What is Asymmetric Hearing Loss (AHL)?

Q: Do I need one hearing aid or two?

If you have a significant hearing loss in both ears, you should be wearing two hearing aids. Here are the audiological reasons why: Localisation . The brain decodes information from both ears and compares and contrasts them. By analysing the miniscule time delays as well as the difference in loudness of each sound reaching the ears, the person is able to accurately locate a sound source. Simply put, if you have better hearing on one side than the other, you can't accurately tell what direction sounds are coming from. Less amplification required. A phenomena known as “binaural summation” means that the hearing aids can be set at a lower and more natural volume setting than than if you wore only one hearing aid. Head shadow effect. High frequencies, the part of your hearing that gives clarity and meaning to speech sounds, cannot bend around your head. Only low frequencies can. Therefore if someone is talking on your unaided side you are likely to hear that they are speaking, but be unable to tell what they have said. Noise reduction. The brain has it’s own built in noise reduction which is only really effective when it is receiving information from both ears. If only one ear is aided, even with the best hearing aid in the world, it will be difficult for you to hear in background noise as your brain is trying to retain all of the sounds (including background noise) rather than filtering it out. Sound quality. We are designed to hear in stereo. Only hearing from one side sounds a lot less natural to us.

Q: What are the benefits of rechargeable hearing aids?

For most people, the main benefit of a rechargeable hearing aid is simple convenience. We are used to plugging in our phones and other devices overnight for them to charge up. For anybody with poor dexterity or issues with their fingers, having a rechargeable aid makes a huge difference as normal hearing aid batteries are quite small and some people find them fiddly to change. One downside is that if you forget to charge your hearing aid, then it is a problem that can't be instantly fixed. For most a 30 minute charge will get you at least two or three hours of hearing, but if you are the type of person who is likely to forget to plug them in regularly then you're probably better off with standard batteries. Rechargeable aids are also a little bit bigger and are only available in behind the ear models. Finally, just like with a mobile phone, the amount of charge you get on day one is not going to be the same as you get a few years down the line. Be sure to ask what the policy is with the manufacturer warranty when it comes to replacing the battery.

Q: Are behind the ear aids better than in the ear aids?

For most people, the answer is yes. But it's never that simple. The majority of hearing problems affect the high frequencies a lot more than the low ones. Therefore open fitting hearing aids sound a lot more natural and ones that block your ears up can make your own voice sound like you are talking with your head in a bucket. Therefore in-ear aids tend to be less natural. However the true answer is we can't tell until we have had a look in your ears to assess the size of your ear canal, and until we have tested your hearing to see which frequencies are being affected. People with wider ear canals tend to have more flexibility, also there are open fitting modular CIC hearing aids now that do not block your ears. There is also the age old rule to consider, that a hearing aid will not help you if it's sat in the drawer gathering dust. If the only hearing aid you would be happy wearing is one that people can't see, then that's what you should get. Most people can adapt to any type of hearing aid, as long as they know what to expect. Have an honest conversation with your audiologist as to what your needs are.

Q: What are channels, and how many do I need?

Generally speaking, six or more. Unless it's none at all. The number of channels a hearing aid has is often a simplistic way an audiologist will use to explain why one hearing aid is better than another, but channels are complex and it is really not that straightforward. Hearing aids amplify sounds of different frequencies by different amounts. Most people have lost more high frequencies than low and therefore need more amplification in the high frequencies. The range of sounds you hear are split into frequency bands or channels and the hearing aids are set to provide the right amount of hearing at each frequency level. Less than six channels and this cannot be done with much accuracy, so six is the magic number. However, a six channel aid is typically very basic with few other features and is suitable only for hearing a single speaker in a quiet room. The number of channels is not what you should be looking at, it's more the rest of the technology that comes with them. As a final note, different manufacturers have different approaches. One method is not necessarily better than any other. For example some manufacturers have as many as 64 channels in their top aids. Most tend to have between 17 and 20. One manufacturer has no channels at all.

Q: Where can I get the hearing aids covered?

Hearing aids are easily lost, misplaced or damaged and typically are one of the most expensive personal possessions an individual can own. We offer hearing aid warranty cover for £80 per year per aid. Find out more here

Q: How much does the hearing test cost?

All our audiologists use the very latest technology and provide the full range of tests to accurately measure your hearing for free. Find out about what we offer all our customers here

Q: Do home visits cost extra?

Hearing Aid UK offers all their customers free home visiting services and home visits for hearing aids - Including hearing tests, fittings, maintenance, check-ups and much more in the comfort of your own home and at your convenience. Find out more information here

Q: How come you're much cheaper than other places?

Here, at Hearing Aid UK, we are dedicated to offering low hearing aid prices. We achieve this by having no head office and low marketing costs. Our hearing aid prices are amongst the lowest you will find anywhere in the world.

What isAsymmetric Hearing Loss (AHL)?

An uneven hearing loss between the ears

Overview

Asymmetric hearing loss refers to a significant difference in hearing ability between the two ears. Causes include infections, trauma, tumours, and Meniere's disease. Symptoms often include difficulty locating sounds and understanding speech in noisy environments.

Diagnosis and treatment involve audiometric tests, imaging, and addressing the underlying condition.

The silent struggle

Our senses play a vital role in navigating our daily life. Hearing, in particular, allows us to connect with others, enjoy music, and stay alert to our surroundings. But what happens when this sense starts to falter unevenly?

This is known as asymmetric hearing loss (AHL), and it affects a significant number of people in the UK, often silently disrupting their lives. In this article, we briefly explore the reasons behind uneven hearing loss between the ears and how hearing care professionals can assist with treatment.

What is asymmetric hearing loss?

Asymmetric hearing loss occurs when there is a noticeable difference in hearing ability between the two ears. Unlike symmetric hearing loss, where both ears experience a similar degree of impairment, asymmetric hearing loss can vary widely. One ear may have normal or near-normal hearing while the other suffers from mild to profound loss.

For many with hearing loss, the hearing abilities in both ears are generally similar. If your hearing test shows uneven hearing between your ears, your hearing care provider might refer you to an ENT specialist before fitting you with hearing aids.

This is because differing levels of hearing ability in each ear could indicate an underlying medical condition.

The way asymmetric hearing loss affects your hearing differs depending on circumstance and level of loss. If one ear has significantly poorer hearing than the other, you might experience the "head shadow" effect and other challenges associated with unilateral hearing loss, also known as single-sided deafness.

How asymmetric hearing loss impacts daily life

Asymmetric hearing loss can have a profound impact on quality of life as communication becomes challenging and sound localisation and clarity are compromised. Simple conversations can be exhausting, and social interactions may become frustrating. This often leads to social withdrawal and isolation, impacting mental health.

One of the subtle yet significant challenges of asymmetric hearing loss is the difficulty in identifying the direction and distance of sounds. This spatial hearing loss can make environments like busy streets or crowded rooms particularly daunting.

Safety can also become an issue, as crucial auditory cues, like approaching vehicles or alarms, may go unnoticed.

Causes of asymmetric hearing loss

Several factors can lead to asymmetric hearing loss, ranging from mild to more serious conditions. Here are some common causes:

Acoustic Neuroma: A benign tumour that develops on the vestibulocochlear nerve can cause asymmetric hearing loss. Symptoms often include tinnitus (ringing in the ears) and balance issues.
Sudden Sensorineural Hearing Loss (SSNHL): This condition typically affects only one ear and occurs suddenly. The exact cause is often unknown, but it can be linked to viral infections, autoimmune diseases, or vascular issues.
Meniere’s Disease: This inner ear disorder can lead to vertigo, tinnitus, and hearing loss, which can become permanent over time.
Noise Exposure: Prolonged exposure to loud noises, can cause hearing loss in one ear more than the other, especially if the exposure is uneven.
Otosclerosis: This abnormal bone growth in the middle ear can lead to conductive hearing loss, often affecting one ear more than the other.
Ear Infections and Ear Trauma: Severe ear infections or injuries can cause damage to one ear, resulting in asymmetric hearing loss.

Asymmetric hearing loss

What is Asymmetric Hearing Loss?

Diagnosing and treatments

Diagnosing asymmetric hearing loss

Diagnosing asymmetric hearing loss involves a thorough evaluation by an audiologist or an ear, nose, and throat (ENT) specialist. The process typically includes:

Audiometric Testing: A series of hearing tests to determine the degree and type of hearing loss in each ear.
Imaging: MRI or CT scans may be used to identify structural abnormalities, such as tumours.
Blood Tests: To rule out underlying health conditions that might contribute to hearing loss.

Treatment for asymmetric hearing loss

Once asymmetric hearing loss is diagnosed, these common treatments might be recommended by an audiologist:

Hearing aids: Custom-fitted hearing devices can amplify sound, making it easier to hear. For AHL, a binaural (two-ear) fitting is often recommended, even if one ear has better hearing.
Cochlear implants: In cases of severe to profound hearing loss, cochlear implants may be an option. These electronic devices bypass damaged parts of the ear and directly stimulate the auditory nerve.
Medications and surgery: For conditions like SSNHL or Meniere’s disease, medication may help manage symptoms. Surgery might be necessary for cases involving tumours or structural issues.

Fitting hearing aids for asymmetric hearing loss

Your treatment options will depend on the cause and severity of your hearing loss. Usually, hearing aids, bone-anchored hearing devices, or cochlear implants are recommended.

This type of hearing loss can be more complex, and finding the right solution might involve some trial and error. The goal is to balance the sound signals reaching each ear so you can hear as "normally" as possible, though this can be more challenging with significant differences in hearing ability between ears.

Modern hearing aids can often be adjusted by an audiologist to accommodate the differences between your ears. However, if the hearing loss is severe in one ear or if one ear is completely normal, bone-anchored hearing devices might be a better option.

If you are fitted with hearing aids, remember to be patient whilst you are adjusting to them. You may need additional adjustments to achieve the right balance for your specific hearing needs, and it might take your brain a bit longer to integrate the amplified sounds.

The effort will pay off and the health benefits of using hearing aids to treat asymmetrical hearing loss will improve your ability to localise sounds.

Living with symmetric hearing loss

Adapting to life with asymmetric hearing loss requires different approaches. Here are some strategies that can help:

Communication strategies: Positioning yourself so the better-hearing ear is towards the sound source, using visual cues, and reducing background noise can improve communication.
Assistive listening devices: Devices like FM systems and loop systems can enhance sound quality in specific environments.
Support networks: Joining support groups or seeking counselling can provide emotional support and practical advice.

You can also download the white paper on Asymmetric hearing loss from the Royal Australian College of General Practitioners by clicking on the green button further down the page.

Asymmetric hearing loss conclusion

Asymmetric hearing loss may not be as widely discussed as other health issues, but its impact on daily life is significant.

Awareness and understanding of asymmetric hearing loss can lead to better diagnosis, treatment, and support for those affected.

If you or someone you know is experiencing hearing difficulties, it’s important to seek professional advice.

With the right strategies and technologies, living with asymmetric hearing loss can become more manageable and less isolating.

Common FAQs about hearing aids and hearing loss

Is this the best model for me?

If you are looking at this page then it is likely that an audiologist has suggested that you purchase this particular hearing aid, so is this the best model for you?

In general, any audiologist will always be recommending to you the model that best suits your needs. Here is a useful check list to make sure that is the case.

Audiologist level of knowledge. The audiologist you have seen will hopefully have a wide knowledge of all available hearing aids, however some will only be familiar with a small number of brands and therefore may not really be in a position to know which model is the best for you. It is OK to challenge their recommendation and ask them to justify why this particular brand is the one for you.
Do research. Read about the hearing aid that was recommended. Does it seem like it will suit your lifestyle? Does it have more or less features than you need?
Be aware of sales targets. Many high street retailers have specific tie-ins to a particular manufacturer/brand. The hearing aid they have suggested may still be the correct one for you, but do your research so that you know why they might have recommended it.

If in doubt, feel free to give us a call. That's what we're here for.

Do I need one hearing aid or two?

What are the benefits of rechargeable hearing aids?

Are behind the ear aids better than in the ear aids?

What are channels, and how many do I need?

Where can I get the hearing aids covered?

How much does the hearing test cost?

Do home visits cost extra?

How come you're much cheaper than other places?

What is Asymmetric Hearing Loss?: The uneven hearing loss and its causes, treatments, and challenges