Tinnitus Today June 1996 Vol 21, No 2

June 1996 Volume 21, Number 2
Tinnitus Today
THE JOURNAL OF THE AMERI CAN TI NNITUS ASSOCI ATI ON
"To carry on and support research and educational activities relating to the treatment of
tinnitus and other defects or diseases of the ear."
Since 1971
Research- Referrals- Resources
In This Issue:
ATA's 1996 Patient Survey
William Shatner Testifies
for Tinnitus Research
Tinnitus and Hyperacusis:
A "Multi-Therapies"
Treatment
Capitalizing on Celebrities
We Need Each Other
Sounds Of Silence
Control your audible ambience with
sounds caused by Tinnitus with the
Marsona Tinnitus Masker from Ambient
Shapes. The frequency and intensity of the
simulated sounds march the tones heard by
many tinnitus sufferers. These masking
devices are proven effective in assisting
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We cannot predict whether or not the
Marsona is appropriate for you, but the
probability of successful masking is well
worth TAKING ADVANTAGE OF OUR 30
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The TinnituS Masker can be
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- - - __
Tinnitus T o d ~ y
Editorial and advertising offices:
American Tinnitus Association,
P.O. Box 5 Portland, OR 97207
Executive Director&' Editor:
Gloria E. Reich, Ph.D.
Associate Editor:
Barbara Thbachnick
Editorial Advisor:
'nudy Drucker, Ph.D.
Advertising sales: ATA-AD, P.O. Box 5,
Portland, OR 97207, 800/634-8978
Trmmus Thday is published quarterly in
March, June, September and December. lt is
mailed to members of American Tinnitus
Association and a selected list of tinnitus suf-
ferers and professionals who rreat tinnitus.
Circulation is rotated to 75,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuit-
able for Tinnitus Thday. Acceptance of adver-
tising by Tinnirus 1bday does not constitute
endorsement of the advertiser, its products
or services, nor does Tinnitus Thday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The opin-
ions expressed by contributors to Ttnmtus
1bday are not necessarily those of the
Publisher, editors, staff, or advertisers.
American Tinnitus Association is a non-
profit human health and welfare agency
under 26 USC 501 (c)(3)
Copyright 1996 by American Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
without the prior written permission of the
Publisher. ISSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, IL
Robert A .Dobie, M.D., San Antonio, TX
John R. Emmett, M.D., Memphis, TN
Chris B. Foster, M.D., San Diego, CA
Barbara Goldstein, Ph.D., New York, NY
Richard L. Goode, M.D., Stanford, CA
John W. House, M.D., Los Angeles, CA
Robert M. Johnson, Ph.D., Portland, OR
William H. Martin, Ph.D., Philadelphia, PA
Gale w. Miller, M.D., Cincinnati, OH
J. Gail Neely, M.D., St. Louis, MO
Jerry Northern, Ph.D., Denver, CO
Robert E. Sandlin, Ph.D., San Diego, CA
Alexander J. Schleuning, IT, MD,
Portland, OR
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Honorary Board
Senator Mark 0. Hatfield
'll:>ny Randall, New York, NY
William Shatner, Los Angeles, CA
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey
Portland, OR
Board of Directors
Edmund Grossberg, Chicago, IL
Dan Robert Hocks, Portland, OR
W. F. S. Hopmeier, St. Louis, MO
Paul Meade, Portland, OR
Philip 0. Morton, Portland, OR, Chmn.
Aaron I. Osherow, St. Louis, MO
Gloria E. Reich, Ph. D., Portland, OR
The Journal of the American Tinnitus Association
Volume 21 Number 2
1
June 1996
Tinnitus, ringing in the ears or head noises, is experienced by as many
as 50 million Americans. Medical help is often sought by those who
have it in a severe, stressful, or life-disrupting form.
Contents
4 From the Editor
by Gloria E. Reich, Ph.D.
5 ATA Regional Meeting: Maryland
8 NIDCD to Fund Tinnitus Research
9 William Shatner Thstifi.es for Tinnitus Research
10 ATA's Tinnitus Support Network
10 Media Noise
by Barbara Th.bachnick
11 My Pets, the Spider and the Cricket
by Leon Morgenstern, M.D.
14 The Road from Marathon
I 5 Tinnitus and Hyperacusis: A "Multiple-Therapies" 'freatment
by Kenneth Greenspan, M.D.
16 Capitalizing on Celebrities
by Corky Stewart
18 Book Review
18 Glossary of Hearing- and Non-Hearing-Related Thrms
by Bena Shuster
21 Public and Professional Awareness
22 Bibliography Update
23 We Need Each Other
by Michael Cohen
Regular Features
6 Letters to the Editor
20 Questions & Answers
25 'fributes, Sponsors, Special Donors, Professional Associates
Cover: 'Succulent Sunburst (oil on canvas) by Dorothy Churchill-Johnson.
Inquiries to the Indigo Gallery Fine Art & Jewelry, 311 Avenue B, Suite B,
Lake Oswego, OR 97034, (503) 636-3454.
From the Editor
Hope is the hidden ingredient
in research, and here is a mea-
sure of hope that should bright-
en your day.
The following is from Dr. Pawel
J astreboff whose recent
research work has been sup-
ported by ATA. "I am happy to
inform you that it seems we do
have in hand an animal model of tinnitus result-
ing from exposure to sound! The paradigm
allows for evaluating the extent of sound-induced
tinnitus in individual rats while it is insensitive
to the hearing loss per se (conductive hearing
loss did not induce behavioral manifestation of
tinnitus, and even in animals with sound-
induced cochlear injury there was only a mild
correlation of hearing loss and tinnitus.) This
feature of the model is of particular importance,
since it is very easy when working on hearing-
loss-related tinnitus to get results reflecting non-
specific effects which have no direct connection
with tinnitus. We can measure the extent of tin-
nitus and hearing loss independently and there-
fore correlate physiological measurements, such
as metabolic activity, single unit spontaneous
activity, etc. with both the extent oftinnitus and
the extent of hearing loss. We can then deter-
mine what features of our physiological mea-
surements are really related to tinnitus."
"I See What You Say .... "
As a hearing-impaired person who relies
heavily on speechreading, I found the "I See
What You Say" tape enjoyable and engaging. (See
advertisement in this issue.) I learned some new
tricks for recognizing speech sounds on the face
and found Ms. Kleeman's use of descriptive
terms for individual speech sounds such as
"pinchers," "lip-biters," and "teethy"
both innovative and easy to remember. I would
recommend this tape to people who are self-
motivated and will take the time to use it and
learn from it. The advantages of this self-help
method is that you can choose your own time to
practice, and you don't risk being in a
speechreading class where you are either the
4 Tinnitus Thday/ June 1996
worst or the best learner. The disadvantage is
that you don't have an opportunity to compare
your progress with others. At the very least, the
tests are good for a few laughs as you compare
what you thought you heard with the actual text.
If your family is willing to watch the tape with
you, they will learn a great deal about the prob-
lems of listening when the listener's listening
equipment isn't working well. They'll also learn
that sometimes giving you a "topic" clue can
help keep you abreast of a conversation without
disrupting the situation by calling attention to
your difficulty. For example, on the tape there is
a section called "Tiivia" where you are given a
one word cue for each sentence presented. With
just that one word, it's a cinch to speechread the
sentence. Without the cue, it's very difficult. I
have a friend who hears better now with a
cochlear implant, but before that she used to sig-
nal her husband by making a "T" with her fin-
gers to indicate that he was supposed to clue her
in on the topic of conversation. The method
worked well for her but I've yet to train my hus-
band to give one word answers to anything!
"I'm easily satisfied with the
very best."
Quite a few issues ago I told you about my
delight at being able to wear "in the canal" hear-
ing aids. After 20 years of the big, behind the ear
aids, it almost seemed as though I had normal
hearing. Mind you, this is an overstatement but
it expresses some of my joy. I was even able to
pay less attention to my tinnitus. But, alas, after
wearing the new aids for more than a year I
began to experience what I thought was an aller-
gic reaction in my ears. They would itch, burn
and run, and nothing I
would do - short of
not wearing the
aids - seemed to
help. Finally the
problem
became so
acute that my
ear canals
swelled and I
ATA REGIONAL MEETING:
Maryland - September 26, 1996
For Patients and Professionals
Including theoretical discussions and hands-
on demonstrations, this meeting will provide
enhanced understanding of tinnitus from evalu-
ation to treatment to management strategies.
Patients, audiologists, physicians, psychologists,
nurses, hearing aid dispensers and support
givers should all plan to attend.
Advance Registration Required
(space is limited) Cost for the full day,
including lunch, is $75 per person.
Faculty
Presenters are counselors, researchers, and
qualified instructors from every aspect of the
hearing field.
Logistics
Thursday, September 26, 8:30 AM - 5 PM, at The
Inn and Conference Center, University of
Maryland, College Park Maryland.
From the Editor (continued)
couldn't put the aids in. I spent the next eight
months wearing the old, big, behind the ear aids
- with modified earmolds - and visiting the
ENT's office every two weeks for a variety of
treatments. One day I was so discouraged I told
the doctor I was ready for the Van Gogh treat-
ment! I was grumpy, tired, increasingly both-
ered with my tinnitus, and generally pretty
miserable. Fortunately there is a happy ending
to this tale. On my next visit to the ENT, another
doctor was called in who said, "Why don't you
try this new medication for a few days'?" Within
two or three days my ears were on the road to
recovery and within five days I could tolerate -
read WELCOME - my wonderful canal aids
again. The moral to this story is don't give up!
Keep bugging yourself or those who treat you to
get the problem fixed. I know that my tinnitus is
going to be with me for awhile and I can accept
that. But what I wasn't going to accept was
diminished hearing and chronically painful ears.
I'm sure you won't be surprised when I tell you
that the tinnitus is less bothersome too.
Continuing Education Credit
Starkey Laboratories is approved by the
Continuing Education Board of the American
Speech Language Hearing Association (ASHA)
to sponsor Continuing Education activities in
speech-language pathology and audiology; this
program is offered for .6 CEU. Application has
been filed with National Institute of Hearing
Instrument Studies, the educational branch of
the International Hearing Society (IHS).
Proof of attendance and supporting data will
be provided for individuals wishing to file for
credits with State and other agencies.
WATCH YOUR MAIL FOR DETAILS!
If you haven't received registration information
by August 1, please write to us.
Targeting
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Tinnitus
Learn Lip Reading
Developed by Speech
Pathologist, Mary Kleeman,
the I See Wlzat You Say
program provides an
interesting, new approach to
acquiring speecbreadiog
skills for the hard of hearing.
"Instruction and
practice are
imaginative,
easy to follow and
enjoyable."
Journal Self Help for
Hard of Hearing People
Video - ~ mmules Manual 51 pp. with pbocoo
with this Fun,
Self-Help,
Easy to Use,
Lipreading Course
Video & Manual
Compensate for Noise & Tinnitus
Aid Speech Discrimination
Enhance Communication
Stop Feeling Isolated
This clearly presented fom1at of
instruction includes practice activities
for single words to stories. Sixteen
speakers are presented.
****
American
University
Washington, D.C.
Tinnitus Today/ June 1996 5
Letters to the Editor
Prom time to time, we include letters from our
members about their experiences with "non-tradi-
tional treatments. We do so in the hope that the
information offered will help others. Please read
these anecdotal reports carefully, consult with your
physician or medical advisor, and decide for your-
self if a given treatment is right for you. As always,
the opinions expressed are strictly those of the letter
writers and do not reflect an opinion or endorse-
ment by ATA.
I
am writing to thank you for all the support
and information that you have provided for
my patients. As an audiologist, I routinely
refer patients who have tinnitus to your organi-
zation. These people tell me that they have
been extremely pleased with the ATA, especially
those who have telephone or computer consul-
tations with Dr. Vernon. I display your magazine
in the waiting room of our outpatient audiology
unit and patients enjoy reading it. Thank you
again for all your help.
Lisa B. Kaye, M.C.S.D. I CCC-A, Director of
Outpatient Audiology, Framingham, MA
F
or the past year I have been suffering
from tinnitus which came on graduaUy
but intensified to such an extent that it
interfered with my sleep and dominated my
waking existence. My daughter, who is a
research biologist, got on her computer and
accessed a report on an experimental study that
employed ginkgo. I immediately began to use
this substance which I obtained through a mail
order drug firm from which I buy my vitamins.
The label simply says "Ginkgo Biloba extract,
250 mg."
Before the bottle of 100 tablets were con-
sumed I saw definite improvement. The intensi-
ty of the signal diminished as well as its length
of duration. Moreover it became very uneven,
hesitating. It still came on when I did anything
requiring any intense effort. Gradually it
became less obvious to me and eventually
almost disappeared. Right now it is like quiet
buzz from a distance and has ceased to be a
dominant problem. Once in a while it comes on
when I awake, but stops completely as I start
my day. I take one tablet every day. At the start
I was taking two but cut back.
Henry Hirschberg, Warren, VT
6 Tinnitus Thday/June 1996
I
have been fitted with inhibit_ors
for six months and have noticed mcreased
diminishing of the sounds. The difference is
astonishing! The treatment is being given by Dr.
Pawel Jastreboff and his associates at the
University of Maryland.
Charles chuck Atkinson, Millsboro, DE
I
read with interest the short discussion of
otosclerosis by Dr. Ian Storper in the most
recent issue of Tinnitus Tbday. I found it to
be a very nice overview of otosclerosis and the
potential treatments. I do however take excep-
tion to one comment made by Dr. Storper.
Under the treatment section Dr. Storper states
that "as a result of this procedure, there is no
need for hearing aids and the disease process is
essentially removed from the inner ear." I feel
that this comment is misleading. The stapedec-
tomy operation only bypasses the otosclerosis to
improve hearing and conduct the sound pres-
sure waves to the inner ear. It is still possible
and often the case that the otosclerosis contin-
ues to progress into the cochlea. The stapedecto-
my operation does not eradicate the otosclerosis
disease process.
There has been a significant body of litera-
ture published documenting the use of fluoride
therapy in otosclerosis. This therapy may arrest
the progression of the otosclerosis process and
prevent cochlear otosclerosis and further sen-
sorineural hearing loss. Thank you for the
opportunity to present this point of view.
f. Thomas Roland Jr., M.D., New York, NY
I
tried acupuncture for my tinnitus. The doc-
tor was very competent both in Eastern and
Western medicine. He hooked the needles
up to electrodes and zapped every nerve that
could possibly have any effect on the auditory
system. (It hurt!) I went for three treatments.
The tinnitus remains the same.
I continue taking Paxil and the sensation of
tinnitus is not as irritating - although the Paxil
does not make it any better. Also, I wear the
masker constantly. If I do not wear the masker I
am miserable. All and all the masker/ Paxil com-
bination helps me to cope and for that I am
grateful.
Gladys Gottlieb, flion, NY
Letters to the Editor (continued)
l
am a 34-year-old woman who, before May
1995, had never heard of the term "tinnitus."
I have suffered from chronic tonal tinnitus
since that time. I had an MRI that ruled out
acoustic neuroma or any other abnormal activi-
ty. I did not have a head trauma, nor had I been
exposed to extreme noise or ototoxic drugs. I
began using a masking machine at night to
sleep, and by early July, I had resigned myself to
accept it as part of my life.
Then, on July 9th, I awoke with a horrible
clicking sound in my ears. For months I went
from ear doctors to neurologists in search of
help. I was prescribed Thgretol"as a trial" but
without much hope of help. Now at a dose of 400
mg/ day, after four months of use, Tegretol helps
a great deal with the loudness and frequency of
this rare type of objective ''muscle contraction
tinnitus." My particular type is called "palatal
myoclonus." I finally found a neurologist at
Scripps in La Jolla, CA and doctors at the House
Ear Clinic in L.A. who knew of this condition
and advised me to stay on the Thgretol at a
dosage I found tolerable and helpful.
In mid-November, I suddenly began experi-
encing horrific shock-like all-body myoclonus at
night which was not only terrifying but allowed
for no sleep. I was given Klonopin (Clonazepam)
at 1-1.5 mg/bedtime. Over the past month, this
drug has greatly helped to quiet this multi-focal
myoclonus and allow me normal sleep patterns,
even though there is a bit of sedation from the
dn1g. I presently feel I am back in life after
being out of my former, very athletic, and cre-
atively productive life. I still have both types of
tinnitus, and the myoclonus I hope will just fade
in time as one neurologist has suggested. I con-
tinue to rely on the Thgretol and Klonopin, long
walks, a positive attitude, laughter and getting
back into my artwork as best I can. I am baffled
to this day how the brain, nervous system and
perhaps cranial nerves could just "break down"
as some aspects of mine have.
Kim Frohsin, San Francisco, CA
A!
an avid woodworker who suffers from
innitus and hyperacusis, both of which
re greatly aggravated by noise exposure,
I have had to seek out the best hearing protec-
tion available to wear when operating power
tools, hammering, etc. The most effective muff-
style protection that I have found in several
years of searching is the Peltor model HlOA.
They have an exceptional noise reduction rating
(NRR) of 29dB and are available through several
woodworking supply catalogs. I obtained mine
from Trendlines (800/767-9999) for $19.95 plus
$5.95 shipping, catalog number: PElO. Peltor
offers several other models with lower NRR rat-
ings. I find their products to be very comfortable
to wear.
I often wear ear plugs in conjunction with
muffs or in situations where muffs are a bit too
conspicuous. I highly recommend Max-1 foam
earplugs by Howard Leight Industries. They are
both the most comfortable and the most effec-
tive that I have found, with a NRR of 33dB. I
purchased them from McMaster-Carr Supply Co.
(404/346-7000), at a cost of $30.20 plus $3.09
shipping for a box of 200 pairs (the minimum
order), catalog number: 54725T32. This is the
deal of the century for hyperacusis sufferers.
Richard R. Glisson, Bahama, NC
I
was injured by a NYC bus while I was riding
my bicycle in 1991 and was hospitalized
for three months. While in the hospital, I
realized that I had lost partial hearing in my
right ear and had developed permanent ringing
noises. I became depressed and couldn't
concentrate.
Since recuperating, I have gone back to run-
ning (I was a runner for 15 years before the
accident) which helps me to not think about tin-
nitus. Also listening to music CDs of rain, thun-
der, and animal sounds through head phones
helps out a lot. If it weren't for find-
ing out about ATA I still would
be alone. By reading letters
from others I realize I'm
not alone.
Barry Feder,
Brooklyn, NY
Tinnitus Thday/ June 1996 7
NIDCD To Fund Tinnitus Research
The National Institute on Deafness and
Other Communication Disorders (NIDCD)
announced its invitation to researchers to specif-
ically explore research addressing the "physio-
logic and molecular bases of tinnitus." A total of
$750,000 is being made available this year to
successful grant applicants.
According to the NIDCD, "Tinnitus affects at
least 18.5 million people in the Unites States. It
usually results from a disease of the auditory
system that also produces hearing impairment.
Although the initial insult that produces tinnitus
may be known, there is little if any evidence
implicating specific physiologic or molecular
mechanisms in the pathogenic process.
Recent advances in the physiology and mole-
cular biology of the auditory system have pro-
vided insights into the function of the inner ear
and the auditory portion of the central nervous
system.
Letters to the Editor (continued)
D
rugs play a most vital part in the relief
from tinnitus we hope to obtain. My
source in the proper use of drugs tries to
help me in this need. We all know that there is
danger in this area of treatment through the
reactions drugs can cause.
Two previous Letters to the Editor refer to the
use of drugs - one, Elavil; the other, Seldane -
to help relieve tinnitus problems. My source
warns to NOT USE these drugs when other
drugs will work without the dangers of side
effects and reaction. Of course any question of
this issue is to be thoroughly discussed with
one's physician. I offer this only for the welfare
of other tinnitus victims.
Fred J. Jenkins, Pueblo West, CO
[Ed. Note: It is possible that other drugs were pre-
scribed prior to the successes experienced with
Seldane and Elavil. See Dr. Vernon's Q&A in this
issue for additional information on drug side
effects.]
Progress in auditory system research has
advanced this field to the point that concerted
study of the problem of tinnitus is now possible."
Anticipated award date of this grant is
December 1, 1996. By the time this issue of
Tinnitus Tbday is printed, the grant application
deadline will have passed. However,
if you would still like informa- ~ ~
tion, please contact Kenneth A.
Gruber, Ph.D., Division of
Human Communication,
NIDCD, 6120 Executive Blvd.,
#400C - MSC-7180, Bethesda, MD,
20892, Telephone: (301)402-3458,
FAX: (301 )402-6251, e-mail:
Kenneth_Gruber@nih.gov
MEMO
From: Phil Morton,
Chairman of the Board
Th: All ATA Members
Tb those of you who donated to my
research appeal in the last issue, thank
you very much.
As I mentioned in my letter, the only real
hope of finding relief and an eventual
cure for tinnitus is through research. I
am determined to raise the funds neces-
sary to push for ongoing, in-depth
research.
If you intend to donate, but haven't yet,
this is a gentle reminder. We need your
help to reach our goal. Why not send
your check today while you're thinking
about it? Be sure to note on it "Phil
Morton Research Appeal." Thanks!
William Shatner Testifies for Tinnitus Research
If you want a work well done,
select a busy man:
the other kind has no time.
ATA honorary board member William
Shatner took time from his busy schedule to
meet me in Washington, D.C. on March 5, 1996
to testify before the House Appropriations
Subcommittee in support of the 1997 budget
for the National Institute on Deafness and
Other Communication Disorders. By coming for-
ward, Shatner gives hope to all of us with this
condition.
Gloria Reich and William Shatner are smiling because the
subcommittee was responsive to their testimony in support of
tinnitus research.
'I am asking, in fact, begging you to respond positively to this
appeal to fund tinnitus research.
Representative Bonilla from Texas chaired
the meeting until Chairman Porter from Illinois
arrived. Shortly after Porter's arrival we were
called to speak. Bill Shatner told the committee
how he had been exposed to a routine explosion
30 years ago on the set of "Star 'frek" and has
had tinnitus ever since. He asked the legislators
to make research monies available that can put
a stop to the pain and suffering of tinnitus. The
committee members appeared to be moved by
Shatner's testimony and asked him many ques-
tions about how he got it, how it felt to have it,
and what he wanted them to do about it.
Testimony has also been submitted to the Senate
Committee on Appropriations.
'llTA has been able to fund some research but, as Gloria
outlined, it takes the sort of budget you are considering to really
make a difference.
'Tb find the magic bullet we all hope for, we need more
research.
ATA's Tinnitus Support Network
A Grateful Welcome to our New
Self-Help Volunteers!
New Support Group Leaders:
Ralph Gentry
135 Edgewater Dr. , Anderson, SC 29624
(864) 224-8578
Mort Gulden
5179G Europa Dr., Boynton Beach, FL 33437
( 407) 369-0831
Thomas D'Aiuto
7205 Kingsbury Cir., Thmpa, FL 33610
(813) 628-6168
New Telephone/Letter contacts:
Harry Hochman
3 Railroad Ave., Califon, NJ 07830
(908) 832-7641
Christina Hewitt
27 'Ifail Edge Circle, Powell, OH 43065
(614) 885-4140
Jeff Bassett
419 Colorado Ave., Findlay, OH 45849
( 419) 425-2243
Media Noise
by Barbara Th.bachnick, Client Services Manager
Nintendo's Play It Loud" Campaign -
Still Too Loud
In response to last year's public protest
against Nintendo's "Play It Loud" advertising
campaign, the company pulled the offending
slogan from its ads. It was a triumph for hearing
conservation in this country, or so it was
thought. Disappointingly the slogan resurfaced
as part of Nintendo's ad campaign early this
year. According to Beth Llewelyn, Nintendo's
Public Relations Manager, the original ad that
contained the "Play It Loud" slogan had just run
its course last year coincidental to the concerted
outcry against it.
Per Ms. Llewelyn, Nintendo has no imme-
diate plans to withdraw the "Play It Loud" tag
10 Tinnitus 1bday/ June 1996
Jeffrey Selles
1605 Norse Pkwy., Stoughton, WI 53589-1193
(608) 873-8825
Tinnitus and Meniere's
Pen Pal Support Network
The national and international Tinnitus and
Meniere's Pen Pal Support Network has more than
300 members. Each participant receives a mem-
ber directory listing names, addresses, phone
numbers, lifestyle information (occupation, per-
sonal interests, etc.) and tinnitus particulars
(onset, type, treatments/ drugs tried). If you are
interested in joining the Pen Pal Network, con-
tact Lorraine Cherkas, PO Box 47172, St.
Petersburg, FL 33743-7172. The cost is $5 in the
U.S.; $10 outside of the U.S. To keep the directo-
ry up-to-date, Lorraine asks all members to
promptly notifY her of address changes. Here-
mail address: http:/ /home.aol/ com/lenni05.
If you are considering becoming part of our
Tinnitus Self Help Network, either as a group
leader or a telephone and/ or letter contact, please
write for our SelfHelp Packet of information.
line from their ads. "We never meant for kids to
crank up their TV's," she said, "just to live life to
the fullest." Their studies show that kids under-
stand Nintendo's intent. When Llewelyn was
asked if she understood the potential dangers of
excessive noise exposure on ears, she had no
comment.
Sony Takes the High Road
The Sony Walkman model# WM-FX405 fea-
tures an "Automatic Volume Limiter System" that
has two maximum sound output settings - 85dB
and 95dB. (The user can override these settings.)
The instruction packet contains the following
warning: "Hearing experts advise against continu-
ous, loud and extended play. Ifyou experience a
ringing in your ears, reduce volume or discontin-
ue use." In bold letters, Sony asserts, "Thrn it
down! We want you listening for a lifetime."
My Pets, the Spider and the Cricket
by Leon Morgenstern, M.D., Los Angeles, CA
In his declining
years, bemoaning his
physical deterioration,
Michelangelo wrote a
poem that included the
lines, " A spider's web is
hidden in one ear, and
in the other, a cricket
sings throughout the
night."
In this affliction, he
was not alone. In one
estimate, 40 million
Americans are afflicted
with this auditory phe-
nomenon of tinnitus,
with a substantial pro-
portion of them suffer-
ing serious disability.
Beethoven also expe-
rienced a constant buzz in his ears, heralding
the onset of his progressive deafness. He
decried the inability of all the physicians he'd
visited to relieve him of his symptoms, and
accused them of making him worse.
Tinnitus is a word derived from the Latin
"tinnere," meaning "to ring." The term "ringing"
is not adequate to describe the variegated forms
of this phenomenon. It may be a whistle a hiss
I I
a roar, a hum, a buzz, a chirp - or a thousand
other sounds that intrude where they do not
naturally belong.
I date the onset of my tinnitus to periods of
intense stress occurring almost ten years ago.
Mercifully, at that time, the tinnitus was transi-
tory. It was only about a year ago that I began to
experience a continuous, high-pitched ringing in
one ear, resembling a flat note on the E string of
a violin.
The constancy of the tinnitus preoccupied
me. As a physician trained to attempt a differen-
tial diagnosis of all disorders, I naturally put the
worst causes highest on the list. I postulated a
tumor of the cerebellopontile angle, an acoustic
neuroma, a serious metabolic disorder, cere-
brovascular dysfunction, or a dozen other worri-
some diagnoses.
The first physician I visited did a superficial
ear examination, removed some impacted ceru-
men, ordered audiometric tests, and ended up
reassuring me that my ongoing tinnitus was
nothing to worry about. I had been hoping that
perhaps the cause might be impacted cerumen,
but this was not the cause. The audiometric
tests showed mild depression of acuity in the
high-frequency range. To my dismay, the tinni-
tus continued unabated, reassurance notwith-
standing.
As the tinnitus continued, I noted some less-
ened acuity in my hearing. I began to lean for-
ward to catch some phrases uttered in a casual
conversational tone. In noise-filled rooms
'
whether restaurants, meeting rooms, or hall-
ways, the ambient noise made it difficult to dis-
cern words I should have been able to hear
without difficulty. In the evenings I had to turn
up the volume on the television or miss half the
dialogue.
So there I was, along with Michelangelo,
having a spider's web in one ear and a cricket
singing, not only all night but all day in the
other.
Inexplicably, there were some days when T
felt that the problem had suddenly disappeared,
so hardly noticeable was the adventitious sound
in either ear. On other days, it was a high-
pitched alarm whistle that made hearing under
any circumstance more difficult. I tried to corre-
late this variation in the intensity of the tinnitus
with every available circumstance and situation
I
all to no avail.
1 finally came to explain it as a general phe-
nomenon that I called the "periodicity of well-
being." Some days the
whole body machinery
seems out of kilter -
the head, the limbs, the
gut- and all other com-
ponents of the human
machine feel unoiled and
somewhat awry, not with
any specific disorder, but just
a general deviation from the norm of "feeling
well." It is on these days that the cricket sings
the loudest and the spider's web is the thickest.
It is also on these days that the joints ache a lit-
Tinnitus Thday/June 1996 11
My Pets, the Spider ... (continued)
tle more, fatigue occurs earlier, and energy level
is at its nadir.
Then there are days when the head is clear,
the limbs are supple, the joints are painless, and
there is no limit to what can be accomplished.
On such days, both the hearing and the tinnitus
seem better and hope springs anew that the dis-
order may have disappeared. This periodicity
has no rhythm or definable explanation.
Like most physicians, I
deferred seeking further
medical attention or advice
for my increasingly annoy-
ing affliction. I kept hoping
against hope that it was self-
limiting, that I would awak-
en one morning to find it
gone. I also entertained the
feeble hope that it was a
labyrinthitis or some other
bland inflammatory condi-
tion that would play itself
out, so I could once again
enjoy the luxury of silence.
ly felt as if somebody had seized me by the
shoulder and spun me around clockwise. In
utter amazement, I found myself on the ground,
bewildered as to what might have happened. I
had not felt faint. My pulse was slow and regu-
lar. There was full power in all extremities. The
major accompanying symptom as I sat on the
ground was apprehension. It was but a single
episode that passed quickly, but worrisome
enough to make me seek
medical help again.
The second physician, a
well-known otologist, lis-
tened carefully to my com-
plaints and ordered the
battery of tests usually done
to investigate my malady.
Also ordered was a magnetic
resonance imaging (MRI)
procedure, a new experience
for me. With most serious
etiologic mechanisms ruled
out, I was given the usual
reassurance, and resigned
myself to living with a new
sensation.
Then, two occurrences
helped catapult me again
into the office of the oto-
laryngologist. The first of
these was my attendance at
a wedding, where the brassy
post-ceremony festivities of
band and master of cere-
monies blared forth in
megadecibels. The combina-
tion of the crowded hall, the
aural offense of the band,
and the incessant chatter of
the master of ceremonies
set my ears ringing like a
"Then there are days when the head
I began to make observa-
tions into what made the
condition better and what
made it worse. It was made
better temporarily if I
occluded my ear canals with
fingers or cotton, excluding
all external sounds. At
is clear, the limbs are supple, the
times, it seemed to me that
it was made better if I was at
rest rather than engaged in
activity. And there were
joints are painless, and there is no
limit to what can be
thousand church bells. Several times, the ringing
became almost painful, causing me to leave the
room for some relief. For days thereafter, the
intensity of the high-pitched sounds in both ears
continued, an unsolicited memento of the rau-
cous wedding.
The second occurrence was a surprise, a
physical sensation that I had never before expe-
rienced. Several days after the wedding, on a
sunny morning while walking with my wife at a
leisurely pace, I looked to one side and sudden-
periods when it was better
for no obvious reason. But more than anything
else, it was made better by diversion. If I
became occupied with some task or thought that
claimed my complete attention, I was often sur-
prised that I had not noticed the tinnitus at all.
This, then, became my most potent weapon
against the unwanted sounds.
Many things made it worse. Loud noises of
any kind inevitably caused a worsening that lin-
gered. At home, the tinnitus was worse in some
rooms than in others, having something to do
My Pets, the Spider . . . (continued)
with the configuration of the room. The ringing
was also made worse if I spoke loudly at long
intervals. It was made worse when I was unduly
fatigued, when I was under unusual physical
exertion, or when I became upset for any rea-
son. It seemed to me that there might be some
relation with heightened blood pressure,
although I never took my blood pressure on
these occasions. At times it seemed to me that it
was worse on immediately rising in the morn-
ing, diminishing as the day went on. At other
times, the ringing grew worse as the day pro-
gressed. Those were my "bad ear" days.
As for the episode of vertigo, I had several
more minor episodes, but these gradually dimin-
ished and eventually disappeared.
I should consider myself fortunate, along
with millions of others who have this annoying
malady, inasmuch as I have only the garden
variety form of tinnitus. The diagnostic garden
is filled with a vast array of exotic disorders,
such as neoplasms, aneurysms, unusual inflam-
mations, malformations, and others. Some of the
varieties are pulsatile, others vibratory. When
Assistive Listening Device
for Cellular Phones
Palmer Wireless, Inc. offers a free assistive
listening device called HATIS (Hearing Aid
Telephone Interconnect System) with purchase
of an OKl 1335 cellular phone. The HATIS is a
hand-free system that plugs directly into the
headphone jack of the wireless phone, and
works directly with any hearing aid with a
T-Coil.
The HATIS can be purchased separately and
plugged into any cellular phone that has a
2.5mm earphone jack. The cost of the device
alone: $96.85 including shipping. For more
information, contact Valerie Thompson c/o
HATIS Device, Marketing Dept., Palmer
Wireless Inc., 12800 University Dr. #500, Ft.
Myers, FL 33907.
the etiologic agent is unequivocally discover-
able, treatment is perhaps possible. For the vast
majority, of which I am one, the cause remains
an unfathomable mystery.
Few things in nature have an elemental puri-
ty, such as sunlight or newly fa11en snow.
Among them is utter, undiluted, and unsullied
silence. What provoked my feeling of panic ini-
tially, when the ringing became constant, was
that I should never again experience that exquis-
ite luxury of the pure absence of sound.
But as every physician knows, time heals
many ailments by its mere passage. Although
the ringing has not changed in character and
there is a gradual loss of auditory acuity, still,
neither is life-threatening. Diversion has
remained the most reliable remedy. Another
delectable aid is music, which masks, dilutes,
and sweetens the unwanted noise.
In short, I have made peace with those two
creatures, who at first I deemed implacable ene-
mies. I have made the spider and the cricket my
companions for life, my pets. After all, it is the
only way we can live together in peace.
WANTED!
HEARING-AIDS AND/OR
MASKERS IN ANY CONDITION
If you have ever wondered what to do with
those aids that are just sitting in the drawer,
think no further. ATA will be happy to receive
them. Donations to ATA are tax deductible, and
we'll provide an acknowledgement. Simply
package them up carefully (a small padded
mailing bag is fine) and send to:
ATA, PO Box 5, Portland, OR 97207.
If you are using UPS or another shipper; ship to
our street address: 1618 SW 1st Ave., #417,
Portland, OR 97201.
What happens to the aids that you tum in? In
some cases they can be repaired and given to
needy people or used in charitable missions to
underdeveloped countries. Even if they can't be
reused as is, the parts are needed for repairing
other aids. (And the plastic is recycled.) Your
IJ old aid could give someone the gift of hearing!
The Road from Marathon
by Barbara Tabachnick,
Client Services Manager
On one side of my desk is a
stack of research papers that
examine the problem of objec-
tively verifying the presence of
tinnitus. On the other side of
my desk is a stack of letters
from people in every age
group; from every economic,
educational, and social strata; ofboth genders in
equal number. In long hand and at great length,
these troubled authors describe intimate and
near-identical experiences with tinnitus -
though they've never met another soul who has
endured what they endure. I began to wonder
if these letters would amount to evidence good
enough to satisfy the "verifiability nay-sayers," if
these letters are in truth a gold mine unquarried.
1 think of the many ba1lot petitions I've
signed over the years, the dedicated signature
collectors who stood in front of supermarkets
reasoning for my support, and the democracy
that acknowledges petitions from its citizens.
I've seen enough names collected to attract
notice, and often to effect change. The power
has always been in the numbers.
Whether an election day goes my way or not,
I'm always pleased when I do something. A win
at the polls feels a little empty when I'm not in
part responsible for it. And regrets are hard to
swallow when an important measure goes dmi\TU
in defeat and I failed to act.
So I began to dream: V'lhat if we could turn
over tens of thousands of personal accounts of
tinnitus experiences to the American Medical
Association, the National Institutes of Health
the U.S. House and Senate Appropriations c o ~
mittees? What if these documents inspired
powerful political and scientific heads to push
tinnitus research beyond its present limits? What
if these accounts filled legal data banks, and pro-
vided Worker's Compensation committees, Social
Secmity review boards, and the Department of
Veteran's Affairs with indisputable proof at last?
What if?
The 1996 "Tinnitus Patient Survey," included
in this issue of Tinnitus Tbday, may be the
means to that end. Many of the same questions
from the 1992 survey (''How long have you been
aware of your tinnitus?" "What does your tinni-
tus usually sound like?") are included to allow
us to track long-term changes and patterns. New
to the survey is our request for your opinions
regarding ATA's services, and your experiences
with legal and insurance issues. Finally, we
include a place for you to write a personal
account of your life since tinnitus. Many person
hours will be spent on the surveys - codifying,
tallying, transcribing. We expect and encourage
a huge response.
Thke caution against the thought that a sin-
gle letter or, for that matter, a single vote carries
no weight. lt is just not true. What is true is that
it takes some organizational effort to bring the
votes and the letters home. I've seen drops of
water, powerless one by one, turn turbines with
just a little channeling.
Many who suffer with tinnitus do so under a
weight of unnecessary isolation. The road you
are on, you write, is like the unfathomably long
and lonely passage from Marathon to Athens
I
one that more than two millennia ago supported
a solitary messenger and a single message.
But it is an easier and far more fruitful
trip if run together. Imagine us travel-
ing down the same road in unison
bearing the very message of that '
ancient herald: Victory.
Write your story.
Send in your
survey.
Tinnitus and Hyperacusis:
A "Multiple-Therapies" Treatment
by Kenneth Greenspan, M.D.
In 1973, I created The Center for Stress and
Pain Related Disorders at the Columbia
Presbyterian Medical Center in New York City.
Over the years, many stress-related disorders
have been treated there including tinnitus,
hyperacusis, temporomandibular and cervical
muscular dysfunction, migraine headaches anx-
I
1ety, insomnia, and depression. Over the past
twenty years, our treatments have expanded to
include an integration of supportive and cogni-
tive therapy, relaxation therapy, exercises, tapes,
rhythmic breathing, biofeedback, self-hypnosis,
guided imagery, transcutaneous nerve stimula-
tion, and psychopharmacology.
Most practitioners use only one or two of the
above ten treatments with any given tinnitus
patient. Although each of these treatments can
prove useful, we believe that none are as effec-
tive as when applied in an integrated approach.
This is because tinnitus has multiple physical
and psychological causes, and each is at least
partially sustained by distress. When the above
ten treatment approaches are utilized, in a man-
ner and sequence that fits the specific physical
and psychological needs of the individual, then
the results are positive and prolonged.
By using this "multiple-therapies" approach,
I have had exciting success with tinnitus and
hyperacusis patients. Out of the five patients
treated, three are no longer aware of their tinni-
tus and hyperacusis, and the other two have had
significant improvement. These clinical benefits
have persisted since the treatment ended more
than one year ago.
Based on these results, Jack Wazen, M.D.,
Director of Otology and Neurotology at
Columbia-Presbyterian Medical Center in New
York City, Maurice H. Miller, Ph.D.
1
, Professor of
Audiology and Speech Language Pathology at
New York University, and I, have joined togeth-
er to develop a Tinnitus and Hyperacusis
'freatment and Research Center. As the center's
director, Dr. Wazen will be responsible for all ini-
tial evaluations, and for the research control
group of 35 patients.
2
Dr. Miller is developing
the audiological protocol, will test each patient
before and after treatment, and will participate
in the evaluations. I will administer the treat-
ments for the 35 clinical research patients, each
of whom will receive the "multiple therapy"
approach for a total of 15 one-hour sessions after
an initial screening evaluation.
Our treatment protocol utilizes a model of
coping and adaptation, based on studies done by
Cannon, in which he defined the fight-flight
response.
3
Much research has been done that
examines various aspects of this fight or flight
response and the heightened arousal of the mus-
cular, sympathetic:, and central nervous system.
Patients who suffer from tinnitus and hyperacu-
sis usually exhibit these heightened motor, sym-
pathetic, and central nervous system patterns.
All of our techniques work by decreasing the
level of stress and by giving the patient con-
scious control over this response.
Biofeedback, foT example, decreases these
maladaptive response patterns through the use
of modern technology. The object is to give the
patient moment-to-moment information about
specific physiological and psychological process-
es. This gives the individual an element of con-
trol over their distress responses. When we add
breathing and cognitive conditioning techniques
that reinforce healthier psycho-physiologic
responses, the patient becomes even more
relaxed and in control.
There is a fee for these services although
many insurance companies will cover all or part
of the treatment. If you would like more infor-
mation, or are interested in participating in this
study, please contact the office of Kenneth
Greenspan, M.D. at the Center for Stress locat- ,
ed at 348 E. 51st Street, New York, NY 10022,
(212) 888-5140.
l. Or. Miller is Chief Audiological Consultant at New York City
Department of Health.
2. There will be a research control status for 50% of patients accepted for
the protocol . These patients will initially (for the first nine months)
receive only part of the treatment, followed by the full treatment at the
end of the nine months.
3. Cannon, W.B.: The function of the adrenal medulla in pain
and the maJOr emot1ons. Am J Physiol 33:356, 1914
Capitalizing on Celebrities
by Corky Stewart, Special Projects Coordinator
He's a delightful person and talented actor
but does the fact that 'Tbny Randall has t i n n i ~ s
make a difference to others wjth it? Yes it does.
Maybe not directly (unless they're in the "mis-
ery loves company" crowd) but by talking about
his own experience with tinnitus, Thny has done
much to expand awareness and understanding
of the problem.
By the same token, when Barbra Streisand
gave ATA $25,000 for tinnitus research, it didn't
mean that a cure would be instantly discovered.
But it did call attention to the fact that research
into the causes and treatment of tinnitus is nec-
essary and a worthwhile investment.
An opinion, concern, or illness always
seems to have greater relevance for the general
public when expressed or experienced by a
celebrity or "public" figure. That may not seem
fair, but neither is tinnitus. So what we intend to
do is make the best of both of them - capitalize
on one to benefit the other.
That is why we were so excited when
William Shatner joined our cast. An eloquent
advocate of tinnitus research, he never fails to
use an opportunity to speak on our behalf, be it
in connection with Star Trek, promoting his lat-
est book or a general public appearance. And it
works. Through personal letters, he has enticed
several other celebrities to join ATA and to
authorize use of their names in our publicity.
Some, like Steve Martin and Leonard Nimoy,
have tinnitus; others, like Hugh O'Brian, don't
have it but joined anyway.
Further, on a recent Late Night with David
Letterman Show, not only did Shatner talk about
ATA, his own tinnitus, and how he had recently
testified on the critical need for tinnitus
research at federal budget hearings in
Washington D.C., but he actually got Letterman
to discuss the sounds he (Letterman) hears
because of tinnitus.
16 Tinnitus Thday/June 1996
Needless to say, ATA received lots of calls
because of that show. For many people, it may
have been the celebrity that got their initial
attention, but it was the discussion of tinnitus
that helped put them in contact with ATA. Some
knew what they had but didn't know where to
get information, others thought they were alone
in hearing these strange sounds.
We're about to release two new public ser-
vice spots to TV stations nationwide (yes, at
long last!). One features Tony Randall and Jerry
Stiller, the other is by William Shatner. We're
certain that both will heighten public awareness
of tinnitus.
But, ATA's success depends on our entire
cast of celebrities - and that includes you. Oh
yes, even if you don't currently appear on stage
or screen, you have your audience, your circle
of influence. Chances are huge that you come
into daily contact with people who need to
know more about tinnitus and/ or would appre-
ciate being asked to help support such a worthy
cause. Thlk about tinnitus and about .ATA. Help
us provide information or support to patients
and the professionals who treat them. Help us
fund research. Help us ring down the curtain on
tinnitus.
Former First Lady ROSALYNN CARTERjoinedATA in 1992
and says 'I am pleased to be a member of the American
Tinnitus Association and strongly support research and
education programs about tinnitus. As a sufferer myself, I hope
that someday soon we'll be able to find a cure for this nagging
affliction. (Photo by Rick Diamond)
Capitalizing on Celebrities (continued)
SONNY LANDRETH has been a Sponsor
Member since 1984 and proclaimed his support
of the work and research efforts of ATA in the
liner notes of his CD 'South ofl-10.' (Photo by
Dennis Keeley)
STEVE MARTIN knows there's nothing funny
about tinnitus. He has become an ATA
Champion of Silence to prove it.
Also a Champion of
Silence, LEONARD
NIMOY has heard a
high thin whistle in his
left ear since an
explosion on the Star
1Yek set (which also
gave William Shatner
his tinnitus).
TONY RANDALL made
his first public service
spots for ATA in 1985.
Watch for his latest in
which he and JERRY
STILLER take to the
New York streets to talk
about ti-nigh-tus (or is it
tin-i-tus?).
Book Review
by Barbara Tabachnick, Client Services Manager
Life After Deafness - A Resource Book for
Late-Deafened Adults, by Berra Shuster, addresses
the practical and sometimes painful aspects of
lifestyle adjustments necessary for newly deaf-
ened individuals. In a warm and experienced
voice, the author discusses rehabilitation options
and tips for successful social interaction, travel,
driving, education, and job interviewing. Shuster
also discusses alternative methods of communi-
cation for the technologically-shy (modems,
computers), as well as sign language, relay ser-
vices, speech reading, TTY, hearing ear dogs,
oraJ interpreters, closed captioning, and all
manner of assistive devices.
home). Despite its Canadian flavor, the book is a
solid resource for anyone anywhere who has lost
hearing.
Th order, send $20 in U.S. or Canadian funds
plus shipping ($5 Canada, $6 US, $7 International)
to: The Canadian Hard of Hearing Association
(CHHA), 2435 Ho1ly Lane, Suite #205, Ottawa,
Ontario, K1 V 7P2, Canada. Voice: (613) 526-1584
or TTY: (613) 526-2692.
The book is packed with government and
service agency references for the hearing-
impaired communities in Canada (the author's
When You Order Books from ATA ...
.. . It's best if you can keep your membership
number handy when you call. (You'll find it
on the label of this magazine.) This will help
speed up the ordering process, take less time
on the telephone, and save everyone money.
Thank you!
Glossary of Hearing and Non-Hearing-Related Terms
by Bena Shuster
(The following glossary was taken
from Life After Deafness: A Resource
Book for Late-Deafened Adults and is
reprinted with permission from the
author.)
adventitiously deaf
persons born with hearing whose sense
of hearing has become non-functional
through illness or accident
American Sign Language (ASL)
in Canada and the United States, a
visual-gestural language used as a pri-
mary means of communication by per-
sons who are deaf; the native language
of Deaf people and Deaf culture
audiogram
a graph showing the degree of loudness
at which a person responds to a sound
at a given frequency; loudness is given
in decibels, and frequency is given in
hertz
audiologist
a health care professional who mea-
sures hearing and assists individuals
with hearing problems; requires at
least a master's degree in audiology
audio-loop system
a system that uses electromagnetic
waves for transmission of sound in
public areas such as theaters. The elec-
trical output from an amplifier is fed
either into a wire loop surrounding the
seating area, or into a small individual
loop worn around the listener's neck.
18 Tinnitus Today/ June 1996
The signal from the loop can be picked
up by the telecoil in many hearing
aids. (Hearing aids without a T-switch
can use a special induction receiver to
pick up the sound.) Also known as
induction loop system.
auditory nerve
the cranial nerve that carries informa-
tion from the inner ear to the brain
aural rehabilitation
education or therapeutic procedures to
improve the effectiveness of the com-
munication ability of the hearing-
impaired persons
barotrauma
rapid or forced air pressure changes dur-
ing diving or aircraft descent
closed captions
text display of spoken dialogue and
sounds included in some television sig-
nals and videos. Closed captions are vis-
ible on the screen only when processed
through a caption decoder. (Most newer
televisions have a built-in decoder chip)
cochlea
the hearing part of the inner ear; resem-
bles a snail in shape
cochlear implant
a device which directly stimulates the
auditory fibers of the inner ear, allowing
deaf or deafened individuals to receive
some auditory information. The internal
part, surgically implanted in the
cochlea, is connected to a tiny micro-
phone and transmitter (hooked over the
ear) connected by wires to a speech
processor (worn like a body hearing aid)
conductive hearing loss
a deficit in hearing caused by an abnor-
mality in the outer or middle ear
congenitally deaf
persons who are born deaf
Deaf (with a capital D)
refers to individuals who are deaf (or
hard of hearing) who identify with and
participate in the language, society and
culture of Deaf people, based on sign
language
deaf (with a lowercase d)
an audiological term used to describe
individuals who have no useful residual
hearing and who generally use sign lan-
guage as their primary mode of commu-
nication. They may also use
speechreacling, hearing aids, and other
assistive technology to aid in communi-
cation. See also congenitally deaf,
adventitiously deaf.
deafened adults
persons who grew up hearing or hard of
hearing and then experienced a gradual
or sudden profound loss of hearing.
They cannot understand speech without
visual clues such as speechreading, sign
language, or reading text (such as real-
time captioning or note taking)
decibel (dB)
a logarithmic measure of the intensity
or loudness of sound. The decibel read-
ing of a sound increases lOdB for every
ten-fold increase in loudness. For exam-
ple, a 30dB sound is 100 times louder
than a lOdB sound. This non-linear scale
corresponds roughly to the way humans
perceive sound.
Glossary of Hearing and Non-Hearing-Related Terms (continued)
degrees of hearing loss (in decibels)
The faintest sounds a person with nor-
mal hearing can detect are at levels of 0
to 20dB. With hearing loss, the threshold
at which sound can be detected become
higher:
mild: 26-40dB
moderate: 41-SSdB
moderately severe: 56-70dB
severe: 71-90dB
profound or deafness: over 90dB
finge r spelling
A form of communication in which
there is a separate hand shape for each
letter of the alphabet. Words are spelled
out letter by letter
fluxcoil
a small device, installed in the receiver
of a telephone, which creates an electro-
magnetic signal compatible with the T-
switch on a hearing aid
FM system
a group listening system in which a low-
power transmitter broadcasts a signal
via frequency modulated (FM) radio
waves from the sound source to a
receiver worn by the listener. FM sys-
tems have good sound quality, and they
are useful in large public areas because
the signals can have a range of over 100
meters and pass through physical
obstructions
frequency
the number of complete cycles a sound
signal makes in one second; the higher
the frequency, the higher the pitch of
the sound
hair cells
the sensory receptors in the inner ear
that translate sound vibrations into mes-
sages that go to the brain
hard of hearing
a term used to describe persons with
mild to moderate hearing Joss. Persons
who are hard of hearing can understand
some speech sounds with or without a
hearing aid. Most people who are hard
of hearing are oralists, although a small
number learn sign language. Generally,
these individuals are committed to par-
ticipating in society by supplementing
their residual bearing with hearing aids,
speechreading, and assistive technology
to aid communication. Some late-deaf-
ened adults prefer to describe them-
selves as hard of hearing.
hearing aid
an amplification device to assist persons
with hearing loss. Hearing aids can be
worn in the ear, behind the ear, or on
the body. A hearing aid dispenser is an
individual who sells, fits, and adjusts
hearing aids and instructs the consumer
in their use and care.
hearing impaired
a generic term formerly used to
describe all persons with a hearing loss,
regardless of the degree of loss; now
used only as a description of a medical
condition
Hertz (Hz)
the scientific unit for measuring the fre-
quency of waves or vibrations; equal to
one cycle per second
induction loop system
see audio-loop system
infrared system
a group listening system, frequently
used in theaters, in which a transmitter
broadcasts a signal via invisible infrared
light waves. Users require special
receivers
Langue des signes quebecois (LSQ)
the French-Canadian sign language, is
based on ASL
lipreading
the skill of understanding spoken lan-
guage by observing the movement pat-
terns of a speaker's lips. See
speech reading
manual deaf
persons who are deaf whose preferred
mode of communication is sign lan-
guage; also known as signing deaf
Manually Coded English (MCE)
a visual representation of English
designed to improve academic achieve-
ment. There are three systems of MCE:
Signing Exact English, Signed English,
and Seeing Essential English. MCE sys-
tems are used in educational settings
with children
Meniere's disease
an over accumulation of fluid in the
inner ear causing a fluctuating hearing
loss, a roaring sound in the ear, dizzi-
ness, and a feeling of fullness in the
head and ears
meningitis
a disease of the membranes of the brain
or the spinal chord. Sometimes meningi-
tis causes hearing loss
neurofibromatosis (NF)
a genetic neurological disorder that can
cause the formation of tumors on the
nerves. Some forms of this progressive
disorder can cause deafness. 'TWo dis-
tinct forms of neurofibromatosis have
been identified: NF-1 (formerly called
Reckinghausen's disease), and NF-2
(also known as bilateral acoustic neuro-
ma). In NF-2, the development of
tumors in the cranial nerve complex
affects the auditory nerves, resulting in
deafness and balance problems.
otitis media
inflammation of the middle ear, usually
caused by infection
otology
the study of the anatomy and diseases
of the ear
otorhinolaryngology
the surgical specialty concerned with
diseases of the ear, nose, and throat.
Also known as otolaryngology
ototoxic
poisonous to the ear; usually refers to
drugs such as antibiotics
oral deaf
persons who are deaf whose preferred
mode of communication is speech and
speechreading; also known as oralist
pre-lingual deaf (or hard of hearing)
an individual whose hearing loss
occurred before normal language skills
were well established (usually before the
age of four)
post-lingual deaf (or hard of hear-
ing)
an individual whose hearing loss
occurred after normal language patterns
had been established
presbycusis
a sensorineural hearing loss that occurs
with age
residual hearing
the amount of hearing available to a
hearing-impaired person in the speech-
sound frequencies; charted on an audio-
gram by an audiologist
sensorineural hearing loss
loss of hearing sensitivity produced by
damage or alteration of the sensory
mechanism of the cochlea or the neural
structures that lie beyond
sign language
a formal system of hand configurations
and movements that constitutes the
basis for communication. See American
Sign Language, Langue des signes
quebecois, Manually Coded English
speechreading
a skill used by a person with hearing
loss to understand speech by observing
a speaker's lip, tongue and jaw move-
ments; formerly known as lipreading.
The term speechreading is now pre-
ferred, since it includes facial expres-
sions, gestures, and body language.
TDD
see TTY
tinnitus
a ringing, roaring, buzzing, or other
noise in the head or ears caused by
damage to the auditory system
T-switch
a setting on a hearing aid. Many hearing
aids contain an induction telecoil which
is activated by moving a switch on the
hearing aid to its "T" setting. The tete-
coil can pick up the magnetic field gen-
erated by hearing-aid compatible
telephones, assistive listening devices or
audio loop systems.
TTY
an electronic device with a keyboard
and a small screen which enables per-
sons who are deaf, deafened, or hard of
hearing to communicate over the tele-
phone lines; formerly called TDD
(telecommunication device for the
deaf); also known as TT (text telephone)
in the United States
Tinnitus 1bday I June 1996 19
Questions and Answers
by Jack A. Vernon, Ph.D., Oregon Hearing
Research Center
[QJ
Mr. S. in Alabama writes to say, "I don't
understand side effects. It seems that
almost every drug has tinnitus listed as
a side effect. Is this true? Are the number of
side effects additive? That is, if one is taking two
drugs at the same time will you get all of the
side effects listed for both drugs?"
First of all, please know that the listing
of side effects does not mean that they
will happen to everyone who takes the
drug. Indeed, most of the side effects listed in
the Physician's Desk Reference (PDR) are those
observed in only 2% or 3% of the people tested
with the drug in question. For example, in the
PDR under Lidocaine the following adverse
reactions are listed: "Central Nervous System:
CNS manifestations are excitatory and/ or
depressant and may be characterized by light-
headedness, nervousness, apprehension, eupho-
ria, confusion, dizziness, drowsiness, tinnitus,
blurred or double vision, vomiting, sensations of
heat, cold or numbness, twitching, tremors, con-
vulsions, unconsciousness, respiratory depres-
sion and arrest." The listing goes on to include
other side effects under Systemic, Allergic and
Cardiovascular System.
Thke a moment and carefully read this list-
ing of side effects. Note that many of them need
little more than the mere mention to create the
effect listed. Such things as nervousness, appre-
hension, confusion, respiratory suppression are
very prone to suggestion. Most of all, notice that
tinnitus is included as a side effect even though
it is well established that an IV injection of lido-
caine eliminates tinnitus for half an hour or so
in 88% of tinnitus patients.
Mr. S., side effects do not happen to every-
one taking drugs but they do happen to a small
percentage of patients. Moreover, when side
effects do occur they tend to habituate and dis-
appear in time. Side effects also tend to be tem-
porary so that if they do appear, cessation of the
drug will usually eliminate them. I think the
best approach to drugs is to discuss them and
their potential side effects with either your pri-
mary physician or your prescribing physician.
[QJ
Mr. S. In Georgia writes that his tinnitus
is altered by sleep conditions.
Apparently when he goes to sleep with a
low level of tinnitus it starts to increase in loud-
ness which he can stop if he wakes himself up.
Mr. S. asks if there is some chemical in the brain
that controls this function.
There is a fairly large number of
patients whose tinnitus will change in
loudness according to the sleep condi-
tion. If their tinnitus is loud when they go to
sleep, they may wake up with it reduced. Or, if it
is soft and they go to sleep they may wake up
with it loud. The real problem is that the pattern
of sleep does not a1 ways reverse the condition of
their tinnitus. It only does it sometimes and no
one understands this problem. I have discussed
it with people who investigate sleep, and they
are as confused as I am. Your case is different in
that you are able to exercise some control over
the level of your tinnitus, and the nature of that
control causes me to make a suggestion. If you
use bedtime masking with a bedside unit, you
might find that the presence of masking has the
same effect as awakening yourself. It is worth a
try. A good bedside masker is available from
Marpac. (See inside front cover of Tinnitus
1bday.)
[QJ
Mr. P. in California makes the following
statement: "Six weeks ago I came down
with a sinus infection which is now
cleared up. During the sinus infection my ears
started ringing and they are still ringing. Some
days the ringing is very low - almost gone, and
some days it is very obvious and loud. Do I have
permanent tinnitus and, if so, what can be done
about it?"
I would guess that th. e sinus infection
started your tinnitus and that it will
gradually go away. For some reason that
I do not understand, things that cause tinnitus
can occur very rapidly while systems that cor-
rect tinnitus are very slow. I view it as a positive
sign that your tinnitus fluctuates; I think that is
part of the healing process so don't get discour-
aged if your tinnitus is mild and acceptable for a
period and then becomes louder. As I said, I
think that is part of the healing system. We do
Questions and Answers (continued)
not judge tinnitus as being permanent until it
has remained unchanged for a period of two
years.
[Q]
Mr. T. in Connecticut asks the following:
"I have tinnitus which I am able to
control fairly well but I do not want it to
get any louder. I have heard of people whose
tinnitus was produced by the inflation of the air
bag in their automobile. Should I disconnect the
air bag in my car?"
Some German literature indicates that
the explosion which inflates the air bag
produces a brief sound of 130dB at the
ear level of the passenger and l60dB at the cen-
ter of the steering wheel where the air bag is
contained. Sounds of this magnitude are much
too loud for tinnitus patients. The fact that the
air bag noise is very brief helps. Keep in mind
that people vary enormously in their susceptibil-
ity to hearing damage produced by loud sounds.
Nevertheless, I always think that tinnitus
patients are especially susceptible to tinnitus
exacerbation from loud sounds, and thus they
should avoid loud sounds as much as possible.
I don't know the law about air bags in
Connecticut but in some states it is unlawful to
disconnect air bags. Best to check the law in
your state before you act. If I had air bags in my
truck, I would disconnect them, depend upon
the seat belt with a shoulder harness, and try to
drive more cautiously.
[Q]
Mr. B. in New York comments that he
has read several anecdotal reports
regarding patients whose use of corti-
sone for other reasons brought relief from their
tinnitus too. If any of you have had experiences
with cortisone and tinnitus, please write and
share them with us!
Send your questions to Dr. Vernon cl o ATA,
Tinnitus Tbday!Q&A, PO Box 5, Portland, OR
97207-0005.
Public & Professional Awareness
Efforts Continue Across the West
The unveiling of a new display for ATA,
(designed to be easily transported and assem-
bled by one person), occurred at the Th-State
Hearing Convention held February 28-March 3
in Portland, OR. This annual meeting attracts
hearing aid dealers from Washington, Oregon
and Idaho.
Pat and Walt Daggett represented ATA at the
annual convention of the American Society on
Aging March 16-19, in Anaheim, CA. It was sur-
prising that ATA was the only hearing-related
exhibitor there considering the prevalence of
hearing problems in the senior population.
Salt Lake City, UT was the site of the annual
convention of the American Academy of
Audiology, held April 18-21. Gloria and Pat dis-
tributed ATA information to thousands of audiol-
ogists on hand. Four sessions about tinnitus
were included in this year's program. (Gloria
spoke at two of them.) In the past, it would have
been surprising to see even one such presenta-
tion. We are making progress!
Pat Daggett and ATA's new dif.play.
ATA Bibliography Update
The latest update of our bibliography is now
available. The newest list (Supplement #8)
includes 150 newly published article titles about
tinnitus, which can be added to your original
edition. Bibliography update cost: $10. The com-
plete bibliography is available for $40 (mem-
bers) or $75 (non-members).
The ATA bibliography is a list of approxi-
mately 3000 published articles about tinnitus,
alphabetical by author, that includes the source
of the articles and their length in pages. (It does
not include the actual articles.)
Th narrow the search for information, we
can compile SUBJECT SEARCH lists for you on
topics ofyour choice. (Again, these are lists of
article titles, not the articles themselves.) The
cost per subject search: $5 (members) or $10
(non-members).You can obtain the actual arti-
cles on the subject search list at your library, or
you can order copies of them from us for 10 a
page, plus postage and handling. Please call us
first to confirm the exact amount of your order.
Suggested Subject Search 'Ibpics:
Acoustic Neuroma
Acupuncture
Allergy
Antidepressants
Bilateral Tinnitus
Biofeedback
Clinical Masking
Cochlear Implant
Cognitive Therapy
Depression
Diet/Nutrition
Drugs Known to Cause Tinnitus
Drug Treatments
Eighth Nerve Section
Electrical Stimulation
Ginkgo Biloba
Hearing Aids
Hyperacusis
Hypnosis
Lidocaine
Magnetic Resonance Imaging (MRI)
Meniere's Disease
22 Tinnitus 'Ibday/ June 1996
Myoclonus
Noise
Otoacoustic Emissions
Otosclerosis
Pulsatile Tinnitus
Recruitment
Sleep
Stress/ Anxiety
Sudden Hearing Loss
Surgical Management
TMJ
Vertigo
White Noise
Xanax
Others topics can be requested. Thke advan-
tage of this opportunity to educate yourself
about individual aspects of tinnitus.
The Combined Federal
Campaign
Since this will be the
only issue of Tinnitus
7bday to reach you
before the kickoff of
the National Voluntary
Health Agency's
Combined Federal
Campaign for 1996, we
want to remind all of
you who are federal employees to send us a
copy of your pledge card. We don't want you to
miss any of our quarterly reports on the latest
treatments and coping strategies for tinnitus.
ATA's national designation number is 0514.
Many thanks for your ongoing interest and
support!
We Need Each Other nlcomPosedunre-
. adolescence, whe compelled to
slnce my love" letters, 1 am this time for
quited "puppy te another letter
sit down and wn d than myself.
someone in more nee
by Michael Cohen ther dramatic life event,
Tinnitus, any o n us: we must care not
mlSS10n U pO
can force a but for oth- .-----
only for ourselves I January 4, 1996
ers to feel more Ms. w
th the }'{fA as a Finley, TN
involved Wl d letter contact
t
lep
hone an e I Dear Ms. w.:
e rt"1-.e first respons 1 d fi d 1 d _, __
1
u I am g a you oun my name as a te ephone an letter contact in Tinnitus TbwAy.
person. from a woman Believe me, your letter of 12/28/95 was very touching.
received was ho sounded What you have written about is pain - pain that is not talked, empathized, kissed
in wrote: "1 have and loved, medicated, meditated, or even prayed away. It's a real you-know-what and it
desperate. doctors doesn't stop.
been to they I know this because I have had constant tinnitus since this past summer, and even
who say ert ..... nltus. It has though r had a $10,000 operation to repair a tear in my cochlea, this did not help my tin-
d abou t.u. nitus nor restore much hearing in my right ear. Fortunately. my left ear is not affected.
can life 1f there is Heartbroken after the failure of the operation, I went to a tinnitus "expert." This doctor
te1l1ne was upbeat about his favorite histamine and allergy treatments. Unfortunately, hope for a

J horrid disease, I couple of months was alii got because neither treatment worked. The only thing that has
about thlSld appreciate it." had any real palliative effect is one .25 mg tablet of Xanax which 1 take every night about
sure wou ly she an hour before bedtime. With the help of the pill and a masking device called "Heart and
V[hat to do? sure I Sound Soother and timer" set at a low white noise level and placed next to my pillow, 1
knows about the

usually get a fair night's sleep. And usually r can get up for work without feeling too ener-
h .KfA after a , vated: i.e. T can go through a busy day not overcome by self-pity.
oft e I d me V{hat So I survive. But I would be less than honest if I didn't tell you that there are times
hoW she when I feel like crying. And there are guilty moments when I wish J could change the
more can fferer? 1 time last July when r blew my nose too hard and screamed at the dog and then, within
offer a fellow in one hour, felt dizzy, couldn't hear, and the hissing sound WHICH NEVER STOPS started.
call directorby at there is no In your letter, you write, "If there is anything you can tell me about this horrid dis-
Tennessee, u no ease, I sure would appreciate it ... I'm having a very hard time coping." I can tell you, Ms.
. . NoW 1 have W., that we are all having a hard time coping - whether it's William Shatner, a fellow suf-
hstlfig. h first time ferer who is giving his name value to television spots and going to Washington, D.C., to
choice; fort e lobby for more research money, or Michael Cohen, a teacher bumped out of a full-time
position and now trying to hold onto a substitute teaching job in a chaotic, gang-ridden
inner city high school in Chicago while trying to find enough energy to single-parent a
14-year-old son full-time.
Ms. W., there is no simple response to you when you say, "It has destroyed my life.
I've been to numerous doctors who say there's nothing they can do about it! How discour-
aging to hear this." I can only say that I believe there will be a cure some day, prayerfully
in our lifetime. But I don't believe that a cure is possible unless more of the estimated
10 million tinnitus sufferers make some public noise instead of just Jiving with it" in
isolation.
What I am trying to say is that each of us, to the best of our ability, has to make a
choice. We must decide whether or not tinnitus education and research should be sus-
tained with as much intensity and consistently as the sound of tinnitus itself. 1 think the
answer should be "yes and that in unity, our sufferings will have some meaning.
Again, thanks for your letter, Ms. W., and for listening to my "tinnitus noise." I hope
you will write back and perhaps give me a telephone number where you can be reached.
All of us - we need each other!
Sincerely,
Michael Cohen
505 N. Lake Shore Dr. #5412
Chicago, IL 606ll
(312) 321-0783
. 1J day/ June 1996 2.3
Ti:nrutus o
------
----- ___________ .. __.____
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Raymond E. Hankamer Donald V. Thompson
Veronica Rust David W. Bryan
Lawrence E. Happ Scott Thrner Josephine Sammartino
Leffie Burton
Dennis D. Heindl - Heindl
Arlene B. Vannorden Barbara Mellin -
Floyd Butterfield
Family Foundation John Vassilcs Mainlands Unit Six Social Club
Mary Howard Cadwell
A. James Heins James W. Walter, Jr.
Lenore Galbo
Tinnitus 'IOday/ June 1996 25
Tributes, Sponsors ... (continued)
Sol Charen
Michael S. Checke
Aurelita Cherven
Rosanne Chilcoat
Loretta C. Choy
John B. Clifton
Willie L. Coberly
James J. Contrada
Donald J. Cook
John B. Corcoran
Ward S. Cottrell
Harold T. Crawford
Priscilla Crombie
Glen R. Cuccinello
Dennis M. Daly
Lori M. Delamarter
Robert B. Dellbrugge
Carole Desnoes
Carl D. Distefano
Rosa and Will iam Dixon
Frances Kaufman Dofl:
Thelma D. Dry
James T. Duckworth
Howard 0. Dugger
Mr. and Mrs. Harold F. Ealer
Millicent B. Edgerton
James Eisenbacher
Paul Etxeberri
Michael A. Ferraro
William D. Finnell
Eunice Fitzell
Mary A. Floyd
Juanita R. Focha
Larry c . Focht
Martin E. Fossler
Franklin L. Fountaine
James A. Foxx
Norman Frankel
Lewis and June A. Freedman
Harlan R. Frey
Sherry L. Frey
Jim Ray Fugate
Vivian L. Gallon
Gabriel B. Gavino
Florena Genzink
Olga Georeff
Pam and Greg Gibbs
William R. Gillam
Madge Glass
Seymour Goldberg
Harriett S. Goldman
Ronald K. Granger
Carl Granitzer
Marjorie E. Gremmel
Gerald Griepenstroh
Mr. and Mrs. August H.
Grimaldi
Allen Griswold
John F. Hallgren
Richard E. Haney
Walter W. Hardcastle
Walter C. Hardebeck
Rita Harrison
Joseph and Janice Harvey
Michael Hayden
Charles R. Heidrick
James and Lois Heitz
Julia Hicks
26 Tinnitus 'lbday/ J une 1996
E. Alan Hildstrom
Margaret J. Hoffmann
Anne C. Holland
Arvid V. Holt
Floyd K. Hooper
Gul ielma T. Hooper
Barbara Horowitz
Lucille J. Jantz
Barbara L. Jensen
George C. Juilfs
Henry C. Keene
R. L. Keheley
Harry G. and Marion Keiper
Joan W. Keller
TI:ish Lehr Keirn
Wayne M. Kern
David Kiecker
Clifford H. Kingsbury
Joanne E. Kinney
Richard Kittell
Daniel L. Knipple
Steven G. Korte
Norma Kratz
M. Virginia Kreckman
Stefan .P. Kruszewski, M.D.
Joseph A. Kuhn
Ema Ladage
Blanche A. Lagasse
Rose Lanzarone
Florence Leone
Robert L. Lewis
Vilis I. Lietuvietis
Duane Logsdon
BettY B. Lotz
Marian B. Lovell
Isabelle C. Ludlum
Richard C. Luke
Delbert L. Mabe
Chester J. Mackson
Donald Mahler
Vince Majerus
Eleanor Mammino
Emanuel Maris
George K. Marlangoutsos
John W. Mars
Bruce Martin
W. Gordon Martin
Brenda J. McDaniel
Margaret E. McGroary
Janice A. McGuire
John E. Meehan
Richard L. Meiss
F. N. Men-alls
Marvin Mesker
Mark Meza
Patrick Michael
Bulut Mihmandarli
Karl W. Miller
Lawrence S. Miller
Jeff Morse
Louis G. Moser
Stephanie Muenzberg
Florence C. Murphy
Arlo and Phyllis Nash
Vilma Neill
Alfred Q Nervegna
Lyle G. Newcombe
Edward H. Newman
Jack M. O'Lexey
Paul M. Olinski
Joseph Opitz
William L Overbey
Elsie L. Owen
Karl E. Owen
James L. Paradise- Cleaning
Service Inc.
Peter Parmagos
Charles R. Paroubek
Thomas J. Patrician
Lawrence W. Peterkin
Jan L. Peterson
Linda M. Peterson
Harold w. Piggott
Ann S. Pittenger
Anna G. Platt
Robert L. Pope
Lela M. Powell
Barbara Press
Donald E. Pullen
Thomas J. Rabideau
Eldon Radtke
Rose Rainona
Barbara S. Raper
Robert W Ravenscrofl:
Allen Raymon
Herman B. Raymond
Sunny Rich
Joy Riggs
Raymond A. Ritter
Judy T. Robinson
Steven P. Rocco
James G. Rudd
Veronica C. Rust
Frederick J. Ryan
Rebecca J. Sammons
Stewart Sandman
Herman J. Schechter
Jennie M. Schimnoski
John H. and Faye Schleter
Claude H. Schmidt
Martin F. Schmidt
Arlene Schreder
Gerald J . Schwartz
Gloria E. Senno
Norma T. Sheld
Claire and Jacques Simon
Carl ton B. Simons
Lee L. Sims
Thelma M. Sjostrom
Jack N. Skiver
Sandy Slutsky
Irene Smith
Mildred F. Sohn
Diane Solowjow
Setty Jean Sonnie
Linda Steinberg
Edward L. Steinman
Susan K. Stevens
Douglas H. Steves
Philip E. Strohmeier
Elsebeth S. Stryker
David E. Sullivan
Jack and Camille Swoboda
Fred J. Thupel
Kent J. Thompson
Alfred A. 'lbrre
Domenick T. 'lbrrillo
Jean E. 1bwle
J une P 'lbwnsend
Greg TI:uax
Stan U1ick
Arthur Vianna-Neto
Maxine Vincent
Dorothy R. Waiste
Joseph E. Wall
Kay Watkins
Betty Webber
Glenn L. Weiand
Helen J. Wells
Daniel G. Wheeler
James S. Whyte
Brian D. Wideman
Norman Wightman
John T. Williams
Melvin K. Williams
Matjory Willoughby
J. T, Wilson
Dolores E. Winslow
John Wisniewski
Rudy Wolf
Gena Lou Woywood
Stephanie W. Wratten
Robert S. Wright
Roger K. Yerkey
James R. and Claudia Zinser
Allyne B. Zorn
Florence Zuchowski
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Tinnitus Today June 1996 Vol 21, No 2

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Tinnitus Today June 1996 Vol 21, No 2

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June 1996 Volume 21, Number 2

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