Learning to Hear Again: Life with Single-Sided Deafness After Acoustic Neuroma

As promised with a reader, today I am offering a blend of insight and personal reflection on single-sided deafness caused by acoustic neuroma. Remember, my blogs are an attempt to make sense of my diagnosis and should not be considered medical advice. For diagnosis, treatment, or any health decisions, always consult medical professionals.

The tumour, called acoustic neuroma or vestibular schwannoma, arises from Schwann cells on the vestibular portion of the nerve but, as it grows, it can compress the cochlear nerve, disrupting sound transmission from the ear to the brain. It can also reduce blood flow to the inner ear, further undermining hearing.

For me, that silence was not sudden. It crept in over months — muffled voices, missed high tones, a ring that never left. For a long time, I thought it was ageing or side effects of working in a noisy environment. Until an MRI told me otherwise. In rarer cases, hearing might suddenly disappear overnight, possibly due to disrupted blood flow to the cochlea. These sudden changes are sometimes reversible with prompt treatment, but not always.

The Invisible Challenges of SSD

Living with single-sided deafness (SSD) can be challenging in ways that are not immediately visible to others. It changes how you navigate social spaces, understand conversations, and feel connected to your surroundings. But with understanding, technology, and adaptation, many people go on to live full and connected lives.

Losing Direction: The Struggle with Sound Localisation

One of the earliest things you notice with SSD is losing the ability to tell where sounds are coming from. Your brain normally uses input from both ears to determine direction. Without that comparison, sound loses depth and you find yourself turning in circles trying to locate a voice or a noise. This can be disorienting, and in some cases, even dangerous. Imagine not realising a car is approaching from your deaf side because you can’t tell where the sound is coming from.

The Noise That Exhausts

Busy environments are especially difficult. In restaurants or at gatherings, your good ear receives all the sound — without help from the other side to filter it. Group conversations become tiring. If someone is speaking on your deaf side, you might miss everything. It becomes mentally exhausting just to keep up.

The Head Shadow Effect

Another overlooked challenge is the head shadow effect. Sounds from your deaf side get blocked by your own head before they reach the hearing ear. This makes voices on that side seem far away or unclear. It is not that people are mumbling — your hearing field is simply limited.

The Emotional Impact

SSD is an invisible condition. People forget or do not realise you cannot hear on one side. You find yourself constantly asking: Please speak on my right side or Face me when you talk. Hiding hearing loss can lead to awkward moments and misunderstandings. Being open about your needs often makes communication easier.

The Unexpected Benefit

Interestingly, SSD can sometimes bring unexpected benefits. One of them is better sleep. If you sleep on your hearing ear, the world becomes quiet. In noisy cities or shared rooms, this can be a hidden blessing. When I turn onto my good ear, it is like flipping off the noise of the world.

Assistive Technologies

Thankfully, there are many tools and strategies that help people with SSD adjust. One is the use of CROS (Contralateral Routing of Signal) or BiCROS hearing aids. These devices pick up sound from the deaf side and wirelessly transmit it to the good ear, allowing you to hear conversations and noises that would otherwise be missed. Though some users need time to adjust to hearing everything in one ear, many find these aids reduce the constant need to reposition themselves during conversations.

Another option is a bone-anchored hearing system (BAHS), which transmits sound through the bones of the skull to the good ear. Unlike CROS, BAHS works via bone conduction, bypassing the damaged ear entirely. It can offer a more seamless auditory experience for some users and does not require wearing a device on the good ear. While this approach involves minor surgery to implant the anchor, it often improves spatial awareness and speech comprehension significantly.

Beyond hearing aids, other assistive technologies can be helpful in specific situations. Remote microphones, personal amplifiers, or Bluetooth streaming devices can improve hearing in meetings, classrooms, or public events. Even using smartphone features like Live Listen or subtitles on media content can make daily life more manageable. These tools do not restore normal hearing, but they improve clarity and reduce strain in many listening environments.

Personal Strategies

Practical lifestyle strategies also play a major role in coping with SSD. Positioning is crucial: at dinner, in a car, or at a meeting, orient yourself so your good ear is toward the sound source. Do not hesitate to ask people to switch sides or speak up. Most are happy to accommodate once they understand the situation. Similarly, make sure you can see the speaker’s face — facial expressions and lip movement provide essential visual cues that support understanding. Good lighting and facing people directly can dramatically improve communication.

Being open with others is key. Let people know you only hear on one side and explain how they can help. Specific requests, like sit on my right side in the car or tap me before speaking if I am not facing you, can make conversations smoother. Educating close friends, family, or coworkers helps prevent frustration and ensures you are not mistakenly seen as aloof or inattentive.

Some people find that managing their sound environment improves quality of life. Choosing quieter restaurants, taking breaks during loud events, or using noise-cancelling headphones in overstimulating environments can reduce auditory fatigue. Others discover creative ways to reduce sensory overload, such as momentarily using an earplug in the good ear during chaotic moments to take a sound break. There is no one right way — the key is figuring out what works for you.

In addition, talking to others with SSD or acoustic neuroma experiences can provide emotional relief and practical tips. Mental health professionals can assist if you are dealing with anxiety, fatigue, or feelings of isolation. You are not alone, and connecting with others who understand can be empowering.

Maintain a sense of humor and perspective: It may sound trivial, but many people with hearing loss find that laughing at the small absurdities (like mis-hearing something in a ridiculous way) and educating others with a light touch (“Oops, I can’t hear on that side – I’m not ignoring you, I promise!”) helps ease social tension. Over time, your friends and colleagues will learn your preferences (for example, that you’ll always take the seat on the left side of the conference table so your right ear is toward everyone). It gets easier as you and your circle adjust together. Celebrate the victories – like attending a big family dinner and realizing you caught almost everything, thanks to smart positioning and maybe your new CROS device – and be gentle on yourself on the tougher days.

The Bigger Picture: Learning from Others

In learning more about this journey, I also came across Neurofibromatosis Type II (NF2) — a genetic condition where tumours grow on both auditory nerves, leading to hearing loss in both ears. People with NF2 often face profound or total deafness, and sometimes even cochlear implants are not an option. They rely on auditory brainstem implants, which bypass the cochlear nerve altogether. When I read about NF2 and the challenges of bilateral deafness, I could not help but feel a quiet gratitude for my one good ear. That perspective changed how I moved through the world — it made every sound from my hearing side feel like a gift.

Living Fully, Even with One Ear

With time, people with SSD find their rhythm. Yes, there are challenges — but there is also resilience, adaptation, and a new appreciation for sound. Your hearing may be one-sided, but your life does not have to be.

My Story, Your Story

If you are new to this journey, or have lived with SSD for years, know this: your experience is real. Your frustration is understood. Your silence is heard. And you are not alone.

For those interested in a more personal perspective, my book Whispers Through the Fog offers a deeper look at my journey with acoustic neuroma — from diagnosis to adaptation and everything in between. You may find comfort or reflection in its pages, just as I found healing in writing it.

Let Us Hear Each Other

The world may sound different now, but it has not gone away. It is waiting for you to hear it in your own way.

I would love to hear from you. What tools or habits have helped you? Please share in the comments or get in touch.

Your silence is heard. And you are not alone.