One “Dead” Ear
November 15, 2021

One “Dead” Ear

A close up of a man 's face with a blurry background.

Today’s treatment options for single-sided deafness, often referred to as a “dead” ear, can vastly improve a person’s quality of life and safety.


Have you ever wondered why we have two ears instead of just one? Our ears come as a pair for several very important reasons. Here’s why.


Localization

Having an ear on each side of your head makes it easier to determine where sound is coming from. This is called localization. Try this experiment: Plug one ear then have someone stand behind you and speak to you. It becomes very difficult to determine, without looking, if the person is to your right, left or directly behind you.


Clarity

Having two ears also allows you to hear sounds more clearly. Have you ever listened to a stereo, and one speaker is not working? How does it sound? Muffled and garbled, right? Two speakers give you crisper, louder sound. The same is true with your two ears.


Cushioning

Having two ears also provides cushioning for louder sounds as the sound is divided between both ears. It allows you to tolerate sudden, jarring sounds much easier.


With all this in mind, it is simple to understand how important it is to receive sound from both sides of the head. Now consider that a unique type of hearing loss, called single-sided deafness, affects tens of thousands of Americans. Just as the name of the condition implies, single-sided deafness is when a person has lost all hearing in one ear and has normal to even profound hearing loss in the other ear. The condition is also referred to as having a “dead” ear.


Though the precise causes for single-sided deafness are not always identified, it may be caused by viral infections, a sudden and prolonged decrease in blood pressure, Meniere’s disease (an inner ear disorder which causes dizziness), a stroke within the inner ear, genetic defects, vascular diseases, physical trauma to the head or ear, autoimmune diseases and surgical removal of tumors within the lower part of the brain.


Each year, 60,000 new cases of single-sided deafness are diagnosed in the United States, and since your brain expects to hear sounds from both the right and the left ear equally, single-sided deafness can be a real challenge for those who suffer with it. Commonplace activities—that those with normal hearing take for granted—are hurdles that must be surmounted daily. In fact, those with single-sided deafness report that difficulty understanding basic conversations with others, especially when any background noise is present, is one of the most difficult struggles associated with the condition.


Patients with single-sided deafness often relate that every listening environment requires a plan, a workaround. For instance, professionals with single-sided deafness often mention that they must arrive at meetings early to carefully pick a seat in the room which will allow the best opportunity to hear as much as possible.


Mike Gallagher, age 75, struggled with single-sided deafness since birth. He related this experience: “I was in management at Wal-Mart for 20 years, and my hearing loss really impacted my work life. Tasks like working a check-out line were impossible for me because as I scanned items for purchase, I wasn’t able to distinguish a beep at my register from beeps at other registers. When someone called to me over the walkie-talkie, I couldn’t hear them. When I finally addressed my single-sided deafness, it made a huge difference in my life.”


A parent of a child with the condition explained that participating in Little League, an iconic childhood pastime, was a struggle for her young son because the typical raucous background noises of a ball field make verbal cues from the coach almost impossible for him to discern and process.


Attending a church service, eating in a restaurant, conversing with a loved one on a car ride, recognizing a honking horn in traffic—all these activities become a mountain to climb for those with single-sided deafness. And what does this mean for the brain? It is working double time to keep up. Those with single-sided deafness report that everyday listening environments can be intimidating, stressful and exhausting. In fact, a technical audiologic term even exits for it—listening fatigue. Over time, research shows that various forms of untreated hearing loss—including single-sided deafness—can lead to social isolation, anxiety, and depression and can contribute to brain tissue loss and dementia.


Most troubling is that single-sided deafness is all too often discounted and left unaddressed because of a lack of awareness and understanding of the condition and of the treatment options, even among some medical practitioners. People with single-sided deafness are told their hearing is “adequate,” that they will “adapt” and are left untreated.


Here’s the great news though! Advancements in hearing aid technology now offer a host of options so that “adequate hearing” and “adapting” can become a thing of the past for many with the condition. By working with your partner in hearing health—a university-trained audiologist—restoration of the sensation of hearing from both sides is now available for many challenged with single-sided deafness.


Current treatment and technology options are outlined below, and it is worth noting that this advanced technology is available from reputable, university-trained audiologists and not through channels like hearing aid counters at big box stores or off the internet.


Contralateral Routing Of Signals (CROS) hearing aid system

With a CROS hearing aid system, a person wears a device on the poorer ear that wirelessly transmits sound signals from that side of the head to an instrument on the better ear. If a person also has some hearing loss in their better ear, a BiCROS device can address their needs for both ears, with a BICROS being a CROS transmitter paired with an active hearing aid. Several of the major hearing aid manufacturers offer a CROS and BICROS system.


Bone-conduction hearing aid

With a bone-conduction hearing aid, a bone vibrator is held on the mastoid bone behind the poorer ear by a soft or rigid headband. The aid detects sounds and transmits the information through micro-vibrations of the skull to the better ear.  


Bone-anchored hearing aid

A bone-anchored hearing instrument acts similarly to the bone conduction hearing aid. However, it requires the surgical placement of a magnet or titanium screw within the mastoid bone behind the poorer ear. Following recovery from this surgical placement, the hearing aid is then attached to the screw or magnet leading to optimal sound transmission via vibrations of the skull to the better ear.



People with single-sided deafness experience a unique hearing impairment. However, by partnering with your audiologist, who can recommend and offer support for adjusting to today’s available CROS, BICROSS, bone-conduction or bone-anchored technology, the person with single-sided deafness can experience vast improvement in many facets of life. They can enjoy better communication with friends, family, co-workers and others in a variety of listening settings. Safety issues associated with not being able to respond to cues like sirens and alarms are minimized.


Treating hearing loss can help reduce a person’s risk for co-morbidities associated with the loss like anxiety, depression and dementia. And statistics support that addressing single-sided deafness—and all forms of hearing loss for that matter—can even increase a person’s ability to advance in their career and have a higher earning potential.


To learn more about single-sided deafness and to work with an audiologist trained in all types and degrees of hearing loss, please contact Johnson Audiology.

 

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Like anything new in life, adjusting to hearing aids can take time and perseverance to achieve the best results. Yet many people are too quick to give up, not allowing the brain the chance to relearn how to hear or not giving themselves the opportunity to become accustomed to the use and maintenance of their devices. “We meet so many people who wait—who convince themselves their hearing is not ‘bad enough’ or that they can just get by. But untreated hearing loss quietly steals moments, connection, and joy. At Johnson Audiology, we understand the fear, the frustration, and the doubt. That is why we offer more than hearing aids—we offer compassion, answers, and a partner you can trust. You don’t have to do this alone. Let us help you hear your life again,” says Dr. Megan Johnson, audiologist and owner of Johnson Audiology. “Hearing aids should never be an experience where a person is fit with devices and then they never see their hearing care provider again. To ensure patient success, Johnson Audiology seeks to be a lifelong partner on a person’s journey to healthy hearing, someone who is there at every turn,” says Dr. Megan Johnson, audiologist and owner of Johnson Audiology. What are the most common reasons why people give up on hearing aids and why is it important to stick with it? Reasons why people might give up on hearing aids An adjustment period It is your brain that hears, not your ears. The ears transmit sound to the brain where it is interpreted. Dr. Johnson explains, “When a person’s brain has not been stimulated by sound because of hearing loss and then sound is restored with hearing aids, it can take some getting used to. For some people, it takes more than one appointment to get them up to full sound prescription, stair stepping up gradually to let the brain adjust. The brain’s capacity to do this is called neural plasticity .” Research by the University of Colorado Boulder’s Hearing Epidemiology and Research Diagnostic Laboratory has revealed that what the brain can experience impacts within weeks rather than years when hearing loss reaches a certain level. Dr. Johnson says, “The brain’s temporal lobe is where much of hearing and sound interpretation happens. Electroencephalogram (EEG), which is a medical test that measures the electrical activity of the brain, shows that in the presence of hearing loss, the brain will recruit areas assigned to other tasks—like vision—to compensate. The trouble is that this extra cognitive load can tax those areas. However, after treatment with hearing aids, brain recruitment is shown to reverse, partially or fully.” The adjustment period for hearing aids tends to be more seamless for those who have not been without sound for years and years. Dr. Johnson says, “I always encourage people to get their hearing checked when they first notice they are struggling. Sooner is always better.” An investment in quality of life People often make an investment in their health and well-being—for example, purchasing glasses, getting a knee replacement, straightening their teeth—and yet many relegate hearing to the backburner because of cost. Dr. Johnson says, “I’ve seen many patients struggle with hearing aids after buying inferior products in an attempt to save money. Without the guidance of a hearing care provider, even the best device can quickly become ineffective and frustrating.” Dr. Johnson encourages making hearing a priority and budgeting for your hearing health. Perceived benefits and ease of use Getting in the routine of putting hearing aids in each day and being diligent about regular cleaning and maintenance might be a challenge that some face and which deters them from being successful with their aids. “At Johnson Audiology, we offer a plan for regular in-office cleaning and maintenance, easing the task of upkeep for patients. Plus, our offices have dedicated walk-in hours that do not require an appointment. We are here to answer questions, make hearing aid adjustments, and much more as we seek to help people safeguard their investment in hearing technology and make the process easy and convenient.” Family attitudes and support When it comes to hearing aids, having a support system can be crucial to success. “In my 20 years as an audiologist, I have seen the immense benefits when a person’s family members show patience and support during the adjustment period with new hearing aids,” said Dr. Johnson. What about patients who do not have that familial encouragement? Dr. Johnson says, “We are your support system. That’s where our caring and professional audiologists, audiology assistants, and patient care coordinators can lend a helping hand. Success with hearing aids is our goal for every patient, so we promise to be there every step of the way.” Why is healthy hearing so important Hearing loss is a family affair The positive impact of treating hearing loss is often manifested most significantly through improved relationships with family and friends. Hearing loss leads to miscommunication. It can also cause mounting frustration as family members must constantly repeat every sentence. Dr. Johnson comments, “Living with the TV blaring can put a strain on others living in the same household. Untreated hearing loss can quietly tear at the fabric of your relationships. When words go unheard and conversations fade, love and connection start to suffer, and that pain is felt by all involved.” Healthy hearing can help the brain stay sharp and pliable For many years, researchers at Johns Hopkins University have been studying the relationship between hearing loss and dementia. While there is still much left to discover, increasingly scientists recognize healthy hearing as a key factor in maintaining a healthy brain and potentially decelerating the risk of dementia, like Alzheimer’s disease. Dr. Johnson says, “It seems logical that when certain areas of the brain are not stimulated by sound, they atrophy. In fact, research suggests an actual reduction in the physical size of the brain, especially in areas where sound processing and memory take place.” She goes on to say that “while there are many risk factors that individuals cannot control about the effects of aging on the brain, hearing is definitely one that can and should be addressed.” Healthy hearing keeps a person engaged in life Humans are social beings. Since hearing loss can impair effective communication, it is not difficult to understand how it also could lead to social isolation, which can cause increased anxiety and depression. “Conversely, addressing hearing loss can keep a person engaged in life and connected to family and friends,” Dr. Johnson says. Falls and other health risks The ears have two main functions. Hearing is one that most of us learn as youngsters, but the ears also play a major role in helping a person maintain their balance and knowing where their body is in space. “The fluid, or endolymph, in the ear’s semicircular canals is what helps a person do things like stand up from a seated position without falling, walk a straight line, and not run into a door frame when turning a corner into a room,” says Dr. Johnson. In the presence of hearing loss, the reduction in acoustic signals impairs a person’s ability to process spatial information and can mean a higher risk for falling. In turn, falling can lead to broken bones and other injuries and a cascading effect of hospital stays and loss of independence. If you have been unsuccessful with hearing aids in the past, call Johnson Audiology, a hearing health clinic comprised of caring and professional staff. The team can bring a range of options to the table to help people hear better, including hearing aids from all six of the major manufacturers, custom fit products, cochlear implants, and Lyric, the world’s only extended wear hearing aid. Call your office of choice today or schedule online.