**5. Discussion**

Hearing loss subtopics indicated that users posted about the relationship between hearing loss and hearing loss-related disease. The themes of sudden deafness, noise-induced hearing loss, and otitis media, and related complications of diseases are covered by hearing loss-related disease. Sudden deafness and otitis media themes show that users searched for social Q&A about the cause of diseases, treatment options, and side e ffects of the medicine. These topics confirmed that people are not well-informed about their medications. Notably, sudden deafness is considered an otologic emergency. Patients with sudden deafness can recover from the hearing loss problem if they receive appropriate treatments promptly. Prior studies reported that treatment within seven days of the onset of sudden deafness is e ffective for better hearing recovery [61]. The standard gold treatment of sudden deafness is oral high-dose corticosteroids [62]. Our findings reveal that users want to ge<sup>t</sup> the information and are worried about the side e ffect of the steroids, which means that patients did not ge<sup>t</sup> the information about their treatment and medicine.

In the theme complications, we found several keywords are related to diseases, including diabetes, anemia, cancer, thyroid, hepatitis, and kidney disease. The medications for these diseases have side

effects that can cause hearing loss. Based on our findings, health providers, such as physicians, did not give enough information about treatment and medicine. Lee et al. [63] indicated that the average real consultation time for outpatients was 4.2 min in Korea, and patient satisfaction was too low regarding consultations. This consultation time is not long enough to ask questions about their treatments. The physicians need to ensure that they have enough consultation time for e ffective communication.

On the other hand, noise-induced hearing loss is a slow-occurring hearing loss. In subtopics of noise-induced hearing loss, users post about the causes of hearing loss, such as loud noise exposure and the usage of listening devices with headphones. People wonder how much loud noise exposure causes hearing loss. Exposure to noise increases the risk of tinnitus, as well. Noise-induced hearing loss is the only preventable loss, so education on the usage of a safe listening device is necessary [64]. For preventing noise-induced hearing loss, people are advised to avoid listening to loud music or noise above 85 dB (A) for no longer than 1 h. People need to avoid listening to music because it increases the volume when they listen to it under noisy circumstances. Interestingly, in these subtopics, we found keywords related to the military. Military personnel exposed to significant impulse noise. For this reason, in social Q&A, many people seek information about the relationship between hearing loss and military noise. The hearing conservation program needs to be developed adequately to ensure the health of military personnel in Korea.

Next, users posted the relationship between hearing loss and symptoms of hearing loss, tinnitus, and dizziness. The highest subtopics are related to tinnitus. Tinnitus is a symptom associated with ear disease, including hearing loss, but tinnitus does not cause hearing loss. More than 50 million people, with an estimated prevalence of 10–15% in adults, reported that they experienced tinnitus in the U.S. [65]. The keywords related to hearing loss indicated that people want to know about the cause of tinnitus, medicines, and di fficulties caused by tinnitus. The findings show that people want to find a way to cure tinnitus. However, the treatment of tinnitus focuses on minimizing the impact and burden of tinnitus rather than the "cure" of tinnitus [65]. There are several rehabilitation methods for relieving tinnitus, such as counseling and sound therapy. Additionally, there are applications that patients can use to alleviate their tinnitus. Health providers need to inform the options of tinnitus relief.

Tinnitus is a symptom that people feel chronically, while dizziness is a symptom that people feel acutely. Our results reveal several keywords related to the symptoms of Ménière's disease. Ménière's disease is a disorder of the inner ear that leads to dizziness and sudden hearing loss. The a ffected ear may lead to progressive or permanent hearing loss [49]. Other distinct symptoms of Ménière's disease include tinnitus, migraines, and nausea. Ménière's disease is hard to diagnose because not all of the signs are shown at the early stage [50]. The patients who feel dizziness need to visit the Ear, Nose and Throat (ENT) doctor and check their conditions.

Lastly, people want to search for information about the treatment options of hearing loss, such as hearing aids and cochlear implants. Hearing aid usage is the most common treatment to reduce the adverse e ffects, including communication di fficulties and cognitive decline, caused by hearing loss [66]. In addition, the use of hearing aids improves productive time use, quality of life, economic circumstances and mental health for listeners with hearing loss [67]. In our results, people searched for information on hearing aid benefits or the specification of hearing aids. Additionally, they searched about brands of hearing aids and reasonable prices for hearing aids. They also asked for recommendations regarding good hearing aid centers. Since the national insurance subsidizes all or part of the cost of purchasing hearing aids or cochlear implants for hearing impairments in Korea, users search the information about disability degree and national insurance benefit. This information should be provided to websites so that those who want to use hearing aids can accurately check the price and specifications of hearing aids and ge<sup>t</sup> national insurance benefits.
