Prevalence of adult unilateral hearing loss and hearing aid use in the United States

Objective: The prevalence of unilateral hearing loss (UHL) in adults has not been well characterized. The objectives of this study are to determine the prevalence of UHL in U.S. adults and its treatment with hearing aids using a nationally representative study.

Study design: Cross-sectional national epidemiologic study (n = 6,242).

Methods: Subjects ≥ 18 years old with audiometric testing in the 2005 to 2006, 2009 to 2010, and 2011 to 2012 cycles of the National Health and Nutrition Examination Study were included. UHL was defined as normal hearing (≤25 decibels hearing level [dB HL] pure tone average [PTA]) in one ear and at least mild hearing loss (>25 dB HL PTA) in the other ear. Hearing aid usage was defined by at least 5 hours per week (2005-2006) or at least seldom (2009-2012) use. Sampling weights were utilized to ensure generalizability to the U.S.

Results: The overall prevalence of UHL in adult Americans was 7.2% (95% confidence interval 6.1%-8.6%), with 5.7% (4.8%-6.7%) having mild and 1.5% (0.1%-2.1%) with moderate-or-worse UHL; nearly one-third of the latter reported trouble hearing. The prevalence of hearing aid usage in those with UHL was 2.0% (0.6%-6.7%). Of those with mild UHL, 1.4% (0.2%-8.0%) used hearing aids. Of those with moderate UHL, 4.2% (0.1%-22%) used hearing aids. Among those with UHL and also at least moderate subjective difficulty hearing, only 11% wore hearing aids.

Conclusion: UHL is common among U.S. adults. Hearing aid usage is very low, even when there is perceived handicap. Public health education is needed to increase awareness of and auditory rehabilitation for UHL.

Level of evidence: 2. Laryngoscope, 128:1681-1686, 2018.