Although most people with hearing loss have a binaural (both ears) loss, there is also the less common unilateral, or one sided, hearing loss.

The most clear example of this pattern is the person with perfect hearing in one ear and a complete loss of hearing in the other ear.

Typical causes of the unilateral loss are trauma (blow to the head), ear infection, viral infection, a blockage in the blood flow to the ear, and inherited hearing loss and even earwax blocking the ear canal.

If a child is born with unilateral hearing loss, the loss is often not detected until 5 or 6 years of age because the child will appear to hear normally and speech and language development should not be affected.

Another common case is the person with significant hearing loss in both ears who uses only one hearing aid. This person will experience the same difficulties as the person with the unilateral loss, even if hearing in the aided ear is excellent. Some of these difficulties are one-sided hearing, understanding speech in noise, determining the sound source and stress and fatigue.

With one-sided hearing the person won't hear well from the affected side and may ask people to “stay on the good side.” Speech and noise will be heard only by the good ear, making it harder to differentiate the speech from the noise. It is also virtually impossible for someone with unilateral hearing to localize a sound because all sounds, regardless of direction, are heard in the same place, the good ear. The stress and the fatigue of having to use the one good ear constantly forces the listener to work harder to hear well.

Research indicates that unilateral hearing loss does have significant effects on the person's ability to communicate and psychosocial status. Individuals with unilateral loss should make sure they receive appropriate medical and audiological care.

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