Unilateral hearing loss (Single Sided Deafness)

Laura James, Professional Services Manager and Hearing Aid Dispenser at The Hearing Care Partnership. Laura James  |  Published 12 December 2024  | 6 mins read

A mature woman with hearing problems touching her ear with her hand, viewed from the side, indicating discomfort or concern related to her hearing loss.

Unilateral hearing loss is a type of hearing loss that only affects one ear. It can be disorienting and potentially isolating. This type of hearing loss isn’t always permanent and there are lots of treatment options alongside a variety of ways to manage unilateral hearing loss. Read on to learn more about it.

What is unilateral hearing loss?

Unlike bilateral hearing loss which affects both ears, unilateral hearing loss only affects one. It occurs when you experience partial or total hearing loss in that ear and can be caused by multiple things including blockage, infection, inflammation, and damage to the cochlear nerve.

Unilateral hearing loss causes

From physical blockages to infections and head trauma to inherited disorders, there are multiple causes for unilateral hearing loss. Some of these causes are temporary and can be treated while others can not and cause permanent damage. 

Common hearing loss causes include:

  • head trauma
  • a blockage in the ear
  • a perforated eardrum
  • an acoustic neuroma
  • viral or bacterial infections
  • inherited or genetic disorder

Some less common causes can include tumors, sudden idiopathic hearing loss (a rapid and unexplained loss of hearing in one ear), and congenital conditions that appear from birth. 

A bustling city street filled with pedestrians walking in various directions.

Unilateral hearing loss symptoms

Because it only affects one year, unilateral hearing loss can be more obvious to notice once it develops than bilateral hearing loss. The specific symptoms of hearing loss you experience may differ from person to person but the most common symptoms include:

  • Difficulty hearing conversations, especially in busy environments.
  • Difficulty understanding where sounds are coming from.
  • Struggling to tell how loud a sound is.
  • Problems hearing people from one side.
  • Speech sounding muffled, and struggling deciphering ‘s’ or ‘f’ sounds.
  • Reduced spatial awareness.

How can I prevent unilateral hearing loss?

There are some steps you can take to help prevent certain types of unilateral hearing loss. However, some cases, such as congenital hearing loss can’t be prevented and will require lifelong management instead. 

  • Use hearing protection – Make sure to wear hearing protections (earplugs or earmuffs) during activities with loud noise levels such as concerts, riding motorcycles, or working with loud machinery.
  • Turn down the volume – Especially 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%. 
  • Don’t stick anything into your ear canal – Including cotton swabs or hairpins. They could become lodged in your ear canal, impact wax, or cause a ruptured eardrum.
  • Avoid smoking – This can impair circulation which can affect your hearing.
  • Do regular physical activity – Regular exercise can help prevent health issues like high blood pressure which can affect blood flow to your inner ear and cause hearing problems.
  • Treat ear infections – Have any ear infections looked at and treated by your doctor as soon as possible to prevent any damage and ease hearing loss associated with the infection. 
  • Manage chronic illnesses properly to help prevent further damage.
  • Avoid ototoxic medicines as much as possible.
  • Have your ears tested regularly – Book in your free hearing assessment and attend regular check ups to catch any hearing problems early. 

How is unilateral hearing loss diagnosed?

If you suspect you have unilateral hearing loss (or any other kind of hearing loss) should always be seen by a qualified audiologist for diagnosis for a comprehensive hearing assessment. Your audiologist will perform multiple tests to work out the severity of your hearing loss as well as your range of functional hearing and be able to suggest suitable treatment or management options.

Children will receive a screening at birth but you can also take them to be tested at the pediatrician’s office to detect any potential hearing issues including unilateral hearing loss. This should then be confirmed with further testing by an audiologist.

How is unilateral hearing loss treated?

The treatment and management options you are offered will depend on the severity of your unilateral healing as well as the impact it has on your daily life. Sometimes, temporary hearing loss can be treated and will restore hearing back in that ear. Other times, the hearing loss is permanent and will require management.

Any sudden hearing loss not associated with earwax buildup needs immediate medical attention to help preserve as much hearing level as possible. If you suffer from sudden hearing loss, please contact NHS 111 or head to your nearest A&E.

Close-up of a woman wearing Receiver In Canal (RIC) hearing aids.

Unilateral hearing loss is managed using the following tools:

  • Hearing aids – These devices help to pick up and magnify sound and transmit them into your ears via a receiver.
  • Contralateral routing of signal (CROS) devices – a type of hearing aid specifically designed for people with unilateral hearing loss.
  • Cochlear implant – A surgically implanted device that transmits sound directly into the cochlear (hearing) nerve.
  • Bone conduction hearing system – A device that sends sound straight to the inner ear, bypassing any blockages of the middle or outer ear.
  • Frequency modulation (FM) systems – used to help a person with hearing loss listen in noisy places, such as a classroom or in group settings. 

When Should You See a Hearing Specialist?

You should always see someone if you have any concerns about your hearing, especially if it’s sudden (not related to ear wax buildup) or accompanied by pain or any head trauma. Your unilateral hearing loss may get worse over time so if you notice any changes in your hearing, including your good ear, make sure you visit your audiologist and book in regular hearing tests – early diagnosis and prompt treatment is important.

Conclusion

While you can live healthily and happily with unilateral hearing loss, it’s important to recognise the signs and treat it as early as possible. You may be able to regain the hearing back in that ear if the hearing loss is related to ear infections or a blockage of some kind. And if it’s permanent, receiving the right treatment and care can help you regain your quality of life. Book your free hearing test at your local The Hearing Care Practice today.