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Deafness in One Ear

What does it mean to be deaf in one ear?

People with reduced hearing in one ear can still manage conversation well in quiet environments. This can give others the impression that single-sided deafness isn’t a big deal. Even amongst ENT surgeons in the past there was a view that as long as the other ear was ok, intervention wasn’t worth it.

However, we know there are specific difficulties associated with reduced hearing in one ear:

  • Conversation in noisy environments (‘Speech in noise’)
  • Knowing which direction a sound is coming from (‘Spatial hearing’)
  • Not hearing sounds from one side of the head (‘The head shadow effect’)
  • Appreciating audio recorded in stereo
  • Increased listening effort & ‘cognitive fatigue’
  • Lack of stimulation meaning the brain stops learning to process sound on that side (‘Plasticity’)

How is deafness in one ear diagnosed?

The solutions for hearing improvement are dependent on:

  • the middle ear (determined by examination, hearing test and CT scan)
  • the inner ear (determined by MRI scan)
  • the level of deafness (determined by hearing test)

How is deafness in one ear treated?

Options to rehabilitate partial deafness include:

However, once deafness reaches profound levels in one ear, even the loudest amplification won’t help. Focus then moves to sending sound over from the deaf side to the good ear. Options for this are:

  • CROS hearing aid (‘Contralateral Routing Of Signal’)
  • Bone conduction hearing aid
  • Bone conduction implant

Sending sound to the good ear will overcome the ‘head shadow effect’ but won’t help with ‘spatial hearing’ (Good for crossing the road, not so for finding your ringing phone)

There is however another emerging option: Cochlear Implantation for single-sided deafness. Research over the last decade has shown that ‘spatial hearing’ and improved ‘speech in noise’ can be achieved. Consequently, cochlear implantation for single-sided deafness gained FDA approval in 2019. Multi-specialist assessment involving audiology & speech therapy is essential before implant surgery.

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