How does having a hearing loss in one ear affect my hearing?

There are various causes for hearing loss in one ear. Hearing can deteriorate gradually over time or it can be lost quite suddenly. In some cases, hearing may be partially recovered, or the hearing loss may fluctuate. Unilateral hearing loss is not a normal part of ageing.

People with hearing loss in only one ear usually adapt quite well and are generally able to hear at normal levels, if they have normal hearing in the better ear. In most situations their ability to communicate is not affected by their hearing loss, however there are situations in which having a hearing loss in one ear can affect communication, including:

  • Hearing in background noise – Even people with normal hearing experience some difficulty hearing when there is background noise. People with normal hearing in both ears still hear the background noise, but they are able to tune into the person talking. People with unilateral hearing loss have added difficulty. They can struggle to hear in environments with background noise, especially if the noise is on their good side and the speaker is on their bad side. In this case it is best to move the conversation away from the noise and move the talker to the side of the better hearing ear. Background noise can be reduced by turning televisions and stereos off or down, closing doors and placing soft furnishings that will absorb sound in the room.
  • Localising sound – Our brains need the input from two ears to work out the direction of a sound. People with hearing in only one ear cannot usually tell where a sound is coming from. It is also harder to hear people who are speaking or approaching from behind or on the poor side. For safety, it is important to be aware of this when crossing roads, driving, in the workplace, and other situations where locating a sound is important.
  • Hearing in group situations – Hearing in groups (e.g. meetings and dinner parties) is made more difficult when some speakers are on the poor hearing side. It is important to ask to be seated so that the group of speakers is on the better hearing side.
  • Hearing in specific situations – Motorists with left sided hearing loss may have difficulty hearing passengers in the car.  Passengers with right sided hearing loss may have difficulty hearing the driver.

What about my good ear?

When there is usable hearing in only one ear, it is important to protect the hearing in that ear from any potential damage. This includes avoiding environments with excessive noise, wearing hearing protection in noisy environments and having regular hearing tests to monitor the hearing levels. It is important to seek a medical opinion before doing any activities which could potentially harm the ear such as scuba diving, water skiing, or flying in a plane with a cold or flu. It is also important to protect the hearing by avoiding inserting objects into the ear canal (such as cotton buds).

Would I benefit from wearing hearing aids?

Some people may benefit from using a hearing aid in the poorer ear. For other people a hearing aid may not be useful because it will amplify hearing that is distorted. This may make speech unclear. Hearing aid use can be discussed with your audiologist. In many cases there is a trial period available with hearing aids.

There are specific hearing aid systems designed especially for patients with a unilateral hearing loss including:

  • CROS aids: In this system a microphone is placed on the poor ear, while the hearing aid is placed on the better ear. The microphone picks up the sound from the poor hearing side and transfers it so that it is heard in the good ear. This allows the user to hear the sound in the whole environment and they will be able to hear speakers who are on their poorer hearing side, however it will not help users localise sounds as the sound is still being transferred to the better hearing ear.
  • BICROS aids: These aids work in the same way as the CROS system, however, when there is a hearing loss in the better ear, each ear has microphone. Both microphones pick up sound and transfer it to the better ear, in which it is amplified by the hearing aid.
  • Bone conduction Implants: Other types of hearing aids such as a bone anchored hearing aid (BAHA) and a trans-cranial aid have been used for people with unilateral hearing loss. These aids transfer the sound waves from the poor side to the good side via the vibration mechanisms of the skull bones.
  • Cochlear Implant: In some cases a cochlear implant may also be considered for unilateral deafness on a case by case basis. A cochlear implant works by providing electrical stimulation in the poor ear in patients with a severe to profound hearing loss when a hearing aid is of no or little benefit.

What if my hearing changes?

If you notice a decline in your hearing in either of your ears, contact your Audiologist, or visit the Emergency Department at The Royal Victorian Eye and Ear Hospital.

How can I find a hearing aid provider or more information?

Hearing Services Program
For a local hearing services provider directory, contact the Hearing Services Program:

Phone: 1800 500 726

BAHA or Cochlear Implant Service
For more information or to discuss funding options, please contact the Eye and Ear Cochlear Implant team:

Phone: 03 99298624

Disclaimer This document describes the generally accepted practice at the time of publication only. It is only a summary of clinical knowledge regarding this area. The Royal Victorian Eye and Ear Hospital makes no warranty, express or implied, that the information contained in this document is comprehensive. They accept no responsibility for any consequence arising from inappropriate application of this information.

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  • Unilateral Hearing Loss #82
  • Owner: Audiology
  • Last Reviewed: February 22, 2023
  • Next Review: February 22, 2028