Roughly 1 in 7 people in the U.S. have hearing loss.1 That’s over 50 million people across the nation. While it most commonly manifests in both ears (bilateral hearing loss), sometimes the condition affects just one ear. This is called single-sided hearing loss (unilateral hearing loss), and it affects roughly 12.8 million people in the U.S.2
In this guide, we provide a detailed overview of what single-sided hearing loss is, common symptoms to look for, and how it’s diagnosed and treated.
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What is Single-Sided Hearing Loss? (Unilateral Hearing Loss)
Single-sided hearing loss, also known as unilateral hearing loss, occurs when hearing is reduced or completely absent in one ear, while the other ear functions normally. It can range from mild to profound hearing difficulty in the affected ear, and it may develop suddenly or gradually over time.
Single-sided hearing loss can affect people of any age and may be temporary or permanent, depending on the underlying cause. Read on to take a closer look at the common signs and symptoms to watch for.
Symptoms of Single-Sided Hearing Loss
Symptoms of single-sided hearing loss can develop gradually over time or come on suddenly. If symptoms appear suddenly, it could be a sign of a medical emergency, and you should seek care right away.
In addition to hearing changes, single-sided hearing loss can sometimes come with physical symptoms. Depending on the cause, symptoms may also fluctuate.
Some of the most common symptoms of single-sided hearing loss include:
- Difficulty hearing conversations, especially in noisy environments
- Difficulty following group conversations or distinguishing overlapping voices
- Sounds or speakers seem muffled, muted, unnatural, or far away
- Turning your head or positioning your “good ear” toward sounds or speakers
- Trouble determining where sounds are coming from (sound localization issues)
- Struggling to hear people during phone conversations or needing to switch the phone to the other ear
- A physical feeling of pain, pressure, or a blockage in one ear
- Ringing or buzzing in one ear (tinnitus)
- Episodes of dizziness, vertigo, or other balance issues
If you or a loved one is experiencing any symptoms of hearing loss, it’s important to schedule a hearing exam as soon as possible to identify the cause and receive timely treatment.
Causes of Single-Sided Hearing Loss
Single-sided hearing loss can develop for many reasons. For some people, it’s something they’re born with. For others, it develops gradually over time or strikes suddenly without warning. Understanding the root cause is important because it is key to determining the right treatment approach and preventing further complications.
Below are some of the most common causes of single-sided hearing loss:
Congenital Causes (Present from Birth)
Some children are born with hearing loss in one ear. Common congenital causes include:
- Malformation of the outer, middle, or inner ear
- Underdevelopment or absence of the auditory nerve
- Genetic conditions that affect hearing function
- Complications during pregnancy or childbirth, including certain infections
Because babies don’t often show obvious symptoms of hearing difficulties, newborn hearing screenings are critical for catching congenital hearing loss early.
Sudden Sensorineural Hearing Loss (SSNHL)
Sudden sensorineural hearing loss is a condition that develops rapidly, sometimes within minutes, hours, or days. While it can happen in both ears, it’s more common in just one. Sudden sensorineural hearing loss is considered a medical emergency that requires immediate attention.
Earwax Impaction
When earwax accumulates and becomes impacted, it can block the ear canal and cause hearing loss on one side. This is called conductive hearing loss, where sound waves can’t properly reach the inner ear. Beyond muffled hearing, impaction can also cause a sensation of fullness, tinnitus, earache, or dizziness.
Physical or Acoustic Trauma
Acute acoustic trauma is caused by exposure to sounds above 120 decibels (dB), leading to immediate injury to one or both ears. Similarly, physical trauma to the head, ruptured eardrum, or damage to the tiny bones within your middle ear can all interfere with sound processing and cause single-sided hearing loss.
Medical Conditions
Many common medical conditions can cause hearing damage over time, sometimes in only one ear:
- Acoustic neuroma (vestibular schwannoma): A rare, slow-growing benign tumor that compresses the auditory nerve, causing progressive hearing loss in the affected ear.
- Systemic conditions: Diabetes, high blood pressure, and circulatory disorders can impair blood flow to the inner ear over time, resulting in hearing loss in one or both ears.
- Infections: Fluid buildup or inflammation in the middle, outer, or inner ear can reduce hearing in one ear.
- Systemic infections: Conditions like measles, mumps, and meningitis can damage the auditory nerve in one or both ears.
- Ménière’s disease: A chronic inner ear condition that can cause hearing loss, often in one ear.
- Lyme disease: A bacterial infection that causes damage to the nervous system and inflammation that can cause gradual hearing loss in one or both ears.
- Autoimmune conditions: Conditions like lupus, rheumatoid arthritis, and Cogan’s syndrome can cause the immune system to mistakenly attack inner ear tissue, resulting in progressive hearing loss in one or both ears.
If you’re experiencing single-sided hearing loss and suspect an underlying medical condition, don’t wait to seek care. Many of these conditions are treatable, and the earlier they’re caught, the better the outcome for your hearing.
Diagnosing Single-Sided Hearing Loss
The first step in diagnosing single-sided hearing loss is a comprehensive hearing exam. This simple exam can sometimes identify the cause right away, or it can rule out obvious problems and point toward further testing.
The process typically includes a physical examination of the ear, a pure-tone audiogram to test your hearing range in each ear, and speech recognition testing to see how well each ear processes spoken words.
Your specialist will also ask you about your lifestyle and medical history to assess if any underlying conditions could be contributing to your symptoms. If a physical cause is suspected, you may be referred for additional imaging.
Single-Sided Hearing Loss Treatment Options
Treating single-sided hearing loss depends on the cause, severity, and how long the condition has been present. Early intervention is crucial, especially if the cause of the condition stems from a physical injury or medical condition.
Here’s a breakdown of the most common treatments for single-sided hearing loss:
- Treating Underlying Cause: When hearing loss stems from a treatable condition, like earwax impaction, addressing that cause directly is always the first step.
- Medications: Oral or injected anti-inflammatory medications help treat infection and inflammation in the inner ear.
- Surgery: Procedures like eardrum repair (tympanoplasty) or surgery to remove abnormal bone growth (otosclerosis) can significantly improve or restore hearing.
- Hearing Aids: When single-sided hearing loss is permanent or cannot be fully corrected, hearing aids can dramatically improve sound clarity and overall quality of life.
- Bone Conductive Hearing Aids: In some cases, bone-conduction hearing aids help bypass the damaged ear and transmit sound directly to the cochlea.
No single treatment works for everyone. A specialist will evaluate your degree of hearing loss, its cause, and your lifestyle to recommend the most appropriate option. Because hearing loss is a condition that often changes over time, annual hearing tests are highly recommended. This allows you to catch changes early and get timely care.
Schedule a Hearing Exam at an Audibel Clinic Near You
Single-sided hearing loss is a complex condition, but it’s often a treatable one. If you suspect that you or a loved one may be experiencing hearing loss of any kind, scheduling a hearing exam is a crucial first step.
Find an Audibel hearing clinic near you today to safeguard your hearing health and quality of life for years to come.
References
- Hearing Loss Association of America. (2026c, February 13). Hearing loss by the numbers – Hearing Loss Association of America. Hearing Loss Association of America -. https://www.hearingloss.org/understanding-hearing-loss/hearing-loss-101/hearing-loss-by-the-numbers/
- Kay‐Rivest, E., Irace, A. L., Golub, J. S., & Svirsky, M. A. (2021). Prevalence of Single‐Sided deafness in the United States. The Laryngoscope, 132(8), 1652–1656. https://doi.org/10.1002/lary.29941
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