Partially Deaf in one ear? 8 Causes of hearing loss in one ear

Is your hearing worse in one ear? Perhaps you’re experiencing partial hearing loss in your left or right ear over time or you’ve noticed sudden deafness after a trauma?

A rapid decline in hearing within one or both ears could signal various health issues, such as an infection, accumulation of earwax, head injury, and growth of a tumour, among others, some of which require immediate medical attention. Additional manifestations may include vertigo, ringing in the ears (tinnitus), and further symptoms.

Most people are affected by deafness in both ears, referred to as “binaural” hearing loss. But some people lose their hearing in one ear which is often referred to as SSHL or Sudden Sensorineural Hearing Loss.

This condition can develop at birth or later in life, depending on the cause. Also known as “unilateral hearing loss” or “unilateral deafness”, this can mean complete hearing loss or deafness in one ear. The other ear remains unaffected, and you should still be able to hear clearly through it.

It’s important to contact your doctor promptly if you suddenly experience hearing loss. Sudden hearing loss is classed as a medical emergency (sensorineural) and requires immediate attention. Your doctor will be able to provide treatment options or refer you to an experienced audiologist. 

Hearing Loss Explained

As we get older, hearing loss becomes an increasing problem. It occurs gradually as you age and is known as presbycusis. Over 11 million people are affected by hearing loss in the UK, making it a common issue, especially amongst the older population.

Loss of hearing is categorised into three types:

• Conductive(outer or middle ear)
• Sensorineural (inside the ear)
• Conductive and sensorineural (combination of both)

There are lots of causes of hearing loss. Ageing, chronic exposure to loud noises or excessive ear wax build-up can temporarily cause deafness. But deafness in one ear can be caused by a number of symptoms as we’ll explain in this article.

How does being deaf in one ear affect a person’s hearing? Symptoms of Unilateral Deafness

If you’re experiencing any of the below symptoms, then you have likely lost your hearing in one ear. Unilateral deafness presents challenges that can make everyday life difficult.

Depending on how severe your condition is, you might experience the following:

1. You can’t work out where certain sounds are coming from — the brain works out where sound is coming from via sound localisation. Whichever ear receives the sound first indicates the location of the sound. If you suffer from hearing loss in one ear, you may have trouble working out where the sound is coming from.
2. You find yourself having to concentrate to hear — the brain filters out noises that aren’t useful through selective listening. This works better through two working ears — listening becomes an increasing effort and may leave you feeling tired and stressed. This can lead to trouble communicating and understanding other people, making loud places highly disorientating.
3. You’re asking people to speak up, or having the TV on much louder than usual — Your brain naturally hears sounds more loudly when they’re received through both ears. The nerves located in both ears pass signals to the brain, which uses this information to interpret sound. So if you’re listening to music or watching TV at a higher volume than necessary, it might be a sign of unilateral hearing loss.
4. Your hearing is muffled — Known as the “head shadow effect”, high-frequency sounds have to pass through the head to be received by the other functioning ear. Sounds can’t bend around the head to reach the other side, so sounds like birdsong can sound muffled and difficult to locate.
5. You have a ‘good side’ – if you’ve spoken to someone who can only hear out of one ear, you’ll notice that they may seemingly ignore you when you start up a conversation. You’ll often have to make sure you’re on the ‘good ear’ side to be heard.

Our ears are responsible for both hearing and balance, so hearing loss can impact your physical stability. If you’re feeling dizzy, it might be another symptom of unilateral deafness.

Causes of hearing loss in one ear

Now that you’ve evaluated your symptoms, it’s useful to determine what causes loss of hearing in one ear. Sometimes this can be due to excessive ear wax build-up in the ear canal or an ear infection. In other cases, unilateral hearing loss can be a problem with the function of the ear itself.

There are eight main causes of deafness in one ear:

• Ageing — This is due to changes in your inner ear as you get older. Factors such as genes and exposure to loud sounds over several years can cause accelerated hearing loss.
• Earwax buildup — A build-up of earwax in your ear canal can make your ear feel blocked and cause difficulties in hearing.
• Ear Infections — Ear infections cause problems with hearing and produce excess discharge from your ear, clogging it up.
• Ruptured Eardrum — This can happen when you insert foreign objects into your ear, accidentally perforating the eardrum. This can also result from a change in air pressure (e.g. flying) or loud noises.
• Diseases — Some symptoms of medical conditions such as Ménière’s disease include hearing loss.
• Head injuries – Trauma to the head can damage the structures of the ear or the nerves responsible for hearing.
• Vascular Diseases: Conditions affecting the blood vessels, such as stroke, can impact hearing if the inner ear or the auditory nerve is affected.
• Sudden Sensorineural Hearing Loss (SSHL): An unexplained, rapid loss of hearing that can occur instantly or over several days. SSHL requires immediate medical attention.
• Noise Exposure: Sudden loud noises or prolonged exposure to loud sounds can damage the inner ear, leading to temporary or permanent hearing loss on one side.

What do our audiologists say?

We often see firsthand the challenges that individuals face when experiencing deafness in one ear, also known as unilateral hearing loss. This condition not only affects one’s ability to localise sound but also significantly impacts daily communication, social interactions, and overall quality of life. It’s crucial to understand that even though one ear may function normally, the loss in the other ear creates a unique set of challenges that require specialised attention and care. Early intervention and tailored hearing solutions are key to managing unilateral hearing loss effectively, enabling individuals to lead full and active lives despite their hearing impairment.”

Lee Fletcher:( RHAD), (BSHAA), Ba(Hons)
Company Director, Principal Audiologist

How Much Can Earwax Affect Hearing?

The ear naturally produces wax to clean and protect the delicate inner ear. It’s produced by glands on the outer layer of skin inside your ear canal. Earwax and tiny hairs work to trap foreign particles and dirt that could harm your eardrum.

Typically, earwax moves to the outer ear, pushed out by the cilia (tiny hairs) — but sometimes it blocks up the ear canal and causes hearing loss. Luckily, this is easily treatable. Your doctor can remove the excess ear wax by using a suction machine or manually with a tool like a curet that will gently scrape out the wax. If the wax is hard to remove, your doctor might use an ear bulb syringe, warm water or ear drops to soften the wax.

Related: How to Safely Remove Earwax: Top Tips

Can Ear Infections Cause Hearing Loss?

Both bacterial and viral ear infections can cause loss of hearing. Ear infections, such as Otitis externa, cause fluid to build up in the ear canal, resulting in some cases in temporary hearing loss. Antibiotics are the best way to clear the infection and get rid of the fluid blocking up your ear.

Deafness from Ruptured Eardrums

The eardrum is a very delicate part of your ear. It’s a thin layer of skin stretched tightly (like a drum) and separates the outer ear from the middle ear. The eardrum is a crucial part of hearing a sound, as it vibrates in response to soundwaves that our brain interprets into information.

Your eardrum can rupture from an ear infection, loud noises like explosions or pressure caused by flight landings and take-offs. Be mindful of taking relevant precautions when flying, like earplugs to relieve air pressure in your ears. A ruptured eardrum can also be caused by inserting objects into the ear, like cotton buds used to clean inside the ear canal.

It isn’t recommended to use cotton swabs to clean the inside of your ear. Using a cotton bud can push earwax further into the ear canal and cause further blockage. Swabs can also cause damage to sensitive structures behind the ear canal, rupturing the eardrum and causing other medical implications.

Ménière’s Disease

Ménière’s disease is a chronic disorder that affects the inner ear, which can cause problems with hearing and balance. Ménière’s disease can affect any age group but is more likely to be experienced by those in their 40s and 50s.

Ménière’s is caused by increased pressure in the inner ear, which can be due to head injuries, allergies, infections or stress — to name a few. Symptoms of Ménière’s include dizziness, hearing loss and tinnitus.

It’s best to consult your doctor if you’re suffering from Ménière’s. They may prescribe inner ear infections with antibiotics such as gentamicin or recommend some lifestyle changes to ease symptoms. Reducing salt intake, drinking less caffeine and stopping smoking can help relieve the symptoms of Ménière’s disease.

Other Medical Conditions That Cause Hearing Loss in One Ear

In addition to the above, other medical conditions can cause impaired hearing on one side.

• Acoustic neuroma — These are noncancerous tumours that are typically benign. Growing on the nerve that connects the brain to the ear, these tumours can grow too big and damage them, causing hearing loss.
• Labyrinthitis — There are two vestibulocochlear nerves in your inner ear that send spatial and navigational information to your brain. When one of these nerves becomes inflamed, it creates the condition called Labyrinthitis.
• Neurofibromatosis type 2 — A genetic disorder that causes tumours to grow in the brain, spinal cord and nerves. Neurofibromatosis type 2 tumours develop on the eighth cranial nerve that connects the brain to the inner ear. They’re known as acoustic neuromas and cause hearing loss.
• Shingles — characterised by a red skin rash, shingles is an infection caused by the varicella-zoster virus ( the same virus that causes chickenpox). Visible symptoms are painful blisters that appear on one side of the body, often on the torso, face or neck. In some cases, symptoms can escalate to hearing loss and dizziness.

Typical complaints of deafness in one ear

At Regain Hearing Clinic, it’s a common complaint for our patients to ask ‘Why can’t I hear out of one ear?.’ Typically, we find that the causes are generally categorised in one of 4 groups depending on the type and onset of the hearing loss:

Partial hearing loss in one ear with ringing?

Possible causes:

• Tinnitus: Earwax buildup can cause Tinnitus. It’s common for earwax to trigger tinnitus by blocking the ear canal in one or both ears.
• Noise-induced Hearing Loss: Exposure to loud noise can damage the inner ear, leading to hearing loss and often accompanied by tinnitus.
• Meniere’s Disease: This disorder of the inner ear can cause fluctuating hearing loss, tinnitus, and episodes of vertigo.
• Acoustic Neuroma: A noncancerous tumour on the auditory nerve can press against it, leading to hearing loss and ringing in the affected ear.

Hearing loss in one ear with no pain

Possible causes:

• Sudden Sensorineural Hearing Loss (SSHL): An abrupt drop in hearing sensitivity without an apparent cause. It’s often unaccompanied by pain.
• Ototoxic Drugs: Certain medications can damage the inner ear, resulting in hearing loss without pain.
• Viral Infections: Some viral infections can lead to sensorineural hearing loss by affecting the inner ear or the auditory nerve.

Muffled hearing in one ear

Possible causes:

• Earwax Blockage: Accumulation of earwax can obstruct the ear canal, leading to muffled hearing.
• Eustachian Tube Dysfunction: This condition prevents the equalisation of pressure across the eardrum, causing muffled hearing or a feeling of fullness in the ear.
• Otitis Media with Effusion: Fluid buildup in the middle ear without infection can muffle sounds.

Sudden hearing loss in one ear

Possible causes:

• Sudden Sensorineural Hearing Loss (SSHL): A rapid loss of hearing, typically in one ear, that can occur suddenly or over a few days. The cause is often idiopathic but can be related to viral infections or vascular disorders.
• Traumatic Injury: Physical damage to the ear or head can lead to sudden hearing loss.
• Labyrinthitis: An inner ear infection that causes inflammation of the nerves responsible for hearing and balance, leading to sudden hearing loss and vertigo.

Each of these conditions requires prompt evaluation by a healthcare professional for accurate diagnosis and appropriate management. Early treatment can significantly improve outcomes, especially in cases like SSHL, where immediate intervention is critical.

Treating Hearing Loss in One Ear

Unilateral deafness can be frightening and disorientating, adding stress to daily life. Fortunately, hearing loss in one ear is usually easily treatable and only temporary. It’s well worth consulting a specialist ear clinic to receive the diagnosis and answers that encourage a speedy recovery.

Regain Hearing is an independent specialist ear clinic based in London and Kent that offers industry-leading hearing solutions. Book a hearing test consultation today with same-day appointments and home callouts available.