Why can’t I hear?


Helping you to understand how hearing works and options that might help you to regain a sense of hearing

Hearing loss. It can be a slow, gradual process that can happen without you noticing it at first. You might not clearly understand people speaking to you, need to turn up the volume on the TV, or are startled by a car approaching that you didn’t hear.

Our hearing is something that we take for granted. We often only realise how important it is when it no longer works properly. But poor hearing isn’t something that you have to put up with.

We often think that hearing aids are the only option when we lose our hearing. But what if they don’t work for you or you can’t wear them for medical reasons like eczema in your ear?

Modern hearing implants have helped people like our Mentors to hear again even though some suffered from severe or profound hearing losses. Patricia found that hearing aids didn’t give her the help that she needed so now uses a middle ear implant; visit Patricia’s profile page to read her story today.

Implants are designed to help people with a wide range of hearing loss from moderate, severe, or even profound to hear again. With hearing implants, even children born with a profound hearing loss have the opportunity to grow up in a hearing world, going to a mainstream school.


How hearing works


So far, the sense of hearing is the only human sense that can be replaced (replicated) by a medical technology.

Knowing the anatomy of the ear will help you understand how hearing with an implant works.

During the natural hearing process, sound passes through several parts of the ear .

Outer ear:

The outer ear picks up sound waves via the pinna (your ear) and sends them to the eardrum. The eardrum with its thin membrane is the “entry” to the middle ear.

Middle ear:

The sound waves cause the eardrum to vibrate, make the ossicles (hammer, anvil and stirrup) move. These then amplify and send the vibrations to the inner ear.

Inner ear:

This is where the cochlea is located. With its hair cells, the snail-shaped cochlea converts these vibrations into electrical signals to the auditory nerve. Once here, the nerves carry these signals to the brain which “translates” them into language, speech, music, etc.

If any step of this complex process is damaged, you will experience hearing loss.

Depending on which part of the ear is affected, various medical options and hearing solutions are available.

Why do we lose our hearing?

Hearing loss is common. We expect that it’s a problem for older people, especially as people aged 50+ are likely to experience age-related hearing loss. The sensitive hair cells in the inner ear may get damaged over many years so cannot convert the sound signals for the brain properly anymore.

But long-term exposure to noise may lead to reduced hearing or a sudden hearing loss. Diseases, infections or accidents are among other common reasons for hearing impairments, which can happen at any age.

When children are born deaf this may be due to a hereditary genetic cause.

Different types of hearing loss:

Not all hearing impairments are the same. Depending on which part of the ear is affected, you might experience different types:


Conductive hearing loss:

The outer and/or middle ear are damaged or has a temporary problem such as glue ear, so cannot send sound properly to the inner ear.


Sensorineural hearing loss:

The hair cells in the cochlea or the auditory nerve are damaged so cannot convert vibrations into electrical pulses to the brain as effectively.


Mixed hearing loss:

Mixed hearing loss is a combination of a conductive and a sensorineural hearing loss.


Hearing aid or hearing implant to help you hear again?

Treatment varies depending on which part of the ear is affected. It ranges from medication to hearing aids or surgical options.

While traditional hearing aids amplify incoming sounds, hearing implants bypass the damaged or missing part of the ear. They can be a solution when hearing aids are no longer effective.

In case of a severe to profound hearing loss, cochlear implants are often the only solution, as damaged hair cells in the cochlea cannot regenerate. Bone conduction devices can restore hearing abilities in case the outer or middle ear is affected. There is even a solution if the auditory nerve is damaged or missing completely.

Hearing implants consist of two components – an external and an internal one. The internal part is surgically implanted behind the ear. The external part, the audio processor, sends sound to the implant.

Hearing implants can be a solution for both children and adults. There is no upper age limit.


Restoring the sense of hearing? How cochlear implants and other hearing implants work :

Cochlear implants pick up sound using a microphone, process and code it, before transmitting the information to the internal implant, which will then stimulate the hearing nerve using an electrode that’s surgically placed in the cochlea. A cochlear implant essentially takes over the task of the damaged hair cells to create electrical pulses that are sent on to the auditory nerve.

Bone conduction and middle ear devices use the bones’ natural ability to conduct sound.

Auditory brainstem implants bypass the auditory nerve to help people who have a problem with their hearing nerve to hear.


Do you have questions about life with a cochlear implant or other hearing implants?

HearPeers Mentors are hearing implant users who share their stories and personal experience about life with a hearing implant. They are happy to support you in your hearing journey and are looking forward to answering your individual questions about life with hearing implants.

Connect to a HearPeers Mentor now