Hearing loss in one ear — what it can mean and what to do

Hearing loss in one ear most often has a simple, reversible cause, such as a build-up of earwax or a blocked ear after a cold. It can, however, be a sign of a condition that needs prompt treatment. That is why one-sided hearing loss, especially when it comes on suddenly, should be checked with a test rather than waited out.

What one-sided hearing loss can mean

The ear has three parts: the ear canal, the middle ear (eardrum, ossicles, Eustachian tube) and the inner ear (cochlea and auditory nerve). A problem at any of these levels can make one ear feel “worse”. Common causes include:

• Impacted earwax — a plug of wax in the ear canal causes a blocked, muffled feeling. It usually builds up slowly, but can seem sudden after a bath or shower, when the wax swells.
• Ear infection — inflammation of the outer or middle ear. It usually comes with pain, a feeling of fullness and sometimes fever or discharge.
• Fluid in the middle ear — after a cold or sinus infection the Eustachian tube can become blocked and fluid collects behind the eardrum. Sounds feel muffled, as if the ear were under water.
• Barotrauma (pressure injury) — after a flight, diving or a hard blow to the ear. It can damage the eardrum or the inner ear.
• Sudden sensorineural hearing loss — a rapid drop in hearing in one ear, often with tinnitus, without pain and without a cold beforehand. It affects the inner ear or the auditory nerve and needs urgent treatment.
• Acoustic neuroma — a rare, benign growth on the auditory nerve that slowly reduces hearing on one side, sometimes with tinnitus or balance problems. This is one reason why hearing loss confined to one ear calls for fuller investigation than loss in both ears.

The symptom alone does not tell these causes apart. A wax blockage and sudden sensorineural loss can feel very similar, yet the treatment is completely different.

When to seek help urgently

Do not wait for a routine appointment if:

• hearing in one ear dropped suddenly (over a few hours or overnight) — this calls for an urgent ENT consultation, ideally within 24–72 hours;
• the hearing loss comes with ear pain, fever or discharge from the ear canal;
• you have dizziness, loss of balance or nausea;
• the symptom followed an injury — a blow, an explosion, diving or a rapid change in pressure;
• you notice weakness of the facial muscles on the same side.

With sudden sensorineural hearing loss, time matters: the earlier treatment starts, the better the chance of improvement. If you cannot get to an ENT specialist quickly, go to a hospital emergency department.

If hearing is worsening slowly, without pain or other symptoms, a routine appointment is fine — but do not put it off for months.

Which tests explain the cause

Investigating one-sided hearing loss is painless and usually fits into one or two visits:

• Otoscopy — the doctor looks into the ear canal and at the eardrum. Wax, signs of infection, a perforation or fluid behind the eardrum are visible straight away. At Sonar Clinic the doctors providing ENT consultations also use an endoscope, which gives a more detailed view.
• Pure-tone audiometry — a test with headphones in which you signal the quietest sounds you can hear at different pitches. The result (an audiogram) shows how much hearing is reduced and whether the problem lies in sound conduction (outer or middle ear) or in sound perception (inner ear or nerve). It takes about 30 minutes.
• Tympanometry — a soft probe placed in the ear measures how freely the eardrum moves. It confirms fluid in the middle ear or pressure problems. It takes a few minutes and can also be done with acoustic reflexes.
• ABR (auditory brainstem response) — a test of how the auditory nerve and brainstem respond to sound, recorded through electrodes stuck to the skin. It is ordered when the nerve pathway needs assessing, for example in asymmetric sensorineural loss. If the result is abnormal, the doctor may refer you for an MRI scan.

Together, these results show where the problem lies — and whether it is enough to remove wax or treat an infection, or whether further investigation is needed.

How it works at Sonar Clinic

At Sonar Clinic, ul. Gubińska 8A, Wrocław, the pathway depends on your symptoms:

• Hearing tests — pure-tone audiometry, tympanometry and ABR are carried out by Paulina Waloszek, MSc, audiologist and hearing aid specialist. This is a good first step when hearing has worsened gradually and without pain. Details are on the hearing diagnostics page.
• ENT consultation — with Patryk Manycz, MD or Piotr Potyrała, MD, doctors in specialty training in ENT. The visit includes a history, an endoscopic examination and, where indicated, tympanometry and ear irrigation. This is the right route when the symptom came on suddenly, hurts or comes with other complaints. The scope is described on the ENT page.

After the consultation the doctor can refer you for further hearing tests on site and discuss the audiogram at a follow-up visit. Indicative prices: pure-tone audiometry 50 zł, tympanometry 50 zł, adult ENT consultation 300 zł — the current price list is on the pricing page.

You can book by phone on +48 880 018 703 or online on the specialist’s profile. If your hearing dropped suddenly, mention this when booking.

What to bring to the appointment

• A note of when and how quickly your hearing worsened and what was happening at the time (an infection, a flight, loud noise, an injury).
• A list of accompanying symptoms: tinnitus, pain, discharge, dizziness, a feeling of fullness.
• Results of any previous hearing tests.
• A list of the medicines you take — some can affect hearing.
• If you use a hearing aid, bring it with you.

Before the visit, do not try to clean the ear yourself with cotton buds or use “unblocking” drops without advice — it makes assessment harder and can make things worse.