Ayurvedic Management and Rehabilitation Therapy for Vardhakyajanya Badhirya

1. International Journal of Trend in International Open Access Journal International Open Access Journal | www.ijtsrd.com International Journal of Trend in Scientific Research and Development (IJTSRD) Research and Development (IJTSRD) www.ijtsrd.com ISSN No: 2456 ISSN No: 2456 - 6470 | Volume - 2 | Issue – 6 | Sep 6 | Sep – Oct 2018 Ayurvedic Management Ayurvedic Management and Rehabilitation Therapy for Vardhakyajanya Badhirya Therapy for Vardhakyajanya Dr. Ashwini Kumbar Ashwini Kumbar1, Dr. Suraj Kumbar2, Dr. A. M. Madni 1,2PG Scholar, 3Lecturer Shalakya Tantra, S. M. V. V’s R. K. M. Ayurveda Medical College Research Centre, Vijayapur, Karnataka, India f Panchakarma, SDM College of Ayurveda and 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. Badhirya is described under Karna ro Acharya Sushruta stated that v Kapha dosha causes margavarodha srotas 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,with individuals who will suffers signific from Presbycusis2. As per Ayurveda, Badhirya manifests by vitiated vata dosha and in old age there is predominance of Vata dosha leads to Vardhakyajanya Bhadi The risk factors for Presbya factors, environment, 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 area Schuknecht(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 Madni3 1,3Department of Shalakya Tantra, S. Hospital & Research Centre, Vijayapur, Karnataka, India 2Department of Panchakarma, SDM College M. Ayurveda Medical College, nd Hospital, Hassan, Karnataka, India ABSTRACT Karna is one among the important panchgyanendriya which perceives shabdha. These gyanendriya are acts like bridge for communication in socia 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 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 rehabilitation Hearing 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 is a sensorineural hearing loss associated with 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 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. 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 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. 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. acusis includes Genetic factors, Environmental Environmental ototoxicity, factors factors systemic like like –noisy 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 Vardhakyajanya Bhadhirya, Presbyacusis, Degeneration of the cells of starting at the basal coil and There is high tone loss as patient may or but speech discrimination is poor. may not be aware of the hearing loss in initial stage. It egeneration of the organ starting at the basal coil and progressing @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 603

2. International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470 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 movements. Audiogram is sloping type. Diagnosis of Presbaycusis includes history taking, examination and Audiometry i.e. screening and testing of central auditory system. Patients testing of central auditory system. Patients usually gradually to the apex. Higher frequencies are ted but speech discrimination remains good. trophy of stria vascularis in all presents, Deafness-Gradual bilateral symmetrical progressive hearing loss with varying degree to understand in a noisy environment and poor speech discrimination. Tinnitus-It accompanied with high frequency heari will 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 p becomes higher the hearing gets worsen. becomes higher the hearing gets worsen. Gradual bilateral symmetrical and with varying degree, difficult to understand in a noisy environment and poor speech It accompanied with high frequency hearing loss. There will be Speech distortion along with recruitment (+/-). physical and chemical is is at at initial initial stage stage process of energy production affected. Audigram is flat but speech discrimination is good. This is due to stiffening of the basilar membrane gram is sloping type. thus thus affecting affecting its its 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 history taking, screening and Hearing loss Assesment Hearing loss Assesment – WHO grades of hearing impairment4 4 Grade of Imapirement 0-No impairment 1-slight impairment 2-Moderate impairment 3- Severe impairment 4-Profound impairment Audiometric ISO value Audiometric ISO value Description Description 25dBHL or less 26-40dBHL 40dBHL 25dBHL or less Very slight hearing problem, able Able to hear and repeat wors spoken in normal voice at 1metre Able to hear and repeat words using raised voice at 1 metre Able to hear some words when Shouted into better ear. able to hear whispers Able to hear and repeat wors spoken 41-60dBHL 60dBHL 61-80 dBHL 80 dBHL 81dBHL or greater than 81dBHL or greater than that Unable to hear and understand Even a shouted voice. Prevention is better than treating Presbyacusis aging is irreversible and inevitable process in it leads to social isolation, feeling of social inferiority even they suffers from pshycological illness like depression as the aged people depends on hearing to overcome other disabilities at old age includes avoidance of noisy environment; gunshooting and high frequency music sounds. One gunshooting and high frequency music sounds. One 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 should go under routine systemic health check up to focus on risk factors and taking treatment for it. 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 implementation of different types of hearing rehabilitations. Aural rehabilitation is adopted in Age related sensory includes implementation of different types of hearing diagnosis diagnosis and and at old age. Prevention environment; reduce the @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 604

3. International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470 ?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 4 ventricle. 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 preventing disorders and the many reaserches effective results in treating Vardhakyanadi Badhirya. Karna pooran (instillation of medicated dravya in External auditory canal) is prime treatment modality adopted for Karna rogas Charaka ,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 managem Badhirya 6 ?Karnapoorana reduces the frequency of sound by reflecting and refraction of sound. Because sounds frequency and pressure changes from frequency and pressure changes from one medium here are many varieties of hearing aids are available which is used on the basis of type and configuration of hearing loss. Air to other medium thus its frequency reduces and disability decreases. ?According to Ayurveda K Vayu 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 inner which 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 K is indicated in vardhakyanadi Badhirya. As the Badhirya is manifestated because of vitiated Vata and Kapha dosha in karnanadi the dravyas having Vata kaphahara property instillation. Taila reduces rukshata and creates media for sounds. Purvakarma like Karna abhyanga with murchita tila taila which has the Vishad, 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 chikitsa as Badhirya manifests in Vardhakya Bhrihamna prevents further depletion of Dhatus and nourishes Nerves. Induvati, Ashwagandha churna and Yogaraja G pacifying the Vata dosha and strenghthen weakened nerves. Conclusion: Vardhakyajanya Badhirya is more common among elder people now days because of more exposure 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 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. 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 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 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 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 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 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 aids the quick absorption ses blood circulation to ears.8 are not actual solution for presbyacusis hich includes Rasayana chikitsa, as Badhirya manifests in Vardhakya, Rasayana and further depletion of Dhatus and erves. Induvati, Ashwagandha churna and Yogaraja Guggulu helps in ata dosha and strenghthen weakened Recurrent infections of external auditory canal and Sa Sarivadi Vati, Choclear implants may cause, Facial nerve palsy, Meningitis and has great role for preventing geriatric disorders and the many reaserches shown that 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. 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 @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 605

4. International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 rnal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470 References 1.Sushruta, Karnagata roga vigyaniyam Adhyaya,20/8, Edited From Beginning To 9th Adhyaya Of Chikitsastana By Jadavji Trikamji Acharya And The Rest By Narayan Ram 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 Reprinted 2015. 5th chapter Hearing Loss. Page No 38. 4.Gajanan B. vPatil Vidyapeeta College Maharastra, India. Review on Age Related Maharastra, India. Review on Age Related Sensori-Neural Deafness Ayurvedic 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 International Journal of Medical Science and Clinical Inventions Volume 3. 7.Shee Govinda Das, Volume2, Karna roga chikitsa adhyaya 62 chapter. 8.Savita S. Angadi Kotrannavar: A case discussion on Presbyacusis: Journal of Auyrveda and Integrative Medicine. Elsevier. Neural Deafness (Badhirya) and its Ayurvedic Sushruta, Karnagata roga vigyaniyam Adhyaya,20/8, Edited From Beginning To 9th Adhyaya Of Chikitsastana By Jadavji Trikamji Acharya And The Rest By Narayan Ram Chaukhambha Orientalia, Varanasi, Reprint: 2012 Sushruta Sushruta Samhita, Samhita, Uttaratantra, Uttaratantra, Approach. Approach. Asian Asian . Vol4. Journals Journals of Aural en.wikipedia.org/wiki/Aural_rehabilitation. Rehabilitation, @ Wikipedia Acharya Acharya Kavyatirtha, Kavyatirtha, Rjiv Amal, Jigisha Patel, Haridra Dave: A conceptual Study of Karnapoorana in Prevention (Noise Presbyacusis upto date Induced Induced of Medical Science and Hearing Hearing Loss): Loss): 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. Clinical Inventions Volume 3. Shee Volume2, Karna roga chikitsa adhyaya 62 chapter. Govinda Das, Bhaishajya Bhaishajya Ratnavali Ratnavali Angadi and and Vijayakumar Vijayakumar S. S. Patil Phd of of Phd Scholor, Ayurveda Ayurveda Scholor, Bharati Kotrannavar: A case discussion on Presbyacusis: and Integrative Medicine. Vidyapeeta College Pune, Pune, @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 606