Monaural Hearing Aid
A monaural hearing aid is a single hearing aid worn in one ear only. In some cases, only one ear requires or can benefit from amplification, for example when hearing is normal in one ear and impaired only in the other. In other cases, both ears have hearing loss but only one is fitted, a decision sometimes made for reasons of cost, ear canal conditions, or because one ear does not have sufficient residual hearing to benefit from amplification.
When only one ear is aidable, a monaural fitting is the appropriate choice. When both ears have hearing loss and both could potentially benefit, audiologists generally recommend bilateral fitting (hearing aids for both ears) because of the well-established advantages of binaural hearing, including improved sound localization and better speech understanding in noise. A monaural fitting in someone with bilateral hearing loss reduces these binaural processing benefits.
In some clinical situations, a monaural trial with one hearing aid before committing to a bilateral fitting is used to help a patient new to amplification adjust gradually, particularly when cost is a significant barrier. In Ontario, the Assistive Devices Program (ADP) provides per-device funding and does not require bilateral fitting, so the clinical recommendation and patient preference guide the decision.
