Examples of sociocusis-related stimuli are the continuous noises from traffic, home appliances, music, television, and radio. The accumulated exposure to these noises over many years can lead to a condition similar to pure presbycusis. Nosocusis
Nosocusis factors are those that can cause hearing loss, which are not noise-based and separate from pure presbycusis. They may include:
Ototoxic drugs: Ingestion of ototoxic drugs like aspirin may hasten the process of presbycusis. vascular degeneration
Atherosclerosis: May diminish vascularity of the cochlea, thereby reducing its oxygen supply. Dietary habits: Increased intake of saturated fat may accelerate atherosclerotic changes in old age. Smoking: Is postulated to accentuate atherosclerotic changes in blood vessels aggravating presbycusis. Diabetes: May cause vasculitis and endothelial proliferation in the blood vessels of the cochlea, thereby reducing its blood supply. Hypertension: causes potent vascular changes, like reduction in blood supply to the cochlea, thereby aggravating presbycusis.However, a recent study found that diabetes, atherosclerosis and hypertension had no correlation to presbycusis, suggesting that these are nosocusis (acquired hearing loss) factors, not intrinsic factors. Pathophysiology
Examples of microscopic changes seen in this condition are hair cell degeneration of the cochlea and giant stereociliary degeneration. There are four pathological phenotypes of presbycusis:

Sensory: characterised by degeneration of the organ of Corti, the sensory organ for hearing. Located within the scala media, it contains hair cells with stereocilia, which extend to the tectorial membrane. The organs outer hair cells play a significant role in the amplification of sound and is extremely sensitive to external and internal factors.
Osilodrostat, sold under the brand name Isturisa, is a medication for the treatment of adults with Cushings disease who either cannot undergo pituitary gland surgery or have undergone the surgery but still have the disease. It is taken by mouth.The most common side effects are adrenal insufficiency, headache, vomiting, nausea, fatigue, and edema (swelling caused by fluid retention).Hypocortisolism (low cortisol levels), QTc prolongation (a heart rhythm condition) and elevations in adrenal hormone precursors (inactive substance converted into a hormone) and androgens (hormone that regulates male characteristics) may also occur in people taking osilodrostat.Osilodrostat was approved for medical use in the European Union in January 2020, and for medical use in the United States in March 2020. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.Osilodrostat is an orally active, nonsteroidal corticosteroid biosynthesis inhibitor which was developed by Novartis for the treatment of Cushings syndrome and pituitary ACTH hypersecretion (a specific subtype of Cushings syndrome). It specifically acts as a potent and selective inhibitor of aldosterone synthase (CYP11B2) and at higher dosages of 11β-hydroxylase (CYP11B1). History
In October 2014, an orphan designation was granted by the European Commission for osilodrostat for the treatment of Cushings syndrome.Osilodrostat was approved for medical use in the European Union in January 2020, and for medical use in the United States in March 2020.Osilodrostats safety and effectiveness for treating Cushings disease among adults was evaluated in a study of 137 adult subjects (about three-quarters women) with a mean age of 41 years.