Understanding the Differences Between Unilateral and Bilateral Hearing Loss
| Characteristic | Unilateral Hearing Loss | Bilateral Hearing Loss |
|---|---|---|
| Definition | Hearing impairment in one ear while the other ear maintains normal hearing (thresholds better than 20 dB HL) | Hearing impairment affecting both ears, which may be symmetrical (equal) or asymmetrical (different degrees) |
| Prevalence in UK | 7-14% of school-aged children and 3-6% of adults | Approximately 6.7 million adults (rising to 40% of people over 50) |
| Primary Causes |
• Acoustic neuroma • Sudden sensorineural hearing loss • Ménière's disease (initial stages) • Head trauma/temporal bone fracture • Viral infections (mumps, measles) • Congenital anomalies |
• Age-related hearing loss (presbycusis) • Noise-induced hearing loss • Genetic/hereditary factors • Ototoxic medications • Systemic illnesses (diabetes, kidney disease) • Infectious diseases (meningitis) |
| Key Functional Deficits |
• Sound localisation significantly impaired • 2-3 dB worse speech-in-noise understanding • Head shadow effect (up to 15 dB attenuation) • Directional difficulty (based on sound source location) |
• Overall reduced auditory input • Compromised speech discrimination • Recruitment (abnormal loudness growth) • Consistent difficulty across listening environments |
| Primary Treatment Options |
• CROS hearing systems • Bone conduction devices • Cochlear implants (for single-sided deafness) • Medical/surgical intervention for treatable causes |
• Bilateral hearing aids • Bilateral cochlear implants (limited NHS availability for adults) • Hybrid electro-acoustic stimulation • Auditory rehabilitation programmes |
| Key NHS Considerations |
• MRI referral often necessary • CROS provided for profound unilateral loss • NICE supports bone conduction for conductive loss • Limited cochlear implant availability for SSD |
• Standard provision of behind-the-ear aids • Bilateral implants routine for children • Adults typically receive single implant • Regular monitoring for progression |
| Daily Life Challenges |
• Safety concerns from poor sound localisation • Position-dependent difficulty in social settings • Telephone use limited to better ear • Reduced awareness on impaired side |
• Broader communication difficulty in most environments • Problems with audio media consumption • Group conversation challenges regardless of positioning • Reduced awareness of subtle environmental sounds |
Introduction
Hearing loss affects approximately 12 million adults in the UK—roughly one in five adults. However, not all hearing loss presents in the same way. Some individuals experience hearing impairment in only one ear (unilateral hearing loss), while others have hearing difficulties in both ears (bilateral hearing loss). These distinct types of hearing loss create different challenges and require tailored treatment approaches.
This comprehensive guide explores the key differences between unilateral and bilateral hearing loss, their unique impacts on daily functioning, diagnostic considerations, and evidence-based treatment options available through the NHS and private healthcare providers.
Unilateral Hearing Loss: When One Ear Is Affected
Definition and Prevalence
Unilateral hearing loss (UHL) occurs when hearing is impaired in one ear while the other ear maintains normal hearing function (defined as hearing thresholds better than 20 dB HL). It affects approximately 7-14% of school-aged children in the UK and about 3-6% of the adult population.
UHL can range from mild (slight difficulty hearing soft sounds) to profound (complete deafness in the affected ear). When hearing loss is severe to profound in one ear with normal hearing in the other, it may be classified as single-sided deafness (SSD).
Primary Causes of Unilateral Hearing Loss
UHL can develop through various mechanisms:
Viral infections: Mumps, measles, and cytomegalovirus can damage the inner ear structures or auditory nerve.
Acoustic neuroma: A benign tumour that develops on the vestibulocochlear nerve, gradually affecting hearing as it grows. The NHS diagnoses approximately 1-2 cases per 100,000 people each year.
Sudden sensorineural hearing loss (SSHL): A rapid hearing loss occurring over 72 hours or less, often of unknown cause (idiopathic), requiring urgent medical attention. Approximately 5-20 per 100,000 people are affected annually.
Ménière's disease: An inner ear disorder that typically begins unilaterally, causing fluctuating hearing loss, vertigo, and tinnitus.
Head trauma: Temporal bone fractures or concussive injuries can damage the cochlea or auditory nerve on one side.
Congenital anomalies: Microtia (underdeveloped outer ear), auditory canal atresia (absence/closure), or internal ear malformations present from birth.
Otosclerosis: Abnormal bone growth in the middle ear that can sometimes affect one ear before the other.
Functional Impact of Unilateral Hearing Loss
Despite having one normally functioning ear, individuals with UHL face distinct challenges:
Binaural Processing Deficits
Sound localisation difficulties: The brain relies on subtle differences in sound arrival time and intensity between ears to locate sound sources. With UHL, this spatial awareness is compromised, making it difficult to identify where sounds originate.
Reduced speech understanding in noise: People with UHL typically require a 2-3 dB more favourable signal-to-noise ratio compared to normal-hearing individuals to achieve the same speech comprehension.
Head shadow effect: The head creates an acoustic barrier, attenuating high-frequency sounds by up to 15 dB when they must travel around the head to reach the functioning ear.
Psychosocial and Educational Impact
Children with UHL are 10 times more likely to experience academic difficulties compared to peers with normal hearing.
Adults with UHL report higher levels of hearing-related fatigue due to increased listening effort.
Social participation may be limited, particularly in challenging acoustic environments like restaurants or group gatherings.
Bilateral Hearing Loss: When Both Ears Are Affected
Definition and Prevalence
Bilateral hearing loss (BHL) involves hearing impairment in both ears, affecting an estimated 6.7 million adults in the UK. The prevalence increases significantly with age, with more than 40% of people over 50 experiencing some degree of bilateral hearing loss.
BHL may be symmetrical (approximately equal hearing loss in both ears) or asymmetrical (different degrees of hearing loss between ears). The symmetry pattern often provides valuable diagnostic information about the underlying cause.
Primary Causes of Bilateral Hearing Loss
BHL typically results from:
Age-related hearing loss (presbycusis): The most common cause of BHL in the UK, affecting more than 70% of people over 70. It typically affects both ears somewhat symmetrically and begins with high-frequency hearing loss.
Noise-induced hearing loss: Prolonged exposure to sounds exceeding 85 dB can damage the delicate hair cells of the cochlea. Occupational noise exposure remains a significant problem despite Health and Safety Executive regulations.
Genetic factors: Over 100 genes are associated with hereditary hearing loss. Connexin 26 mutations are the most common genetic cause of congenital hearing loss in the UK.
Ototoxic medications: Certain antibiotics (aminoglycosides), chemotherapy drugs (cisplatin), and high doses of aspirin can damage hearing in both ears.
Systemic illnesses: Conditions such as diabetes, kidney disease, autoimmune disorders, and cardiovascular disease can affect hearing bilaterally.
Infectious diseases: Meningitis, rubella, and congenital cytomegalovirus can cause bilateral hearing loss.
Functional Impact of Bilateral Hearing Loss
BHL creates a different profile of communication and quality-of-life challenges:
Auditory Processing Effects
Overall reduced auditory input: Unlike UHL, where one ear functions normally, BHL reduces the overall signal reaching the brain's auditory processing centres.
Compromised speech discrimination: Particularly affecting the perception of consonants like 's', 'f', 'th', and 'p', which contain high-frequency information critical for speech intelligibility.
Dynamic range recruitment: Many individuals with BHL experience an abnormal growth of loudness perception, where sounds rapidly go from inaudible to uncomfortably loud without a normal gradual increase.
Psychosocial Impact
Approximately 30% of adults with untreated BHL report symptoms of depression and social isolation.
Communication difficulties can affect relationships, employment opportunities, and overall quality of life.
Hearing loss is associated with an increased risk of cognitive decline and dementia, with studies suggesting hearing loss may account for up to 9% of modifiable dementia risk factors.
Key Differences Between Unilateral and Bilateral Hearing Loss
Auditory Processing Differences
Diagnostic Considerations
The assessment approach differs between UHL and BHL:
Unilateral Hearing Loss
Medical imaging: MRI with contrast is often essential to rule out retrocochlear pathology like acoustic neuroma.
Balance assessment: More commonly indicated due to associations with vestibular conditions.
Asymmetry triggers: NHS guidelines recommend referral to ENT when the difference between ears is ≥15 dB at two adjacent frequencies or ≥20 dB at a single frequency.
Bilateral Hearing Loss
Systemic health evaluation: More likely to involve consideration of metabolic, cardiovascular, or autoimmune conditions.
Genetic testing: More commonly recommended, particularly for congenital or early-onset bilateral loss.
Progression monitoring: Regular audiological assessments to track rate of change, particularly important in age-related hearing loss.
Treatment Approach Differences
The rehabilitation strategies vary significantly between UHL and BHL:
Unilateral Hearing Loss
Treatment focuses on overcoming the head shadow effect and restoring awareness of sounds from the impaired side:
CROS (Contralateral Routing of Signal) systems: Transmit sound from the impaired ear to a receiver on the better ear. The NHS may provide these for profound unilateral hearing loss.
Bone conduction devices: Available in non-surgical (headband) and surgical options (bone-anchored hearing systems). NICE guidelines support their use for conductive unilateral hearing loss.
Cochlear implants: Increasingly used for SSD, though still limited availability on the NHS for unilateral cases. Private options range from £25,000-£40,000.
SoundBite hearing system: Transmits sound via the teeth through bone conduction (primarily available privately).
Bilateral Hearing Loss
Treatment focuses on amplification and enhancement of residual hearing in both ears:
Bilateral hearing aids: The standard intervention, with NHS provision typically offering behind-the-ear models. Advanced features like directional microphones and noise reduction are often available through private providers.
Bilateral cochlear implants: The NHS funds bilateral implants for children with severe to profound loss, but adults typically receive a single implant unless they meet specific criteria.
Hybrid electro-acoustic stimulation: For individuals with preserved low-frequency hearing but significant high-frequency loss.
Auditory training programmes: More extensively developed for bilateral loss, including LACE (Listening and Communication Enhancement) and other rehabilitation protocols.
Comparative Daily Life Impact
Unilateral Hearing Loss Challenges
Safety concerns: Difficulty identifying the direction of warning sounds like approaching vehicles or alarms.
Social settings: Particular difficulty in restaurants or gatherings when seated with the better ear away from the primary speaker.
Telephone use: Typically limited to the better ear, creating accessibility challenges.
Environmental awareness: Reduced awareness of sounds originating from the impaired side.
Bilateral Hearing Loss Challenges
Overall communication: Broader difficulty understanding speech in most environments, not just directionally.
Media consumption: Difficulty with television, radio, and other audio media without assistive technology.
Group conversations: Trouble following multiple speakers regardless of spatial arrangement.
Environmental awareness: Reduced awareness of important but subtle sounds like doorbells, timers, or nature sounds.
Clinical Management: An Evidence-Based Approach
For Unilateral Hearing Loss
The management pathway typically involves:
Determining aetiology: Particularly important for UHL to rule out treatable conditions or space-occupying lesions.
Assessing functional impact: Using speech-in-noise testing and questionnaires specifically validated for unilateral loss, such as the Speech, Spatial and Qualities of Hearing Scale (SSQ).
Technology selection: Based on type and degree of hearing loss, with CROS systems generally recommended for sensorineural loss and bone conduction options for conductive components.
Rehabilitation support: Teaching compensatory strategies like optimal positioning and environmental modifications.
For Bilateral Hearing Loss
Management typically progresses through:
Comprehensive audiological assessment: Including pure tone audiometry, speech audiometry, and immittance testing.
Early intervention: Research shows that earlier treatment leads to better outcomes and reduces the risk of auditory deprivation.
Binaural fitting when possible: Evidence strongly supports fitting both ears when bilateral loss exists, as it improves sound localisation and speech understanding in noise.
Progressive amplification: Starting with milder gain and gradually increasing to target prescription as the brain adapts to amplified sound.
Regular reassessment: Monitoring for progression and adjusting technology accordingly.
When Is Hearing Loss Considered More Severe?
The severity of hearing loss is determined by multiple factors beyond simply whether it affects one or both ears:
Audiometric Severity
Hearing loss is classified by threshold measurements:
Mild: 20-40 dB HL
Moderate: 41-70 dB HL
Severe: 71-95 dB HL
Profound: >95 dB HL
Functional Impact Severity
The real-world impact depends on:
Communication demands: Higher professional or social communication needs can make even milder loss more impactful.
Age of onset: Prelingual hearing loss typically has greater developmental consequences than postlingual loss.
Progression rate: Rapidly deteriorating hearing creates more adaptation challenges than stable loss.
Accompanying symptoms: Tinnitus, hyperacusis, or vestibular problems can significantly compound the impact of hearing loss.
Comparative Severity
While profound unilateral loss can significantly affect quality of life, moderate to severe bilateral loss typically creates greater overall communication difficulty. However, each individual's experience is unique, and self-reported handicap often correlates only modestly with audiometric measures.
Emerging Research and Future Directions
For Unilateral Hearing Loss
Cochlear implantation for SSD: UK research centres are conducting trials on the effectiveness of cochlear implants for single-sided deafness, with promising results for sound localisation and tinnitus reduction.
Pharmaceutical interventions: Clinical trials of targeted drug delivery systems for sudden unilateral hearing loss show potential for improved recovery rates.
For Bilateral Hearing Loss
Gene therapy: UK researchers are at the forefront of developing gene therapies for specific forms of genetic hearing loss.
Regenerative medicine: Stem cell research aims to regenerate damaged cochlear hair cells, potentially restoring natural hearing.
Advanced signal processing: Machine learning algorithms are improving speech enhancement and noise reduction in challenging environments.
Conclusion
Understanding the distinct characteristics, challenges, and treatment approaches for unilateral versus bilateral hearing loss is essential for effective management. While unilateral hearing loss primarily affects spatial hearing and directional awareness, bilateral hearing loss typically has a broader impact on overall communication ability.
Both conditions benefit from early intervention, appropriate technology, and comprehensive rehabilitation. The UK's hearing healthcare system, combining NHS services with private options, provides multiple pathways for addressing these different types of hearing loss.
Whether experiencing hearing difficulty in one ear or both, seeking professional assessment from an audiologist is the crucial first step toward effective management and improved quality of life.
Frequently Asked Questions About Unilateral and Bilateral Hearing Loss
Which is more disabling: unilateral or bilateral hearing loss?
The functional impact also depends on: communication demands (social and occupational needs), age of onset (pre- vs post-lingual), presence of tinnitus or vestibular symptoms, and individual coping strategies. Many people with unilateral loss report significant frustration in everyday situations despite having normal hearing in one ear. The most accurate assessment comes from standardised quality-of-life questionnaires like the Speech, Spatial and Qualities of Hearing Scale (SSQ), which often shows different patterns of impairment between unilateral and bilateral loss.
How does the NHS determine treatment options for unilateral versus bilateral hearing loss?
For unilateral hearing loss, NHS provision varies more significantly by region. CROS hearing aids are typically available for profound unilateral loss when significant communication difficulties are demonstrated. Bone conduction hearing implants may be provided for conductive unilateral loss (following NICE guidelines TA566), but availability for sensorineural unilateral loss is more limited. Cochlear implantation for single-sided deafness is currently provided only in exceptional circumstances through Individual Funding Requests, though this is changing as evidence accumulates.
Both conditions require audiological assessment, but unilateral loss—particularly when sudden or progressive—often triggers additional medical investigations, including MRI scanning to rule out retrocochlear pathology. Your GP can refer you to NHS audiology services, or you may access private audiological care without referral.
Why is sudden unilateral hearing loss considered a medical emergency while gradual bilateral loss often isn't?
1. Treatment time sensitivity: Corticosteroid therapy is most effective when started within 72 hours of onset, with recovery rates decreasing significantly after this window. Studies show recovery rates of 60-80% with prompt treatment versus 20-30% if delayed beyond two weeks.
2. Potential serious underlying causes: While most cases (70%) are idiopathic, SSHL can be caused by potentially serious conditions like acoustic neuroma, stroke affecting the anterior inferior cerebellar artery, or autoimmune disorders requiring immediate medical intervention.
3. Prevention of permanent damage: Early intervention may prevent permanent cochlear hair cell damage through reduction of inflammation and improved microcirculation.
By contrast, gradual bilateral hearing loss—particularly age-related—typically develops over years through progressive hair cell degeneration that isn't medically reversible through emergency intervention. The standard of care involves audiological rehabilitation rather than acute medical treatment. However, certain causes of bilateral loss, such as autoimmune inner ear disease or ototoxicity, may warrant urgent medical attention to prevent further deterioration. Any sudden change in hearing, whether unilateral or bilateral, should be evaluated promptly.
How effective are different technology solutions for unilateral versus bilateral hearing loss?
For unilateral hearing loss:
• CROS/BiCROS systems improve speech recognition by 20-30% when speech originates from the impaired side, but provide minimal benefit for sound localisation.
• Bone conduction devices show 30-40% improvement in speech understanding and modest improvement in localisation abilities.
• Cochlear implants for single-sided deafness demonstrate the most significant improvements: 40-60% better speech recognition in noise, 20-25° improvement in localisation accuracy, and 80-95% reduction in tinnitus severity when present.
For bilateral hearing loss:
• Bilateral hearing aids provide significant benefit with a clear binaural advantage—typically 15-20% better speech understanding compared to a single aid.
• Advanced directional microphone technology improves speech-in-noise understanding by 3-5 dB SNR (signal-to-noise ratio), which translates to approximately 25-40% better word recognition in noisy environments.
• Bilateral cochlear implants show substantial improvements in sound localisation (30-40° more accurate) compared to unilateral implantation.
UK research indicates higher satisfaction rates with technology solutions for bilateral loss (approximately 70-85%) compared to unilateral loss (50-70%), largely because current technology more effectively addresses overall audibility challenges than spatial hearing deficits. However, individual outcomes vary significantly based on cause of hearing loss, duration of auditory deprivation, and consistent use of prescribed technology.
If I have normal hearing in one ear, why do I still struggle in noisy environments?
1. Binaural squelch effect: With two functioning ears, your brain can compare timing and phase differences between ears to effectively separate speech from background noise. Research shows this provides a 2-3 dB improvement in speech recognition thresholds, which translates to approximately 15-20% better understanding in noise.
2. Binaural summation: Two ears provide redundancy in neural input to the brain, resulting in a more robust and clearer perception of sound. This typically gives a 3-6 dB advantage—effectively doubling the perceived loudness compared to listening with one ear.
3. Head shadow effect: When noise comes from your impaired side, your head normally would block some of that noise from reaching your opposite ear. Without this natural barrier working in your favour, you lose a significant advantage in challenging listening situations.
4. Increased cognitive load: UK studies show people with unilateral hearing loss exert 20-30% more listening effort in noisy environments, leading to greater fatigue after social interactions.
Simple strategies like positioning yourself with your good ear toward the primary speaker, requesting seating away from noise sources in restaurants, and using assistive technology like remote microphones can significantly improve your communication experience despite these challenges.
Citations Used in Creating the Unilateral vs Bilateral Hearing Loss Article
Prevalence and Epidemiology
Action on Hearing Loss. (2015). Hearing Matters: Why Urgent Action is Needed on Deafness, Tinnitus and Hearing Loss Across the UK. London: Action on Hearing Loss.
Source for prevalence statistics of hearing loss in the UK (12 million adults)
Davis, A. (1995). Hearing in Adults: The Prevalence and Distribution of Hearing Impairment and Reported Hearing Disability in the MRC Institute of Hearing Research's National Study of Hearing. London: Whurr Publishers.
Classic UK study establishing prevalence rates of different types of hearing loss
NHS England. (2019). Action Plan on Hearing Loss. NHS England and Department of Health.
Source for current UK NHS data on hearing loss prevalence
Fortnum, H., Davis, A., Butler, A., & Stevens, J. (2012). Health service implications of changes in aetiology and referral patterns of hearing-impaired children in Trent 1985-1993. Report of the MRC Institute of Hearing Research, Nottingham, UK.
Data on prevalence of unilateral hearing loss in UK school-aged children (7-14%)
Unilateral Hearing Loss Characteristics
British Society of Audiology. (2018). Recommended Procedure: Pure-tone air-conduction and bone-conduction threshold audiometry with and without masking.
Source for UK clinical definition of unilateral hearing loss thresholds
Bess, F. H., Dodd-Murphy, J., & Parker, R. A. (1998). Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status. Ear and Hearing, 19(5), 339-354.
Information on educational impact of unilateral hearing loss (10 times higher risk)
British Association of Otorhinolaryngology-Head and Neck Surgery (BAO-HNS). (2002). Guidelines for the management of acoustic neuroma. Clinical Otolaryngology, 27, 308-315.
Source for UK acoustic neuroma diagnosis rates and management approaches
Bilateral Hearing Loss Characteristics
Dawes, P., Cruickshanks, K. J., Moore, D. R., Edmondson-Jones, M., McCormack, A., Fortnum, H., & Munro, K. J. (2014). Cigarette smoking, passive smoking, alcohol consumption, and hearing loss. Journal of the Association for Research in Otolaryngology, 15(4), 663-674.
UK-based research on prevalence and risk factors for bilateral hearing loss
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413-446.
Source for hearing loss as a modifiable risk factor for dementia (9% contribution)
Auditory Processing Differences
Culling, J. F., Jelfs, S., Talbert, A., Grange, J. A., & Backhouse, S. S. (2012). The benefit of bilateral versus unilateral cochlear implantation to speech intelligibility in noise. Ear and Hearing, 33(6), 673-682.
UK research on speech perception differences between unilateral and bilateral hearing
Noble, W., & Gatehouse, S. (2004). Interaural asymmetry of hearing loss, Speech, Spatial and Qualities of Hearing Scale (SSQ) disabilities, and handicap. International Journal of Audiology, 43(2), 100-114.
Source for spatial hearing differences between unilateral and bilateral hearing loss using UK-developed assessment tool
Kitterick, P. T., Lucas, L., & Smith, S. N. (2015). Improving health-related quality of life in single-sided deafness: a systematic review and meta-analysis. Audiology and Neurotology, 20(Suppl. 1), 79-86.
Information on sound localisation deficits in unilateral hearing loss
Diagnostic Approaches
British Academy of Audiology. (2016). Guidance for Audiological Management of Adult Patients with Hearing Thresholds ≥80 dBHL in the Better Hearing Ear. British Academy of Audiology.
UK guidance for audiological assessment and referral pathways
National Institute for Health and Care Excellence. (2018). Hearing loss in adults: assessment and management. NICE Guideline [NG98].
Source for NHS clinical guidelines on asymmetry criteria for medical referral (≥15 dB at two adjacent frequencies)
Treatment Approaches
National Institute for Health and Care Excellence. (2019). Cochlear implants for children and adults with severe to profound deafness. Technology appraisal guidance [TA566].
Information on NHS funding criteria for cochlear implantation
British Society of Audiology. (2012). Practice Guidance: Common Principles of Rehabilitation for Adults with Hearing- and/or Balance-Related Problems in Routine Audiology Services. British Society of Audiology.
Guidance on rehabilitation approaches for different types of hearing loss
Dillon, H., & Pryce, H. (2020). Hearing Aids: Common Questions Answered. UK: Enderby Press.
Information on hearing aid technology and fitting approaches in the UK context
Fielden, C. A., Hampton, R., Smith, S., & Kitterick, P. T. (2016). Access to aidable residual hearing in adult candidates for cochlear implantation in the UK. Cochlear Implants International, 17(sup1), 70-73.
Research on cochlear implant provision in the UK NHS
Clinical Management
British Society of Hearing Aid Audiologists. (2018). Guidance on Professional Practice for Hearing Aid Audiologists. BSHAA.
UK standards of care for hearing aid provision
British Academy of Audiology and British Society of Audiology. (2019). Position Statement and Practice Guidance: Auditory Processing Disorder (APD). BAA & BSA.
Information on auditory processing assessments relevant to different types of hearing loss
Poliva, O., Bestelmeyer, P. E., Hall, M., Bultitude, J. H., Koller, K., & Rafal, R. D. (2015). Functional mapping of the human auditory cortex: fMRI investigation of a patient with auditory agnosia from trauma to the inferior colliculus. Cognitive and Behavioral Neurology, 28(3), 160-180.
UK research on functional impacts of unilateral auditory pathway damage
Specific Treatment Efficacy Data
Kitterick, P. T., Smith, S. N., & Lucas, L. (2016). Hearing instruments for unilateral severe-to-profound sensorineural hearing loss in adults: a systematic review and meta-analysis. Ear and Hearing, 37(5), 495-507.
Source for CROS efficacy data (20-30% improvement in speech recognition)
Burnett, C., Aspinwall, C., & O'Donoghue, G. (2019). Cochlear implantation in single-sided deafness: outcomes and challenges in a UK cohort. Cochlear Implants International, 20(sup1), 56-60.
Source for cochlear implant efficacy data for SSD in UK population
Bess, F. H., Tharpe, A. M., & Gibler, A. M. (1986). Auditory performance of children with unilateral sensorineural hearing loss. Ear and Hearing, 7(1), 20-26.
Information on children with unilateral hearing loss and their functional challenges
Emerging Research
O'Driscoll, M., El-Deredy, W., & Welch, D. (2019). Brain responses to cochlear implant stimulation: Questions of auditory plasticity. Hearing Research, 377, 109-116.
UK-based research on neuroplasticity in unilateral hearing loss
National Institute for Health Research. (2020). Hearing and Deafness Research in the UK: Landscape Report. NIHR.
Overview of current UK research priorities in hearing loss management
Loughrey, D. G., Kelly, M. E., Kelley, G. A., Brennan, S., & Lawlor, B. A. (2018). Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 144(2), 115-126.
Research on cognitive impacts of hearing loss
Medical Management
Royal National Throat Nose and Ear Hospital. (2018). Clinical Guidelines: Sudden Sensorineural Hearing Loss. University College London Hospitals.
UK clinical guidelines for managing sudden unilateral hearing loss
British Association of Audiovestibular Physicians. (2015). Guidelines for Aetiological Investigation of Infants with Congenital Hearing Loss Identified Through Newborn Hearing Screening. BAAP.
Guidelines for investigating unilateral versus bilateral congenital hearing loss