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Understanding Unilateral Hearing Loss (Single-Sided Deafness) | A Guide

In this guide we will talk about:

  1. What UHL & single-sided deafness is
  2. Symptoms & causes
  3. Treatment & prevention
  4. Living with unilateral hearing loss
  5. FAQs


Jump to the section you want or read on to get started:

A man with unilateral hearing loss

Unilateral hearing loss (UHL) is a problem that reduces the amount you can hear out of one ear. It might only be a minor problem — or it can develop to a point where some people cannot hear at all. When the hearing loss is severe like this, audiologists also refer to it as single-sided deafness (SSD). 

Some people are born with UHL. Many others develop it later in life, and it can come about suddenly or gradually. Most of the time, it is a hearing loss in one ear with no pain.

Unilateral hearing loss is more common than you might imagine. For example, one study found that 7.2% of adult Americans had UHL and that most of these people are suffering without adequate forms of treatment. 

What is unilateral hearing loss?

If you can’t hear out of one ear, or if your hearing is poorer in one ear than it is in the other, then you have unilateral hearing loss. 

UHL is different from bilateral hearing loss, which is where the hearing loss affects both ears and not just the one. It can affect both adults and children.

UHL goes by many different names and may also be called:

Single-sided hearing loss

One-sided hearing loss

Single-sided deafness (if the hearing loss is severe or profound)

Unilateral sensorineural hearing loss

Unilateral conductive hearing loss

What is single-sided deafness?

If your UHL is really bad (‘severe’ or ‘profound’) then it might be classed as single-sided deafness. In these instances, you might hardly be able to hear out of one ear or not at all. 

SSD is also sometimes called by different names. Including:

Monaural hearing

Unilateral deafness

Unilateral hearing loss symptoms

The following signs and symptoms are common with UHL and SSD sufferers:

 

Using one ‘favourite’ ear over the other for conversations 

Tinnitus (a ringing sound) in only one ear

Having trouble figuring out where sounds are coming from

Difficulty listening when people talk to you on the ‘wrong’ side

Difficulty filtering our noises in crowded places

Higher-pitched sounds seem deadened or muffled 

Feeling tired after trying to listen to people all day

What causes deafness in one ear?

There are a number of reasons why you may be partially deaf in one ear. The most common unilateral hearing loss causes are:

  • An infection (viral or bacterial)

  • A build-up of earwax in one ear

  • Trauma/damage to the ear

  • Head injury/trauma

  • A genetic problem inherited from a family member

  • An issue with the circulatory system

  • Meniere’s disease

  • A benign brain tumour (acoustic neuroma)

Sometimes a combination of more than one of these factors is the cause of unilateral deafness. Remember, however, that it isn’t always possible for audiologists to determine why it happens. 

If you are experiencing additional symptoms such as facial weakness, problems with your balance, dizziness, or neurological problems — see your doctor immediately.

How is hearing loss in one ear treated?

It depends on what caused the UHL in the first place, and also the severity of the hearing loss. For example, if you suspect earwax is the reason, then you might be able to treat it using simple over-the-counter earwax removal products. 

Other treatments for hearing loss in one ear may include:

Most cases of unilateral hearing loss can be managed or improved. But not always. Some instances of single-sided hearing loss may be irreversible. We strongly recommend getting a doctor to examine you — and not just an audiologist — to try and get to the bottom of the problem. 

The chances are, your doctor will recommend a hearing aid, or for you to speak to an audiologist, if there is nothing they can do to treat your UHL.

Treating unilateral hearing loss with CROS and BiCROS hearing aids

If you can still hear out of the affected ear, even if not by much, then your UHL might be treatable with normal hearing aids

But if you have severe hearing loss in one ear, or single-sided deafness, then a CROS hearing aid may be the best option. CROS stands for ‘Contralateral Routing of Sound’. These hearing aids pick up sound in the deaf ear and send them to the ear that’s still working. 

CROS hearing aids are available wireless and also wired, in which case the wire sits behind the neck. They tend to work best if the hearing in your working ear is at full strength. If you also have diminished hearing in your other ear, but mostly still have unilateral hearing loss, then BiCROS hearing aids may be the best option. 

Our audiologists will come to your home, at a time convenient to you and free of charge, to perform a hearing test that will determine whether you’re suited to regular hearing aids, or CROS or BiCROS types — or if another form of treatment is recommended.

Click here for more information on CROS & BiCROS hearing aids. And here to find out what to expect from one of our audiology tests here.

Why it’s important to treat UHL and single-sided deafness:

The brain ideally needs to get sensory input from both ears in order to hear as best as it can. When both ears are working together, the brain amplifies the intensity of both inputs. This helps the listener to hear soft and high frequencies better. 

If one ear has hearing loss, the head itself can block higher noises coming at you from the wrong side from ever reaching your good ear. The result is soft and high-pitched sounds are muffled at best if they are ever heard. This is sometimes known as the ‘head shadow’ effect

Additionally, UHL can make it hard to localise sounds. This can be a health and safety issue, especially in instances such as driving a car, or in noisy places or crowded gatherings where an accident could happen.

How to prevent unilateral hearing loss and single-sided deafness:

Some instances of UHL and SSD are genetic or down to factors that cannot be avoided or anticipated entirely (such as head trauma). But a lot of cases are also preventable. 

To give yourself the best chance against developing UHL, limit your exposure to loud noises where possible. Turn down the volume on headphones and electronic devices, and wear earplugs or earmuffs in loud environments — such as at rock concerts or on construction sites. 

Find out more about how to keep your ears healthy here. 

A Hearmore Case Study

A picture of Natasha, who has single-sided deafness.

Meet Natasha, our canvasser at Hearmore UK. Since from about four years of age, Natasha has had trouble hearing out of her left ear. After a short while of living with single-sided deafness, struggling, feeling tired at the end of the day from listening so much, and having to talk to people on her ‘good’ side, she decided to do something about it. 

One of our audiologists performed a hearing test on Natasha and found that she was mostly deaf in her left ear and with some minor hearing loss in the other. So we fitted her with Starkey Evolv AI 2400 CROS. Now, she no longer has to concentrate on listening so much, and is more likely to talk your ear off rather than shy away from a conversation.

A word on sudden unilateral hearing loss

Sudden unilateral hearing loss is defined as a type of hearing loss that develops over a period of three days or less. Even if your hearing doesn’t diminish by all that much, it is still very important that you seek medical attention immediately. The quicker you are treated, the better your chances are of recovering your lost hearing.

What to do if you think you have unilateral hearing loss or single-sided deafness

If the hearing loss comes on rapidly or suddenly, treat it as a medical emergency. Call your doctor. They will then likely schedule an appointment with an Ear, Nose and Throat (ENT) specialist.

But if you have suspected unilateral ear deafness and it has developed over a slower period of time, then it’s time to arrange an appointment with an audiologist. If you live in the UK, our audiologists will come to your house and assess your hearing for free. We can get out to you in just a few days. Find out what to expect from our audiology tests here.

Remember, it’s better to seek treatment as early as possible to get the best results on restoring or managing your hearing loss.

Frequently Asked Questions

No. Although lots of common conditions — including a head cold (and therefore nothing to worry about) — can decrease the amount of hearing in one ear, it isn’t normal. If you notice a difference and feel it’s impacting your life, speak to an audiologist. If the hearing loss comes on suddenly, contact your doctor immediately.

Yes, it can be. Persons with single-sided deafness can register for a Disabled Persons Railcard, for example, under the Equality Act 2010.

No. While it is common for some people with UHL to report having tinnitus at the same time — which can affect both ears and not just the affected one — the two aren’t always connected. Some people have UHL and do not experience tinnitus.

Not always. Some people regain much of their hearing back and even make a full recovery with treatment. But for many people, the amount of hearing loss may be permanent. The earlier you seek treatment, the better your chances of recovering what you’ve lost.

About the author

A headshot of one of our audiologists.

Asa Richards, Audiologist/HAD M.S.H.A.A

Head of Audiology & contributor

Asa has worked as an audiologist for 6 years, providing expert and revolutionary care to patients who suffer from hearing loss in the meantime. He also supervises the management, learning, and career development of the Hearmore Audiology and Sales Management team.

You can reach Asa on his LinkedIn page here.