Objective: This research aimed to investigate the effects of hearing aids(HAs) on sound localization in noisy environment for individuals with unilateral hearing loss(UHL). Method: The study used an experimental approach with 43 participants (22 with UHL, 21 with normal hearing). Hearing thresholds were measured at 500 - 4000 Hz using pure-tone audiometry. Sound localization experiments were conducted in a 2 m × 2 m room with five loudspeakers arranged in a semicircle, both with and without hearing aids, in a simulated noisy environment. Tests were performed at different signal-to-noise ratios (SNR 5, SNR 0, SNR -5), and localization accuracy was assessed by participants pointing to the speaker playing the target signal, ignoring background white noise. Each participant completed at least 45 trials. Data were statistically analyzed to compare localization accuracy between groups and evaluate hearing aid effectiveness in complex listening conditions. Results: Pure tone tests showed substantial hearing loss in UHL individuals’ impaired ear (40 - 80 dB HL), but aided conditions brought thresholds closer to normal hearing level. Unaided UHL individuals had lower mean correct identification rate (CIR) (26.36% at SNR 5, 23.03% at SNR 0, 22.12% at SNR -5) than aided (45.76% at SNR 5, 39.70% at SNR 0, 38.12% at SNR -5). Hearing aids reduced mean angle deviation from 74.18° (SNR 5), 76.09° (SNR 0), and 77.73° (SNR -5) unaided, to 45.82° (SNR 5), 48.41° (SNR 0), and 47.73° (SNR -5) aided. It is proven that the accuracy in sound localization is improved statistically (p-values < 0.05) at all SNRs. However, a big performance gap persisted between UHL individuals using HAs and those with NH, especially under challenging SNR conditions. Conclusion: The study concludes that HAs enhance sound localization for UHL in noise although there remains a notable gap when compared to NH individuals, it proves the need for HAs technology improvement to optimize auditory outcomes for UHL individuals.
Cite this paper
Chobola, P. , Wang, Y. , Shi, W. , Wang, Y. , Xu, H. , Sheng, Y. and Tu, L. (2025). Effects of Hearing Aids on Sound Localization in Noisy Environment for Individuals with Unilateral Hearing Loss. Open Access Library Journal, 12, e3313. doi: http://dx.doi.org/10.4236/oalib.1113313.
Wang, Y., Xie, Y., Wang, M., Zhao, M., Gong, R., Xin, Y., et al. (2024) Hearing Loss Prevalence and Burden of Disease in Chi-na: Findings from Provincial-Level Analysis. Chinese Medical Journal, 138, 41-48. https://doi.org/10.1097/cm9.0000000000003096
Podury, A., Jiam, N.T., Kim, M., Donnenfield, J.I. and Dhand, A. (2023) Hearing and Sociality: The Implications of Hearing Loss on Social Life. Frontiers in Neuroscience, 17, Article ID: 1245434. https://doi.org/10.3389/fnins.2023.1245434
Golub, J.S., Lin, F.R., Lustig, L.R. and Lalwani, A.K. (2017) Prevalence of Adult Unilateral Hearing Loss and Hearing Aid Use in the United States. The Laryngoscope, 128, 1681-1686. https://doi.org/10.1002/lary.27017
Snapp, H.A. and Ausili, S.A. (2020) Hearing with One Ear: Consequences and Treatments for Profound Unilateral Hearing Loss. Journal of Clinical Medicine, 9, Article No. 1010. https://doi.org/10.3390/jcm9041010
Galloway, J., Zhang, V., Marnane, V., Hou, S., Stewart, G. and Bardy, F. (2019, March 21) Individual Perspectives on How Unilateral Hearing Loss (UHL) Affects Their Daily Lives, Attitudes, and Relation-ships. Middle-Ear Implants, Research, Surveys & Statistics. https://hearingreview.com/inside-hearing/research/impact-unilateral-hearing-loss-adult-life
Purcell, P.L., Cushing, S.L., Papsin, B.C. and Gordon, K.A. (2020) Uni-lateral Hearing Loss and Single-Sided Deafness in Children: An Update on Diagnosis and Management. Current Otorhino-laryngology Reports, 8, 259-266. https://doi.org/10.1007/s40136-020-00293-8
Tyagi, A.K., Gupta, K., Kumar, A., Varshney, S., Sood, R., Malhotra, M., et al. (2020) Rare Causes of Unilateral Sensorineural Hearing Loss in Adults: Our Expe-rience. Indian Journal of Otolaryngology and Head & Neck Surgery, 72, 428-436. https://doi.org/10.1007/s12070-020-01837-6
Corbin, N.E., Buss, E. and Leibold, L.J. (2021) Spatial Hearing and Functional Auditory Skills in Children with Unilateral Hearing Loss. Journal of Speech, Language, and Hearing Research, 64, 4495-4512. https://doi.org/10.1044/2021_jslhr-20-00081
Brown, K.D., Dillon, M.T. and Park, L.R. (2021) Benefits of Cochlear Implantation in Childhood Unilateral Hearing Loss (CUHL Trial). The Laryngoscope, 132, S1-S18. https://doi.org/10.1002/lary.29853
Sheffield, S.W., Wheeler, H.J., Brungart, D.S. and Bernstein, J.G.W. (2023) The Effect of Sound Localization on Auditory-Only and Audiovisual Speech Recognition in a Simulated Multitalker Environment. Trends in Hearing, 27. https://doi.org/10.1177/23312165231186040
Carlini, A., Bordeau, C. and Ambard, M. (2024) Auditory Localization: A Comprehensive Practical Review. Frontiers in Psychology, 15, Article ID: 1408073. https://doi.org/10.3389/fpsyg.2024.1408073
Zheng, Y., Swanson, J., Koehnke, J. and Guan, J. (2022) Sound Locali-zation of Listeners with Normal Hearing, Impaired Hearing, Hearing Aids, Bone-Anchored Hearing Instruments, and Coch-lear Implants: A Review. American Journal of Audiology, 31, 819-834. https://doi.org/10.1044/2022_aja-22-00006
Derleth, P., Georganti, E., Latzel, M., Courtois, G., Hofbauer, M., Raether, J., et al. (2021) Binaural Signal Processing in Hearing Aids. Seminars in Hearing, 42, 206-223. https://doi.org/10.1055/s-0041-1735176
Kumpik, D.P. and King, A.J. (2019) A Review of the Effects of Unilateral Hearing Loss on Spatial Hearing. Hearing Research, 372, 17-28. https://doi.org/10.1016/j.heares.2018.08.003
Brown, K.D. and Balkany, T.J. (2007) Benefits of Bilateral Cochlear Implantation: A Review. Current Opinion in Otolaryngology & Head & Neck Surgery, 15, 315-318. https://doi.org/10.1097/moo.0b013e3282ef3d3e
Epstein, M. and Florentine, M. (2012) Binaural Loudness Summa-tion for Speech Presented via Earphones and Loudspeaker with and without Visual Cues. The Journal of the Acoustical Soci-ety of America, 131, 3981-3988. https://doi.org/10.1121/1.3701984
Wick, C.C., Durakovic, N., Herzog, J.A. and Buchman, C.A. (2022) Hearing Rehabilitation Following Acoustic Neuroma Surgery. In: Bambakidis, N.C., Megerian, C.A. and Spetzler, R.F., Eds., Surgery of the Cerebellopontine Angle, Springer International Publishing, 157-167. https://doi.org/10.1007/978-3-031-12507-2_12
Akeroyd, M.A. (2014) An Overview of the Major Phenomena of the Localization of Sound Sources by Normal-Hearing, Hearing-Impaired, and Aided Listeners. Trends in Hearing, 18, 1-7. https://doi.org/10.1177/2331216514560442
Valzolgher, C., Capra, S., Gessa, E., Rosi, T., Gio-vanelli, E. and Pavani, F. (2024) Sound Localization in Noisy Contexts: Performance, Metacognitive Evaluations and Head Movements. Cognitive Research: Principles and Implications, 9, Article No. 4. https://doi.org/10.1186/s41235-023-00530-w
Jespersen, C.T., Kirkwood, B.C. and Groth, J. (2021) Increasing the Effectiveness of Hearing Aid Directional Microphones. Seminars in Hearing, 42, 224-236. https://doi.org/10.1055/s-0041-1735131
Aldè, M., Zanetti, D., Ambrosetti, U., Monaco, E., Gasbarre, A.M., Pignata-ro, L., et al. (2024) Unilateral Sensorineural Hearing Loss in Children: Etiology, Audiological Characteristics, and Treatment. Children, 11, Article No. 324. https://doi.org/10.3390/children11030324
Shiraishi, K. (2021) Sound Localization and Lateralization by Bilateral Bone Conduction Devices, Middle Ear Implants, and Cartilage Conduction Hearing Aids. Au-diology Research, 11, 508-523. https://doi.org/10.3390/audiolres11040046
Johnstone, P.M., Náblek, A.K. and Robertson, V.S. (2010) Sound Localization Acuity in Children with Unilateral Hearing Loss Who Wear a Hearing Aid in the Impaired Ear. Journal of the American Academy of Audiology, 21, 522-534. https://doi.org/10.3766/jaaa.21.8.4
An, Y., Lee, E.S., Kim, D.H., Oh, H.S., Won, J.H. and Shim, H.J. (2022) Long-Term Effects of Hearing Aid Use on Auditory Spectral Discrimination and Temporal Envelope Sensitivity and Speech Perception in Noise. The Journal of International Advanced Otology, 18, 43-50. https://doi.org/10.5152/iao.2022.21228
Zavdy, O., Fostick, L., Fink, N., Danin, S., Levin, A., Lipschitz, N., et al. (2022) The Effect of Hearing Aids on Sound Localization in Mild Unilateral Conductive Hearing Loss. Journal of the American Academy of Audiology, 33, 357-363. https://doi.org/10.1055/a-1889-6578
Teschner, M.J., Seybold, B.A., Malone, B.J., Hüning, J. and Schreiner, C.E. (2016) Effects of Signal-to-Noise Ratio on Auditory Cortical Fre-quency Processing. The Journal of Neuroscience, 36, 2743-2756. https://doi.org/10.1523/jneurosci.2079-15.2016
Olusanya, B.O., Davis, A.C. and Hoffman, H.J. (2019) Hearing Loss Grades and the International Classification of Functioning, Disability and Health. Bulletin of the World Health Organization, 97, 725-728. https://doi.org/10.2471/blt.19.230367
Xiao, B., Zhou, B., Ye, J., Chen, Q. and Zhang, C. (2023) On the Performance Limits of Array-Based Acoustic Source Localization. IEEE Sensors Journal, 23, 23303-23316. https://doi.org/10.1109/jsen.2023.3303216
Haragopal, H., Dorkoski, R., Pollard, A.R., Whaley, G.A., Wohl, T.R., Stroud, N.C., et al. (2020) Specific Loss of Neural Sensitivity to Interaural Time Difference of Unmodulated Noise Stimuli Following Noise-Induced Hearing Loss. Journal of Neurophysiology, 124, 1165-1182. https://doi.org/10.1152/jn.00349.2020
Nearity Team (2024) The Importance of Noise Reduction in Hearing Aids: How to Reduce Background Noise. https://www.nearity.co/blog/the-importance-of-noise-reduction-in-hearing-aids
Dincer D’alessandro, H., Sen-naroğlu, G., Yücel, E., Belgin, E. and Mancini, P. (2015) Gli effetti squelch binaurale e ombra nei bambini con impianto co-cleare monolaterale e protesi acustica controlaterale. Acta Otorhinolaryngologica Italica, 35, 343-349. https://doi.org/10.14639/0392-100x-497
Loiselle, L.H., Dorman, M.F., Yost, W.A., Cook, S.J. and Gifford, R.H. (2016) Using ILD or ITD Cues for Sound Source Localization and Speech Understanding in a Complex Listening Environment by Listeners with Bilateral and with Hearing-Preservation Cochlear Implants. Journal of Speech, Language, and Hearing Re-search, 59, 810-818. https://doi.org/10.1044/2015_jslhr-h-14-0355
Ha, J., Kim, H., Lee, J.H. and Park, H.Y. (2022) Sound Localization in Patients with a Unilateral Hearing Aid: Discordance between the Right and Left Ears. Laryngoscope Investigative Otolaryngology, 7, 599-603. https://doi.org/10.1002/lio2.769
Ellinger, R.L., Jakien, K.M. and Gallun, F.J. (2017) The Role of Interaural Differences on Speech Intelligibility in Complex Multi-Talker Environments. The Journal of the Acoustical Society of America, 141, EL170-EL176. https://doi.org/10.1121/1.4976113
Armstrong, A.G., Lam, C.C., Sabesan, S. and Lesica, N.A. (2021) Compression and Amplification Algorithms in Hearing Aids Impair the Selectivity of Neural Responses to Speech. Nature Biomedical Engineering, 6, 717-730. https://doi.org/10.1038/s41551-021-00707-y
May, T., Kowalewski, B. and Dau, T. (2020) Scene-aware Dynam-ic-Range Compression in Hearing Aids. In: Blauert, J. and Braasch, J., Eds., The Technology of Binaural Understanding, Springer International Publishing, 763-799. https://doi.org/10.1007/978-3-030-00386-9_25
Kerber, S. and Seeber, B.U. (2012) Sound Localization in Noise by Normal-Hearing Listeners and Cochlear Implant Users. Ear & Hearing, 33, 445-457. https://doi.org/10.1097/aud.0b013e318257607b
Spencer, N.J., Tillery, K.H. and Brown, C.A. (2019) The Effects of Dynamic-Range Automatic Gain Control on Sentence Intelligibility with a Speech Masker in Simulated Cochlear Implant Listening. Ear & Hearing, 40, 710-724. https://doi.org/10.1097/aud.0000000000000653
Wu, Y., Stangl, E., Chipara, O., Hasan, S.S., Welhaven, A. and Oleson, J. (2018) Characteristics of Real-World Signal to Noise Ratios and Speech Listening Situations of Older Adults with Mild to Moderate Hearing Loss. Ear & Hearing, 39, 293-304. https://doi.org/10.1097/aud.0000000000000486
Marin-Hurtado, J.I. and Anderson, D.V. (2012) Preservation of Localization Cues in BSS-Based Noise Reduction: Application in Binaural Hearing Aids. In: Naik, G.R., Ed., Independent Component Analysis for Audio and Biosignal Applications, InTech, 209 p. https://doi.org/10.5772/48241
Llave, A., Leglaive, S. and Séguier, R. (2020) Localization Cues Preservation in Hearing Aids by Combining Noise Reduction and Dy-namic Range Compression. 2020 Asia-Pacific Signal and Information Processing Association Annual Summit and Conference (APSIPA ASC), Auckland, 7-10 December 2020, 686-693. https://ieeexplore.ieee.org/abstract/document/9306420
Kolarik, A.J., Moore, B.C.J., Zahorik, P., Cirstea, S. and Pardhan, S. (2015) Auditory Distance Perception in Humans: A Review of Cues, Development, Neuronal Bases, and Effects of Sensory Loss. Attention, Perception, & Psychophysics, 78, 373-395. https://doi.org/10.3758/s13414-015-1015-1
Oxenham, A.J. (2018) How We Hear: The Perception and Neural Cod-ing of Sound. Annual Review of Psychology, 69, 27-50. https://doi.org/10.1146/annurev-psych-122216-011635
National Guideline Centre (UK) (2018) Hearing Loss in Adults: Assessment and Management. National Institute for Health and Care Excellence (NICE). https://www.ncbi.nlm.nih.gov/books/NBK536536/
Nelissen, R.C., Agterberg, M.J.H., Hol, M.K.S. and Snik, A.F.M. (2016) Three-Year Experience with the Sophono in Children with Congenital Conductive Unilateral Hearing Loss: Tolerabil-ity, Audiometry, and Sound Localization Compared to a Bone-Anchored Hearing Aid. European Archives of Oto-Rhino-Laryngology, 273, 3149-3156. https://doi.org/10.1007/s00405-016-3908-6
Lawrence, B.J., Jayakody, D.M.P., Henshaw, H., Ferguson, M.A., Eikelboom, R.H., Loftus, A.M., et al. (2018) Auditory and Cognitive Training for Cogni-tion in Adults with Hearing Loss: A Systematic Review and Meta-Analysis. Trends in Hearing, 22. https://doi.org/10.1177/2331216518792096