The use of a single hearing aid to support the affected ear has been shown to allow for improved access to conversation, balance of sound, and sound awareness.

Unilateral Hearing Loss: Exploring the Impact on Everyday Life

by | Jul 10, 2023 | Hearing Loss, Patient Resources

“I hear just fine out of my good ear!”

Have you ever heard anyone say that before? Though most people with hearing loss in one ear have it in both ears, there are cases in which individuals experience hearing loss in only one ear, known as unilateral hearing loss (UHL).

According to a 2020 study conducted at the University of Miami, “asymmetry in hearing has been reported to result in a reduced quality of life comparable to, or exceeding, binaural hearing loss.” In addition, profound unilateral hearing loss can “have a substantial impact on socialization, learning and work productivity.”

Unfortunately, many experiencing UHL are either unaware of their condition or choose not to treat it. Though it presents differently than binaural hearing loss, unilateral hearing loss is still a major hearing health concern.

To help raise your awareness of the dangers of ignoring UHL, let us take a closer look at what it is and how it can impact your daily life.

What Is Unilateral Hearing Loss?

Unilateral hearing loss is characterized by experiencing normal hearing in one ear with hearing loss in the other. It can range from mild to very severe in both adults and children.

When hearing is completely ineffective in one ear, it is known as single-sided deafness (SSD), which is a form of unilateral hearing loss.

Exploring the Symptoms of UHL

If you are experiencing unilateral hearing loss, you will have reduced awareness of sound on the affected side and might also experience tinnitus in the affected ear. Because our brains rely on both ears to localize a sound, like how you need both eyes for depth perception, those experiencing UHL struggle to follow conversations in a noisy environment.

Unilateral hearing loss in children often becomes a concern when parents or teachers observe the child straining to hear, especially in group environments; poor behavior; and/or poor academic performance. The age of onset depends on the cause of the unilateral hearing loss.

Acquired UHL has often been associated with embarrassment, frustration, anxiety, insecurity, and social isolation, which can have a significant impact on your quality of life.

Examining the Possible Causes of UHL

In general, unilateral hearing loss can occur due to any of several causes, like:

  • Inherited or genetic conditions
  • Traumatic brain injury (TBI)
  • An outer, middle, or inner ear abnormality
  • Various illnesses or infections
  • Exposure to loud noise
  • Acoustic neuroma
  • Meniere's disease and mastoiditis
Comprehensive hearing assessment

How Is Unilateral Hearing Loss Diagnosed?

Whether you are experiencing UHL that has come on suddenly or it is something that has developed gradually over a period of years, unilateral hearing loss is diagnosed using a comprehensive hearing assessment.

Through a series of tests, which evaluate the hearing in each ear separately and together, your audiologist can zero in on the type and severity of the hearing loss you are experiencing.

Screening for UHL in infants involves using auditory brainstem response (ABR) testing at birth, which produces a pass or fail result, leading to further testing. UHL is typically diagnosed in children thanks to regular hearing tests during early development and school screening tests.

Managing and Treating Your Unilateral Hearing Loss

How your UHL is managed or treated will depend on the degree of loss and the impact it has on your daily life.

Cases involving sudden unilateral hearing loss are sometimes treated by an otolaryngologist or an ENT using various proven medical therapies. For longstanding hearing loss cases, or when medical treatment is not an option, unilateral hearing loss can be treated with different technologies in accordance with the person’s needs and hearing loss.

Potential technologies used in the management and treatment of unilateral hearing loss include:

Hearing Aid(s)

The use of a single hearing aid to support the affected ear has been shown to allow for improved access to conversation, balance of sound, and sound awareness.

CROS Hearing Aid
Those who cannot be helped with a traditional hearing aid are sometimes better served by a CROS (contralateral routing of sound) system, which looks like a hearing aid but does not amplify sound for the affected ear. Instead, it uses a microphone to pick up sound in the direction of the poor ear and transmits it to a device worn on the good ear, improving the awareness of sound on the affected side.
Bone-Anchored Devices
UHL that is conductive or mixed in nature, meaning there is some abnormality in the ear canal or middle-ear space, may be treated successfully with a bone-anchored device for balance of sound, though sound localization is still poor.

Bone-anchored devices route the sound to the better hearing ear, acting similarly to a CROS device, when used to address SSD.

Cochlear Implants
Cochlear implants can improve speech perception and sound localization for individuals with SSD and can be considered for children or adults. The success of cochlear implantation requires an extensive evaluation with an audiologist and otolaryngologist who specialize in cochlear implantation.
Remote Microphone
A remote microphone, or an FM system, is another option considered for the management and treatment of UHL. Remote microphones are helpful when the speech of interest is at a distance or within an environment where there is a lot of background noise.


No Treatment
Tragically, some individuals choose to leave unilateral hearing loss untreated, believing they can get along just fine in daily conversations using their good ear. While amplification may not be the appropriate choice for all individuals, the potential benefits of amplification can significantly alter the impact of UHL on a patient’s quality of life.


Communication Skills
Whether technology is used to help manage UHL or not, it is important for individuals with all types of hearing loss to learn and utilize good communication skills and strategies. These techniques can help individuals with UHL adjust to their environments and be more successful when it comes to understanding speech.


Managing Unilateral Hearing Loss Is Essential for Better Hearing

Though many ignore the fact that they hear better out of one ear than the other, unilateral hearing loss can cause you a lot of embarrassment, frustration, anxiety, insecurity, and social isolation, all of which can negatively impact your quality of life.

If you are struggling to hear out of one ear or hear better out of one ear, I encourage you to consider taking the first step toward enjoying better hearing by scheduling a comprehensive hearing assessment using the adjacent form.

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Monica Walker

After many years of working in busy environments to care for thousands of people’s hearing across Atlanta, I made the decision to focus on what actually matters – building real-world relationships to offer the highest level of hearing care available to trusted friends. Through the “HEARoeClub,” I work hands-on to personally care for a small number of incredible people to help them achieve better hearing, and going above and beyond to deliver much more than just hearing care.

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