{"id":166,"date":"2019-07-03T11:09:14","date_gmt":"2019-07-03T17:09:14","guid":{"rendered":"https:\/\/santafeent.fm1.dev\/hearing-loss\/"},"modified":"2020-02-28T13:06:06","modified_gmt":"2020-02-28T20:06:06","slug":"hearing-loss","status":"publish","type":"page","link":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/","title":{"rendered":"Hearing Loss"},"content":{"rendered":"\n<h2>Reconnect with Quality Care<\/h2>\n\n\n\n<p><strong>Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)<br>Fellow in American Academy of Otolaryngic Allergy (1995)<\/strong><\/p>\n\n\n\n<p><strong>Let\u2019s begin the discussion with, \u201cHow do I know I have\na hearing problem?\u201d&nbsp; Well, in each of my\nENT exam rooms there is a poster that is titled, \u2018How is your hearing?\u2019<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"1280\" height=\"1978\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-1280x1978.jpg\" alt=\"\" class=\"wp-image-854\" srcset=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-1280x1978.jpg 1280w, https:\/\/santafeent.com\/wp-content\/uploads\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-768x1187.jpg 768w, https:\/\/santafeent.com\/wp-content\/uploads\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-994x1536.jpg 994w, https:\/\/santafeent.com\/wp-content\/uploads\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-scaled.jpg 1325w\" sizes=\"(max-width: 1280px) 100vw, 1280px\" \/><\/figure><\/div>\n\n\n\n<p>This is how the initial office\nvisit starts \u2013 in fact, both the Audiologist completing your hearing test (audiogram)\nand I will continue to ask about situations that seem to be associated with\nyour hearing difficulties.&nbsp; This is how\nwe get an idea of how to help you improve your hearing\u2026 more later.&nbsp; We will also ask about a variety of \u2018risk\nfactors\u2019 for hearing loss\u2026 some of these are pretty obvious:<\/p>\n\n\n\n<ul><li><strong>Noise Exposure<\/strong>\u2026\nwork related noise exposure, use of guns without hearing protection, exposure\nto loud music.&nbsp; (Parents\u2026 if you can hear\nthe music from your kid\u2019s headphones or ear buds \u2013 it\u2019s too loud!!!)&nbsp; This may now be the #1 cause of hearing loss.<\/li><li><strong>Age<\/strong>\u2026 30% of us\nover the age of 60 will have hearing loss\u2026 and it gets worse as we all get\nolder!<\/li><li><strong>Family History<\/strong>\u2026\nyour parents give you both the good and the bad!<\/li><li><strong>Medications<\/strong>\u2026\ncertain antibiotics and cancer (chemotherapy) medications are associated with\nthe loss of the inner ear \u2018hair cells\u2019 (see below). <\/li><li><strong>Health Conditions<\/strong>\u2026 acute illnesses such as severe infections or trauma may cause hearing\nloss.&nbsp; Poorly controlled high blood\npressure, diabetes, and high cholesterol are chronic health conditions that create\na higher risk of hearing loss.&nbsp; <\/li><li><strong>Outer Ear<\/strong>\ncanal conditions such as recurring ear wax impactions and chronic eczema of the\near canal skin create recurring problems with the sound wave passing to the ear\ndrum. (See ear diagram)<\/li><li><strong>Middle Ear<\/strong>\ninfections prevent the sound wave from passing efficiently from the ear drum,\nthrough the three hearing bones, and into the inner ear.&nbsp; (See ear diagram)<\/li><li><strong>Inner Ear <\/strong>conditions\nsuch as viral infections that cause the sudden loss of hearing, certain\nautoimmune diseases, an inner ear condition called Meniere\u2019s Syndrome that is\nassociated with progressive hearing loss and episodes of a severe spinning\nsensation (vertigo) \u2013 all can cause permanent loss of the \u2018hair cells\u2019 in the\ninner ear. (See ear diagram)<\/li><li><strong>\u2018Brain Problems\u2019<\/strong>&#8230;\none way to think about this possible cause of hearing problems is that the ear\ntakes the energy of sound waves and creates nerve energy for the brain to use \u2013\nbut its really the brain that \u2018hears and understands\u2019 the information present\nin the sound wave of speech, music, a car horn, or doorbell. &nbsp;This is such an important health problem that\nI\u2019ve included a separate discussion at the end of this page\u2026 see \u2018Hearing and\nthe Brain\u2019.<\/li><\/ul>\n\n\n\n<p>Following this initial\ndiscussion, I will examine your outer ear (auricle), ear canal (auditory canal)\nand eardrum (tympanic membrane).&nbsp; Many\ntimes I will need to use an operating microscope to clean your ear canal of ear\nwax (cerumen) before the Audiologist completes the hearing test (audiogram). <\/p>\n\n\n\n<p><strong>After we: 1) discuss how your hearing seems to be\naffecting your day-to-day activities; 2) discuss potential risk factors for\nyour hearing difficulties; and 3) examine your ear, I will have you walk over\nto the Southwestern Hearing Center to have the Audiologist complete a\ncomprehensive hearing test or AUDIOGRAM.&nbsp;\n<\/strong><\/p>\n\n\n\n<p><strong>However, before I move into\na discussion of how hearing is measured with an audiogram, I think I should\ndescribe the basics of how hearing works. <\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"423\" height=\"263\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/2.jpg\" alt=\"\" class=\"wp-image-838\"\/><\/figure><\/div>\n\n\n\n<ul><li>The information of\nsound and speech travels in the energy of a soundwave.<\/li><li>The soundwave\ntravels down your auditory canal to the eardrum (tympanic membrane) where the\nenergy of the soundwave moves the eardrum back and forth.<\/li><li>The movement of\nthe eardrum is then \u2018concentrated\u2019 by movement of the hearing bones (malleus,\nincus, stapes) down to the inner ear.<\/li><li>Inside the inner\near, the energy within the movement of the hearing bones stimulates the hair\ncells of the inner ear (cochlea). These hair cells have the ability to transform\nthe energy in the soundwave into nerve energy that the brain uses for hearing.<\/li><\/ul>\n\n\n\n<h2><strong>HEARING TEST OR AUDIOGRAM<\/strong><\/h2>\n\n\n\n<p>A couple of words about\nhearing tests or audiograms.&nbsp; The actual\nhearing test is conducted by an Audiologist.&nbsp;&nbsp;\nThe Audiologist is a healthcare professional with doctorate level degree\nin disorders of hearing and balance.&nbsp; The\nAudiologist\u2019s role in hearing and balance care may include:<\/p>\n\n\n\n<ul><li>assisting in the\ndiagnosis of your hearing and\/or balance problem by completing and interpreting\nmany of the diagnostic studies;<\/li><li>counseling\npatients on communication strategies that may be helpful in dealing with their\nhearing loss;<\/li><li>treating hearing\nloss by helping the patient use and manage the many hearing aid technologies\navailable.<\/li><\/ul>\n\n\n\n<p>For adults, the audiogram is a\n<strong>graph<\/strong> representing individual <strong>Frequencies<\/strong> (cycles of sound\/second) of\nsound that a human uses for speech <strong><em>compared to<\/em><\/strong> the <strong>Hearing Level<\/strong> (decibels) of how<strong>\nloud<\/strong> the noise or speech has to be for the patient to hear the sound.&nbsp; (Note: there other kinds of audiograms the\nAudiologist will use for infants and children younger than 5 years of\nage.)&nbsp; In order to understand the\ninformation on an audiogram, let\u2019s look at an <strong>\u2018Audiogram of Familiar Sounds\u2019<\/strong>:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"673\" height=\"801\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/3.jpg\" alt=\"\" class=\"wp-image-839\"\/><\/figure>\n\n\n\n<ul><li>Notice the frequencies\nof familiar sounds of our environment compared to how loud these sounds usually\nare in our day-to-day activities.&nbsp; For\ninstance, a loud rock and roll band is at 120 decibels.<\/li><li>Notice the\nfrequencies of individual speech sounds\u2026 f, s and th sounds are consonant\nsounds of speech at the \u2018higher\u2019 frequency of 4,000 Hz and usually \u2018quiet\u2019\ndecibel level of 20 dB.<\/li><li>Notice the grey\nshaded \u2018speech banana\u2019 that represents the frequency and hearing level for\nnormal human conversation.&nbsp; This speech\nbanana is what we compare to your own graph on the audiogram.<\/li><\/ul>\n\n\n\n<h3>Audiogram: Levels of Hearing Loss<\/h3>\n\n\n\n<ul><li>This is an actual audiogram\nfrom our office showing normal hearing.&nbsp;\nNote the markings for the right ear (O) and the left ear (X).&nbsp; Again, it represents a graph of <strong>how loud <\/strong>the sounds and speech need to\nbe for you to be able to hear them for the individual <strong>frequencies of speech<\/strong>.&nbsp; &nbsp;0 dB is \u2018quiet\u2019 and 120 dB is really loud; for\nthe frequencies, 125 is a low frequency sound (vowels), and 8,000 (8k) is a\nreally high frequency sound (consonants).<\/li><li>Also on this graph\nis the \u2018speech banana\u2019 (irregular box shaped area) mentioned previously\u2026 this\nis the range of normal conversation, for the most part between 20db and 50db\nloudness.<\/li><li>The other important\naddition to audiogram is the \u2018<strong>Speech\nDiscrimination\u2019<\/strong>.&nbsp; This is measure of\nhow well <strong>your brain understands<\/strong>\nspeech.&nbsp; It\u2019s not a perfect test, as it\nmeasures only the percent of words you understand in the quiet of a hearing\nbooth\u2026 it doesn\u2019t measure what happens in the conversations of a party or in\nthe loud background noise of a restaurant.<\/li><li>Lastly, note the\nmarkings of <strong>Normal, Mild, Moderate,\nModerate-to-Severe, Severe and Profound <\/strong>on the left side of the graft.&nbsp; These represent the \u2018Levels of Hearing Loss\u2019\npresent for everyday sounds and speech.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"685\" height=\"695\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/4.jpg\" alt=\"\" class=\"wp-image-840\"\/><\/figure><\/div>\n\n\n\n<p>After the Audiologist\ncompletes your audiogram you will return back to my office to discuss your\naudiogram.&nbsp; The audiogram will likely\nshow four possible patterns:<\/p>\n\n\n\n<ul><li><strong>Normal Hearing<\/strong>\nas shown by the first audiogram.<\/li><li>Problems with the <strong>outer\/middle ear <\/strong>function<strong>, <\/strong>where the auditory canal, eardrum or\nhearing bones are not able to effectively conduct sound to the inner ear.&nbsp; Reasons for this type of hearing loss\n(conductive hearing loss) would be ear wax in the auditory canal, fluid behind\nthe eardrum, a perforation of the eardrum, or fixation of hearing bones from\nscar tissue of recurring ear infections.&nbsp;\nMost of these conditions can be managed by medications or surgery.<\/li><li>Problems with the <strong>inner ear<\/strong> function, where the inner ear\nis not able to take the energy in a sound wave and create nerve energy for the\nbrain to use for understanding sound and speech.&nbsp; The most common reasons for this type of\nhearing loss (sensorineural hearing loss) would be age, genetics, and excessive\nnoise exposure<strong>.&nbsp; This type of hearing loss can be improved by\nthe use of hearing aids.<\/strong><\/li><li>A combination of\nthe last two\u2026 having both a conductive and sensorineural problem.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"260\" height=\"194\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/5.jpg\" alt=\"\" class=\"wp-image-841\"\/><\/figure><\/div>\n\n\n\n<p><strong>However, over 90% of the patients we see will have\nproblems of the inner ear\u2026 usually due to the combined effects of aging,\ngenetics and noise exposure.&nbsp; So, let\u2019s\ntake a look at a series of audiograms for this group of patients.<\/strong><\/p>\n\n\n\n<p><strong>Along with the first normal audiogram, the following\ntwo audiograms show the \u2018progression of hearing loss\u2019 with the inner ear not\nable to hear sounds and the brain not able to understand human speech (Speech\nDiscrimination).&nbsp; <\/strong><\/p>\n\n\n\n<p>I want to repeat two important\npoints about the audiogram: <\/p>\n\n\n\n<ol><li>The ability to\nhear sounds is represented by the (O) marks for the right ear and the (X) marks\nfor the left ear.&nbsp; <\/li><li>The brain\u2019s ability\nto understand human speech is represented by the <strong>Speech Discrimination<\/strong> score, or the percent of words you understand\nin the audio booth.&nbsp; <\/li><\/ol>\n\n\n\n<p>And remember, the Speech\nDiscrimination score is not perfect\u2026 it doesn\u2019t really accurately reflect what\nyou are understanding in the noisy restaurant.&nbsp;\n&nbsp;I\u2019ll come back to the brain issue\nafter we look at the next two audiograms showing the \u2018progression of hearing\nloss\u2019 present in my family.<\/p>\n\n\n\n<h3>Mild\/Moderate Hearing Loss<\/h3>\n\n\n\n<ul><li>This is my\naudiogram at age 65.&nbsp; I have normal\/mild\nhearing loss in the lower frequencies and drop down to a moderate hearing loss\nbetween 2,000 \u2013 8,000 Hz.&nbsp; <\/li><li>I have problems in\ngroups, at parties, and restaurants;&nbsp; I\nhave to concentrate on facial expressions and \u2018lip movements\u2019 to understand\nsome conversations; I sometimes miss words even during one-on-one\nconversations; I may commonly ask people to repeat themselves.<\/li><li>Notice that my\nSpeech Discrimination score was only 88% for the left ear.&nbsp; This means I\u2019m starting to have \u2018brain problems\u2019\nunderstanding speech.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"671\" height=\"695\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/6.jpg\" alt=\"\" class=\"wp-image-842\"\/><\/figure>\n\n\n\n<h3>Moderate\/Severe Hearing Loss<\/h3>\n\n\n\n<ul><li>This was my\nmother\u2019s audiogram at age 84\u2026 she had been wearing hearing aids for about 12\nyears.&nbsp; (Yes, part of my hearing issue is\ngenetic.)<\/li><li>Unless she was\nwearing her hearing aids, she found it impossible to understand conversations\nin groups or restaurants;&nbsp; telephone\nconversations were difficult; unless she was wearing her hearing aids, she would\nnot even hear the doorbell ring.<\/li><li>Her Speech\nDiscrimination score was 80%&#8230; in the quiet of a hearing booth.&nbsp; It was a lot worse when there was the\nbackground noise of a party or at a restaurant.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"681\" height=\"695\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/7.jpg\" alt=\"\" class=\"wp-image-843\"\/><\/figure>\n\n\n\n<h2>HEARING&nbsp; AND THE BRAIN<\/h2>\n\n\n\n<p>Five years ago, I produced my\nfirst article on hearing loss and how your ENT physician and audiologist team\nevaluate your hearing and then work towards improving hearing and quality of\nlife.&nbsp; The article also introduced\ninformation on one aspect of hearing loss that was not widely appreciated \u2013 the\nassociation of age-related hearing loss (presbycusis) with dementia; dementia\nbeing described as an abnormal loss of memory and ability to think clearly\n(cognition).&nbsp; Since my last article there\nhas been an ongoing push to better understand how hearing loss, cognition and\ndementia are related, as well as proving what seems to be common sense \u2013 how\nhearing aids can improve age related hearing loss, quality of life, and how to\nslow down or prevent dementia.&nbsp; To build\non what I wrote five years ago I am going to add additional information from\narticles in the medical literature.&nbsp; <\/p>\n\n\n\n<p><strong>First, what is known about\nthe association of hearing loss, cognition and dementia?&nbsp; <\/strong><\/p>\n\n\n\n<p>To paraphrase from articles\nwritten by Frank Lin MD, an ear specialist at Johns Hopkins University:<\/p>\n\n\n\n<ul><li>Individuals with a\nmild hearing loss have twice the risk of developing dementia; those with\nmoderate hearing loss have three times the risk of developing dementia; and\nthose with severe hearing loss have five times the risk of developing dementia.<\/li><li>Hearing impairment\nis associated with a 30-40% rate of accelerated cognitive decline.<\/li><li>Hearing loss is\nassociated with a decrease in actual brain volume in the part of the brain\nassociated with hearing.<\/li><li>Hearing loss is\nknown to cause individuals to isolate themselves from family and friends.&nbsp; This loss of social engagement and resulting\ndepression is a major problem for those of us trying to maintain good health as\nwe age.&nbsp; <\/li><li>There are common\nrisk factors that impact both the cochlea of the ear and the brain.&nbsp; These would include age, vascular risk\nfactors such as high blood pressure, diabetes and smoking, and the level of\neducation and ability to compensate for loss of hearing and cognition. <\/li><li>Hearing loss may\nbe a thought of as a \u2018second hit\u2019 on the brain, with the overall effect of\nhearing loss adding to the decrease in cognitive performance associated\nwith other brain problems such as Alzheimer\u2019s and vascular risk factors.<\/li><\/ul>\n\n\n\n<p><strong>Hearing loss is clearly \u2018associated with dementia\u2019.&nbsp; But, this is different than saying, \u2018hearing\nloss causes dementia\u2019.<\/strong>&nbsp; &nbsp;At\nthis time, while hearing loss has not been shown to cause dementia, a 2017\narticle in The Lancet, titled \u2018<strong>Dementia\nPrevention, Intervention and Care\u2019<\/strong>, postulated that hearing loss was the\nlargest <strong>\u2018modifiable risk factor\u2019<\/strong> for\ndementia in patients over the age of 55.&nbsp;\n(Other modifiable risk factors are level of education, high blood\npressure, obesity, smoking, depression, physical inactivity, social isolation,\nand diabetes.) &nbsp;One theory of aging and\nhearing research suggests that hearing loss makes the brain use its \u2018cognitive\nreserves\u2019 in its effort to understand the world around us.&nbsp; In other words, hearing loss makes our brain\nwork extra hard to understand what is going on in our immediate\nsurroundings.&nbsp; But as our brain does all\nthis extra work associated with our hearing loss, we damage other brain\nfunctions such as memory and the ability to interact socially.&nbsp; The end result of combining hearing loss with\naging and dementia is that we pull away from world \u2013 social isolation leading\nto depression, etc.&nbsp; <\/p>\n\n\n\n<p><strong>So\u2026 if hearing loss is the\nlargest \u2018modifiable risk factor\u2019 \u2013 usually modified by the use of hearing aids\n\u2013 what current evidence is there that hearing aids improve cognitive function\nor decrease the risk of dementia?<\/strong><\/p>\n\n\n\n<ul><li>A University of\nMichigan team published a 2016 article in the <em>Journal of the American Geriatrics Society<\/em> postulating that\nolder adults who get hearing aids for newly diagnosed hearing loss have a lower\nrisk of being diagnosed with dementia (18% lower), depression or anxiety (11%\nlower), and a decrease in the risk for falls (13% lower) for at least the next\nthree years.&nbsp; <\/li><li>A 2015 British\nstudy looked at, \u2018Hearing Loss and Cognition: The Role of Hearing Aids, Social\nIsolation and Depression\u201d.&nbsp; Their\nstudy postulated that hearing aid use was associated with better cognition, and\nwas independent of the effects of social isolation and depression.<\/li><li>Following the\nLancet study which postulated that hearing loss was the largest modifiable risk\nfactor for preventing dementia, a study titled, \u2018Wearing Hearing Aids May\nProtect Brain Later in Life\u2019 came out of the University of Exeter.&nbsp;&nbsp; The group of patients who wore hearing\naids performed better in measures assessing working memory and aspects of being\nable to pay attention than those who did not wear hearing aids.<\/li><li>Another\narticle showing only the association between hearing aids and improved\ncognitive function, was \u201cSelf-Reported Hearing Loss: Hearing Aids and Cognitive\nDecline in Elderly Adults: A 25-year Study\u201d,published in the October edition of\nthe&nbsp;<em>Journal of the American Geriatrics\nSociety<\/em>.&nbsp; They compared the trajectory of cognitive\ndecline among older adults who were using hearing aids and those who were not. The\nstudy found no difference in the rate of cognitive declinebetween people with no reported hearing loss and people with\nhearing loss who used hearing aids.&nbsp;<\/li><li>Lastly, the\nresults of the ACHIEVE (Aging and Cognitive Health Evaluation in Elders) study\nlooking at hearing aid treatment for reducing cognitive decline is ongoing at\nJohns Hopkins University (Drs Lin and Coresh).&nbsp;\nEstimated time with results\u2026 sometime in 2022.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"1280\" height=\"720\" src=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/8-1280x720.jpg\" alt=\"\" class=\"wp-image-844\" srcset=\"https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/8-1280x720.jpg 1280w, https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/8-768x432.jpg 768w, https:\/\/santafeent.com\/wp-content\/uploads\/2020\/01\/8.jpg 1333w\" sizes=\"(max-width: 1280px) 100vw, 1280px\" \/><\/figure><\/div>\n\n\n<p>Call <span class=\"company-name \">David R Brown MD Ear, Nose and Throat<\/span> at <a href=\"tel:+15058209945\" class=\"phone \"> <span class=\"phNum\">(505) 820-9945<\/span><\/a> for more information or to schedule an appointment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995) Let\u2019s begin the discussion with, \u201cHow do I know I have a hearing problem?\u201d&nbsp; Well, in each of my ENT exam rooms there is a poster that is titled, \u2018How is your hearing?\u2019 This&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":206,"menu_order":20,"comment_status":"closed","ping_status":"closed","template":"","meta":{"schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":""},"service_tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hearing Loss - David R Brown MD Ear, Nose and Throat<\/title>\n<meta name=\"description\" content=\"(505) 820-9945 | Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hearing Loss - David R Brown MD Ear, Nose and Throat\" \/>\n<meta property=\"og:description\" content=\"(505) 820-9945 | Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995)\" \/>\n<meta property=\"og:url\" content=\"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/\" \/>\n<meta property=\"og:site_name\" content=\"David R Brown MD Ear, Nose and Throat\" \/>\n<meta property=\"article:modified_time\" content=\"2020-02-28T20:06:06+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/[uploads]\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-1280x1978.jpg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"13 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Hearing Loss - David R Brown MD Ear, Nose and Throat","description":"(505) 820-9945 | Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995)","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/","og_locale":"en_US","og_type":"article","og_title":"Hearing Loss - David R Brown MD Ear, Nose and Throat","og_description":"(505) 820-9945 | Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995)","og_url":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/","og_site_name":"David R Brown MD Ear, Nose and Throat","article_modified_time":"2020-02-28T20:06:06+00:00","og_image":[{"url":"[uploads]\/2020\/02\/david_brown_md_how_is_your_hearing_poster_11x17_v1-1280x1978.jpg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"13 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/","url":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/","name":"Hearing Loss - David R Brown MD Ear, Nose and Throat","isPartOf":{"@id":"https:\/\/santafeent.com\/#website"},"datePublished":"2019-07-03T17:09:14+00:00","dateModified":"2020-02-28T20:06:06+00:00","description":"(505) 820-9945 | Reconnect with Quality Care Board Certified in Otolaryngology \u2013 Head &amp; Neck Surgery (1987)Fellow in American Academy of Otolaryngic Allergy (1995)","breadcrumb":{"@id":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/hearing-loss\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/santafeent.com\/"},{"@type":"ListItem","position":2,"name":"Ear &#038; Hearing","item":"https:\/\/santafeent.com\/ear-hearing\/"},{"@type":"ListItem","position":3,"name":"Hearing Loss Overview","item":"https:\/\/santafeent.com\/ear-hearing\/hearing-health\/"},{"@type":"ListItem","position":4,"name":"Hearing Loss"}]},{"@type":"WebSite","@id":"https:\/\/santafeent.com\/#website","url":"https:\/\/santafeent.com\/","name":"David R Brown MD Ear, Nose and Throat","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/santafeent.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/pages\/166"}],"collection":[{"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/comments?post=166"}],"version-history":[{"count":12,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/pages\/166\/revisions"}],"predecessor-version":[{"id":856,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/pages\/166\/revisions\/856"}],"up":[{"embeddable":true,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/pages\/206"}],"wp:attachment":[{"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/media?parent=166"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/santafeent.com\/wp-json\/wp\/v2\/service_tags?post=166"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}