Single-sided deafness (SSD), or being deaf in one ear, isn’t exactly the poster-child for disabilities. Rather, it’s an overlooked one that is often misunderstood by the public. There is no way to see SSD, also called profound unilateral sensorineural hearing loss, so those who suffer from it are often misperceived as “rude” or “unintelligent” when they don’t understand or quickly respond to others. That’s just one of the many less-obvious negative aspects of this condition.


Few people are aware how many SSD sufferers are among us. According to hear-it.org, about 60,000 people get SSD in the U.S. every year. Studies in school-aged children estimate as many as 3% have SSD, but it is difficult to be certain because the condition is often mistaken as a learning disability or behavioral concern, such as ADHD. These numbers are only estimates because sensorineural hearing loss develops over time in many cases, due not only to trauma or loud music, but also from other less-expected causes such as smoking and stress. Also, many people who are beginning to develop single-sided hearing loss treat it as a minor annoyance and don’t quickly seek medical attention.


A person with SSD has no problem hearing with his or her “good ear,” but things get complicated quickly. Important aspects of hearing such as sound localization and the ability to selectively listen to one conversation in a noisy room become almost impossible. For many SSD sufferers, it is very difficult to follow conversations, making social interaction exhausting and frustrating, increasing irritability, stress, jumpiness and anxiety, and headaches.


Even less obvious are the safety concerns for people, especially children, coping with SSD. Without 2 working ears, the brain interprets sounds as flat, hampering a person’s ability to determine the location and direction of traffic, for instance. Imagine trying to cross a busy street without the ability to hear where traffic is coming from. Or imagine knowing a family member is calling your name in the house but having no concept of where the sound is coming from. Even worse is missing sounds completely, such as the siren of an ambulance approaching. The hazards of daily life can sneak up on people with SSD.


Hearing sounds that don’t exist is another challenge of unilateral sensorineural hearing loss. Not only does the world not understand this condition, but your brain doesn’t understand it, either. As the brain tries to interpret missing sensory data it thinks should be there, it sometimes perceives high-pitched beeps or ringing, as with tinnitus. This can create confusion, distraction, and even dizziness.


All these effects add up to an overwhelming extent for many people with SSD. When the social stigmas and frustrations become too much, many withdraw from society and the activities they love. They don’t reach out for help because they think they should be able to manage. Some try to turn to traditional hearing aids, but these often aren’t the solution because they simply amplify sound. If the SSD sufferer’s problem is that the inner ear or cochlea isn’t functional, amplification won’t help.


The good news is that there are solutions available. One kind is contralateral routing of signals (CROS) using bone conduction. These techniques transmit sound to the inner ear via vibrations in the teeth (intraoral) or through a device surgically implanted deep within the ear canal (transcranial). The intraoral method uses a tiny, custom-fitted device in the mouth and a small, discreet tube running to a microphone placed in the impaired ear. The system is less conspicuous than a traditional hearing aid and can help ease some of the complications of single-sided deafness.