Article by Hearing Partners, contributed by Joanne Loo, Senior Clinical Audiologist at Hearing Partners
Our brains rely on input from two ears to locate sounds, filter background noise, and understand speech clearly. When hearing loss occurs in just one ear, a condition known as unilateral hearing loss or deafness in one ear, these everyday listening tasks can suddenly become more challenging.
While it may seem like hearing with one good ear should be enough, many people with unilateral hearing loss find it difficult to tell where sounds are coming from or to follow conversations in noisy environments such as restaurants, offices, or busy streets. This can sometimes lead to frustration, listening fatigue, or decreased situational awareness.
This article explores the reasons for unilateral hearing loss, as well as the process of diagnosis and treatment. Keep reading to learn more.
Key Takeaways
- Unilateral hearing loss refers to hearing loss that occurs in only one ear, while the other ear retains normal or near-normal hearing.
- Buildup of earwax, loud noise exposure, physical trauma, genetics, infections and medical conditions, and tumours can cause unilateral hearing loss or deafness in one ear.
- Hearing loss in one ear is diagnosed with a physical ear examination and a hearing test. Imaging tests may be arranged if necessary.
- Unilateral hearing loss may be managed through ear cleaning, CROS hearing aids, medications and Bone-Anchored Hearing Aids (BAHAs).
What Is Unilateral Hearing Loss?
Unilateral hearing loss occurs when one ear has diminished hearing while the other maintains normal function. This condition is referred to as hearing loss in one ear for mild to severe cases, and single-sided deafness for profound cases. It can develop either suddenly or gradually over time.
Because the condition affects just one side, it can sometimes go unnoticed at first, especially in quiet environments where hearing with one ear may still seem sufficient. However, many people with unilateral hearing loss begin to notice certain challenges in everyday situations.
For example, it may be harder to tell where sounds are coming from, follow conversations in noisy places like restaurants, or hear someone speaking on the affected side. You might find yourself turning your head to hear better or asking others to repeat themselves more often.
What Causes Unilateral Hearing Loss and Deafness in One Ear?
Various factors can contribute to hearing loss or deafness in one ear, ranging from medical issues to environmental influences. In this section, we’ll explore the common causes of unilateral hearing loss.
Buildup of earwax
A buildup of earwax can occur due to factors such as excess wax production, improper cleaning or narrow ear canals. When earwax accumulates in one ear, it causes a blocked ear, leading to temporary hearing loss.
Exposure to loud noise
Noise-induced hearing loss can result from loud noise exposure. Exposure to a single intense sound or prolonged exposure to elevated noise levels in one ear can damage the inner ear’s hair cells. This could result in a decrease in hearing ability in the affected ear.
Physical trauma
Physical trauma to the head or ear can result from accidents or sports injuries. This type of injury can damage the delicate structures or nerves in one ear, leading to unilateral hearing loss.
Genetic/Congenital
While genetic factors more commonly contribute to bilateral hearing loss, specific inherited syndromes do cause unilateral hearing loss. Congenital cytomegalovirus, certain congenital inner ear malformations, and cochlear nerve deficiency can also cause congenital unilateral hearing loss.
Infections and medical conditions
Infections, such as meningitis or recurrent ear infections, can result in hearing loss by damaging the ear structures. Similarly, medical conditions like Ménière’s disease can impact the inner ear, causing symptoms like vertigo and ultimately hearing loss.
Tumours
Tumours, such as acoustic neuroma, that develop near the ear or auditory nerve can lead to unilateral hearing loss. These benign growths press against the auditory nerve, disrupting its function and lowering the affected side’s hearing ability.
How Is Unilateral Hearing Loss and Deafness in One Ear Diagnosed?
Diagnosing hearing loss or deafness in one ear typically begins with a physical examination of the ear, followed by hearing tests. These tests help determine the type and severity of hearing loss by identifying how well you hear different sounds and frequencies.
Your audiologist or hearing care professional will recommend specific tests based on your condition. In some cases, imaging tests may also be requested to provide a clearer view of any damage to the ear structures.
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How Is Unilateral Hearing Loss and Deafness in One Ear Treated?
Depending on the underlying cause and severity of the condition, your audiologist or hearing care professional may recommend various approaches. In this section, we’ll discuss common treatment options, including hearing aids and medication, to help manage unilateral hearing loss and single-sided deafness.
CROS hearing aids
CROS hearing aids are different from regular hearing aids as they’re specifically designed for individuals with hearing loss in one ear.
The CROS system has two main components: a microphone that picks up sounds from the non-hearing ear and a transmitter that wirelessly sends these sounds to a hearing aid on the better-hearing ear. The hearing aid amplifies the sounds from the non-hearing side, allowing the person to hear through their functional ear instead. This approach helps individuals with unilateral hearing loss engage more fully in their surroundings.
Ear cleaning
If the hearing loss is caused by a buildup of earwax, removing the wax may help restore normal hearing. This should be done by an ENT specialist who is trained in the proper procedures. Avoid attempting earwax removal on your own at home or using methods like ear candling, as these can be dangerous and can harm your ears.
Medication
If an ear infection is responsible for the hearing loss, the doctor may prescribe the necessary medications to address it. Once resolved, your hearing should be restored.
Bone-anchored hearing aid
Bone-anchored hearing aids (BAHAs) function by directly stimulating the inner ear, bypassing both the outer and middle ear. They consist of a small titanium implant and an external sound processor surgically placed in the skull. The sound processor captures environmental sounds and converts them into vibrations before sending them directly to the implant. This process helps to overcome hearing loss caused by damage to structures in the middle or outer ear, increasing hearing ability.
It’s important to note that this is an invasive procedure requiring surgery. Additionally, this procedure may not be a suitable treatment option for all. An assessment by both an ENT specialist and an audiologist is necessary to determine your suitability.
FAQs About Unilateral Hearing Loss and Deafness in One Ear
Who is at risk of unilateral hearing loss?
Unilateral hearing loss can affect individuals across different age groups and lifestyles, but certain groups may be at higher risk.
This includes:
- Working professionals in noisy environments (e.g. construction, manufacturing, or frequent exposure to loud settings), where prolonged noise can damage hearing in one ear.
- Frequent earphone or headphone users, especially at high volumes or when one ear is used more than the other.
- Older adults, as age-related changes in hearing can sometimes affect one ear earlier than the other.
- Individuals with a history of ear infections, trauma, or underlying medical conditions, which may impact the ear or auditory nerve.
If you identify with any of these risk factors and notice changes in your hearing, such as difficulty localising sound or hearing clearly in noisy environments, it is advisable to schedule a hearing assessment early.
Why do I have sudden hearing loss in one ear?
Sudden hearing loss or sudden sensorineural hearing loss (SSNHL) occurs when hearing decreases rapidly over a short period of time, sometimes within a few hours or over a couple of days. In many cases, the exact cause is unknown, but it may be related to problems affecting the inner ear or the auditory nerve.
Possible triggers include viral infections, reduced blood flow to the inner ear, inflammation, autoimmune conditions, or head trauma. In rare cases, growths such as an acoustic neuroma or certain medications that affect hearing may also play a role.
How does unilateral hearing loss and deafness in one ear affect your well-being?
The effects of hearing loss in one ear can vary widely from person to person, depending on the severity of the condition. The following are ways it can impact your hearing health:
- Sound localisation: Difficulty locating the source of a sound can affect your spatial awareness, making it challenging to orientate yourself.
- Speech comprehension in noisy environments: Conversations near the ear with hearing loss may be harder to understand, especially with background noise coming from the direction of the ear with better hearing.
- Loudness of sounds: Sounds may be perceived as softer than they are because of the lowered hearing ability in one ear.
- Listening fatigue: The strain on your brain caused by the hearing loss can lead to listening fatigue, making it tiring to engage in conversations.
- Social isolation: Challenges with hearing may cause you to withdraw from social gatherings, leading to isolation. Subsequently, the lack of cognitive stimulation can increase the risk of dementia and falls.
Can unilateral hearing loss or deafness in one ear be prevented?
While deafness in one ear isn’t fully preventable due to genetics, there are steps you can take to reduce the risk. Some good habits to consider are:
- Reducing loud noise exposure: Limit exposure to loud sounds, and use hearing protection in noisy environments to safeguard your hearing.
- Preventing earwax buildup: Practise safe ear hygiene by removing earwax using eardrops only. Avoid using earpicks and seek professional help for earwax removal when necessary.
- Preventing ear infections: Maintain good ear health by undergoing treatment for any ear infections promptly.
Regular hearing tests are essential for identifying any issues early. Prompt detection can allow for timely treatment, helping to prevent further deterioration of your hearing. Book an appointment today!
Joanne is a Clinical Audiologist at Hearing Partners. She has a Bachelor of Audiology with Honours (Distinction) from the Universiti Kebangsaan Malaysia (UKM) and is registered under the Malaysian Allied Health Professional Council, MAHPC(AUD)00256. She is experienced in conducting adult and paediatric hearing tests. She also provides hearing aid counselling, fitting and evaluation for both adults and children.