What It Is, Who It Affects, and Which Treatments Can Help
If you’ve ever found yourself struggling to hear in one ear but not the other, you’re not alone. It’s a less well-known type of hearing loss called single-sided hearing loss.
In this article, we’ll explain what it is, who it affects, what causes it, and what treatments can help.
Whether you’re exploring options for yourself or a loved one, this guide can help you make more informed choices.
What Is Single-Sided Hearing Loss?
Single-sided, or unilateral, hearing loss (SSHL) is when you have a hearing loss in one ear while your other ear hears normally or almost normally. It’s called single-sided deafness (SSD) if your single-sided hearing loss is severe (or worse).
Hearing care professionals don’t all use the same name or definition for SSD, which can make diagnosis and treatment confusing. But in general, SSD is recognized as a significant loss of hearing in one ear, with the other ear working well.
Who Is Affected by Single-Sided Hearing Loss?
Though SSHL is less well-known, it isn’t rare — about 7 in every 100 U.S. adults has it. SSD is less common, occurring in only about 345,064 adults at any given time.
SSD is much more common in older adults, especially between the ages of 60 and 79. Hearing tends to change with age, sometimes unevenly.
Children can also be affected by SSHL, but it’s much less common. In the past, it in children was often missed until they were much older, especially before universal newborn hearing screening became standard.
Today, more cases are caught early, which helps children get treatment sooner. In this article, we’ll focus on adults.
What Causes Single-Sided Hearing Loss?
There are many possible causes of SSHL, such as chronic ear infections, physical trauma, or the following:
Sudden hearing loss
This is a rapid loss of hearing, often with no clear reason (called idiopathic). It can happen instantly, or it might take a few days. The sooner the diagnosis, the sooner the narrow window for treatment can begin.
Ménière’s disease
Ménière’s disease is a disorder of the inner ear. It causes a variety of symptoms, such as vertigo, hearing loss, and tinnitus (ringing in the ears or head). Vertigo attacks are often sudden and can last from a few minutes to several hours.
Autoimmune conditions
Some autoimmune disorders can affect your hearing, such as rheumatoid arthritis, lupus, and Cogan’s syndrome, in which your body’s immune system mistakenly attacks your eye and ear tissues.
Benign tumors
A rare, noncancerous tumor called a vestibular schwannoma (or acoustic neuroma) can develop on the main nerve connecting your inner ear to your brain. If the tumor puts too much pressure on the nerve, it can affect your balance and your hearing.
Why Two Ears Are Better Than One
You might be thinking, “Hearing loss in only one ear? No need for hearing aids!” After all, you have a whole other ear that hears just fine.
But having two ears isn’t just about louder hearing — it’s about better, safer hearing. Hearing with two ears — known as binaural hearing — lets your brain use input from both sides of your head to understand the world around you. Binaural hearing helps you:
- Tell where sounds are coming from
- Focus on one voice in a crowd
- Avoid fatigue from straining to hear
- Stay safe by hearing alarms or approaching dangers
When one ear isn’t working, your brain can’t do these things as well. That’s why treatment — even if it doesn’t fully restore hearing — can greatly improve your comfort and confidence.
How Single-Sided Hearing Loss Affects Everyday Life
Hearing with only one ear can make daily life harder than you might expect. It affects:
Sound localization
Suppose a car horn honks on your left side. The sound will reach that ear first, then the right ear. Your brain uses that difference in timing to help determine where the horn is coming from. It can’t do that as well with SSHL.
Speech understanding in noise
Conversations in noisy environments, like restaurants or crowded rooms, become much harder to navigate when your brain only has input from one ear. Voices often get lost in the noise.
Spatial awareness
Hearing allows you to know what’s happening around you. SSHL can cause you to miss important cues like someone calling from behind you. Worse, you could miss an important sound like a doorbell or alarm clock.
Head shadow effect
Especially with SSD, sounds coming from the deaf side get blocked by your head, reducing sound quality even further.
Binaural summation and squelch
These are the brain’s ways of combining sound from both ears to make listening easier. When one ear is lost, these benefits disappear.
Quality of life
All of this can lead to frustration, social withdrawal, and reduced quality of life.
Treatment Options for Single-Sided Hearing Loss
The good news is there are treatment options for those with SSHL. Getting the right care early can make a big difference. Treatment depends on whether your SSHL is mild, moderate, or SSD and how quickly it is identified.
Hearing aids
If your hearing loss is mild enough, a hearing aid in only one ear might suffice.
CROS hearing aids
If your hearing loss is severe enough, a device called a CROS — contralateral routing of signal — may be a good option. The CROS gathers sound on your deaf side and sends it wirelessly from the deaf ear to the better-hearing ear.
This option is good for those who want a simple solution without surgery. It’s easy to use and helps with lateralizing sound, but it doesn’t restore true binaural hearing.
Osseointegrated devices
Another option for more severe cases is an osseointegrated device. It gathers sound on your deaf side and sends it through the bones of your skull to your good ear. It helps bypass the head shadow effect and improves sound clarity.
The device can be percutaneous (through the skin), transcutaneous (under the skin), adhesive, or surgically implanted. Like the CROS, this doesn’t restore true binaural hearing.
Cochlear implants
For people with SSD, a cochlear implant is the only treatment that can offer binaural hearing. A cochlear implant bypasses the damaged parts of your inner ear and directly stimulates your auditory nerve.
Compared to other options, this offers better speech understanding (especially in noise), ability to pinpoint sounds, control of tinnitus, and overall quality of life.
Not everyone is a candidate, though. You need a detailed consultation with a specialist that includes:
- All treatment options
- What happens without treatment
- What to expect during recovery
- Whether auditory rehabilitation will be needed
Final Thoughts
If this sounds like you or a loved one, you’re not alone. Effective treatments are available. Whether you’re using a hearing aid, exploring a cochlear implant, or just starting your journey, talking to an audiologist is the best first step.
Better hearing in both ears means better conversations, more awareness, and a richer life. Don’t wait to explore your options — contact us today.