Are Two Ears Better Than One?

In this month’s article we answer a common patient question:
“Isn’t treating one ear for hearing loss enough?”

Dr. Brennen Karl from our Englewood clinic goes into depth on why treating both ears with hearing loss is typically standard practice today, even though at one point in the not-so-far past, it may have been common practice to only treat one.

At our clinics, we diagnose hearing loss and make recommendations on treatment which usually includes the prescribing of hearing devices. Our patients have individualized treatment plans based around their specific yearly hearing prescription and budget.

We hope you've chosen us as your trusted hearing-care providers and recognize our mission to improving lives and connections through better hearing! If we've yet had the honor to see inside your ears, we hope one of our 7 front-range locations is an easy and convenient choice.

A common question that our patients have is:
Is it okay to wear one hearing aid, or is it better to wear two?

You might not be surprised to learn that treating both ears for hearing loss is actually a fairly new practice amongst audiologists. As recently as the 1980's, it was more common to treat one ear for bilateral hearing loss, than two, with a staggering 75% of fittings done for only one ear!

Luckily, with time comes science and we have gradually learned that short answer: it is only okay to wear one hearing aid, if an individual has hearing loss in only one ear!

But did you know that we actually hear with our brains? Research is now showing, what we hear with our ears actually stimulate areas of our brain. What's more, when ears are no longer stimulated with sound, those areas of the brain start to atrophy, or shrink and deteriorate.
Even more fascinating is the mounting science linking hearing loss to dementia with actual brain-scans showing how the brain shrinks over time, if it's not being stimulated like it once was.

Because of this, one must ask, "How do you decide which side of your brain is most important to treat, for hearing loss?"
Obviously, as a hearing care professional, I believe both ears should be considered equally important.

Below are some of the reasons why your audiologist will most likely recommend you treat both ears for hearing loss, rather than one, with the intent to help guide you towards making the most educated decision for you and your family.

Better Speech Understanding

Our brain and auditory system are designed to work better with two ears. This is called binaural hearing.

Just as we see better with two eyes, we also hear better when both ears work together. One of the most significant benefits gained from wearing a hearing aid in both ears is that speech becomes easier to understand. When auditory information is sent to the brain from both ears, the brain is able to combine information and interpret this better than with sound coming from one side alone!

What's more, when both ears are treated for hearing loss, speech automatically becomes louder and more clearer. When one ear is missing the information, the other ear must work harder to catch what was heard and often this leads to misinterpretations. If both ears are being treated, it leaves a lesser chance for misinterpretation during conversations; "Two ears are better than one!"

Better Hearing in Background Noise

Conversation in background noise, such as in noisy restaurants or at large family gatherings, are commonly the most difficult listening situation for our patients. This is because as we age, our brains have a more difficult time naturally filtering out background noise from actual speech!

Treating hearing loss with hearing aids that have directional microphones actually helps our brain better separate speech from the background noise that we don't want to hear! Hearing aids communicate together to scan the environment for speech and reduce actual unwanted "noise" that is occurring simultaneously, heightening clarity of what you actually want!

If you are only wearing one hearing aid, the untreated ear will continue to struggle with the added background noise it's unable to naturally filter. Often, this can lead to the listener becoming overwhelmed with social gatherings and experiences, with potential for eventual isolation.

Auditory Effort

As previously states, studies have found an increased risk of the early development of dementia from untreated and under-treated hearing loss. Part of this comes from the increased effort it takes to hear speech, which can even change the structures of the brain.

As our brain uses more energy to hear, the brain has less ability to process what we hear and store it in memory. By treating both ears for hearing loss, the effort it takes to hear and understand speech is drastically improved and puts less strain on the brain.

Leaving one ear untreated also risks auditory deprivation on that side of your brain. Auditory deprivation follows the “use it or lose it” adage. Simply, as one ear gets less access to sound, the side of the brain associated with that ear starts to receive less neural feedback and eventually starts to shrink because it's not being stimulated.

Lastly, by treating both ears for hearing loss, the effort it takes to hear and understand speech is drastically improved and puts less strain on the brain! Individuals are better able to remember what was said to them and aren't as exhausted trying to hold conversations.

Tinnitus Management

Many patients suffer from a ringing, buzzing, or hissing called tinnitus. Wearing hearing aids is the most effective method for reducing how bothersome or noticeable tinnitus is.

This symptom of hearing loss most commonly occurs in both ears. Wearing a hearing aid in only one ear may help with tinnitus on that side, but can leave the unaided ear’s tinnitus even more noticeable!
Stimulating the auditory system in both ears is the best method for treating your tinnitus.

Is it Ever Better to Wear Just One?

Although it is more common to have hearing loss in both ears, there are certainly people with hearing loss in only one ear.

If you have normal hearing in one ear and hearing loss in the other, wearing one hearing aid may be enough.

In instances of deafness in one ear and hearing loss in the other, treating the hearing loss with a hearing aid is the standard treatment plan; however, your audiologist may also prescribe what is called a CROS device, in the worse or deaf ear.

A CROS looks exactly like a hearing aid but sends the sounds that you would normally hear in your deaf ear, "across" to the hearing aid on your BETTER ear so that you no longer miss sounds on that side. Instead, you receive sounds from both ears, into your better-hearing ear.

Two Versus One: Conclusion

In most circumstances, treating both of your ears for hearing loss offers many advantages and improved outcomes for your hearing health. Hearing aids are a medical device fitted to your specific hearing prescription, regardless of whether you have hearing loss in one ear or both.

If the choice comes down to treating one ear with the highest technology versus both ears with a lower technology, the better choice will be to treat both your ears with the lower technology.

Contact your Hearing HealthCare Centers audiologist if you have any questions about your specific hearing and needs. We are excited to help improve your life through better hearing!

Dr. Brennen Karl Au.D., CCC-A
Hearing HealthCare Centers
Englewood, Colorado

E. Robert (Cy) Libby. 2007. The Hearing Review. The Search for the Binaural Advantage...Revisited.

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