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For some time now, you’ve noticed that when someone speaks to you from your left side, you have to turn your head. In the car, you ask for the volume to be turned up a bit, even though everyone else can hear it fine. In meetings, you always sit in the same spot to “be better positioned.” And when there is background noise, you lose the thread of the conversation more easily than you should.
But since the other ear is working, you let it slide. After all, “it’s not that big a deal.”
Our colleague Isabel Aymerich—an audiologist with over 20 years of experience at the Burriana and Puerto de Sagunto hearing centers—is very familiar with this line of reasoning. “It is one of the most common ones I encounter in consultations,” she explains, “and also one of the factors that most often delays diagnosis.” Single-sided hearing loss has a very specific characteristic: the healthy ear compensates so effectively that it can take months, or even years, for a person to realize that something is wrong.
In this article, drawing on Isabel’s clinical experience, we explain the signs you are ignoring, why that compensatory effect occurs, and what you should do if you identify with any of the situations we are about to describe.
Do you notice that one ear responds better than the other? Isabel Aymerich conducts comprehensive, free hearing assessments at the Burriana and Puerto de Sagunto centers to detect unilateral hearing loss and guide you toward the best solution.
What is unilateral hearing loss?
Unilateral hearing loss—or hearing loss in a single ear—is the reduction or absence of hearing in one of the two ears, while the other maintains normal or near-normal function.
It can present in varying degrees—mild, moderate, severe, or profound—in the affected ear; it may appear gradually or suddenly and stem from a wide range of causes. What all forms have in common is that, without a professional hearing assessment, they are difficult to detect.
“Unlike bilateral hearing loss, which tends to cause more alarm because it affects both sides, hearing loss in just one ear easily goes unnoticed,” explains Isabel Aymerich. “The healthy ear does its job so effectively that the brain compensates for the information not received from the affected side. And that compensation—which initially seems like an advantage—is precisely what delays diagnosis.”
To better understand the different types and degrees of hearing loss, we explain them in detail in our article on degrees of hearing loss and when you need a hearing aid.
Why the compensation effect is so difficult to detect
The human brain is extraordinarily adaptable. When it stops receiving auditory information from one side, it does not simply “shut down”; instead, it redirects resources to make the most of the functioning ear. This phenomenon is known as auditory cortical reorganization and is the primary reason why so many people live with unilateral hearing loss for years without realizing it.
“In over 20 years of practice, this is the profile that appears most frequently,” says Isabel.
People who hear well at home—in quiet conversations—but get lost as soon as there is noise or the sound comes from their “bad” side. And since it doesn’t happen all the time, they treat it as normal.
Compensation works well in simple situations: a calm conversation, a quiet space, a speaker facing you directly. The problem arises under more demanding conditions:
- When there is background noise (a restaurant, a meeting, an event)
- When the voice comes from the side of the affected ear
- When you need to locate the source of a sound
- When the environment has poor acoustics (reverberation, echo)
In such situations, compensation by the healthy ear is insufficient, and symptoms appear. However, since they are not constant, many people attribute them to fatigue, distraction, or the idea that “the venue has poor acoustics.”
Signs you are ignoring
This is the most important part of the article. During consultations, Isabel Aymerich describes a series of everyday behaviors that her patients do not recognize as warning signs until someone points them out.
“Most people who come to see me don’t say, ‘I think I have hearing loss in one ear.’ They say, ‘The sound was terrible in that restaurant,’ or ‘My husband doesn’t enunciate.’ There is a whole narrative of justifications that actually masks something that should be evaluated.”
If you identify with three or more of these situations, it is very likely that you have some degree of hearing loss in one ear.
You turn your head without realizing it.
When someone speaks to you from a specific side, you instinctively turn your head to present the ear that hears better. You do it so automatically that you don’t even notice.
You always sit on the same side.
In the car, at the table, on the sofa. Without even realizing it, you have learned to position yourself so that your healthy ear is turned toward the most important sound source.
You lose the thread of the conversation during meetings or dinners when there is background noise.
You understand well in quiet settings, but when multiple conversations are happening at once, you start to get lost. You ask people to repeat themselves or pretend you understood so as not to interrupt.
You always hold the phone to the same ear.
You have a very strong preference for using a specific ear when talking on the phone. If you try using the other one, the voice sounds more distant or less clear.
You struggle to pinpoint where a sound is coming from.
An approaching car, someone calling you from another room, the sound of a doorbell. You know there is a sound, but you can’t quite tell where it’s coming from.
You feel that others are “mumbling” or not articulating clearly.
Difficulty understanding consonants and high-frequency sounds makes speech sound less clear, especially from a specific side.
You get more tired in social situations.
The extra effort the brain makes to compensate for the information it isn’t receiving causes auditory fatigue that becomes noticeable by the end of the day.
“Listening fatigue is one of the most common complaints I hear in the clinic,” says Isabel. “In Burriana, many patients tell me they leave family dinners or work meetings feeling exhausted, and that they had assumed it was due to stress or a lack of sleep. When we run the test and they see the audiogram, everything falls into place.”
If you can hear well but sometimes feel you don’t quite understand what is being said, our article on why you hear but don’t understand when there is background noise explains exactly what happens in those situations.
Most common causes
Exposure to intense noise
Sudden hearing loss
Ménière's disease
This inner ear disorder presents with episodes of vertigo, tinnitus, and hearing loss, typically in one ear. In our article on Ménière’s syndrome, you will find comprehensive information about its symptoms and treatment.
Chronic unilateral tinnitus
Otitis or recurrent infections
Acoustic neuroma
Congenital causes
How it is diagnosed
“The first thing I always do is evaluate both ears separately,” explains Isabel Aymerich. “An audiometry test that only measures the ear the patient is concerned about is not enough. Comparing both sides is what reveals whether there is asymmetry, even if the person believes they hear well.”
A comprehensive hearing evaluation to detect unilateral hearing loss includes:
Pure-tone audiometry: Assesses hearing ability in each ear independently across various frequencies. It is the fundamental test for detecting and quantifying hearing loss in the affected ear and confirming that the other ear retains normal hearing.
Speech audiometry: Measures speech comprehension in each ear separately. It makes it possible to assess not only whether sound is heard, but whether it is correctly understood.
Tympanometry: Analyzes middle ear function to rule out conductive causes such as earwax impaction, otitis, or eardrum problems.
Depending on the results, Isabel may refer the patient to an otolaryngologist for additional tests, such as an MRI, when there is no clear explanation for the hearing loss.
“A hearing assessment at Clinicaudio is much more than just a test,” explains Isabel. “We dedicate the time each person needs to understand what is happening, answer all their questions, and find the solution best suited to their situation. Every case of hearing loss is different, and we believe every patient deserves personalized care—without rushing and with the necessary support from the very start. Simply book an appointment at our hearing centers in Burriana or Puerto de Sagunto to begin understanding what is happening with your hearing and to explore, together, the best way to help you.”
Detecting unilateral hearing loss early makes a difference in treatment outcomes. Isabel Aymerich attends to you personally in Burriana and Puerto de Sagunto.
What solutions are there?
Treatment for unilateral hearing loss will always depend on the cause, the degree of hearing loss, and how it affects your daily life. “There is no single solution that works for everyone,” explains Isabel Aymerich. “What really matters is first understanding what is happening so that the most suitable option can be recommended for each case.”
When hearing loss can benefit from amplification, a properly fitted hearing aid can help improve speech understanding, reduce listening effort, and restore more balanced hearing in many everyday situations.
However, not all cases of hearing loss are treated in the same way. In some instances, follow-up will be necessary; in others, different hearing solutions will need to be evaluated; and when the cause of the loss requires it, a referral to the appropriate specialist will be needed to complete the diagnosis or treatment.
“Our goal is not to offer the same solution to all patients,” notes Isabel. “It is to understand what each person needs and guide them in making the best decision for their situation.”
If you want to know in detail how the different types of hearing aids work, you will find a comprehensive guide in our article on hearing aid types and which one is best for your hearing loss.
Why acting in time matters
“The biggest mistake my patients make is waiting for it to get worse,” says Isabel Aymerich. “Unilateral hearing loss doesn’t usually worsen dramatically, but a brain that has gone months or years without receiving stimulation from the affected side gradually loses its ability to process signals from that ear. And that makes subsequent adaptation much more difficult.”
This phenomenon is known as auditory deprivation and has real consequences; those who take action early adapt better and more quickly to any hearing solution than those who wait years.
Beyond just hearing, chronic auditory fatigue has a real impact on concentration, working memory, and emotional well-being. “Patients tell me that since they started wearing hearing aids, they are less tired, more present in conversations, and more at ease in social settings,” says Isabel. “It’s not just a matter of hearing better; it’s a matter of living better.”
Where can you get a hearing check-up in Burriana or Puerto de Sagunto?
Burriana Hearing Center – Terradez Orthopedics
If you are looking for a hearing center in Burriana, Isabel is available to assist you at Calle Federico García Lorca, 19 C, inside Ortopedia Terradez. The consultation includes a comprehensive hearing assessment—featuring separate pure-tone and speech audiometry for each ear—a diagnosis of unilateral hearing loss, and personalized guidance on the most suitable solutions for your specific needs.
“In Burriana, I see many patients from the La Plana Baixa region who have been compensating for years without realizing it,” says Isabel. “Most leave the consultation surprised—not so much by the diagnosis itself, but by how much it explains things they had been noticing for a long time.”
19 C Federico García Lorca St. — Burriana (inside Ortopedia Terradez)
607 65 75 85
Monday to Friday by appointment: 9:00am –1:30pm and 5:00pm – 8:00pm
Puerto de Sagunto Hearing Center – Valerorto Orthopedics
If you need a hearing center in Puerto de Sagunto, Isabel also sees patients at Calle Sagasta 78—inside the Valerorto orthopedics center—serving patients from Sagunto, Puerto de Sagunto, and the entire Camp de Morvedre region.
The same comprehensive, free, and personalized hearing assessment protocol applies. No medical referral is required, and there are no waiting lists.
78 Sagasta St. — Puerto de Sagunto (inside Ortopedia Valerorto)
607 65 75 85
Monday to Friday by appointment: 10:00am – 2:00pm and 5:00pm – 8:00pm
Frequently Asked Questions About Unilateral Hearing Loss
What is unilateral hearing loss?
It is the reduction or absence of hearing in one ear, while the other maintains normal or near-normal function. It can be mild, moderate, severe, or profound, and has a wide variety of causes. It is detected through audiometry, which evaluates each ear separately.
Why does it take so long to detect?
This is because the healthy ear compensates very effectively. The brain redirects resources to make the most of the functioning side, allowing the person to hear well in simple situations. Problems arise in noisy environments, when sound comes from the affected side, or when it is necessary to pinpoint the source of a sound.
Does hearing loss in one ear require treatment?
Yes, in most cases. Although the healthy ear compensates, untreated hearing loss leads to chronic listening fatigue, difficulties in noisy environments, and—over time—auditory deprivation in the affected ear, which complicates the subsequent fitting of any solution.
What test detects if I have hearing loss in only one ear?
Pure-tone audiometry, performed separately on each ear, is the primary test. It measures the hearing threshold at various frequencies and makes it possible to detect any asymmetry between the two ears, even if the person does not notice it in their daily life.
Do hearing aids help with unilateral hearing loss?
It depends on the degree of hearing loss. For partial loss, a hearing aid in the affected ear can restore balance between the two sides. For profound or total loss, there are specific systems available, such as CROS, BiCROS, or bone-conduction devices. The choice should always be made by a specialist following an evaluation.
Can I get a hearing check-up in Burriana or Puerto de Sagunto?
Yes. Isabel Aymerich sees patients personally at the hearing center in Burriana (19 C Federico García Lorca St., inside Ortopedia Terradez) and at the hearing center in Puerto de Sagunto (78 Sagasta St., inside Ortopedia Valerorto). Evaluations are free, do not require a medical referral, and are available by appointment from Monday to Friday.
Conclusion
Hearing loss in one ear is silent by definition. It is painless, does not cause vertigo in most cases, and the healthy ear masks the problem so effectively that many people go years without realizing it.
But the signs are there. Automatically turning one’s head, always holding the phone to the same ear, fatigue at the end of a meeting, difficulty pinpointing sounds. These are small, everyday adjustments the body makes to adapt to a situation it shouldn’t have to normalize.
“If my experience in the consulting room has taught me anything,” concludes Isabel Aymerich, “it is that no one regrets having come sooner. But there are people who regret having waited too long.”
Did you know that untreated hearing loss also affects the brain?
An ear that does not receive auditory stimulation gradually loses its ability to process sounds, even if the original problem has not worsened. In our article on auditory deprivation, we explain why taking timely action also protects your brain.
Do you have tinnitus in the same ear that is failing?
Persistent buzzing in one ear can be the first sign of undetected hearing loss on that side. In our article on tinnitus, we explain the relationship between the two conditions and what you can do.
