Many "ideal" bilateral hearing aid patients will eventually wear only one hearing aid. At this time, there is no accurate method for predicting which patients may eventually prefer monaural fittings. The advantages of binaural fittings are obvious and well documented—reduced head shadow effects, binaural processing benefits such as improved speech in noise, superior localization ability, binaural squelch, binaural summation and more. As anticipated, the majority of bilaterally hearing impaired people ultimately decide and prefer bilateral amplification and approximately 90 percent of all hearing aid fittings are bilateral.
However, Cox et al (2011) indicate some 41 percent of bilaterally hearing impaired people in controlled field trials, and some 21 percent of the people in retrospective studies, prefer to only wear one device—even when two are readily available. Additionally, the authors evaluated 94 adults (57 men and 37 women) with a mean age of 69 years with mean word recognition scores of 82 percent (females) and 76 percent (males). Subjects were evaluated with open-ended questions, standardized questionnaires, objective tests, and more. Upon conclusion of their test protocol, 43 subjects stated they were very certain or reasonably certain they preferred monaural fittings. Among the reasons some people preferred monaural fittings; in quiet and in noise they report understanding speech about the same with one or two hearing aids, they report their own voice is more natural/comfortable with one hearing aid, they report one hearing aid helps as much as two and using the telephone is a problem with two hearing aids.
The authors concluded that hearing loss (based on the audiogram) did not predict monaural versus binaural preference across mild and moderate hearing losses (their study did not evaluate people with severe and profound hearing loss) and "auditory lifestyle" (i.e., demands on hearing and listening) was not predictive of monaural versus binaural amplification preference.
For More Information, References, and Recommendations
Cox RM, Schwartz KS, Noe CM, Alexander GC. (2011) Preference for One or Two Hearing Aids Among Adult Patients. Ear & Hearing 32(2):181-197.