The Challenges of Single-Sided Deafness

Many people think—incorrectly—that living with unilateral (single-sided or SSD) hearing loss wouldn’t be a big deal. After all, you have another ear through which you can hear, right? What they don’t consider is that being unable to hear much or at all through one ear not only impacts your ability to locate the direction from which sounds are coming, but also challenges your ability to keep up with conversations, especially in noisy environments. Fortunately, while there is no cure currently for the majority of single-sided deafness cases, there are effective treatments available that can make life with SSD easier.

What causes a loss of hearing in one ear?

There are multiple reasons why you might experience a loss of hearing in only one ear, including the following:

  • Microtia/Atresia. Microtia often affects only one ear, leaving you with either a small portion of your pinna (outer ear) or none at all. Microtia is often coupled with Atresia, which is an absence of a functional ear canal.
  • Sudden sensorineural hearing loss (SSHL). This can occur with no warning in as little as a day or two. The cause is usually unknown, but if you catch it quickly and seek emergency treatment, it can often be treated and completely cleared up. The spontaneous rate of recovery without treatment is about 60 percent. However, for those 40 percent who don’t receive treatment within the first 24 hours of the onset of symptoms, the loss can become complete and permanent.
  • Injury to the eardrum. Various physical injuries can cost you part or all of the hearing in one ear. Examples include damaging your eardrum while scuba diving or inserting a cotton swab too deeply. Also being close on one side to an extremely loud noise (e.g., a gun firing) could damage the irreplaceable stereocilia (hair cells) required to process sound.
  • Acoustic neuroma. This noncancerous tumor can develop on the vestibular nerve, which runs from your inner ear to your brain. Damage to branches of this nerve, either from the tumor itself or due to the surgery required to remove it, can permanently impede hearing.
  • Certain diseases sometimes affect only one ear, including measles, mumps, and meningitis, among others.

How single-sided hearing loss interferes with life

For the approximately 60,000 people who find themselves with single-sided hearing loss in the U.S. each year, the loss of bilateral hearing causes varying degrees of interference in their daily lives. Some find they can get along well enough hearing out of one ear, but the majority struggle with activities like:

  • Engaging in conversations. If you have SSD, you might find yourself having to strategically position your “good” ear toward others in order to keep up with conversations. And if you happen to be in a noisy environment like a crowded bar with a group of friends, the struggle to keep up with multiple conversations can quickly become exhausting.
  • Locating where a sound is coming from. This can be merely an inconvenience if, for example, someone is calling your name and it takes you several seconds to turn your head in the right direction to respond. However, it could pose a safety risk if you’re walking across the street, riding a bicycle, or driving a car and you cannot quickly determine from which direction a siren or similar warning is coming.
  • Gauging volume is challenging. The brain is constructed to process sound as perceived by two ears at the same time. When only one ear is functional, it tends to process the incoming sound at a lower volume, which makes adjusting the television or a stereo to a comfortable volume for yourself and anyone else in the room with binaural hearing problematic.
  • Balance issues. You might experience difficulty maintaining your balance, particularly if you have had SSD since birth. Studies¹ have found that those with unilateral hearing loss must depend more on their vision to maintain balance if their SSD also affects the vestibular portion of their inner ear.

Treatment options for SSD

Fortunately, effective treatments are available to improve the lives of people troubled by single-sided hearing loss. These include contralateral routing of signal (CROS) and bilateral contralateral routing of signal (BiCROS) hearing aids and bone anchored hearing system implants. When it comes to the former, you have to wear a hearing aid on both ears so that the aid on your deaf side can route sound to the aid on your hearing side wirelessly. If your hearing ear is at 100 percent, then you would choose a CROS option, which means the aid on your good ear would simply be a receiver. However, if you have some hearing loss in that ear as well, the BiCROS aid worn on the better ear can be programmed to provide additional amplification.

Many people with SSD would prefer not to have to wear two hearing aids or they find that CROS/BiCROS devices are not effective enough for their needs. That’s where a bone conduction device like the Ponto™ comes in. Those who opt for an implantable solution often comment that they can’t believe how much sound they were missing out on and how it takes far less effort to hear and keep up with speech, especially in noise. Even those who have only ever heard out of one ear frequently benefit from a bone anchored hearing solution for single-sided deafness.

If you are hard of hearing on one side or have outer or middle ear problems, Ponto may be the solution for you. Ponto uses the body’s natural ability to transfer sound through bone conduction, and it can provide the support you need to participate more easily in daily life with less listening effort.

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Are you ready to take the next step? We can help you find a clinic close to home where you can get all the answers you need regarding Ponto bone anchored hearing systems, minimally invasive Ponto surgery (MIPS), and more. You can also always contact Oticon Medical directly at 888.277.8014 or at info@oticonmedical.com.

¹Snapp HA, Ausili SA. Hearing with One Ear: Consequences and Treatments for Profound Unilateral Hearing Loss. Journal of Clinical Medicine. 2020; 9(4):1010. https://doi.org/10.3390/jcm9041010

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