50+ Lifestyles

Ask the Audiologist

By Laura Kauth, M. A., CCC-A
Audiology Consultants, P.C.

Why should I get 2 hearing aids vs 1?

If you have similar levels of hearing loss in both ears, your audiologist will most likely recommend hearing aids in both ears (binaural), for much the same reason as a person with vision problems in both eyes gets a pair of glasses, not a monocle. Our ears, like our eyes, work better when they work together; when one ear gets considerably more sound than the other, it is essentially forced to work alone, depending on the degree of hearing loss.

Combined information from two ears improves your brain’s ability to separate out speech from background noise; it also means that your brain is getting more information overall, as cues from one side are supplemented by the other. Binaural audibility improves the ability to localize where sounds are coming from in space, which helps with awareness of the environment around you. It also gives an overall perception of increased volume; two hearing aids can be worn at a softer level and seem just as loud. All of these factors mean that two ears with hearing aids will come closer to normal hearing function, which will typically mean more comfortable, normal seeming sound.

With all this great benefit from two hearing aids, why would anyone get one? Cost is sometimes a reason; if there’s a choice between one aid and no aid at all, certainly there are substantial benefits to getting even one. There are also some cases when only one hearing aid is recommended; when one ear has normal hearing, for example, of course it doesn’t need amplification. Sometimes one ear is so very severely impaired that adding sound on that side actually detracts from the sound coming from the other side; the outcome in this sort of situation can be hard to predict, with some users experiencing great benefit, and some experiencing no benefit. But this is part of the reason a hearing aid fitting includes a trial period; it gives you the opportunity to try one hearing aid versus two to determine what works best.

Some people prefer one hearing aid because it’s easier for them to adjust to a partial boost in sound. The negative effect of having two hearing aids is essentially the same as the positive effect: with two hearing aids, you get more sound from all around you. And if you’ve had a hearing loss for a long time, you may not be used to the sounds which are part of the everyday world. When you hear these sounds all the time, your brain learns to filter and essentially ignore them, but when these sounds are new, they can be a bit overwhelming. With consistent hearing aid use, people typically adapt; our brains are more flexible than we give them credit for. But sometimes people will make the decision to wear only one hearing aid, at least until they’re a bit more accustomed to the sounds around them.

There’s one last argument to be made for the benefits of two hearing aids over one; late-onset auditory deprivation effect. Various studies have been conducted on the long term effects of only providing one ear with auditory input, and while some have shown no permanent impact, others have suggested that without stimulation, the unused ear may not function quite as well in the long run. At this time, there does not seem to be a consensus in auditory research on whether this effect really exists, or who it will impact. But it’s fair to say that it’s awfully hard to get good use out of both ears if you don’t provide both ears with the tools they need.

So should you get one hearing aid or two? That depends on your hearing loss, and it depends on you. Your audiologist should be able to discuss your needs and make appropriate recommendations; be prepared to follow them and provide feedback as part of the fitting process. There is a substantial benefit to a binaural fitting for most binaural hearing losses, but in the end, you need to be comfortable with your choice and with the results; the decision lies with you.