In this guide, you’ll learn what unilateral hearing loss is, the causes, the urgent warning signs of sudden loss, the cause of unilateral tinnitus without hearing loss, and treatment options ranging from hearing aids to bone conduction implants and cochlear implants.

What Is Unilateral Hearing Loss?

Unilateral hearing loss is reduced hearing ability in one ear only, ranging from mild hearing loss to profound deafness. Sounds may seem quieter, unclear, or harder to understand on the affected side. The hearing loss can be transient, fluctuating, progressive or permanent. When one ear has little or no usable hearing, it is often called single-sided deafness (SSD).

Why Am I Deaf in My Right/Left Ear?

If you’re wondering why you’re deaf in one ear, the cause can range from temporary issues like earwax or infection to sensorineural damage in the inner ear or hearing nerve.

If the hearing loss appeared suddenly, a hearing loss evaluation needs to be done urgently. A hearing test is the fastest way to find out what is causing sudden hearing loss and how it can be treated.

Symptoms of Unilateral Hearing Loss

Even mild unilateral hearing loss can be frustrating. Common symptoms include:

• Difficulty hearing in noisy environments
• Trouble locating where sounds are coming from
• Needing to turn your head to hear or “favoring” one ear
• Increased listening fatigue
• Missing speech on the affected side

In a restaurant, voices on your affected side may disappear into background noise. While driving, it can be harder to tell where sirens or other cars are coming from.

Causes of Unilateral Hearing Loss

The causes of unilateral hearing loss can range from simple blockages in the ear to inner ear or nerve damage.

Causes Affecting Sound Transmission (Often Treatable)

• Earwax buildup blocking the ear canal
• Middle ear infections or fluid
• Eardrum problems

These issues often affect how sound is transmitted through the ear and may improve with treatment.

Causes Affecting Sound Transduction (Inner Ear) or Neural Transmission (Auditory Nerve)

• Noise-induced hearing damage
• Ménière’s disease
• Viral or autoimmune inner ear inflammation
• Age-related inner ear changes
• Vascular causes

This type is known as unilateral sensorineural hearing loss and usually involves damage to the inner ear or hearing nerve.

Less Common but Important Causes

• Benign tumors such as vestibular schwannoma
• Head trauma
• Circulatory or neurological conditions

In some cases, even after testing, the exact cause remains unknown.

Unilateral Tinnitus Without Hearing Loss—Is That Possible?

Yes. Tinnitus can occur even when a standard hearing test appears “normal.” Possible explanations include:

• Hidden hearing damage
• Pressure or middle ear issues
• Stress or jaw problems

Get it checked if you experience tinnitus:

• Only on one side
• Accompanied by hearing changes
• Combined with dizziness or balance problems

Unilateral tinnitus deserves medical attention, even without obvious hearing loss.

Treatment Options for Unilateral Hearing Loss

The best treatment option depends on how much hearing remains in the affected ear, your listening needs, and your lifestyle.

Medical treatment

For hearing loss caused by impaired sound transmission, treating the underlying condition is often effective to restore the hearing fully or partially.

Hearing Aid (If the Ear Still Has Usable Hearing)

For mild-to-moderate unilateral loss, a unilateral hearing aid can amplify sound for the affected ear to improve speech understanding.

CROS/BiCROS Hearing Aids

A CROS (Contralateral Routing of Signal) system picks up sound from the deaf ear and routes/transmits it wirelessly to a receiver on the better-hearing ear. BiCROS adds amplification if the better ear also has hearing loss. These hearing aids improve awareness on the poorer-hearing side but don’t restore sound localization.

Bone Conduction Devices

Bone conduction devices like ADHEAR or BONEBRIDGE transmit sound vibrations through the skull. They can help with SSD or conductive hearing loss and can improve sound awareness without blocking the ear canal, but don’t restore sound localization.

Cochlear Implants for Single-Sided Deafness

Cochlear implants are an option for people with severe-to-profound unilateral hearing loss as they stimulate the hearing nerve directly. Wearing a CI may improve speech understanding in noisy environments and help with sound localization and tinnitus in the affected ear. Getting a CI requires a specialist assessment and an evaluation for candidacy. For CI users, cochlear implants can significantly improve quality of life.

Next Steps

If you suspect unilateral hearing loss, here’s a simple checklist:

• Book a hearing test (audiogram) to confirm type/degree of loss.
• If loss is sudden, see an ENT urgently and request prompt testing.
• Explore hearing solutions early—hearing aids, CROS/BiCROS, bone conduction, or cochlear implants—to reduce listening fatigue and improve daily life.