We hear sound and understand speech. We recognize danger and enjoy music. A very important sense that allows us to both communicate and orient ourselves in space.
But we often overstrain our hearing. Ask too much of our ears too often, and our auditory senses can disappear. The worst was when I had a vertigo attack at a gig and fell over at the DJ booth.
Nobody knew what was going on, that it was coming from my ear. Music can calm us, heal us and even motivate us. Hearing is a gateway to the world.
But silence is important too. I like going for walks, I ride my bike, and I go to the sauna it's a good way to wind down. I almost only do quiet activities when I’m not working.
None of our senses are as sophisticated as our sense of hearing. So why are we so careless with it? Starnberg, Upper Bavaria.
Bernhard Junge-Hülsing treats primarily children. The ear, nose and throat doctor specializes in hearing and speech development disorders. Good morning.
We're doing another confirmatory screening today. After giving birth, Josefine’s mother was concerned that her baby couldn’t hear properly. Sonja Plank uses a tiny probe to test her hearing.
The device sends sound waves into the inner ear, where the sensory cells vibrate in response, similar to an echo. The probe then measures the strength of the reflected signals. If there is no response or the results are very weak, it could be a sign of hearing damage.
Early diagnosis is also important, because you can intervene early and ensure speech and intelligence develop normally. We perceive the world through our sense of hearing even in the womb. Embryos begin acknowledging acoustic signals and voices in about the 20th week.
The ear works like a funnel. Sound waves travel through the auditory canal and cause the eardrum to vibrate. The auditory ossicles the hammer, incus, or anvil, and stirrup guide the sound into the inner ear.
There it reaches the cochlea, filled with fluid and 15,000 hair cells. The fine cells bend in response to the vibrations, triggering electrical impulses. The auditory nerves then send these impulses to the brain.
I like to compare the three rows of outer hair cells and the one row of inner hair cells to a field of grain. If there is a slight sound, they bend and straighten up again. And if there's a hailstorm, they fall over and only some of them straighten up again, like with an explosive trauma or a very loud concert.
The fine hair cells can no longer regenerate once destroyed. Let's look at the results. In Germany, approximately every thousandth child is born with a severe hearing defect, usually genetic.
Perfect response rate, 100% on the right, 96% on the left. Little Josefine’s hearing is perfect. Exams like this are now standard in Germany.
Newborn hearing screening is very important because hearing plays a key role in the overall development of language and intelligence. And we used to diagnose it far too late. First at four years old, then at two and a half and now before six months.
Hello, nice to see you. In addition to genetic defects, the most common causes of hearing disorders are illnesses during pregnancy or infections such as measles, mumps and scarlet fever. But the biggest enemy of our ears is noise especially in everyday life.
A typical daycare center in Gronau. The "Familie Sausewind" team looks after 23 children. The two to six-year-olds have a lot of energy.
The noise is stressful not only for them, but also the staff. The daycare is consistently loud all day. Background noise for eight working hours a day is stressful.
Children are very loud by nature by evening you're exhausted, all you want is some peace and quiet to switch off. The constant volume and the short, high peaks caused by children's screams are dangerous: excess noise can permanently damage our hearing. Daycare staff cannot wear hearing protection as they would on a building site.
They must always be aware of the children’s needs. But how loud is "too loud"? Sound is measured in decibels.
Extremely quiet sounds such as breathing and snowfall are around 10 decibels. The decibel curve quickly spikes upward. 60 decibels are perceived as twice as loud as 50.
Continuous noise above 80 db can damage our hearing. The pain threshold is 120 db a trillion times louder than barely perceptible noise. Noise pollution in a daycare center reaches 85 decibels at certain times of day, with even higher peak levels.
Constant exposure to exhausting levels of noise increases stress and agitation in kids and adults alike. The daycare had to do something. The team decided to reduce the size of groups for certain activities, dividing the children among several rooms.
The children go to the gym, the ball pool, the Snoozel room and the room next door. We also have external educators who play with other groups, so that the children aren't in one big group and it's a bit quieter. There are also rest hours, when everyone can relax.
There is peace and quiet when eating, reading aloud and drawing. Noise can drive up blood pressure and heart rate leading to other illnesses over the long term. Turntables, sound mixers and loud music were long just a part of Thomas Sünder’s life.
He was a full-time DJ where high volumes and constant stress were just in a day’s work. The 49-year-old piped good vibes from the DJ booth to weddings, anniversaries and big birthday parties. Then, one day, he collapsed.
I had a vertigo attack in the middle of a gig. It was so severe that I fell over and couldn't find my bearings at all. Somehow I still managed to call for help because nobody around me knew what was going on, that it was coming from my ear.
The collapse didn’t come without warnings but Thomas Sünder didn’t take them seriously. Suddenly, he started hearing a constant ringing in both ears. Tinnitus.
Around 2. 7 million Germans suffer from a chronic form of the disease. In the beginning, when I realized that the ringing was here to stay, I thought: I can't live with this.
It was so disturbing and loud and annoying. Tinnitus can be a phantom sound, where a hair cell is kinked and then continues to emit a phantom sound, which the brain then processes. The stupid thing about tinnitus is that it is subjective.
We can't measure it precisely. We can only rely on what the patient says. Then came another blow for Thomas Sünder.
Suddenly, everything became muffled. I woke up and suddenly felt like I had cotton in my ear. But there was none and everything was muffled on one side.
The exact causes of sudden deafness are not yet fully understood: Sudden hearing loss usually occurs on one side. It is always a circulatory disorder, i. e.
the inner ears are not receiving enough enough oxygen. Then came the final collapse. Thomas Sünder had a vertigo attack during a gig.
He fell. An ambulance took him to a hospital. It took him months to get back on his feet.
Then he realized that he had to fundamentally reorganize his life. And I thought: What do I do now? People had paid in advance, I had commitments, I didn't know how to sort it out.
I also didn't know what I’d do next work-wise. Parties and music used to be his life. Today, he rarely goes to clubs the booming bass and loud sounds are too exhausting for his hearing.
How loud is it right next to the speakers? He uses a free app to measure the volume. Over 100 decibels - continuous noise above 85 decibels is dangerous.
Just 25 minutes of exposure to noise can cause permanent damage. The noise is too much for Thomas Sünder, even with the custom earplugs he’s worn since the attack. This is what it sounds like to him.
The earplugs are individually molded from an impression of his inner ear. This type of hearing protection can cost several hundred euros. The sound is retained, just quieter.
It’s so loud that my body is reacting and I'm nervous about my ears, because my ears are already my weak point and it makes me super uncomfortable. Thomas Sünder is not an isolated case. A new study from the US shows that more than a billion young people worldwide are already at risk of hearing loss.
A corporate canteen in Winnenden, not far from Stuttgart. A busy time for the kitchen staff more than 1,400 meals need to be served soon. Chef Ingo Weiß is preparing soup, hash browns and dumplings.
Working in the canteen is stressful and loud: The equipment is loud People are constantly talking. Even the clattering you just heard. When something falls or something, but that's the way it is in every kitchen.
Occupational health and safety is strictly regulated. Noise levels may not exceed an average of 80 decibels in a working week. Otherwise, employers must take measures such as hearing protection or reducing noise with sound absorbers, for example.
Ambient noise damages our hearing in the long run. That's generally true, but it's not the same for everyone, just as there are workers in steelworks who don't have noise-induced hearing loss. And others get noise-induced hearing loss, even though they both have the same job.
A wooded area near Wermelskirchen in North Rhine-Westphalia. Brothers Jos and Keke Hilverkus have a gardening and landscaping business. When they’re at work, they make noise with loud tools such as stone shakers, leaf blowers, and lawn mowers.
This is their tool now: a chainsaw, which saws at up to 110 decibels. The landscapers protect their hearing. There are simple earplugs, but there are also headphones with radios so that they can communicate.
They all reduce noise. But noise can be tricky not all damage is immediately noticeable. There have been days when I've had to work without hearing protection or when I just forgot to bring it along.
And especially when you're doing tree work like that, you feel like you can't hear as well all day or for a few days afterwards if you're exposed to the sheer volume. Noise-induced hearing loss develops over years and usually goes unnoticed for a long time. Unlike other organs, the sense of hearing does not regenerate.
We live in a loud world and our hearing is needed all the time. And so is our brain. That's not healthy at all.
Keke and Jos Hilverkus make firewood - at 100 decibels. Because they are professionals, they protect their hearing. Anyone who works in their own garden or out of their book.
But many people find hearing protection annoying at home. The Radboud University in Nijmegen in the Netherlands is a research center with 22,000 students. James McQueen heads the university’s "Center for Cognition".
He’s interested in just how our brain processes and perceives sound waves. He and his team are looking at a digital brain model. The researchers have localized the areas of the brain that play an important role in hearing and understanding.
What’s clear is that several areas are involved. The brain makes many decisions in microseconds. When you hear any sound from your ears, one of the first things that you have to do is, is decide whether you're hearing something that's actually language, as opposed to other kinds of environmental noises, like a dog barking And when the decision has been made that this is language, then you start to, in your mind and in your brain to do the work of trying to extract the sounds, the vowels and consonants that make up the word.
James McQueen and his team have decoded the rules of speech comprehension: our brain compares the new impulses with the auditory impressions we’re already familiar with. We understand things that sound familiar to us. A kind of memory, a "dictionary", is stored in the brain.
So our mental dictionary is effectively a store of the knowledge that we have of the words that we've heard earlier in our lives. So we know when we've heard a word, what it sounds like, and we store that in our mind If you say dog to me, I need to recognize that sound pattern. I also need to recognize what a dog is, and I do so by looking that information up in my mental dictionary.
Our sense of hearing does amazing things. For example, it can simply block out disturbing sound waves from a background noise. There used to be an old bakery in Ober-Ingelheim Like at a party, when we filter out a single speaker from many scraps of words.
But it was like before. We felt so young at that moment. James McQueen is preparing a new experiment.
He’s testing to see if Giulio can distinguish between different ways of speaking. How distracting is an accent or an incorrect intonation? The test person hears the same word several times, pronounced or emphasized differently each time.
Can he correctly assign the sounds? The results are evaluated. The experiment confirms James McQueen's thesis: the test subject's auditory center adapted to the different ways of speaking.
When you encounter a new speaker, one of the things you have to do is learn how that speaker talks. And that involves a process of adapting to the way they speak. And that's very much like a tuning in process.
And then, of course, what you do is store that tuned knowledge that you can then use when you encounter that person another time. Our auditory center works like a muscle that needs to be trained. New auditory impressions cause a constant adjustment in the brain.
However, this means that if the auditory system is no longer activated with new impulses, the "muscle" becomes paralyzed. This could even lead to dementia. The brain deteriorates faster if you can't hear well.
And the brain also deteriorates when you're not interacting with others, i. e. when you're not participating in life.
On the road in Rheinhessen. Ruth Siewert and her daughter are going to Köngernheim for an afternoon with friends. The 95-year-old has been hard of hearing for many years.
Even in her mid-50s, she could no longer hear high-pitched sounds such as birds singing or children's voices. Then she also lost the low tones. I need my hearing aids.
If I didn't have hearing aids, I’d be locked out. An estimated 60% of those over 70 suffer from age-related hearing loss. It is a gradual process.
Most people ignore the first signs. They only reach for hearing aids when there is no other option, which can be too late. Hallo, hallo, hallo.
A warm welcome from old neighbours. The volume is turned all the way up on Ruth Siewert’s hearing aids. But they quickly reach their limits.
They’re outdated. All she hears is a mish mash of noise. When I'm in a circle, the voices can be unpleasant.
And that's when you withdraw. You can't always tell by looking at people how much they understand. Those who hear well themselves often show little consideration for the limitations of the hearing impaired.
Ruth Siewert found it increasingly difficult to follow conversations at the table. It’s also embarrassing. Having to ask again and again you don't want to.
So I don’t. Untreated hearing loss and poorly adjusted hearing aids can have serious consequences: people with hearing loss become withdrawn. They become lonely and depressed more often.
This is why timely treatment is important. Ruth Siewert had to concentrate more and more to take part in conversations. She usually gets quiet when she can no longer follow the conversation and stares off.
A little irritated, more inward-looking. A better hearing aid could help. They need to be serviced and readjusted two or three times a year.
Otherwise communication can be frustrating. It's important to change her environment and to reintegrate her into another group so that she learns something new, so that she has other people to talk to, so that she has the feeling that she's taking part. Hearing aids can give back sounds that were thought to be lost and with them a better quality of life.
Back in Hamburg at Thomas Sünder's new workplace. The former DJ has begun advising others with hearing loss. Come in.
You've already got them on. Thomas Sünder trained as a hearing aid acoustician and knows from experience that many are initially ashamed and uncertain when they come in. Over three million people in Germany wear hearing aids.
Just a small proportion of the hearing impaired. Many people think they're old because they have a hearing aid. Like, first comes the hearing aid, then the walker.
But I actually feel like one of the older people when I’m in a group and can't converse because I can't understand the people around me. Hearing aids are actually something that makes me young. People can only hear sound waves between 16 and 20,000 hertz.
Hertz refers to the pitch, or the vibrations of sound waves per second. The faster the vibrations, the higher the frequency. A hearing test: Everyone should be able to hear a whistling sound of 8,000 hertz.
A frequency of 12,000 hertz is usually only perceived by those under 50 years of age. And it goes higher. Anyone who can hear 19,000 hertz is probably very young.
Hearing aids work like powerful micro-computers. They rely on directional microphones, Bluetooth and a power supply. All in tiny casings.
The prices vary enormously: from entry-level models for a few hundred euros to high-end devices for upwards of 5,000 euros. Some hearing aids are fully covered by health insurance and can offer a significant improvement in hearing speech. But a little more money increases comfort.
Which is what I recommend, because you'll be wearing it for at least six years Hearing aids are getting smaller and smaller and are difficult for older people to use. But they’re also getting more powerful. Artificial intelligence is listening too.
And in the future, hearing aids will even know, by measuring impulses in my ear, which direction I want to listen from. And they will focus on that person. And then we will have reached the moment when you can really hear better with hearing aids than a person with normal hearing without them.
But will hearing aids ever become a fashion accessory like visual aids? Let's hope so for the 15 million hearing impaired people in Germany. The University Hospital in Tübingen.
Professor Hubert Löwenheim is the medical director for the ear, nose and throat department and is developing the hearing aid of the future. Marie-Luise Gerkhardt is his patient today. Hello, good afternoon.
The 75-year-old is hard of hearing and has worn a hearing aid for eight years. She has moderate hearing loss and hears 25 to 40% less. Dr Hubert Löwenheim is working with a startup to develop a completely new hearing system.
It’s based on a lens that sticks directly to the eardrum just five millimetres wide. The lens is connected to the sound processor via an ear canal module and transmits sound waves directly to the eardrum. Conventional hearing aids transmit sound acoustically.
This can lead to reflections and distortions in the ear canal, whereas the hearing contact lens transmits sound directly to the eardrum with vibrations, avoiding these distortions. Marie-Luise Gerkhardt is one of over 20 people testing the new hearing system for a week. That's great.
Looks good. The ear canal is clear. Lets get the camera.
The hearing contact lens is custom made because every eardrum is different. The doctor uses a specially developed camera to measure the ear canal. I can see the eardrum well.
The data goes directly to Mannheim. "Vibrosonic’s" main office as well as its lab are located there. Dominik Kaltenbacher and his team have been working on the hearing contact lens since 2016.
It’s now almost market-ready. A silicone mold is created in a 3D printer using Dr Löwenheim's measurements. The lens is a micro-loudspeaker and consists of several layers.
Silicon serves as the base. Metal and ceramic layers ensure that the eardrum vibrates. Precision work that calls for a microscope: the lens must later adhere directly to the eardrum.
The layers of the lens are extremely fine - even thinner than a human hair. Wonderful, everything looks good. Correct.
Juliane Wunder tests the function before it leaves the lab. The test patients currently wear the contact lens for three months then it has to be replaced. Users should be able to use them for longer periods in the future.
The lens covers a very broad spectrum: from very low tones around 80 Hertz to very high tones of 12,000 Hertz. The test subjects report a more natural sound and that they understand better normally too. Hearing and speech comprehension is a very decisive factor as well as the reproduction of music.
The contact lens is expected to cost several thousand euros and health insurers won’t initially pick up the cost. They can even survive a quick swim. The outer module is removed and the ear canal is sealed with an earplug.
Back in Tübingen. Marie-Luise Gerkhardt's contact lens arrives just three weeks later. Only trained doctors are allowed to install the lens.
The tricky thing about the hearing contact lens is that I have to position it very precisely. It is shaped individually for each patient and has to be placed in the exact position that reflects the individual eardrum. This differs from contact lenses that we are familiar with for eyes.
Dr Löwenheim carefully inserts the contact lens into her ear and places it on the eardrum. Good, wonderful. Now the next step is to connect to the hearing aid, which is worn on the outside, the processor.
The ear canal module is connected to the sound processor via a magnet. How does it feel? I didn't have any unpleasant sensation when it was inserted.
I can feel that there is something in my ear, but nothing that presses or is uncomfortable. And the sound? Very clear and also very pleasant.
The lens won’t be available publicly until 2025 at the earliest. Tests and clinical trials have not yet been completed. Winnenden in Baden-Württemberg.
Veronika Romer has to plug in her cochlear implant behind her ear every morning. An aid for the severely hearing impaired and deaf. The cochlear implant makes a lot possible for me.
I can communicate well. It gives me a lot more freedom. The 19-year-old's hearing loss is congenital caused by a genetic defect shared by her twin sister Dominika.
The girls didn’t have any trouble hearing until they turned five. They first learned to read lips and were then given hearing aids. Veronika initially felt like an outsider.
In fifth and sixth grade, I often hid my hearing aids, because it was uncomfortable to have something that others didn't. Hearing aids were eventually unable to compensate for their hearing loss. When she was 12, Veronika decided to take the next big step.
Cochlear implants. Only about 5,000 implants are estimated annually in Germany, even though hundreds of thousands of people with hearing loss could benefit from them. Many fear the surgery, which includes removing part of the skull.
Cochlear implants have two major components. The outer device, a sound processor with microphones, is attached to the head by a magnet. The inner device is placed under the skull during surgery.
Microprocessors convert the audio signals into electrical impulses and transmit them to the cochlea. There, the electrodes stimulate the auditory nerve and transmit the signals to the brain. Surgery on both ears went very well but it took her several months to get used to the implants, known as CI for short.
When I got my CI, I had to relearn some sounds because I hadn't heard them before. Like a dripping tap - it was new to me. Veronika on her way to school.
She can lead an almost normal life. She takes off the CI device to shower or swim. She only has to be extra careful in traffic.
The implant doesn’t allow her to exactly locate the exact source of a sound. Even cochlear implants have their limits. With directional hearing, sound waves first hit the ear facing the source of the sound.
The other ear perceives the sound with a delay and at a different frequency. The brain uses this information to localize a sound. Veronika has troubled perceivíng the differences especially in noisy environments.
I have to pay more attention in traffic. If there's a car behind me, for example, I often don't notice it. Veronika is currently getting her driver's license.
She’s allowed because she has no vision or balance problems. Veronika attends Paulinenpflege, a school for young people with hearing and speech impairments. She hopes to graduate in 2025.
Each class is limited to 12 pupils. A PA system supports the classes. It transmits speech signals directly into cochlear implants.
Everyone uses microphones. The sound is transmitted directly into Veronika's inner ear. A babble of voices also stresses the implant.
During the break, it's very stressful when there are lots of people around me, because it's louder and then it's harder for me to understand the individual people when they want to say something directly to me. A long day ends. She and her roommates agreed to meet at home and cook.
Veronika is upbeat and the implants have become part of her personality. If I didn't have CIs, I would be deaf and would probably be in a completely different place in life. Veronika would like to become a teacher.
The hearing impaired are often limited in career choices. A lot still needs to change in society so that the hearing-impaired have the same opportunities as the hearing. Neuroscientist Tobias Moser is improving conventional cochlear implants at the Göttingen campus.
Instead of using electrical impulses, he uses light to stimulate nerve cells. Researchers place an optical fiber chain in the inner ear and activate the cochlea with a sound. The cells recognize the impulse and pass the information on to the brain.
In principle, the optical cochlear implant works like the electrical cochlear implant. We pick up the sound, break it down and transfer it to the implant. But instead of electrodes, there are light emitters in the cochlea.
Unlike in the eye, the nerve cells in the ear are not sensitive to light, which is why we use gene therapy, a method of optogenetics, to make the cells sensitive to light. The team uses light to specifically control genetically modified cells in the auditory canal. This creates new possibilities for treating functional hearing loss.
Roya Nazempour tests the light guide chain in an optics laboratory before it is later inserted into the cochlea. A tiny chip converts the acoustic signals into optical impulses the basis of the mechanism. Extensive tests are still required at the institute.
The research team is using rats to test the prototypes. Tobias Moser and his team have used genetic engineering to make the nerve cells of deaf rats receptive to light. In this experiment, this rat learned to move across the cage in response to a sound.
And right now it can hear that with light. The tests are promising. The researchers believe that they will soon be able to transport sounds and music in humans with light.
We hope to be able to start the first clinical trial in 2027. And what we want to achieve is more natural hearing than with the electrical cochlear implant. Natural means that it sounds more normal.
We have greater variety, we can follow melodies and, above all, we can understand speech better amidst noise. Listening to music, understanding speech and experiencing sounds our sense of hearing is a valuable treasure. But we usually appreciate this far too late.
When my hearing was damaged, I realized that I hadn't appreciated my hearing enough. And you only become aware how valuable it is when it’s gone. It's worth taking care of our hearing from a young age.
It allows us to appreciate it for far longer.
