Unilateral Hearing Loss (Single-Sided Deafness)

What is unilateral hearing loss?

Unilateral hearing loss is when something affects hearing in one of your ears but not the other. Even though you have hearing in one ear, having unilateral hearing loss affects your ability to figure out where sounds come from and understand what people are saying.

Your hearing loss in one ear may be mild, moderate, severe or worse. When you don’t have any hearing in one ear, you have severe/profound hearing loss (single-sided deafness). Unilateral hearing loss may be congenital (present at birth), develop over time or happen suddenly. Treatments like hearing aids and cochlear implants can help improve the hearing in your affected ear.

How common is unilateral hearing loss?

Experts estimate that 5% of all adults in the U.S. have some form of unilateral hearing loss. Most people have mild hearing loss. A very small percentage of people with this condition have severe/profound hearing loss (single-sided deafness). One in 1,000 babies born in the U.S. have congenital hearing loss, meaning the hearing loss was present at birth.

What are the symptoms of unilateral hearing loss?

Most unilateral hearing loss symptoms are the same as hearing loss that affects both of your ears. You may:

• Ask people to repeat themselves.
• Turn up the volume on your television, laptop or mobile phone.
• Have a hard time understanding conversations, especially when you’re in a noisy environment like a restaurant or busy office.

If there’s an issue with hearing in one of your ears, you may have tinnitus (ringing in your ear) in one ear but not the other. You may favor one ear over the other when you’re on the phone or in conversations.

Unilateral hearing loss typically develops over time, but it can also happen suddenly. Contact a healthcare provider if you suddenly lose hearing in one of your ears.

What causes unilateral hearing loss?

Experts don’t know all the reasons why people lose hearing in one ear. Reasons for hearing loss in adults tend to be different from causes in children. In children, there may be genetic causes or infections. Some possible causes include:

• Noise-induced hearing loss.
• Certain inherited disorders, including neurofibromatosis Type 2, which may cause acoustic neuromas in one ear.
• Being hit in the head.
• Traumatic brain injury (TBI).

Complications of unilateral hearing loss

Unilateral hearing loss complications include:

• Anxiety.
• Issues with localized hearing.
• Social isolation.

Children with unilateral hearing loss may have speech and language and behavior issues.

Localized hearing

Localized hearing is your ability to find where a given sound comes from. For example, say you’re waiting for the bus and there’s a car accident up the street on your left side:

• Your left ear registers the accident sounds — like metal crunching or blaring car horns — before your right ear does.
• Your left ear also registers the noise level, but your right ear doesn’t because your head blocks the sound waves coming from the left. Hearing experts may call this the head-shadow effect.
• When your right ear does register the noise, it reduces competing noise so your hearing can focus on the car accident noise. Experts may call this the squelch effect.
• Your hearing system transmits information to your auditory nerve, which then sends it up to your brain.
• Your brain translates the information into the sounds of the accident.

When your ears can’t work together, like coordinating car accident information, you don’t hear sound as you normally would. That can be the case whether you’re trying to follow a conversation with people talking all around you or you’re trying to cross a busy street with traffic coming from both sides.

How is unilateral hearing loss diagnosed?

A healthcare provider will ask about your symptoms and do a physical exam. They’ll check for signs of earwax, ear infection or other issues that may affect your hearing. They may do a CT scan or MRI if you hurt your ear or they think you may have a tumor in your ear. Once they rule out other causes, they’ll refer you to an audiologist. The audiologist will do hearing tests to find out if you have hearing loss.

How is unilateral hearing loss treated?

Treatment varies depending on what causes it and whether your unilateral hearing loss is mild, moderate or severe. Possible treatments are:

• Hearing aids: You’d wear a hearing aid in your non-hearing ear.
• Contralateral routing of signal (CROS) devices: This treatment uses two hearing devices. One is a hearing aid that you wear in your “hearing” ear. The other is a microphone that picks up the sounds in your non-hearing ear and sends them to your hearing ear.
• Cochlear implant: A cochlear implant may restore hearing in your non-hearing ear and may improve your ability to understand what people are saying to you and to localize sounds.
• Bone-anchored hearing aid: This treatment picks up the sounds in your non-hearing ear and sends them to your hearing ear by using a bone conduction device
• Frequency modulation (FM) systems: FM systems use radio waves to send speech and other signals from a microphone directly to a receiver, like a hearing aid you wear in your non-hearing ear.

Can unilateral hearing loss be prevented?

You may not be able to prevent the condition, but you can reduce your risk by protecting the hearing in both of your ears. Here are some suggestions:

• Use hearing protection (earplugs or earmuffs) during loud activities such as concerts, riding motorcycles or snowmobiles, or working with loud machinery.
• Lower the volume when you listen to music through headphones or earbuds. Keep the volume low enough for you to hear speaking around you. Another good rule is not to exceed 80% volume for more than 90 minutes a day.
• Don’t stick anything into your ear canal, including cotton swabs or hairpins. These objects could become lodged in your ear canal or cause an eardrum rupture.
• Avoid smoking, which can impair circulation and affect your hearing.
• Work regular physical activity into your daily routine to help prevent health issues like diabetes or high blood pressure that can cause hearing problems.
• Manage any chronic illnesses to help prevent further damage.

What can I expect if I have unilateral hearing loss?

Hearing aids and other treatments can help when there is a hearing loss. A cochlear implant can restore hearing in a non-hearing ear.

How do I take care of myself with unilateral hearing loss?

Treatment may improve your hearing, but it can still be challenging when you have hearing issues in one of your ears. There may be times when you can’t hear as well as you’d like. If that’s your situation, you may want to let people know you have unilateral hearing loss. That way, they’ll understand why you don’t always hear what they’re saying or hear sounds that they hear.

Unilateral hearing loss can affect your quality of life. Some people develop anxiety or become socially isolated. If that’s your situation, consider mental health support, like working with a counselor or psychologist.

When should I see my audiologist or hearing expert?

You should always see someone if you have concerns about hearing loss. Unilateral hearing loss may get worse over time, too. Contact your audiologist if you notice changes in hearing in your non-hearing ear and your hearing devices don’t improve your hearing.

What questions should I ask my healthcare provider?

If hearing tests show you have hearing loss in one ear, you may want to ask your provider the following questions:

• What’s causing my unilateral hearing loss?
• What can I do to improve my hearing?
• Will my hearing loss get worse?
• Will I lose the hearing in my other ear?

Does routine newborn screening always detect unilateral hearing loss?

Newborn hearing screening might miss this type of hearing loss. Without diagnosis and treatment, children with unilateral hearing loss may develop speech and language delays. Their teachers may notice that your child doesn’t always pay attention in class or has behavioral issues.