusis, Rehabilitation, Karnapoorana INTRODUCTION Presbyacusis is “Hidden diability” as patient may not be aware of the hearing loss in initial stage. It is a sensorineural hearing loss associated with

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ISSN No: 2456 - 6470 | Volume - 2 | Issue – 6 | Sep

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Ayurvedic Management and Rehabilitation Therapy forVardhakyajanya Badhirya

Ashwini Kumbar1, Dr. Suraj Kumbar2, Dr. A. M. Madni1,2PG Scholar, 3Lecturer

Shalakya Tantra, S. M. V. V’s R. K. M. Ayurveda Medical CollegeResearch Centre, Vijayapur, Karnataka, India

f Panchakarma, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India

Karna is one among the important panchgyanendriya which perceives shabdha. These gyanendriya are acts like bridge for communication in social life. Badirya is a disease affecting Karna. Impairment in hearing mechanism is termed as badhirya when it affects elder age group it is called as Vardhakyajanya Badhirya. It

medical disability. In modern it is condition where

there is progressive sensory hearing loss in bilateral and unilateral ear as the age progresses, which is associated with poor speech discrimination. It hampers the quality of life in elderly individual and

sorders, depression, social

Karna poorana is the main treatment modality which is explained in classics for karna rogas. Use of Balya(Nervine tonic) dravya in the form of sneha will

Rasayana chikitsa in older age group helps in prevention of rasadi dhatu kshaya. Allied science contributed aural rehabilitation-Hearing aids, Speech therapy etc which is not suitable for all and even some cannot offer those because of

resbycusis is most common old age problem in developing countries after Arthritis and HTN. There is need of prevention, rehabilitation and Ayurveda chikitsa to overcome disability.

Vardhakyajanya Bhadhirya, Presbyacusis,

as patient may or may not be aware of the hearing loss in initial stage. It is a sensorineural hearing loss associated with

increase in chronological age. It usually manifests after the age of 65yrs or even in earlier than 60 if there is predisposing risk factors. Badhirya is described under Karna roAcharya Sushruta stated that vKapha dosha causes margavarodhasrotas leading to Badhirya1 , when it affects at old age is called Vardhakyajanya Badhirya. Presbyacusis affects more than half of adults by age of 75 years, most adults over the age of 80,all adults who are 90yrs or older. The WHO estimates that in 2025 there will be 1.2 billion people over 60years of age worldwide,withindividuals who will suffers significfrom Presbycusis2. As per Ayurveda, Badhirya manifests by vitiated vata dosha and in old age there is predominance of Vata doshaleads to Vardhakyajanya Bhadi The risk factors for Presbyafactors, Environmental factors like environment, ototoxicity, HTN,DM2 other metabolic disorders and inner ear damage through bad habits. As the age progresses there is degeneration of auditory nerve cells which leads to presbyacusis. Histopathloigically four distinct types have been described as per degenerative areaSchuknecht(1974).3 � Neural presbyacusis- Degeneration of the cells of

spiral ganglion, starting at progressing to the apex. but speech discrimination is poor.

� Sensory presbyacusis- Degeneration of the organ of corti, starting at the basal coil and progressing

Research and Development (IJTSRD)

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6 | Sep – Oct 2018

Oct 2018 Page: 603

Therapy for

Madni3

M. Ayurveda Medical College,

nd Hospital, Hassan, Karnataka, India

increase in chronological age. It usually manifests after the age of 65yrs or even in earlier than 60 if there is predisposing risk factors. In Ayurveda

Karna roga by Acharyas. stated that vitiated Vata or Vata

causes margavarodha in shabdhavaha when it affects at old age

is called Vardhakyajanya Badhirya.

affects more than half of adults by age of 75 years, most adults over the age of 80, and nearly

or older. The WHO estimates that in 2025 there will be 1.2 billion people over 60years of age worldwide,with more than 500million individuals who will suffers significant impairment

. As per Ayurveda, Badhirya manifests by vitiated vata dosha and in old age there

Vata dosha and also dhatu kshaya ardhakyajanya Bhadirya.

acusis includes Genetic factors, Environmental factors like –noisy

systemic disease –HTN,DM2 other metabolic disorders and inner ear damage through bad habits. As the age progresses

is degeneration of auditory nerve cells which cusis. Histopathloigically four distinct

types have been described as per degenerative area by

Degeneration of the cells of starting at the basal coil and

There is high tone loss but speech discrimination is poor.

egeneration of the organ starting at the basal coil and progressing

International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456


gradually to the apex. Higher frequencies are affected but speech discrimination remains good.

� Strail/Metabolic- Atrophy of stria vascularis in all turns of the cochlea. Here physical and chemical process of energy production affected. Audigram is flat but speech discrimination is good.

� Cochlear conductive- This is due to stiffening of the basilar membrane thus affecting its movements. Audiogram is sloping type.

Diagnosis of Presbaycusis includes history taking, examination and Audiometry i.e. screening and testing of central auditory system. Patients

Hearing loss AssesmentGrade of

Imapirement Audiometric ISO value

0-No impairment 25dBHL or less1-slight impairment

26-40dBHL

2-Moderate impairment

41-60dBHL

3- Severe impairment

61-80 dBHL

4-Profound impairment

81dBHL or greater than

Prevention is better than treating Presbyacusis aging is irreversible and inevitable process init leads to social isolation, feeling of social inferiorityeven they suffers from pshycological illness like depression as the aged people depends on hearing to overcome other disabilities at old ageincludes avoidance of noisy environment;gunshooting and high frequency music sounds. One

rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456


gradually to the apex. Higher frequencies are ted but speech discrimination remains good.

trophy of stria vascularis in all physical and chemical

process of energy production affected. Audigram is flat but speech discrimination is good.

This is due to stiffening of the basilar membrane thus affecting its

gram is sloping type.

history taking, screening and

testing of central auditory system. Patients usually

presents, Deafness-Gradual bilateral symmetrical progressive hearing loss with varying degreeto understand in a noisy environment and poor speech discrimination. Tinnitus-It is at initial stage accompanied with high frequency heariwill be Speech distortion along with recruitment (+/ Audiological testing like Pure tone audimetry and speech audiometry contributes in the diagnosis of Presbyacusis. The classic audiogram will shows a gradual sloping downwards pbecomes higher the hearing gets worsen.

Hearing loss Assesment – WHO grades of hearing impairment4

Audiometric ISO value Description

25dBHL or less Very slight hearing problem, able 40dBHL Able to hear and repeat wors spoken

in normal voice at 1metre 60dBHL Able to hear and repeat words

using raised voice at 1 metre 80 dBHL Able to hear some words when

Shouted into better ear. 81dBHL or greater than that Unable to hear and understand

Even a shouted voice.

Prevention is better than treating Presbyacusis as the inevitable process in life and

feeling of social inferiority even they suffers from pshycological illness like

as the aged people depends on hearing to at old age. Prevention environment; reduce the

gunshooting and high frequency music sounds. One

should go under routine systemic health check up to focus on risk factors and taking treatment for it. Aural rehabilitation is adopted in Age neural deafness, It includes diagnosis and implementation of different types of hearing rehabilitations.

rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470

Oct 2018 Page: 604

Gradual bilateral symmetrical and with varying degree, difficult

to understand in a noisy environment and poor speech It is at initial stage

accompanied with high frequency hearing loss. There will be Speech distortion along with recruitment (+/-).

Audiological testing like Pure tone audimetry and speech audiometry contributes in the diagnosis of

The classic audiogram will shows a gradual sloping downwards pattern, as the frequency becomes higher the hearing gets worsen.

4

Description

able to hear whispers Able to hear and repeat wors spoken

should go under routine systemic health check up to focus on risk factors and taking treatment for it.

Aural rehabilitation is adopted in Age related sensory includes diagnosis and

implementation of different types of hearing



� Hearing aids- There are many varieties of hearing aids are available which is used on the basis of type and configuration of hearing loss. Air conduction hearing aid ,Bone conduction hearing aid which includes BTE,ITE and CIC used in mild to moderate hearing loss.

� Cochlear implants- These are electrical devices which are used in profoundly deaf patients. It is useful in hearing and improves communication ability.

� Auditory Brainstem Implants- It stimulate the cochlear nuclear complex in the brainstem directly by placing the implant in lateral recess of the 4ventricle. It is used in neurofibromatosis,Vestibular Schwannoma. This implants has got limitation now a days as they are in constant technological development.

� Speech reading- Understanding speech by using visual cues like movement of lips, facial expression, gesture and probable context of conversation.

� Auditory training-Teaching an individual to recognize speech sounds, patterns, words, phrases or sentences via audition.

� Manual comminucation- Teaching comminucation via finger-spelling and with a sign language.

Hearing aids are not actual solution for presbyacusis because it has following disadvantages � Cost effective � Recurrent infections of external auditory canal and

middle ear. � Choclear implants may cause, Facial nerve palsy,

Device failure, post op Vertigo, Meningitis and extrusion/ exposure of device.

Ayurveda has great role for preventingdisorders and the many reasercheseffective results in treating Vardhakyanadi Badhirya.Karna pooran (instillation of medicated dravya in External auditory canal) is prime treatment modality adopted for Karna rogasCharaka ,Acharya Vagbhata advised to take daily Karna poorana for preventing ear disease. Acharya Sushruta has explained Karnapoorana in swastavritta Adhyaya. The effects of Karnapoorana in the managemBadhirya 6

� Karnapoorana reduces the frequency of sound by reflecting and refraction of sound. Because sounds frequency and pressure changes from



here are many varieties of hearing aids are available which is used on the basis of type and configuration of hearing loss. Air

e conduction hearing aid which includes BTE,ITE and CIC these are used in mild to moderate hearing loss.

hese are electrical devices which are used in profoundly deaf patients. It is useful in hearing and improves communication

It stimulate the cochlear nuclear complex in the brainstem directly by placing the implant in lateral recess of the 4th

It is used in neurofibromatosis, stibular Schwannoma. This implants has got

days as they are in constant

Understanding speech by using visual cues like movement of lips, facial expression, gesture and probable context of

Teaching an individual to speech sounds, patterns, words, phrases

Teaching comminucation g and with a sign language.5

are not actual solution for presbyacusis

Recurrent infections of external auditory canal and

Choclear implants may cause, Facial nerve palsy, Meningitis and

has great role for preventing geriatric disorders and the many reaserches shown that

Vardhakyanadi Badhirya. (instillation of medicated dravya in

and unique treatment modality adopted for Karna rogas. Acharya Charaka ,Acharya Vagbhata advised to take daily

reventing ear disease. Acharya arnapoorana in swastavritta

The effects of Karnapoorana in the management of

Karnapoorana reduces the frequency of sound by Because sounds

frequency and pressure changes from one medium

to other medium thus its frequency reduces and disability decreases.

� According to Ayurveda KVayu and Akash mahaboota,rukshata of Vata and create a media.

� Smooth walls have tendency to direct sound waves in a specific direction Karnapoorana also smoothing the inner wall.

� It helps to maintain the cilia of innerwhich are responsible for hearing.

� Karna pooran also helps to remove the wax and also protect ear from fungus and many other disease.

Bilva taila, Apamarga kshara taila,Lashunadi Taila, Dashamooladi Taila Kis indicated in vardhakyanadi Badhirya. As the Badhirya is manifestated because of vitiated Vata and Kapha dosha in karnanadi the dravyas having Vata kaphahara propertyinstillation. Taila reduces rukshata and creates media for sounds. Purvakarma like Karna abhyanga with murchita tila taila which has theVishad, Guru and Sara properties it also as Bhrihana so nourishment of Shravanendriya improves hearing mechanism. Bashpa sweda aids the quick absorption of Oil thus increases blood circulation to ears. Shamana chikitsa which includes Rasayana chikitsaas Badhirya manifests in VardhakyaBhrihamna prevents further depletion of Dhatus and nourishes Nerves. Induvati, SaAshwagandha churna and Yogaraja Gpacifying the Vata dosha and strenghthen weakened nerves. Conclusion: Vardhakyajanya Badhirya is more common among elder people now days because of more exposurenoisy environment, hereditary factors and along with risk factors contributes more. Diagnosis made on the base of history taking and Audiometry testing. Aural rehabilitation and its manangement in modern science has got limitation. The hearing devices suitable for all in such cases along with aural rehabilitation Prevention through dinacharya and Ayurveda chikitsa it can be managed. Karnapoorana is effective treatment in Badhirya along with Rasayana, Balya and Bhrihmaneeya Dravya.


Oct 2018 Page: 605

thus its frequency reduces and

According to Ayurveda Karna ia a location of kash mahaboota, oil reduce the

rukshata of Vata and create a media. Smooth walls have tendency to direct sound waves in a specific direction Karnapoorana also

It helps to maintain the cilia of inner ear cells which are responsible for hearing. Karna pooran also helps to remove the wax and also protect ear from fungus and many other

Apamarga kshara taila, Bilvadi taila nadi Taila, Dashamooladi Taila Karna poorana7

vardhakyanadi Badhirya. As the Badhirya is manifestated because of vitiated Vata and Kapha dosha in karnanadi the dravyas which are having Vata kaphahara property are used for instillation. Taila reduces rukshata and creates media

Purvakarma like Karna abhyanga with which has the Vikasi, Sukshma,

Guru and Sara properties it also as Bhrihana so nourishment of Shravanendriya improves hearing

aids the quick absorption ses blood circulation to ears.8

hich includes Rasayana chikitsa, as Badhirya manifests in Vardhakya, Rasayana and

further depletion of Dhatus and erves. Induvati, Sarivadi Vati,

Ashwagandha churna and Yogaraja Guggulu helps in ata dosha and strenghthen weakened

Vardhakyajanya Badhirya is more common among elder people now days because of more exposure to noisy environment, hereditary factors and along with risk factors contributes more. Diagnosis made on the base of history taking and Audiometry testing. Aural rehabilitation and its manangement in modern science has got limitation. The hearing devices are not suitable for all in such cases along with aural rehabilitation Prevention through dinacharya and Ayurveda chikitsa it can be managed. Karnapoorana is effective treatment in Badhirya along with Rasayana, Balya and Bhrihmaneeya Dravya.



References 1. Sushruta, Sushruta Samhita, Uttaratantra,

Karnagata roga vigyaniyam Adhyaya,20/8, Edited From Beginning To 9th Adhyaya Of Chikitsastana By Jadavji Trikamji Acharya And The Rest By Narayan Ram Acharya Kavyatirtha, Chaukhambha Orientalia, Varanasi, Reprint:

2. Nikolas H Belvins, MD, Presbyacusis upto http://www.uptodate.com.

3. P. L Dingra. Shruti Dingra; Diseases of Ear,and Throat & Haed and Neck surgery.Elsevier India Private Limited Reprinted2015. 5th chapter Hearing Loss. Page No 38.

4. Gajanan B. vPatil Phd Scholor,Vidyapeeta College of Ayurveda Pune, Maharastra, India. Review on Age Related



Sushruta, Sushruta Samhita, Uttaratantra, Karnagata roga vigyaniyam Adhyaya,20/8, Edited From Beginning To 9th Adhyaya Of Chikitsastana By Jadavji Trikamji Acharya And The Rest By Narayan Ram Acharya Kavyatirtha, Chaukhambha Orientalia, Varanasi, Reprint: 2012

Presbyacusis upto date

L Dingra. Shruti Dingra; Diseases of Ear, Nose and Throat & Haed and Neck surgery. Red Elsevier India Private Limited Reprinted-2014-

chapter Hearing Loss. Page No 38.

Patil Phd Scholor, Bharati Vidyapeeta College of Ayurveda Pune, Maharastra, India. Review on Age Related

Sensori-Neural DeafnessAyurvedic Approach. Asian Journals Multidisciplinary Studies. Vol

5. Aural Rehabilitation,en.wikipedia.org/wiki/Aural_rehabilitation.

6. Rjiv Amal, Jigisha Patel, Haridra conceptual Study of Karnapoorana of Nihl (Noise Induced Hearing Loss): International Journal of Medical Science andClinical Inventions Volume 3.

7. Shee Govinda Das, Bhaishajya Ratnavali Volume2, Karna roga chikitsa adhyaya 62 chapter.

8. Savita S. Angadi and Vijayakumar S.Kotrannavar: A case discussion on Presbyacusis: Journal of Auyrveda and Integrative Medicine. Elsevier.


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Neural Deafness (Badhirya) and its Ayurvedic Approach. Asian Journals of

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Aural Rehabilitation, @ Wikipedia en.wikipedia.org/wiki/Aural_rehabilitation.

Rjiv Amal, Jigisha Patel, Haridra Dave: A conceptual Study of Karnapoorana in Prevention

(Noise Induced Hearing Loss): of Medical Science and

Clinical Inventions Volume 3.

Shee Govinda Das, Bhaishajya Ratnavali Volume2, Karna roga chikitsa adhyaya 62 chapter.

Angadi and Vijayakumar S. Kotrannavar: A case discussion on Presbyacusis:

and Integrative Medicine.

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