Cochlear Implants: The Right Choice For Single-Sided Deafness? - Attune
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Cochlear Implants: The Right Choice For Single-Sided Deafness?

cochlear implants

Single-sided deafness, or the complete loss of hearing in one ear, affects thousands of Australians, causing them to experience a long list of difficulties in everyday life. Whilst hearing can’t be fully restored, cochlear implants greatly reduce the impact of hearing loss. Could they be the right choice for you, too? Continue reading to find out!

Today’s article will explore how a cochlear implant can provide benefits for the hearing ability and overall well-being of those affected by single-sided deafness. As opposed to hearing aids, cochlear implants do not simply amplify sounds. Instead, they send electrical signals straight to the hearing nerve, bypassing parts of the ear that might have been damaged by trauma or disease. That makes them a viable solution when simple hearing aids aren’t enough.

We’ve previously discussed what cochlear Implants are, who they are for and how exactly they work. If you need a little refresher, check out this article.

Having any type of hearing loss is difficult and presents challenges with communication. Discussing your options with your trusted, local Audiologist is crucial. This will give you the information needed to make decisions about your hearing health, in particular, whether a cochlear implant is right for you.

What is Single-Sided Deafness (SSD)?

Single-sided deafness is the profound loss of hearing in one ear with normal hearing across frequencies in the other ear. This is also known as unilateral hearing loss. Single-sided deafness can have a range of causes. The reasons for having single-sided deafness as listed by the Ear Science Institute of Australia include the following:

  • Physical trauma to the ear such as a head injury
  • Severe Meniere’s disease
  • Viral or bacterial infection in the inner ear
  • Acoustic nerve tumour
  • Sudden hearing loss

signle sided deafness

The Hearing Difficulties To Be Addressed

Hearing loss in one ear can present many hearing challenges as listed:

  • Hard to follow group conversations
  • Can’t tell the direction that sounds are coming from
  • Extreme tiredness from the effort of listening with only one ear
  • More cognitive effort is required with this hearing loss
  • Difficulty hearing in noisy environments
  • Anxiety in noisy places with so much noise but decreased understanding of speech
  • Negative impact on relationships, work, and social life 
  • Concern around losing hearing in the ‘good’ ear 

Current Treatment Options for Single-Sided Deafness

If you’ve undergone a diagnostic hearing assessment and have been diagnosed with single-sided deafness, you will be offered a range of treatment or management options. Before you make a decision, these will be fully explained by your Audiologist and Ear, Nose and Throat Implant Surgeon (ENT).

Do nothing

If you do not wish to choose a hearing solution at the time, your Audiologist will equip you with tactics to assist in everyday communication. These may include: Positioning yourself with your good ear on the side of the speaker, avoiding very noisy environments, and putting your back to any noise and facing the speaker.

Be advised that untreated hearing loss bears many risks, including:

  • A higher risk of social isolation and relationship challenges
  • Increased risk of depression and anxiety
  • Increased risk of cognitive decline
  • Higher risk of falls and trips
  • It can cost you more money down the road

CROS (contralateral routing of signal) system 

Made up of two devices, a microphone being a transmitter and a hearing aid being a receiver, CROS systems are worn on both ears, the good and bad hearing ear. 

The microphone is worn on the side you can’t hear from and it wirelessly sends sound over to the receiver on the better hearing ear. It means you can hear sounds when they come from the side with little or no hearing. 

However, it is just combining all sounds into one ear so not quite restoring hearing to both ears. The ability to tell the direction of sounds and being able to hear well in noisy environments is not improved as for this we need both ears. 

No surgery is required for a CROS hearing system and your Audiologist can fit the device in the clinic to address your single-sided hearing loss.

Bone conduction aid (BAHA / Bonebridge) 

Bone anchored hearing aids are implantable hearing devices that work by transmitting sound to the inner ear (cochlea) through mechanical skull vibration. Essentially the bone-anchored hearing aid is bypassing the outer and middle ear hearing systems and sending an auditory signal directly to the cochlea in order to improve your hearing.

The bone conduction aid is similar to the CROS system in that it transfers sound from the poorer ear over to the good ear, so not restoring hearing to both ears. This again has the limitations of no localisation of sound and difficulty hearing in background noise. 

A bone conduction device requires surgery and an appointment with an ENT Implant Surgeon is needed to progress this option. Anyone choosing to get a bone conduction implant will be asked to do a one-week trial of a CROS system to be fully informed of their options.

Cochlear implant

Australia approved the use of cochlear implants to treat single-sided deafness in 2013.

Essentially, a cochlear implant is a very small device that is surgically implanted discreetly behind a person’s ear. The implant helps you hear better by communicating with an external sound processor worn on the head just behind the top of the ear and held in place magnetically. 

The cochlear implant stimulates the auditory nerve to provide the sensation of sound and overcome hearing loss. This helps with sound directionality and the ability to hear and communicate in groups and noisy situations. 

A cochlear implant does require surgery and an appointment with an ENT Implant Surgeon is needed to progress this option. Anyone choosing to get a cochlear implant for SSD will be asked to do a one-week trial of a CROS system and also a one-week trial of a bone conductor aid in order to have fully explored the range of options.


How can Cochlear Implants Help Those With Single-Sided Deafness?

Improved Quality of Life

Trying to navigate the world on a daily basis given the hearing difficulties listed above can be tiring, isolating, and lead to other health matters such as anxiety and depression. Having single-sided deafness means that you struggle to hear on the affected side so spend a lot of time turning your head with the good ear towards the speaker. This can lead to postural problems over time from constantly having your neck and body on an angle when communicating.

Hearing With Both Ears

Having single-sided deafness can make hearing and communication difficult. If you can restore hearing to both ears then that is the natural way of hearing, which gives us a better binaural sound signal for the brain. 

A joint study published by the University of California and University of Southern California concluded that SSD patients greatly benefit from a cochlear implant. Significant benefits were found to be:

  • A reduction in tinnitus severity
  • Improved localisation of sound
  • Improved speech understanding in noise
  • Improved quality of life

This means with a cochlear implant, you can tell the direction sound is coming from, hear better when in noisy situations with the filtering out of background noise, hear speakers whichever side of your body they are on, and have less listening and mental effort. This leads to reduced social isolation and improved quality of life.  

Click here to learn more about how a cochlear implant can improve your life!

Cochlear Implant: Would You Be a Suitable Candidate?

You’ve been diagnosed with single-sided deafness? The following points are indicators that getting a cochlear implant might help you regain control over your hearing health:

  • You have hearing loss in one ear that is significantly impairing your ability to understand speech and hear sounds in the environment
  • Your auditory nerve is intact
  • There are no medical contraindications
  • You are committed to extensive hearing rehabilitation post-implant

Your Funding Options For a Cochlear Implant

There are a range of costs involved in getting an implant. You can choose between several funding options, depending on your circumstances and eligibility for each.

 Private health insurance

If you are with a private health fund, you may be fully reimbursed. You’ll need to check what level of coverage you have and whether that includes cochlear implants. If you’ve had the policy for less than 12 months, you might have to wait or upgrade your cover. Contact your health fund and check the following:

  • Does your policy cover both the surgical procedure and prostheses?
  • Are there any restrictions on your cover for this procedure? 
  • Do any waiting periods apply?
  • Are there any known costs you will have to pay for yourself?
  • What is your insurance’s sound processor replacement policy? 

Department of Veteran’s Affairs (DVA) cover

If you have DVA cover (Gold or White card for hearing loss), you may be covered for all expenses deemed medically necessary to improve your hearing loss. This includes cochlear implants and all associated costs. For more information, contact the DVA directly or visit the DVA website.

Public funding

Public funding is limited and differs from state to state. And whilst there are usually long waiting periods, it’s worth talking to your hearing health professional about your options. The best person to advise you of what level of public funding may be available to you is your ENT Implant Surgeon. 


You can choose to self-fund your cochlear implant, surgical and specialist cost. We highly advise you to discuss this with your medical team first and ask for a breakdown of all the involved costs. To give all Australians access to the hearing care they need, Attune Hearing offers interest-free repayments through Humm.

In a Nutshell

Having a single-sided hearing loss presents a range of communication and health challenges. Whilst there are a number of treatment options available, a cochlear implant is the only option that will provide true sound localisation ability, better speech understanding in groups and noisy situations, and a reduction in the severity of tinnitus. 

For more information on cochlear implants, check out related articles:

If you have previously been diagnosed with severe to profound hearing loss and want to discuss your options, or would like to schedule a comprehensive hearing test, make an appointment with your local Audiologist at Attune Hearing.

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