Hearing with both ears

From crossing the street with confidence to having conversations in noisy places, there are important advantages to hearing with both ears.

Three adults eating in the garden together

What you'll find on this page

  • The importance of hearing with both ears.
  • The benefits of hearing with a hearing aid and a hearing implant.
  • One person's story about hearing with two implants.

The importance of hearing with both ears

Ears work as a team, and the brain needs both to process speech and locate sound direction.1 Hearing with both ears is known as binaural hearing. If you can only hear in one ear (unilateral hearing) it’s difficult to perform the tasks listed below.

Understand speech in noise

If you can only hear in one ear it makes it more difficult to pick up on quiet speech in a noisy environment.

Hearing with both ears also makes it easier for your brain to practise selective listening. This means you can focus on the conversations you want to hear.2

Locate sound2

Not being able to tell where sound is coming from may cause problems.

For children, it can be hard to understand the teacher in class or the coach on the sports field.

For adults, driving through traffic can be difficult. For both, crossing a busy road could prove dangerous.

Avoid the head shadow effect

When you can only hear with one ear, sounds that come from your 'bad side' fall in the shadow of your head.

Sounds have to travel around your head so your 'good ear' can send them to the brain. As a result, sounds can be difficult to hear and understand clearly, especially in noise.1 This is particularly true for higher-frequency sounds.1

Enjoy music

People who have lost hearing in one ear say they enjoy music less and describe it as sounding unpleasant, indistinct or unnatural, compared to how it sounded with both ears.3

Binaural hearing and speech development in children

Hearing with both ears helps children better understand speech and language. This is important for their learning and development.4

"Binaural hearing provides you with the ability to tell where sounds are coming from and to understand speech in noisy environments. It allows you to take advantage of brain mechanisms that can separate the speech you want to hear from other sounds in the area."

- Ruth Litovsky, Ph.D., Profession of Communication Disorders, University of Wisconsin, Director, Binaural Hearing Lab, Waisman Center

What is bimodal hearing?

For many people, using a cochlear implant on one ear and a hearing aid on the other is the solution that provides them with their best hearing in both ears. This combination is called bimodal hearing.

For the right person, bimodal hearing can provide a better hearing experience than using two hearing aids or a cochlear implant on its own.

When compared to using a hearing aid or cochlear implant alone, users of bimodal hearing report:

  • a more natural hearing experience5

  • improved speech understanding in quiet and noise6-8

  • improved perception of music9 

  • better functioning in real-life environments.8 

In a large study, users of bimodal hearing also reported much higher satisfaction with their hearing performance compared to when they previously used two hearing aids.10

Bilateral hearing: two hearing implants

If you have a bimodal solution but still struggle to understand speech, bilateral hearing implants may improve speech comprehension, which may help you to communicate more effectively.

Children spend most of their waking hours in complex noisy environments.11 To improve speech understanding in noise, as well as localise where sounds are coming from, the brain needs input from both ears. 

Providing both ears with early input ensures the auditory pathways are supported to maximise a child’s development.

Bilaterally implanted children reach hearing performance goals earlier than unilaterally implanted children.11

Your audiologist can advise you on bimodal or bilateral hearing treatment options for you or your loved one.



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Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always follow the directions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

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Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.


  1. Weaver, J. "Single-Sided Deafness: Causes, and Solutions, Take Many Forms." Hearing Journal 68.3 (2015): 20-24. Web. 28 Apr. 2017. http://journals.lww.com/thehearingjournal/Fulltext/2015/03000/Single_Sided_Deafness___Causes,_and_Solutions,.1.aspx.
  2. Hearing Aids | What is a Binaural Hearing Aid [Internet]. Betterhearing.org. 2018 [cited 12 September 2018]. 
  3. Meehan S, Hough E, Crundwell G, Knappett R, Smith M, Baguley D. The Impact of Single-Sided Deafness upon Music Appreciation. Journal of the American Academy of Audiology. 2017;28(5):444-462.
  4. Ching TY, Psarros C, Hill M, Dillon H, Incerti P. Should children who use cochlear implants wear hearing aids in the opposite ear?. Ear and hearing. 2001 Oct 1;22(5):365-80.
  5. Farinetti A, Roman S, Mancini J, et al. Quality of life in bimodal hearing users (unilateral cochlear implants and contralateral hearing aids). Eur Arch Otorhinolaryngol (2015 Nov); 272, 3209–3215.
  6. Ching TY, Incerti P, Hill M. Binaural benefits for adults who use hearing aids and cochlear implants in opposite ears. Ear Hear (2004 Feb); 25, 9–21.
  7. Morera C, Cavalle L, Manrique M, et al. Contralateral hearing aid use in cochlear implanted patients: Multicenter study of bimodal benefit. Acta Otolaryngol (2012 Jun); 132, 1084–1094.
  8. Gifford RH, Dorman MF, McKarns SA, Spahr AJ. Combined electric and contralateral acoustic hearing: Word and sentence recognition with bimodal hearing. Journal of Speech, Language, and Hearing Research. (2007 Aug) 1;50(4):835-43.
  9. Sucher CM, McDermott HJ. Bimodal stimulation: benefits for music perception and sound quality. Cochlear Implants International. (2009 Jan); 1;10(S1):96-9.
  10. Preliminary data on file: Clinical evaluation of the Cochlear Nucleus® CI532 cochlear implant in adults (CLTD5685). 2019, Jan. [Sponsored by Cochlear].
  11. Escorihuela García V, et al. (2016). Comparative study between unilateral and bilateral cochlear implantation in children of one and two years of age.