Single-Sided Deafness (SSD)/Unilateral Hearing Loss

Mount Sinai’s Division of Otology-Neurotology is a global leader in hearing rehabilitation with one of the largest and most comprehensive cochlear implant and bone-anchored implant centers in the United States. Working as a multidisciplinary team, we are able to treat patients with all types of hearing loss, including those with single-sided deafness (“SSD”)/unilateral hearing loss, who only have hearing in one ear.

About Single-Side Deafness
Hearing loss is incredibly common worldwide and in the United States. According to the National Institutes of Health, nearly 40 million American adults report difficulty with hearing, and at least 30 million could benefit from some type of hearing solution. SSD, or severe hearing loss in only one ear, is far less common (only affecting up to 350,000 Americans), and may stem from birth, infections, acoustic neuroma, trauma, or a vascular disorder.  

Symptoms and Diagnosis of SSD

The following symptoms are suggestive of SSD:

  • Tinnitus, or a ringing in one ear
  • Frequently asking others to repeat something they said
  • Reliance on one ear over the other in person and over the phone
  • Difficulty hearing conversations, particularly in noisy environments such as restaurants and sporting events
  • Difficulty hearing the TV at a normal volume
  • Difficulty identifying the source of a certain sound
  • Lack of interest in socializing

At best, these symptoms can be annoying; however, they can pose significant health and safety risks such as when driving or crossing the street. Hence, it is important to consult a physician if you are concerned about your hearing.

Diagnosis typically involves an evaluation performed by an otolaryngologist (ear, nose and throat doctor), a hearing test conducted by an audiologist, and an MRI of the inner ear and brain. After a comprehensive evaluation, the team can make informed recommendations about treatment options.

Treatment Options for SSD
There are several treatment options for hearing rehabilitation that depend on a number of factors that the team can discuss with you:  

Cochlear Implantation: When someone has hearing loss so severe that a conventional hearing aid will not help, cochlear implantation is an excellent option for restoring hearing. When cochlear implants were first FDA-approved in the 1980s, they were for people who had profound hearing loss on both sides. Since then, they have been successfully used in more and more patients with varying degrees of hearing loss. The FDA approved their use in patients with SSD in 2019. Cochlear implants have an internal device that is placed surgically and an external component that receives sound. Because it is the only treatment to directly stimulate the inner ear, it is the only option that allows patients use of both ears and localize sound. This is particularly effective in patients with SSD who suffer from disabling tinnitus, or ringing in the ear.  

Bone anchored hearing aid (BAHA) implant: Bone anchored hearing aid implants convert sounds into bony vibrations that are sensed by the inner ear. Because the inner ear is not functional in SSD, these bony vibrations are only picked up in the opposite, or working ear. Bone anchored implants are especially helpful to individuals who are constantly turning their head toward the good ear or for people who insist that others talk to them on their good side. However, they will not provide you with two functional ears, do not improve tinnitus, and have limited benefit in helping you to localize sound. Nothing has to be worn in the good ear in order for this to work.

Contralateral routing of signal (CROS) devices: CROS devices are specialized hearing aids that re-route sound from the bad to the good ear and do not require surgery. They look just like regular hearing aids, but because they are re-routing sound, something needs to be worn in both ears, even if the good ear is working perfectly. While a great option for some, others do not like wearing something in their good ear. If there is hearing loss in the better ear, then a hearing aid can be worn in the good ear and also receive sound from the bad ear (this is called a BiCROS).   

Conventional Hearing aid: This is the preferred option when the hearing loss in the bad ear is mild or moderate.