Presbyacousis is deafness caused by degenerative changes in the auditory system that occur with aging. The lesions are mainly in the cochlea, but may also involve the auditory nerve, middle ear or auditory cortex. Aging is a fact that no one can resist, so why do some elderly people go deaf and others do not? To explain this phenomenon, we have to start with the etiology of age-related deafness. There are many factors that contribute to age-related deafness, which can be broadly divided into two main categories: first, intrinsic factors, including, genetic factors and systemic factors. Genetic factors play an important role in the aging of the auditory organs, and the age of onset and speed of onset of senile deafness are largely related to genetic factors. Systemic factors include emotional stress, certain chronic diseases such as hypertension, hyperlipidemia, coronary heart disease, diabetes, liver and kidney insufficiency, etc. Another group of external factors are external factors such as environmental noise, high fat diet, smoking and alcohol abuse, exposure to ototoxic drugs or chemicals, infections, etc. All these factors can trigger or aggravate the development of age-related deafness. The aging of the auditory system is the result of tissue aging, and cellular aging may be related to the accumulation of metabolic wastes in the cells that affect their activity. Histological changes are predominantly cochlear damage, manifesting as degeneration of hair cells, vascular striae, supporting structures and spiral ganglion cells, but can also be caused by degeneration of middle ear structures and/or degeneration of the central auditory nerve.