Understanding Unilateral Hearing Loss

Imagine being in a big, noisy room full of people chatting, like at a school assembly or a birthday party. Imagine you can only hear sounds from one side of your head. That’s what it’s like for people with unilateral hearing loss, which means hearing loss in just one ear. Their other ear may have perfect hearing or be slightly weak, but all their “hearing work” relies on that one good ear.

For people with unilateral hearing loss, hearing can feel unbalanced. For example, they may find it hard to tell where a sound is coming from (localisation), which can sometimes be confusing and even scary. If someone calls their name from their weaker side, they might miss it or must keep turning their head to hear. If they hear an ambulance siren blaring, it can be hard to determine which direction it is coming from. In noisy places, like a classroom or playground or restaurant, focusing on sounds from their “bad ear” side is tricky because their good ear is doing all the heavy lifting.

What Are CROS and BiCROS Hearing Aids?

Thankfully, a clever solution for people with unilateral hearing loss are CROS and BiCROS hearing aids. These devices can make life feel more balanced by helping people hear sounds from both sides of their heads. Here’s how they work:

• CROS (Contralateral Routing of Signal): This hearing aid system is designed for people with one ear that works fine and another with no or minimal functional hearing. A CROS system places a small microphone in the weaker ear. When sounds are picked up on that side, they are sent to a hearing aid on the good ear. So, if someone is talking on your wrong side, the microphone on that side “catches” their voice and sends it to your better ear. It’s almost like having a little helper ear on the non-functional side!
• BiCROS Hearing Aids: BiCROS is for people with single-sided deafness who also have some hearing loss in their better ear. Like CROS, BiCROS picks up sounds from the bad ear and routes them to the better ear. But in this case, the better ear also has a personal prescription set up in the hearing aid to help with the hearing loss in the better ear.

How CROS and BiCROS Hearing Aids Make Life Easier

These hearing aids don’t give you “two ears,” but they make it feel that way by creating a “balanced” hearing experience. Often the brain is “tricked” into feeling like it does hear from the non-functional side. Let’s explore some real-life situations to see how helpful they can be:

1. At School

Imagine a child named Sarah who has unilateral hearing loss. When sitting in class, Sarah might struggle to hear classmates if they are on her “bad ear” side. If her teacher stands on that side to give instructions, Sarah might miss some important things that they are saying. However, with a CROS hearing aid, the teacher’s voice is sent directly to her good ear, even if coming from her weaker side. This way, Sarah doesn’t have to keep turning her head and can focus more on learning. In group work, where students are all talking at once, her CROS aid helps her feel like she’s part of the conversation, even if some friends are on her non-functional side. Sarah can stay more engaged and doesn’t feel left out, which helps her have a smoother time at school and makes learning more enjoyable.

• Playing Sports

For kids and adults alike, sports can be challenging, with unilateral hearing loss. Jamie loves playing soccer but has trouble hearing his coach’s instructions or his teammates’ calls if they’re on his “bad ear” side. In a fast-paced game, it’s easy for him to miss important cues, which can frustrate him and his team. With a CROS or BiCROS hearing aid, Jamie can hear teammates calling his name, even if they’re on his weaker side. He can better track the game, localise who calls out, respond faster, and feel more included. This can make a big difference in his confidence and enjoyment of the game because he’s not missing out on important moments.

• At Home with Family

In a family setting, especially during meals, people often sit around a table and talk from different directions. For someone with unilateral hearing loss, it can feel like they’re missing half the conversation if a family member is sitting on their wrong ear side. They might feel like they’re always leaning or turning their head to stay in the loop. A CROS hearing aid makes catching every word at the table more accessible. If Dad is talking from one side and Mum from the other, the person with unilateral hearing loss can hear them without missing out. This makes family time more enjoyable and helps them feel more connected to their loved ones.

• Crossing Busy Streets

Crossing streets safely requires being aware of sounds from all directions. For someone with unilateral hearing loss, hearing cars approaching from their bad ear side can be difficult, making it harder to detect where the sound is coming from. This can be risky. With a CROS or BiCROS hearing aid, they can hear sounds from both sides more clearly. If a car is coming from their weaker side, the sound will reach their good ear, helping them stay alert and cross more confidently. This added sense of awareness helps them feel safer and more secure in everyday situations.

• Talking to Friends in Noisy Places

Imagine you’re at a bustling party or shopping centre with lots of background noise. For someone with single-sided hearing loss, it can be challenging to focus on their friend’s voice if they’re on their weaker side. Background noise, like other people talking, can make it even harder for their excellent ears to manage. A CROS or BiCROS hearing aid helps by giving excellent ear information from both sides, making it easier to hear their friend without feeling overwhelmed by noise. They won’t need to keep turning their head to try and listen from their stronger ear, and conversations feel more relaxed and natural.

• Enjoying Nature Sounds

Simple activities like walking in nature can feel different for someone with unilateral hearing loss. They may miss out on birds chirping, leaves rustling, or other sounds on their weaker side, making the experience feel incomplete. With a CROS hearing aid, sounds from around them come through, giving them the whole nature experience. Whether the sound of a stream on one side or the wind blowing through trees, they feel like they’re hearing everything as it’s meant to be, making outdoor activities more enjoyable.

How CROS and BiCROS Hearing Aids Create “Balanced” Hearing

With a balanced sense of hearing, everyday tasks, conversations, and social interactions become much easier and more comfortable. Instead of constantly feeling like they need to turn their head or focus extra hard, people with unilateral hearing loss can move through their day more naturally. They experience the world in a way that feels more “whole,” just like someone with two strong ears.

Conclusion

For people with unilateral hearing loss, CROS and BiCROS hearing aids provide a remarkable change. They make conversations easier, boost confidence in social settings, and even improve safety by helping them be more aware of sounds around them. These hearing aids open up a more balanced sound world, making life feel fuller and more natural.

Through CROS and BiCROS hearing aid systems, people with single-sided deafness can better enjoy the world’s sounds—from the busy chatter of friends to the calming rustle of nature, allowing them to feel more connected and included. At The Audiology Place, Dr. Signe Steers has many years of experience in managing patients with unilateral hearing loss.

Dr Signe Steers

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