Single Sided Deafness – Everything You Must Know About It!

Hearing loss doesn’t always affect both ears equally. In some individuals, one ear remains functional while the other experiences significant or total hearing loss. This condition is known as single-sided deafness (SSD). For those affected, SSD presents unique auditory challenges, such as difficulty locating sounds and following conversations in noisy environments. Fortunately, advances in hearing technology offer effective solutions for managing this form of hearing impairment.

Understanding Single-Sided Deafness (SSD)

Single-sided deafness refers to a condition in which one ear has normal or near-normal hearing, while the other has little to no usable hearing. This asymmetrical hearing loss may be sudden or progressive and can result from various causes, including:

• Viral or bacterial infections, such as labyrinthitis or mumps
• Head or ear trauma, such as skull fractures or acoustic nerve damage
• Tumors, particularly acoustic neuromas affecting the auditory nerve
• Meniere’s disease, which involves fluid buildup in the inner ear
• Congenital defects or sudden idiopathic sensorineural hearing loss (ISSNHL)

Although the unaffected ear can still hear sounds, the loss of binaural hearing—the ability to hear from both ears—creates several practical difficulties:

• Inability to localize sound sources, making it hard to determine where sounds are coming from
• Poor speech recognition in noisy environments, such as crowded places or restaurants
• Difficulty hearing from the side of the deaf ear, especially when people speak softly or from a distance

Without the input from both ears, the brain struggles to filter out background noise and focus on specific voices or sounds. This can lead to frustration, social withdrawal, and increased listening fatigue.

Hearing Solutions for Single-Sided Deafness

Despite the challenges, several hearing solutions have been developed specifically for SSD. Unlike traditional hearing aids that amplify sounds for the affected ear, devices for SSD typically work by routing sound from the deaf ear to the better-hearing one.

Hearing Systems – CROS and BiCROS

Two of the most common solutions for SSD are CROS (the Contralateral Routing of Signals) and BiCROS (the Bilateral Contralateral Routing of Signals) hearing aids. These systems help restore some degree of directional hearing by collecting sound on the deaf side and delivering it to the functional ear.

CROS Hearing Aids

CROS hearing systems are ideal for individuals who have absolutely no hearing ability in one ear but normal hearing in the other. The system includes:

• A microphone that sits inside the non-hearing ear and picks up sound
• A receiver in the hearing ear that wirelessly transmits the sound from the other side

This setup enables users to identify sounds from their non-functional side, improving awareness and allowing for more balanced hearing.

BiCROS Hearing Aids

BiCROS devices are best suited for individuals who have some scale of hearing loss in their better ear as well. These systems:

• Pick up sound from the poorer ear and send it to the better one
• Amplify sound in the better ear to compensate for partial hearing loss

BiCROS systems not only transfer sound but also enhance it, making them a comprehensive option for people with hearing challenges in both ears.

CROS and BiCROS Benefits

While neither CROS nor BiCROS devices can restore hearing in the deaf ear, they do significantly improve the user’s overall hearing experience. Key benefits include:

1. Enhanced Awareness in Surroundings

These systems help users detect the direction of sounds, which can be crucial for safety—especially when crossing streets or driving. Sound from the deaf side is perceived through the hearing ear, restoring some sense of balance in hearing.

2. Enhanced Speech Comprehension in Noise

In social settings or busy environments, separating speech from noise is difficult with only one functional ear. CROS and BiCROS devices help capture more audio cues, making it easier to engage in conversation without constant confusion or repetition.

3. More Natural Listening Experience

When sound is only received through one ear, the brain has to work harder to make sense of auditory input. This often leads to fatigue. By allowing the brain to process a fuller sound picture, CROS and BiCROS systems reduce mental strain.

4. Less Social Isolation

Hearing from both sides—even if indirectly—can help individuals re-engage in social activities, reducing feelings of isolation and improving emotional well-being.

Are There Other Treatment Options for SSD?

Beyond these systems, other interventions may be considered based on the particular needs and medical condition of the patient:

Bone-Anchored Hearing Systems (BAHS)

Bone conduction devices, such as bone-anchored hearing aids, bypass the damaged inner ear by transmitting sound through the skull to the functioning cochlea. These can be surgically implanted or worn externally and are especially effective for people with conductive hearing loss or SSD.

Cochlear Implants

In cases where traditional hearing aids are ineffective and the cochlea in the deaf ear remains functional, a cochlear implant may be an option. This electronic device directly stimulates the auditory nerve, potentially restoring hearing to the affected ear. It is most often used in cases of profound sensorineural hearing loss.

Assistive Listening Devices

Personal amplifiers, wireless microphones, or apps connected via Bluetooth can help enhance hearing in specific scenarios such as lectures, meetings, or one-on-one conversations.

Auditory Training

Some people benefit from auditory therapy or sound localization training, which helps the brain adapt to asymmetric hearing. Over time, users can become more skilled at interpreting auditory signals from one ear.

Seeking Help for SSD

If you suspect single-sided hearing loss, it’s important to consult with an ENT (ear, nose, and throat) specialist or audiologist. A complete hearing evaluation will determine the degree and type of hearing loss. From there, a customized treatment plan can be developed to suit your lifestyle, medical history, and budget.

Insurance coverage for SSD-related devices varies, so it’s also wise to explore reimbursement options or financial assistance programs before committing to a particular solution.

Final Thoughts

Living with single-sided deafness presents unique auditory and social challenges, but it doesn’t mean resigning oneself to a limited quality of life. Thanks to advancements in hearing technology—particularly CROS and BiCROS hearing aids, bone-anchored systems, and cochlear implants—individuals with SSD have more options than ever before.

Whether the goal is to improve communication, navigate everyday environments more safely, or simply enjoy conversations again, there’s a solution available to make life sound better. By seeking timely diagnosis and appropriate intervention, people with SSD can reconnect with the sounds—and people—that matter most.