March 1997 Volume 22, Number 1

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"
Since 1971
Research- Refenals- Resources
In This Issue:
NIDCD Funds $870,383 in
Tinnitus Research
Treatments for Subjective
Tinnitus
Similarities Between Severe
Tinnitus and Chronic Pain
Profile: New ATA Board
Members
ATA Regional Meetings in
California- Aprill and 3,
1997
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Tinnitus
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: 'll'udy Drucker, Ph.D.
Advertising sales: ATAAD, P.O. Box 5,
Portland, OR 97207, 800/ 634-8978
TinnrnLS 1bday is published quanerly in
March, June, September and December. It is
mailed to members of American Tinnitus
Association and a selected list of tinnitus suf-
ferers and professionals who treat 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 TinmtllS 1bt;lay. AcceptMce of adver-
tising by 7inmws 1bday does not constitute
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or services, nor does Timurus 1bday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The opin-
ions expressed by contnbutOrs w Tm1tus
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 1997 by American Tinnitus
Association. No pan of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any fonn, or by any means.
without the prior written permission of the
Publisher. lSSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Roben E. Brummett, Ph.D., Portland, OR
Jack D. Clemis. M. D., Chicago, lL
Roben A. Dobte, M.D., San Antonio. TX
John R. Emmett, M.D. , Memphis, TN
Chris B. Foster, M.D., La Jolla, CA
Barbara Goldstein, Ph. D., New York, NY
John w. House, M.D., Los Angeles. CA
Gary P. Jacobson, Ph.D., Detroit, Ml
Pawel .J. Jastreboff, Ph 0 ., M [)
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. MO
Robert E. Sandlin, Ph. D., El CaJon, CA
Alexander J. Schlcuning, 11, MD,
Portland, OR
Abraham Shulman. M.D., Brooklyn, NY
Mansfield Smith, M.D .. San Jose. CA
Honorary Directors
The Honorable Mark 0 . Hatfield
Tony R1ndall, New York, NY
Will iam Shatner, Los Angeles, CA
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey,
Portland, OR
Board of Directors
Edmund Grossberg, Northbrook, LL
w. F. S. Hopmeier, St. Louis, MO
Paul Meade, Tigard, OR
Philip 0. Monon, Portland, OR, Chmn.
Aaron I. Osherow, Clayton, MO
Gloria E. Reich, Ph.D., Portland, OR
Jack. A. Vernon, Ph.D., Portland, OR
Megan Vidis, Chicago, lL
The Journal of the American Tinnitus Association
Volume 22 Number 1, March 1997
Tinnit us, ringing in the ears or head noises, is experienced by as many
as SO million Americans. Medical help is often sought by those who
have it in a severe, stressful, or life-disrupting for m.
Contents
9 1b Disconnect or Not to Disconnect: An Air Bag Update
hy Barhara Thbachnick
10 NIDCD Funds $870,383 in Tinnitus Research
13 Treatments for Subjective Tinnitus
1Jy E. 8andlin, Ph.D.
IS ATA's Support Network - Join In!
by Barbara Thbachnick
16 The Similarities Between Severe Tinnitus and Chronic Pain
by Aage R. M1ler, Ph.D.
18 Personal Preferences
by Barbara Thhachnick
19 Profile: New ATA Board Members
23 1997 Regional Meetings Registration Form
24 Announcements
Regular Features
4 From the Editor
by Gloria E. Ph.D
6 Letters to the Editor
20 Questions and Answers
by Jade A . Vernon, Ph.D.
25 Tributes, Sponsors, Special Donors, Professional Associates
Cover: "Kites (acrylic on canvas) by Paul Berg, PO. Box 642011, Los Angeles, CA 90064.
Mr. Berg is a p rofessional artist and an ATA member.
From the Editor
by Gloria E. Reich, Ph.D.,
Executive Director
Usually you read about ATA's
s e l f ~ h e l p groups, their activities
and programs in Barbara
'Thbachnick's Self-Help column.
Today, however, I want to cast
a historical light on the group
movement and pay tribute to
two wonderful people whose
help has been so important in making tinnitus
self-help successful.
The self-help ideal in America is as old as
barn raising in colonial times. Today, groups of
people gather together to help each other learn
to cope with their similar health problems.
When I first came to ATA in 1975, the pur-
pose of the organization was to raise money for
research. It was only as ATA became known that
we took on the job of providing information and
help to tinnitus patients. Now, although both of
these tasks remain, they have been joined by
new programs highlighting the importance of
hearing protection, providing tinnitus education
for health professionals, and attempting to foster
more tinnitus research through cooperation with
the National Institute on Deafness and Other
Communication Disorders and other hearing-
related organizations.
In 1980, a number of us were in London
I
England for a tinnitus symposium sponsored by
the CIBA drug company. By then, ATA was a
viable organization vvith a growing national
membership. Tinnitus sufferers in England had
recently formed the British Tinnitus Association
using the ATA model but with a different twist.
ATA is organized as a single association with the
mission to carry out and support research and
educational activities relating to tinnitus, while
the BTA is more like a federation of semi-inde-
pendent support groups that happen to have a
national office. I had the pleasure of visiting one
4 Tinnitus Thday/ March 1997
of those original groups. The face-to-face bene-
fits achieved for patients was so impressive
that I was determined to bring the idea home
with me.
Serendipitously, at about that time, Dr.
Trudy Drucker came to the Oregon Tinnitus
Clinic as a patient. I met TI:udy there and it was
obvious that she was someone who not only
wanted to help spread the word about tinnitus
but was highly qualified to do so. We talked '
about the idea ofhaving support groups for tin-
nitus and TI:udy was willing to "break the ice"
with the first one. That group, the Bergen
County Tinnitus Self-Help Group, grew to be a
shining example of people helping each other
with very positive advice through some very try-
ing experiences.
TI:udy and her spouse, Joe Alam, have given
their time and talents to this group for all these
years. They have recently decided to retire as
leaders and, leaving nothing to chance, have
recruited a new leader to carry on their work.
(See "ATA Support Network- Join In!" in this
issue.) In addition to outstanding work with the
self-help group, TI:udy and Joe have answered
thousands of telephone calls and letters from
tinnitus sufferers and from others who wanted
to know how to start a self-help group of their
own. Trudy has been reviewing books for
Tinnitus Tbday right from the beginning and f'm
happy to say that she will continue to provide
those insightful commentaries.
Another project that TIudy suggested and
described in minute detail during that fateful
clinic visit in the early 80's, was a fund raiser for
research. This project, the Tribute Fund, still
provides substantial income for ATA's research
account. Last year's donations of nearly $35,000
helped enable us to support four tinnitus stud-
ies. For those of you who aren't yet familiar
with the TI:ibute Fund, it is a system by which
you can make special donations that go 100%
for tinnitus research. These can be gifts of cash
or stock and can be made in honor of someone
or in commemoration of an important event.
ATA will inform the honoree or the family of the
person memorialized that you've made a gift in
his or her name. The amount of the gift is never
disclosed.
From the Editor (continued)
Elsewhere in this issue you'll read the excit-
ing news about the five new NIDCD-funded tin-
nitus studies. Federal research monies are the
principal source of income for many researchers
but those funds are much sought after and diffi-
cult to obtain unless a scientist has an estab-
lished record of research. ATA is proud to be
able to play an important part by funding new
research, often by young scientists, which helps
them establish that "track record." Dr. Donald
Godfrey sent the following note with the final
research report from his ATA-funded study. "I
am grateful to the ATA for this support, which
has now enabled us to obtain some NIH funding
to continue the work." The study that was sup-
ported involved the observation of changes in
the neurochemistry of the cochlear nucleus fol-
lowing exposure to high intensity sound. The
results suggest that chemical changes in some
parts of the auditory system and brain may
accompany tinnitus. (See "NIDCD Funds
$870,383 in Tinnitus Research")
Trudy Drucker, Ph.D., ATA's first selfhelp group facilitator.
Words, we've noticed, can have so many dif-
ferent meanings. If you've ever asked a question
and gotten what you thought was a totally unre-
lated answer, you know what I mean. "Tinnitus"
itself is a rather imprecise word. It lends itself to
various modifiers that attempt to clarify the
speaker's intent but instead often cause more
confusion. In our last issue's Q & A column, Dr.
Jack Vernon answered a patient's question
about "noise-type" tinnitus. Vernon equated
"noise-type" tinnitus to what the tinnitus sound-
ed like, that is "noisy" rather than single toned.
Exception to that answer came in a recent letter
from Dr. Abraham Shulman who says that
"noise-type" tinnitus is a term used to identify
tinnitus due to the cause of noise exposure.
Here are two experts assigning different, but
perfectly reasonable, meanings to the same
words. Is it any wonder that patients are often
confused? A project, The International Tinnitus
Classification System, to address such issues is
currently underway. A group of scientists and
clinicians led by Dr. Gary Jacobson, is working
out a way to describe the different kinds of tin-
nitus using standard terms in the hope of avoid-
ing just this sort of confusion. This standard
system will help everyone who either has tinni-
tus, treats it, or studies it to understand what the
other fellow is talking about.
Finally, our congratulations to Dr. A.
Julianna Gulya who has just become the first
Chief of the new Clinical Ttials Branch of the
NIDCD. We will be looking for enhanced treat-
ment options for tinnitus patients to emerge
under her able leadership. We wish her well and
offer our help and encouragement.
Those of you who browse the Internet can find
information about the NIDCD at
http/ lwww.nih.gov/nidcdl
ATA's home page can be found at
http./ lwww. teleport.com/rv ata
(Please note that we are in the process of enlarging
and updating our Internet information.)
'Dear 'Irutfy ana Joe,
We honor your service to tfie Jl.merican
'Tinnitus .9L5sociation ana wisli you many
fw.ppy years of active retirement. It is trufy
saia tfw.t vo[unteers fw.ve tfie power to
cliange tfie worftf. Peopfe fik:g. you prove it.
We wi[[ forever 6e in your ae6t.
Witli warmest ana sincere regartfs,
(jforia '.Rg.icli ana a[[ your frieruis from Jl.'IJl..
Tinnitus 10day/ March 1997 5
Letters to the Editor
From time to time, we include letters from our
members about their experiences with "non-
traditional treatments. We do so in. the hope that
the information. offered might be helpful. Please
read these anecdotal reports carefully, consult with
your physician. or medical advisor; and decide for
yourself if a given. treatment might be right for you.
As always, the opinions expressed are strictly those
of the letter writers and do not reflect an opinion or
endorsement by ATA.
A
bout a year ago I found not only the
home page of the ATA on the Internet,
but also other tinnitus contacts there. I
also found that a large number of people with
tinnitus were posting ideas, suggestions, and
questions in the alt.support.tinnitus newsgroup.
I thought it would be a good idea to get some of
these people together to "chat" over the Internet
with other fellow tinnitus sufferers. I suggested
it last July and got an immediate response. We
now "meet" two nights a week - Thursday and
Friday nights at 8:00p.m. central time on
Newnet on the #tinnitus channel.
The numbers have continued to grow to
include doctors, audiologists, and others
involved with tinnitus. Anyone can join in. If it
should grow larger, we could begin to have
nightly sessions.
For information about this chat group and
other related tinnitus help on the Internet,
check out the web page that was set up by Carol
Brown: http:/ / wvvw.eskimo.com/ IV carol/ T.html
Roger D. Williams, Nashville, TN
I
've used ginkgo biloba for
the last three years to keep
\ my tinnitus under control.
11 It never eliminates it, but it
gives me a 40% reduction in the
noise. Recently, I read about
DHEA and its affects on stress.
Having a "killer" job, 1 bought
some DHEA, 25 mg., and tried it.
The first thing I noticed was an
80% reduction in tinnitus.
When I don't take it, the tinni-
tus comes back within a day, as
it would without ginkgo.
6 Tinnitus Thday/ March 1997
Having read that DHEA in excess of 50 mg. can
cause problems, I reduced my dosage. Even at
12 mg. per day, it is extremely effective at
reducing the ringing.
Keep up the good work. I enjoy your
magazine.
Marc Heatherington, Salem, OR
I
have had tinnitus in both ears since July of
1994.1 had all the tests and have seen two
different doctors. 1 was also fitted with hear-
ing aids with maskers (but I couldn't get used to
wearing them) and I took ginkgo, Prozac, and
Klonopin without success.
Finally, I tried the natural supplement
Protec (RMC Group Inc., 800/ 982-8338), which
contains grape seed extract, aloe vera powder,
and wild Mexican yam. I've been taking it for a
long time and it seems to really help keep the
ringing down. The tinnitus is still there but now
I can handle it.
'Ibm Burns, Mauston, WI
L
ong before I had tinnitus, I used quinine
for leg cramps. After four days of use I
found my hearing almost gone. I called
my doctor who told me to toss the quinine out
and take 400 I.U. ofVitamin E and 1000 mg. of
calcium at bedtime. I still use the supplements
and haven't had a leg cramp since.
Lillian Markowitz, Melrose, MA
D
octors have recently identified a tumor
that might be associated with VHL (von
Hippel-Lindau disease) which often
causes tinnitus and/ or Meniere's disease as its
first symptom. Most of our members who have
tinnitus were told it was caused by one of the
medications they had been taking for something
else, or loud noises and other common causes of
tinnitus. But it can in fact be caused by a tiny
tumor in the endolymphatic sac (ELST). Some-
times the symptoms come long before they can
even see the tumor on an MRI of the internal
auditory canal, but the body knows it is there
and is responding to that very subtle influence.
VHL is a rare disease, and is not always rec-
ognized by physicians. Diagnosed and treated
early, the outlook is very good. If it goes undiag-
nosed for a long time, however, consequences
can be severe. If you not only have tinnitus, but
Letters to the Editor (continued)
are in a family known to be at risk for von
Hippel-Lindau disease, we strongly recommend
that you be screened for ELST and other VHL
tumors.
If you have tinnitus and any of the follow-
ing, or if a first-degree relative has experienced
any of these, you should follow up with your
internist to rule out VHL:
+ hemangioblastoma of the cerebellum or
brain stem
+ hemangioblastoma of the spinal cord
+ hemangiomas of the retina
+ tumors or cysts in the kidney, or kidney
cancer
+ tumors or cysts in the pancreas, or
pancreatic cancer
+ pheochromocytoma, a tumor of the adrenal
gland
+ unexplained high blood pressure
+ hemangiomas in other parts of the body,
including muscle tissue
We will be happy to answer any questions
about VHL. Please contact us at 800/767-4VHL,
or vhl@pipeline.com, or find us on the Internet
at http://neurosurgery.mgh.harvard.edu/vhl-fa/
Joyce Wilcox Graff, Chair, VHL Family Alliance
171 Clinton Rd., Brookline, MA 02146
F
or the past 12 years, I have been battling
my tinnitus and, until recently, having no
luck at it. About a year ago I joined ATA
and found out about Xanax. I tried it and it low-
ered the intensity of the tinnitus by half It let
me collect my thoughts, let me find a way to
live with my tinnitus without depression.
Being Scottish and being a frustrated musi-
cian because I have no silence, I put two and
two together and got into bagpipes! In this way I
have accepted my tinnitus. It's an uneasy truce,
but I can now embrace music with a passion.
Thank you for being there to help me reach this
point.
Jared McLaughlin, Whitefish, MT
Y
ears back, I worked on noise-related
issues in the research lab of a major auto-
mobile manufacturer. As I recall, the
tests showed that, in a real collision, the noise
energy from the air bag was usually dwarfed by
that of the collision itself. Collapsing metal and
such makes for quite a bang at close range!
In the real world, most air bags deploy in col-
lisions in which there is risk of hearing damage
(not to mention death) with or without the air
bag. It is true that low-speed collisions can trig-
ger air bags and cause damage to hearing. But if
the air bag is disabled, it won't save your life in a
high-speed accident either.
For myself, I usually wear a pair of musi-
cian's ear plugs when driving, just because the
noise of the car and wind bothers me. I can still
hear traffic sounds fine. This drops the probabili-
ty of hearing damage to near zero and keeps me
protected.
Jim Chinnis, Manassas, VA
(Editor's Note: The decibel level of a deploying air
bag has been measured at 160dB. Musician's (or
attenuated) ear plugs can ideally offer up to 20dB of
protection. Exposure to 140dB might still cause audi-
tory damage.)
I
was recently in a rear-end collision. My
friend's car was really creamed but we
weren't injured. The air bag did not explode,
probably because we didn't hit the car in front of
us. (The sensors are in the front.) The para-
medics said we were lucky that it did not
explode as they usually see more injuries from
the air bags in this type of accident than from
the accident itself. I really appreciated your com-
prehensive coverage of the air bag situation in
the December 1996 magazine.
Judi Lane, Oak Grove, MO
T
he December 1996 edition of Tinnitus
Tbday c. ontained a letter from a reader
who had suffered through a bad experi-
ence with an MRJ scan. Luckily, I had read about
the loudness of MRJ machines before I had my
MRJ last year. I searched out and found a quieter
MRI machine, and I used foam earplugs during
the test. The machine was an "open" design. If
you are scheduled for an MRJ, ask that your
physician determine if there is such a machine
in your area, and take your foam earplugs with
you when you go. Be prepared for your doctor to
tell you that MRls are not loud. As we all know,
what is "not loud" for a person with normal noise
sensitivity may be excmciatingly loud for the
hearing-sensitive individual. (See Dr. Vernon's
Q&A for more on MRI's.)
Tinnitus Today/ March 1997 7
Letters to the Editor (continued)
Also, I recently flew from North Carolina to
Arizona and back, and f utilized foam earplugs
and an earmuff hearing protector to ward off the
airplane noise. The combination worked well,
and most folks thought the earmuff was a tran-
sistor radio so it was not embarrassing to wear.
Joe Wall, Raleigh, NC
I
read Dr. Vernon's .response to a
concerning dental work and the arttcle
"Silent Dental Work - At Last!" by Barbara
Thbachnick in the September 1996 Tinnitus
Today. I attribute my tinnitus to the use of ultra-
sonic cleaning tools used for removing plaque
from teeth. My tinnitus, which appeared last
year, is a continuous low level intensity of
"white noise" background sounds from 5,000 to
10,000 hz. Superimposed on this background at
times are long high frequency sounds from
10,000 hz to 15,000 hz, which last from a few
seconds to as long as 30 minutes.
My reason for suspecting the ultrasonic tool
is that I sometimes get a very painful sound in
my ears when my back molars are scaled during
teeth cleaning. The sound lasts from
1
/ to
1
12
second and has an apparent frequency of
12,000-15,000 hz. The technician apologizes for
the effect and says it happens to other people
she works on. (I have had the same experience
with other technicians).
I tried without much success, to find the
I
operation frequencies of these scaling tools. I
was told by one sales representative that the fre-
quency was 30,000 hz, above the human hearing
range. It's nonsense. One can hear this tool the
moment the technician turns it on and before it
is inserted into the mouth.
I would be interested to know if any dental
professional has an opinion or some information
on this subject. I also wonder if the FDA consid-
ered the possibility of hearing damage due to
excessively high intensity sound when it
approved these tools.
C. L. Chaney, San Diego, CA
(Editor's Note: Many dental technicians, if asked,
will clean patients' teeth with non-mechanical
scaling implements.)
8 Tinnitus 1bday/ March 1997
A
fter twelve treatments, I'm very pleased
with the results from Dr. Greenspan's
program. Although my tinnitus is still
audible, I do not experience it as the constant,
nagging whine it was before I started treatment.
It's there, but it's easily dismissed as acceptable
background noise.
For me, the most significant improvement
has been the return of easy and natural sleep. I
get drowsy, I fall asleep, and I awake refreshed
in the morning like I used to before tinnitus.
Subjectively, and certainly unscientifically, I
feel biofeedback and the relaxation tapes have
been most helpful, although the synthesis of
other types of treatment has probably con-
tributed as well.
Elizabeth Van Patten, Southampton, NY
I
have had bilateral tinnitus with associated
hearing loss for more than 15 years. In
September, 1996 I enrolled in a study of
multiple therapeutic modalities for tinnitus,
being performed by Dr. Kenneth Greenspan.
Since that time I have learned various stress
relaxation techniques and have undergone cog-
nitive and craniocervica1 therapy, as well as
some self-hypnosis. 1 am encouraged by several
signs of improvement. Although the tinnitus is
certainly not gone, I have noted more periods
during which the tinnitus is of lower intensity
or barely perceptible. Furthermore, I am able to
"tune it out" much better than before. I look for-
ward to continued treatment and am hopeful of
additional improvement.
Lawrence Skolnick, M.D. , Basking Ridge, NJ
T
hese are the initial results of the study
we first described in the June 1996
Tinnitus 7bday journal. 'I\venty patients
entered the study, and are now nearing comple-
tion of their treatment. Even at this pre-follow-
up stage, over 80% of our patients are showing
significant improvement.
As with any clinical research, we are also
learning as we treat our patients. One very
important piece has been the necessity of cate-
gotizing the signs and symptoms of each
vidual, thus allowing us to further custom1ze
each patient's treatments.
For example, approximately 20% of our
patients were depressed. One patient was suffer-
ing from both depression and panic attacks. Her
To Disconnect or Not to Disconnect:
AN AIR BAG UPDATE
by Barbara Thbachnick, Client Services Manager
As we hurry this issue of Tinnitus Tbday off
to the printer, the verdict on the issue of air bag
disconnection is still pending. The National
Highway 'ftaffic Safety Administration (NHTSA),
accepted the public's comments on this issue
through February 5, 1997. At press time, they
are reviewing the comments received, and will
make a recommendation to the Secretary of
'ftansportation by month's end. A final ruling is
expected in early March. For the interim period,
the government has issued a stopgap proposal to
allow air bag disconnections under certain cir-
cumstances. NHTSA has not stated which cir-
cumstances qualify for disconnection.
The current protocol for requesting a "deacti-
vation authorization" for a driver's side air bag is
as follows: One must write a personal letter to
NHTSA explaining in detail the reason for the
request. To ask for a waiver for both driver and
passenger air bags, one must submit a personal
letter plus a letter from a doctor. Note that ask-
ing NHTSA for the waiver does not guarantee
getting it. And getting it does not guarantee that
Letters to the Editor
depression was hidden by her symptoms of tin-
nitus and hyperacusis, and had therefore
remained undiagnosed by her physicians. These
patients required initial anti-depressant medica-
tion, but I must emphasize that it is essential
that it be the correct medication, and the exact
therapeutic dosage. I have found that with tinni-
tus and hyperacusis, even the correct drug won't
work if given in the wrong dosage.
'TWenty percent of the patients had persis-
tent TMJ disorder or traumatic damage to the
area of the cervical spine. I found that this
could be treated in four sessions when associat-
ed with craniocervical, relaxation, and biofeed-
back therapies.
We have decided to expand this study.
Interested patients can contact my office for an
initial screening session which includes behav-
ioral and symptom evaluations, followed by oto-
a car dealer or mechanic will disconnect the
device. Most car dealers are sitting tight, waiting
for the final word from the Department of
Transportation. NHTSA attorney Rebecca
McPherson comments that if "car dealers won't
[disconnect the air bags] when you present the
deactivation authorization, then try a car modi-
fying company." These are businesses that spe-
cialize in car alterations for the handicapped.
Hundreds of people, many with hearing-
related disorders, have written to NHTSA for
permission to have their air bags disconnected.
NHTSA has granted about 100 such requests.
McPherson believes that the "market forces
will exert themselves" on this issue as con-
sumers continue to tell their elected officials
how they feel about it. If you have concerns
about the air bag law, please write or can your
U.S. senators and representatives.
Find NHTSA on the Internet:
www. nhtsa. dot.gov or contact Dr. Ricardo
Martinez, Director, NHTSA, 400 7th St SW,
Washington, D.C. 20590, 202/ 366-1836, fax
202/366-2106, e-mail: airbag.crash@nhtsa.gov
(continued)
laryngological and audiological evaluations. All
of the above tests are repeated at one, six, and
twelve months following the conclusion of the
fifteen session treatment program.
We thank the American Tinnitus Association
for its support in communicating our work to
the many tinnitus and hyperacusis sufferers. I
have every hope that the present state of affairs
("you will have to learn to live with it") can be
significantly changed by a multiple treatment
protocol.
Kenneth Greenspan, M.D.,
The Center for Stress and Pain Related
Disorders, 348 E. 51st St., New York, NY 10022
(212) 888-5140
Tinnitus Today/March 1997 9
NIDCD Funds $870,383 in Tinnitus Research
by Barbara Tabachnick, Client Services Manager
In 1987, the National Institute on Deafness
and Other Communication Disorders (NIDCD)
was born - an offspring of our nation's only
health-related research funding agency, the
National Institute of Health. The NIDCD's for-
mation resulted directly from the lobbying
efforts, regular presence, and massive grass
roots letter-writing campaign led by this and
other hearing-related agencies across the
country.
Since 1987, Dr. Gloria Reich has made the
annual trip to Washington, D.C. - accompanied
last year by ATA Honorary Director William
Shatner - to implore the House and Senate
Appropriations committees to continue their
funding ofNIDCD's budget. The pleas have thus
far been successful. Attaining a budget-within-
the-NIDCD budget for "tinnitus-only" research
((The Physiologic and Molecular Bases of
Tinnitus
Principal Investigators: Carol A.
Bauer, M.D., Southern fllinois
University School of Medicine,
Springfield, IL; and Dr. Donald
M. Caspary; Dr. Thomas J.
Brozoski; Dr. Richard f. Salvi; Dr.
Larry F Hughes
Award Amount: $196,594
Duration: 2 years
The objectives of this project are to further
develop a practical animal model of tinnitus
using behavioral psychophysical techniques and
to improve current understanding of the contri-
bution of central auditory structures to tinnitus
generation. Initial studies will be directed
towards developing an animal model of chronic
salicylate-induced tinnitus in rats using a modifi-
cation of the conditioned suppression model
originally developed by Dr. Pawel J astreboff. If
successful, the model will then be applied to the
study of other more common forms of tinnitus,
such as tinnitus related to noise-induced hearing
loss. This will allow future systematic investiga-
tion of potential therapeutics aimed at alleviating
tinnitus. Subsequent work will be aimed at
studying the changes that occur in neurotrans-
10 Tinnitus Today/ March 1997
has been a more challenging exercise over the
years. But this has been a bonus year.
ATA's present research funding strategy is to
provide "seed" money for innovative and well-
structured tinnitus research projects. Each
potential project presented to ATA is thoroughly
reviewed by five other professionals in the field
before approval for funding is given. When a
seed project is funded and then successful, its
researchers usually take their data to larger
funding bodies, like the NIDCD, to expand the
research.
Four of the five following NIDCD tinnitus
research studies began just that way - as ATA
seed projects. We are gratified by this level of
federal funding, and grateful to these scientists
for their focus and dedication.
The researchers describe the goals of their projects.
mitter function within auditory structures of the
brain in association with behavioral evidence of
tinnitus. This work will provide tinnitus investi-
gators with new insights into the mechanisms of
tinnitus generation.
Calcium Homeostasis and Tinnitus"
Principle Investigator: James F
Brennan, Ph.D., Dean of the
Graduate School, Professor of
Psychology, Loyola University
Chicago
Award Amount: $95,564
Duration: 2 years
An animal model of tinnitus,
developed over the last 10
years, will be extended to a new direction and
specifically test behavioral disturbances in calci-
um homeostasis within the cochlea which might
play a role in the generation of tinnitus. The
rationale underlying the animal model is as fol-
lows: A thirsty rat exposed to continuous back-
ground noise 24 hours daily is allowed to drink
only during 45-50 minute sessions. At specific
times during the session, the background noise
is turned off for 60 second periods. Then no
more than eight half-second pulses of mildly
aversive footshock are given so that the animal
stops drinking. The suppression of the drinking,
NIDCD Funds $870,383 in Tinnitus Research (continued)
then, is taken as a measure of reaction to silent
periods. When the aversive agent is no longer
given, the animal recovers its drinking during
the silent periods within five to seven sessions.
If some rats are injected with salicylate, the
injected animals do not detect the silent periods
like normal animals, and comparisons with nor-
mals in the recovery of drinking serve as mea-
sures of the strength of calcium in free drinking
water as a method of tinnitus attenuation.
A second series of experiments will examine
whether L-type calcium channel modulators
can modify salicylate-induced tinnitus acting at
the cochlear level, as reflected by disruption in
drinking behavior. Varying dose levels of the
L-type calcium channel antagonists, nimodipine
and nifedipine, and an L-type channel antago-
nist, Bay k 8644, will be administered as inter-
ventions in the predicted effects of salicylate-
induced tinnitus.
Finally, a third series of experiments will
assess the interaction of the calcium channel
modulators and the varying levels of calcium
in free drinking water on salicylate-induced
tinnitus.
((Tinnitus Related to Sound-Induced
Hearing Loss"
Principal Investigator:
Pawel f. Jastreboff, Ph.D., Sc.D.
Award Amount: $169,528
Duration: 2 years
Tinnitus related to hearing loss
is the most common type of
tinnitus observed in clinical
practice. Until now the study
~ - - - - ~ ! i i i of this category of tinnitus was
restricted to human studies because of the lack
of an appropriate animal model. Recent findings
obtained in our laboratory indicate that it is pos-
sible to induce tinnitus by exposing rats to a
high intensity pure tone, detect its presence and
extent in individual rats utilizing a behavioral
paradigm, and, notably, to perform these mea-
surements separating the effects oftinnitus
from those resulting from hearing loss.
Previous work with salicylate-induced tinni-
tus had shown that spontaneous activity of sin-
gle neurons recorded from one of the
subcortical auditory nuclei (inferior colliculus)
exhibited abnormal increase. It also had shown
a burst of high frequency activity emerge after
salicylate administration. These effects were
particularly pronounced for units with character-
istic frequencies corresponding to the behavioral-
ly-determined pitch of tinnitus, supporting the
postulate that this activity may be related to
tinnitus.
In this grant application, the study ofboth
the peripheral correlates of tinnitus related to
hearing loss, and its central representation will
be investigated. The functional properties of the
cochlea will be assessed by evaluating the func-
tion of active processes occurring in the inner
ear, and by evaluating the extent of the excitation
of the auditory nerve by sound before and after
behavioral testing. The behavioral testing is
aimed at detecting tinnitus in rats who have
been exposed to a high intensity pure tone. 'Ib
characterize tinnitus-related neuronal activity,
we plan to monitor spontaneous activity of the
single neurons in the inferior colliculus in rats
who have been previously assessed behaviorally
for the extent of tinnitus. Groups of animals
without additional experimental manipulations
and with conductive hearing loss will serve as
controls.
By correlating the extent of tinnitus (through
behavior data), the extent of changes occurring
in the inner ear, and the modification of the
spontaneous activity recorded from the single
neurons, it should be possible to point out a
potential mechanism of this common type of
tinnitus.
''Human Tinnitus Studied with
Functional MRI"
Principal Investigator:
.Robert A. Levine, Ph.D.
Collaborators: Bruce .Rosen,
M.D.; Michael Jenike; Jennifer
Melcher, Ph.D.; Barbara
Fullerton, Ph.D.; Michael Ravitz,
Thomas Talavage; .Robert
Weisskoff, PhD.; and
-..--. Miriam Furst.
Award Amount: $148,697
Duration: 2 years
Despite much speculation as to the physio-
logical processes leading to tinnitus, no definitive
mechanisms have yet been established. This
project adopts a new approach toward finding an
Tinnitus 1bday/ March 1997 11
NIDCD Funds $870,383 in Tinnitus Research <continued)
objective correlate of tinnitus by using a recently
developed non-invasive method for measuring
brain activity in humans.
We wish to apply functional magnetic reso-
nance imaging (fMRI) to the study of tinnitus.
This technique provides a safe way of imaging
brain activity with a high degree of resolution in
both time and space: independent measures can
be obtained with millimeter resolution on a sec-
ond-by-second basis. (Because we are concerned
about the noise levels of the fMRl testing, we are
currently using an ear muff system. We plan to
add an insert earphone system and noise cancel-
lation, and work with the designers of
the MRI scanners to reduce the noise at the
source.) The method has been applied in a num-
ber of sensory systems to study issues concern-
ing cortical processing in awake human subjects.
In a recent breakthrough, our group has shown
that fMRI can also be used to detect activity in
the subcortical auditory system (inferior collicu-
lus and medial geniculate body). Our prelimi-
nary results on normal and tinnitus subjects
indicate not only that auditory cortical areas in
normal subjects show quantifiable differences in
response to sounds but also that tinnitus subjects
can have abnormal cortical activity, consistent
with the hypothesis that changes in tinnitus per-
ception is associated with changes in neuronal
activity in the auditory cortex.
If successful, we will for the first time have
an objective measure of tinnitus. Our proposed
work will first characterize the nature of the
tinnitus (e.g. pitch match, loudness estimation
}
minimal masking levels, etc.) in each patient.
By design, the tinnitus population will include
subjects with a variety of hearing disorders.
Functional images of various cortical and subcor-
tical regions will be obtained in these tinnitus
subjects by comparing MR images acquired
while they are experiencing tinnitus with images
acquired while the tinnitus is not being per-
ceived during acoustic masking. The MR activity
in tinnitus subjects will be compared with that
of subjects without tinnitus under the same stim-
ulus conditions. These control subjects will
include both normals and matched-hearing loss
subjects with similar etiologies but no tinnitus.
12 Tinnitus 1bday/ March 1997
((Central Mechanisms Related to
Tinnitus"
Principal Investigators:
James A. Kaltenbach, Ph.D.,
Wayne State University; Donald
A. Godfrey, Ph.D., Medical
College of Ohio; Henry E. Heffner,
Ph.D., University of 7bledo.
Award Amount: $260,000
Duration: 2 years
Per Dr. Kaltenbach: Our studies will focus on
abnormal electrical activity (hyperactivity)
which develops in the dorsal cochlear nucleus of
hamsters following exposure to intense sound.
We will study how this hyperactivity progresses
over time, how it relates to the degree of hear-
ing loss, and whether it involves increases in
spontaneous discharge rates of individual
auditory neurons.
Dr. Godfrey's lab will perform chemical
analyses of cochlear nucleus tissue obtained
from my experiments. The goal of his work will
be to determine if the cochlear nucleus of ani-
mals exposed to intense sound shows long-term
changes in the amounts of chemical substances
which regulate electrical activity in the nervous
system. These studies will help identify the
chemical basis of abnormal activity being
studied.
Dr. Heffner's studies will determine if ani-
mals that are exposed to intense sound will
develop tinnitus. Using behavioral testing meth-
ods, he will determine if such animals experi-
ence auditory sensations with a similar quality
and pitch as those experienced by humans with
noise-induced tinnitus. I will also study his ani-
mals electrophysiologically to determine if such
sensations, if they occur, are accompanied by
hyperactivity in the cochlear nucleus.
Thgether, these studies will seek to develop
an animal model for noise-induced tinnitus
which will provide a basis for future work
aimed at identifying mechanisms underlying
this disorder and for testing chemical therapies
for its treatment.
We are deeply indebted to the American
Tinnitus Association for the very generous fund-
ing it provided in support of the preliminary
studies that led to this NIDCD award.
Treatments for Subjective Tinnitus
by Robert E. Sandlin, Ph.D., California Tinnitus
Assessment Center; 6505 Alvarado Rd #104 San
J
Diego, CA 92120, 619/229-0722
For more than a decade, considerable clinical
interest has been generated regarding the under-
standing and treatment of subjective tinnitus.
Much of the credit for this is due to the untiring
efforts of the American Tinnitus Association and
its Executive Director, Dr. Gloria Reich. Although
there has been a significant increase in the num-
ber of therapeutic approaches employed in the
treatment of tinnitus, none has been sufficiently
compelling to accept it above all others. As a
result, various "camps" have emerged, professing
allegiance to this or that philosophical approach
to treatment.
Such camps are positive signs of clinical
investigation and treatment, but fall short of
arriving at some consensus about the tinnitus
itself Th the credit of these camps, none pro-
claims an absolute cure. Further, each camp
continues its investigation, with the goal of
unraveling the mystery associated with the
etiology and treatment of subjective tinnitus.
The following therapeutic modalities were
selected for use at our treatment facility because
they seem to have the greatest potential to posi-
tively affect the lives of those who suffer from
ongoing, subjective tinnitus. It was not our intent
to deny what advantage other treatment methods
may offer. Rather, those selected were thought to
be the most advantageous.
Habituation Therapy: We cannot yet report
first-hand clinical successes with habituation
therapy since we have not yet taken patients all
the way through the protocol. Nevertheless, this
therapeutic approach offers a rational, scientific
basis for the treatment of tinnitus. It applies
known principles of the brain's ability to ignore,
or habituate to, non-threatening and non-
information bearing sounds. As a principal thera-
peutic approach, it offers the potential of com-
plete remission of tinnitus, without reliance on
continued use of medications or sound-producing
devices. By complete remission, one does not
mean that a cure has been achieved. Instead, the
patient no longer has a conscious awareness of
the offending tinnitus, or has concluded it plays
no significant, negative role in their daily lives.
Dr. Pawel Jastreboff and his associates need to be
applauded for their pioneering efforts in the
development of the rationale for habituation
therapy.
For those patients who refuse habituation
therapy because of the extended time frames
involved (up to two years), other more immedi-
ate approaches can be used.
Masker Th erapy: Although the reported suc-
cesses for masker therapy are not as great as
those reported for habituation therapy, some
patients have benefitted significantly from
masker use. We found that for some patients,
certainly not all, masker therapy provides imme-
diate relief and attenuates much of the stress
associated with tinnitus. We recognize that the
associated phenomenon of residual inhibition - a
very short-term cessation of the tinnitus - can
be of positive, clinical value. One must recognize
the early and consistent efforts of Drs. Jack
Vernon and Robert Johnson and their associates
in investigating and promoting this treatment
modality.
Cognitive Therapy: We have found that
most patients benefit from some form of direc-
tive counseling, regardless of the treatment plan
used. It has been our experience that relentless,
ongoing tinnitus can be a stress producer. Many
patients have misconceptions about tinnitus and
these misconceptions (negative distortions) tend
to perpetuate unfavorable and unwanted psycho-
logical and physiological reactions. Much of the
early work in cognitive therapy was due to keen
insights of David Burns, M.D. Fortunately, the
principles employed in cognitive therapy can be
applied directly to the tinnitus patient.
Since no therapeutic
approach meets the
needs for all suffer-
ing from tinnitus, a
program offering
several treatment
modalities may be
of significant value.
The following case
reports support this
concept:
Tinnitus Today/ March 1997 13
Treatments for Subjective Tinnitus (continued)
Case One
Several years ago, a 51-year-old female was
seen by me for a diagnostic evaluation and sub-
sequent management of her tinnitus. She had
experienced tinnitus for some time and was
unable to effectively cope with the disorder.
During the history taking portion of the
initial interview, she stated that her only relief
from her tinnitus was during her morning show-
er. So effective was the masking effect of water
beating down on her head that she took 12 to 13
showers in a single day.
A masker was recommended for this patient
and she agreed to its use. Subsequently, so effec-
tive was the tinnitus masker, that the patient felt
she had been released from the agonies generat-
ed by tinnitus. However, after about six months,
she was unable to mask the ongoing tinnitus
regardless of the level of the masking sound. She
stated, further, that her tinnitus was worse than
ever and that nothing she did offered relief.
Apparently the patient was experiencing
some interpersonal relationship problem that
could not be resolved. Her inability to mask the
tinnitus followed this episode.
This brief report underscores the necessity of
having more than one program to offer the tinni-
tus patient. Had we instituted an effective coun-
seling program based on cognitive therapy, we
might have managed the patient much more
effectively. Further, had we had in place a self-
help group, this report may very well have had a
different ending.
Case Two
14 Tinnitus Tbday/ March 1997
done. Eventually, she agreed to the use of a
masker device. Even though she was still aware
of her tinnitus, the masker device provided a sig-
nificant reduction in loudness level, permitting
her to cope much more effectively with the disor-
der. She reported periods of residual inhibition
lasting for more than one day.
The significance of this report is that we first
saw this patient more than ten years ago. She
continues to use masker devices and to experi-
ence a quality of life impossible without them.
Case Three
For a number of years we supported and
directed a tinnitus self-help group. During this
period of time we were able to observe the behav-
ior of many who attended the meeting. There
was one person in particular, a retired naval offi-
cer, who is representative of those who benefit
from self-help groups. He had complained bitter-
ly about his tinnitus and told everyone that
nothing could be done. Early on he complained
to others at the self-help meeting that he was
receiving little benefit from attending. Neverthe-
less, he continued to go to the meetings.
Over the course of several months his
I
attitudes changed about the value of self-help
groups. He finally confessed that his negative
reactions to the interaction with others having
tinnitus had been greatly reduced, if not eliminat-
ed. As a matter of fact, he admitted to the group
members that, as a result of his attendance and
interaction, he was able to cope much more effec-
tively with his tinnitus.
Although our staff is highly trained, we
cannot be proficient in all forms of therapeutic
intervention. Therefore, we have organized a
local referral network of selected otologists,
psychologists, psychiatrists, and qualified bio-
feedback specialists, to treat other manifestations
of the disorder.
The therapeutic programs that we offer may
change as more clinical and scientific informa-
tion b e c o ~ e s available. But our underlying pro-
fessional goal - to provide ongoing therapeutic
programs suited to the individual needs of
patients - will remain constant.
ATA's Support Network- Join In!
by Barbara Tabachnick, Client Services Manager
When you first j oin ATA, a Tinnitus Support
Netv.rork list is sent to you. A new and updated
list is sent to you every year thereafter when
you renew. The list includes the names, address-
es, and phone numbers of volunteers who facili-
tate support groups and/or who welcome phone
calls and letters from others with tinnitus. If you
need the contact and the conversation, these
volunteers are there for you.
Wbo are these people on our list? They are
men and women; married, single, and widowed.
They range in age from 29 to 82. They are
bakery clerks, accountants, and psychologists;
nurses, students, and teachers. They are people
who at one time wrote or called us and said "I
want to volunteer. I want to help." We never
turn down an offer like that.
Our Self-Help Packet is an introduction to
the world of support-giving through ATA. Write
to us for it. Join in! We ask a potential support
group leader to send us the zip codes from his
or her surrounding area, then let us know the
selected meeting place and time. We then create
and print the first group meeting announce-
ments, and mail them to approximately 300
people in those zip codes. ewe pull the names
from our data base. These people are likely to
be interested in attending because they have
already contacted us for tinnitus information.)
We also send brochures and other materials to
the group leaders to hand out at the meetings.
From that point on the groups are self-funding.
We do, however, keep the support volunteers
networked through their own newsletter (Good
News) which helps them share ideas about meet-
ing topics, guest speakers, fund raising, and the
how-to's of dealing with troubled callers.
If you're looking for a group to attend, check
your list. If there is no group near you, check
with us; new groups are starting all the t ime. If
you want to start a tinnitus support group, just
let us know. Help will be on the way.
A final note: There are a number of unsung
heroes who volunteer for ATA in other ways.
Some people, like Cheri Cope in Bradenton, FL,
represent ATA at local health fairs on a steady
basis. But Cheri does more than attend the fairs.
She scours the local newspapers for health con-
ferences and expos that might be appropriate.
She also contacts hospi-
tals, malls, and schools to
get in on their health
fairs; and contacts the
Chambers of Commerce
in surrounding cities to
keep up on their public
health events. Then she
- -----__.;;=--' negotiates for free booth
Cheri Cope, A'D\ Volunteer space for them all! To
Cheri - and to all of our volunteers - a
tremendous Thank You!
A Big Welcome to our New Group
Facilitators:
Lainie Ganley
No. Jersey Tinnitus Support Group
Holy Name Hospital
718 Teaneck Rd.
Teaneck, NJ 07666
201/833-7177
Susan Zabinski
3532 Arlington St.
Laureldale, PA 19605
610/921-3522
Myrna Calkins
(former telephone-only contact)
1409 Girard Blvd. SE
Albuquerque, NM 87106
505/268-8754
Loretta Rose
169 Wildflower Lane
Pleasanton, CA 94566
510/462-0498
. .. and to our New Telephone and
Letter contacts:
James Dickerson
1250 Byewood Lane SW
Atlanta, GA 30314
404/753-7547
Timothy Hrehocik
2819 Freeland St.
McKeesport, PA 15132
412/673-1513
Tinnitus 10day/ March 1997 15
The Similarities Between Severe Tinnitus
and Chronic Pain
by Aage R. M(()ller, Ph.D., Professor of Neurological
Surgery, University of Pittsburgh School of Medicine
There are many reasons why severe tinnitus
is difficult to study. One reason is that we know
too little about what causes it. We therefore need
to explore all of the possibilities. One way to do
this is to use the results of research that has
been done on similar disorders. Chronic pain
(pain that is unrelenting and that has no obvious
cause) is similar to tinnitus and has been studied
much more extensively than tinnitus. It is a good
place to start.
Why do we want to compare tinnitus and
pain? Simply because knowledge that is gained
from studying one may help us understand the
other. Research on pain has shown that certain
nerve cells in the spinal cord and/ or the brain
can change the way the cells react to informa-
tion from receptors in the skin. Thus a pain syn-
drome results. Similarly some nerve cells in the
brainstem can change the way they respond to
sound and thereby give rise to a constant sensa-
tion of a sound being present even in the
absence of any sound reaching the ear. Thus tin-
nitus. This transformation of the function of
nerve cells is known as neural plasticity.
An important similarity between tinnitus and
pain is that there are many different forms and
causes of both. Acute pain caused by bruising or
cutting is very different from chronic pain that
occurs for a long time after an injury or for no
known reason. The acute pain is caused by stim-
ulation of certain nerve fibers, known as pain
fibers, but the chronic pain is caused by changes
in the central nervous system (spinal cord or the
brain).Even though chronic pain is often caused
by changes in the nervous system, a patient per-
ceives chronic pain as existing in a certain part
of the body where something went wrong.
The changes in the function of the brain
(central nervous system) that cause a person to
perceive a sound when no external sound is pre-
sent may have developed over time as a result of
an injury to the ear or the hearing nerve. The
changes may come about without any explana-
tion. There are also forms of tinnitus that are
caused by something that is actually wrong in
the ear.
16 Tinnitus 'Ibday/ March 1997
Phantom pain is one very clear example of
chronic pain that is not directly caused by
injury to a body part. (Phantom pain is pain
"felt" in an amputated limb.) It is known that
such pain must be generated by abnormal activi-
ty in nerve cells in the part of the brain that
interprets the pain as occurring in the amputat-
ed limb. In the same way, people can have
severe tinnitus although they are deaf. Other
people can experience severe tinnitus after the
auditory nerve has been severed - essentially
amputated - via an operation. Tinnitus, in
those cases, must be generated in the brain.
So why is it that nerve cells in the brain can
change their function so that the person feels
pain or hears tinnitus? This continues to be the
focus of our research which has been supported
by the American Tinnitus Association. We
study, as do other investigators, the changes in
the nervous system that cause some forms of
tinnitus to occur while we search for ways to
reverse these changes.
One of many causes of chronic pain and
tinnitus is an irritation of a cranial nerve by
a blood vessel. If it is the nerve that provides
sensation of the face (the fifth cranial nerve or
trigeminal nerve) then the result may be a
shooting pain in the face, known as trigeminal
neuralgia or tic douloureux. If the hearing nerve
(which is part of the eighth cranial nerve)
becomes irritated, then the result might be tin-
nitus. When the blood vessel that is in contact
with the trigeminal nerve is moved off the
nerve, the facial pain is alleviated. This treat-
ment is now in general use with an 80-85%
success rate. The same treatment (moving the
blood vessel in contact with the hearing nerve)
is used to treat severe tinnitus but the results
are not as good: About 40% experience tinnitus
relief. While facial pain usually disappears
immediately after such an operation, it can take
as long as two years before the tinnitus is allevi-
ated by this form of operation.
The Similarities Between Severe Tinnitus and
Chronic Pain (continued)
The reason that tinnitus is not immediately
alleviated, we believe, is that the changes in the
nervous system that are brought about by injury
or irritation of the auditory nerve are more diffi-
cult to reverse. People who have had their tinni-
tus for a long time before it is treated often
experience that it takes a longer time before
they experience relief.
There are other similarities between tinnitus
and chronic pain that are worth noting. Chronic
pain is often accompanied by an over-sensitivity
to touch of the skin near the place where the
pain is felt. In the same way, severe tinnitus is
sometimes associated with an over-sensitivity to
sound. Some forms of pain can be alleviated by
touching the skin or even better by electrically
stimulating the skin (TENS, transcutaneous
nerve stimulation).This is similar to the observa-
tion that some forms of tinnitus can be alleviat-
ed by sound (tinnitus maskers).
The efficiency of microvascular decompres-
sion of the trigeminal nerve in treating facial
pain suggests that a similar treatment might
help sufferers of severe tinnitus. The use of
electrical stimulation of the skin (TENS) to alle-
viate chronic pain suggested that tinnitus
maskers and in some instances, electrical stimu-
lation of the ear, might relieve some forms of
tinnitus. Some of the medical treatments, like
baclofen, that act on the nervous system to
reduce its over-activity are very efficient in the
treatment of facial pain, and can also help alle-
viate tinnitus. But other forms of medically
effective treatments for facial pain, like Thgretol,
are not as effective in the treatment of tinnitus.
Pain and tinnitus have many similarities, and
clearly many major differences. Further explo-
rations of their similarities will likely lead to the
development ofbetter tinnitus treatments.
ATA's Support Network - Join In! (continued)
Tinnitus /Meniere's Pen Pal
Support Network
The on-line access is no
longer available, but the net-
work continues! The Pen Pal
network offers its members
either a printed copy of the
pen pal list or a 3.5" disk with
the information formatted in
Microsoft Word 6.0. There is
- - ~ - - . . . - _ _ . no additional charge for the
Lorraine Cherkas, disk. Send $5 U.S. inside the
ATA Pen Pal Network U.S. or $10 U.S. outside the
Coordinator
U.S. to Lorraine Cherkas,
2559 35th Ave. N., St. Petersburg FL 33713.
(Note: The network list does not include phone
numbers of members. Says Lorraine, This support
network is geared towards letter writing. I leave it
up to the judgement of individuals to give out their
phone numbers.)
A Sad Goodbye -
To Paul Sestito, an ATA telephone and letter
support contact in Paxton, MA who recently
passed away. Paul was a warm and gentle
individual, and a great fan of ATA. He wanted
more medical people to get involved with this
organization, and most especially for them to
learn everything possible about tinnitus so they
could in turn offer hope to, in his own words,
"us tinheads!"
A Fond Goodbye -
Tb Dr. Trudy Drucker and Joe Alam of
Bergen County, NJ, facilitators of ATA's first
tinnitus self-help group, founded in 1982. In the
group's first announcement, Trudy invited
patients and professionals to come to an organi-
zational meeting to "sound off about tinnitus."
At that time, the meeting format was undeter-
mined. The frequency of group meetings was
not established. The place of the meetings was
undecided. And the source of ongoing funding
was unknown! It was no doubt equally
unknown that their group would thrive for more
than a decade and a half. Trudy and Joe pass
the baton on to Lainie Ganley from Teaneck, NJ.
Our best wishes to all of them.
Tinnitus lbday/March 1997 17
Personal Preferences
by Barbara Tabachnick,
Client Services Manager
One forthright person with tin-
nitus calls himself a "tinnitus
sufferer" and insists that we do
the same. Another person with
tinnitus more optimistically
refers to himself as a "tinnitus
experiencer" and wishes that
we'd do the same. One wants to
lobby to have tinnitus classified as a disease; the
other wants to habituate to it and forget it. We
often use the term "tinnitus patient," and get a
raised eyebrow or two from our members when
we do. ryve know that many people with tinnitus
are not currently seeking medical care.) The var-
ied responses are not surprising. People with tin-
nitus had their unique personalities up and
running long before their tinnitus arrived.
Consequently, they respond to it as they would to
any life problem. They react to their tinnitus as
their individual natures dictate they will.
We are certainly conscious of individual pref-
erences and sensitivities. We also know that we
upset someone regardless of the words we choose.
And which is it: support group or self-help
group? There are in fact the "self-help" followers
and the "support" devotees. We use these words
interchangeably although at first blush they have
different meanings. As we see it, the reason to
give support is to direct someone in distress
towards a path of hope and self-sufficiency. This
means that support groups are also self-help
groups. It just depends on whether you're
coming or going.
Another question begs an answer: Are tinnitus
support groups really useful? Some people feel
that turning their attention towards the noise,
like in a support group setting, will increase the
noise. If that is the case for you, we suggest that
you avoid support groups. If the opposite is true,
we suggest that you seek them out.
We've always known that support groups are
not for all people, just as maskers are not for a11
people. (Some would not dream of introducing
yet another sound to their overburdened ears.
Others crave the "shhh" sound of the maskers to
distract their attention away from the internal
sound.) Xanax is not for all people. (Some become
18 Tinnitus Today/ March 1997
too drowsy because of it or fear the addictive
nature of the drug. Others cannot live without
it.) We've also known that for a vast number_ of
people, getting support from others - and g:tv-
ing it too - is a gift and a great relief. .
In a recent conversation, a caller mentwned
to me that she was going to see an ear doctor
soon to find out if she in fact had tinnitus. I
said, "If you hear it, you have it!" How often we
forget to rely on ourselves for obvious informa-
tion! No one needs to or, for that matter, can tell
me if a pair of shoes that I'm wearing feels com-
fortable, or if I like a particular flavor of ice
cream, or if a medication makes me feel better.
In those and in most situations, only I know.
The principle is the same with seeking support.
If we feel better after we reach out for help,
then reaching out for help helps.
Amazingly, the pronunciation of the word
tinnitus itself has been the center of mild dissen-
sion. At ATA, we place the accent over the sec-
ond syllable and pronounce the second "i" like
"eye" (tin night us). That is also the pronuncia-
tion listed in Dorland's Medical Dictionary.
Some people in other parts of the country place
the accent on the first syllable, and pronounce
both the second "i" and the "u" like the "i" in
the word "if' (tin i tis). The tin i tis pronuncia-
tion is used in many European countries but not
all. (In Germany, it's tin i taos.) In France, it's
another word altogether: "acouphene."
There are those who think that a single pro-
nunciation is necessary to unify the collective
world consciousness about this disorder. There
are others who think that their time could be
better spent thinking about something else.
There is no typical person with tinnitus. No
indeed. Some people are quietly hopeful; others
outspoken and angry. Some are sulle_n; others .
unsinkable. The different causes (n01se, ototox1c
drugs, head injuries, illnesses, etc.), and types
(pulsatile, constant, single tone, multiple
sounds, high-pitched, low-pitched, etc.), further
segregate tinnitus sufferers/ experiencers/
patients from each other. It sometimes seems
that having tinnitus is the only thing that people
with tinnitus have in common.
There is one other exception. All people
with tinnitus want the noises to end. Our per-
sonal preference is to focus our energies on that.
Profile: New ATA Board Members
Jack A. Vernon, Ph.D.,
former Director of the Oregon
Hearing Research Center
He says:
I have three goals for ATA -
1) 7b try to help increase mem-
berships not just by appealing to
people who have tinnitus, but
by appealing to all people. I
want to deliver the message, "You don't have to have
tinnitus to belong to this worthwhile organization.
(Jack, who talks with tinnitus patients from all
over the world, now asks each person he talks
with to get one other person to join ATA. It's the
only "payment" he requires for his services.)
2) 7b work with Gloria Reich and a professional
fund raiser to appeal to foundations and commer-
cial organizations for big funding of ATA. We need
to investigate all avenues for funding.
3) 7b influence the rest of the board to focus on
these goals.
Jack has unparalleled experience with the
struggles faced by people with tinnitus. His
appointment to the board is a significant step
forward for ATA.
WANTED!
I
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, P.O. Box 5, Portland, OR 97207.
If you are u.sing UPS or another shipper; ship to
our street address. 1618 SW 1st Ave., #417,
Portland, OR .97201.
What happens to the aids that you turn 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
old aid could give someone the gift of hearing!
-
Megan Vidis, M.A.,
broadcasting producer
She says:
As a younger tinnitus sufferer
(age 38), I face a lifetime
struggle against this disorder.
I was lucky enough to be
referred to the resources the
ATA has to offer.
In the three years since the onset of my tinni-
tus, I have traveled the gamut of healers both
allopathic and alternative. In this frustrating and
frequently frightening search for treatment I have
found one constant ally: the ATA.
With ATA's assistance, I started the first support
group in Chicago in years. We promoted a news
story about tinnitus to a nationally broadcast news
organization and we continue to search for new
avenues of outreach to sufferers in our community.
I think the most important thing that the ATA
can do in the next five years is work on increasing
public visibility and membership. Everything else
flows from this. If we have strong name recognition
with the public, if they understand what tinnitus is
and what it means to have it, then sufferers will
seek out our help.
Coming from a support background I also feel
that it is imperative that we increase our support
group network. This is where sufferers find solace
and the ATA finds new members and grassroots
volunteer support.
We send warm and grateful thanks to Megan
for donating her impressive and abundant
talents to ATA.
TABLETOP WATER FOUNTAINS
FOR TINNITUS RELIEF
Natural water sound cascading over rocks in
beautiful hand thrown ceramic basin provides
relief. Choice of colors to match decor. Portable.
For more info, contact: Tinnitus Fountains,
4307 N.E. Brazee, Portland, OR 97213 or
e-mail Oregon7@aol.com
See our website at
http:/ / members@aol.com/Oregon7 /index.html
Tinnitus Thday/March 1997 19
Questions and Answers
by Jack A. Vernon, Ph.D.
[Q]
Mr. D. from Massachusetts indicates that
he has multiple sclerosis and that sud-
denly one day he perceived a piercing
tone in the right ear which turned into deafness
in that ear the following day. The deafness last-
ed for two days and then recovered but the high
pitched tone, which has persisted to the present
time, gets louder after exercise. A hearing test at
this time was reported as normal. Mr. D. wants
to know if the MS caused his tinnitus and the
one episode of hearing loss.
You have brought up several interesting
points. I doubt that the MS caused your
episode of hearing loss although MS can
cause hearing impairment and, in some rare
cases, it is associated with a sudden hearing
loss. Your description sounds much more like
what is known as "Sudden Hearing Loss" (SHL),
first reported in 1944. Despite many investiga-
tions since that time, the problem of SHL
remains a diagnostic and therapeutic enigma.
The vast majority of cases are reported as "idio-
pathic" meaning that the cause is unknown.
According to one investigation, two-thirds of
all SHL patients display spontaneous recovery.
One study conducted in Israel found that 71% of
SHL patients complaining of tinnitus recovered
their hearing while only 39% who did not com-
plain of tinnitus recovered their hearing. This
may be one of the very few situations where the
presence of tinnitus has a positive implication.
All investigations of SHL indicate the impor-
tance of seeking medical assistance as early on
as possible. Most patients who recover do so in
the first week. A study done at Stanford
University indicates that only 5% of the patients
who waited as long as three weeks to seek med-
ical help recovered their hearing.
Another study of 100 patients with SHL con-
ducted in London found that of the 77 patients
with tinnitus, 53 (69%) suffered primarily an
inner ear disorder. Of the 23 patients without
tinnitus only eight (35%) had an inner ear disor-
der. The investigator concluded that not only
20 Tinnitus Today/ March 1997
was tinnitus associated in most cases of SHL
I
but the disorder was found to be primarily due
to inner ear problems as opposed to problems in
the higher brain centers.
If the SHL and the tinnitus are part and par-
cel of the same etiology, why is it that your
hearing loss recovered but your tinnitus persist-
ed? One very interesting question! I could not
find any data on how many cases of tinnitus
associated with SHL spontaneously recovered
but I assume the numbers are very low.
However, keep in mind that those patients for
whom both the tinnitus and the hearing loss
recover probably do not contact us or any other
source.
[Q]
Mr. S. from Ohio asks if there is any
relationship between a prolapsed mitral
heart valve and pulsatile tinnitus. He
also mentions that his tinnitus is too high-
pitched for current masking technology.
If your tinnitus is exactly in
phase w1th your heart beat, it is likely
that the prolapsed mitral valve is respon-
sible. At least that is what I would have said
until you indicated the high-pitched nature of
your tinnitus. Pulsatile tinnitus is usually a low-
pitched affair which can easily be masked.
Indeed, it is usually not noticed during routine
daytime activities but is heard in the quiet of
nighttime. I have an artificial heart valve which
I can hear at bedtime (or whenever it is very
quiet). I mask that sound with a Marsona sound
generator. You might find the Moses/ Lang
masking CD to be of help (available from OHRC,
3181 Sam Jackson Park Rd. , Portland, OR 97201).
The Moses/ Lang CD contains seven different
bands of masking noise each of which is digital-
ly produced and each of which extends up into
the very high frequencies. 'TYpically we send
these discs to patients to try, and if any particu-
lar masking band works for them they simply
put that band on "repeat" and use it as often and
as long as they like. If a patient wishes to keep
the Moses/ Lang CD, he or she can send a check
to OHRC for $15 to cover costs. If the CD does
not prove useful, it can be returned to OHRC.
Questions and Answers (continued)
[Q]
Mr. R. from New Jersey makes an
interesting request when he asks that I
write "a comprehensive dissertation" on
MRI (Magnetic Resonance Imaging) background
sounds.
The level of sound produced by many
MRis are beyond that which can safely
be endured by many tinnitus patients.
MRI uses magnets that are activated in such a
manner as to produce at least 93dB of noise.
Since an MRI test can last up to 45 minutes, that
is entirely too much sound exposure for tinnitus
patients. We have heard from nine patients
whose tinnitus was permanently exacerbated by
MRI and two other patients who attribute the
initiation of their tinnitus to an MRI experience.
MRI should always be conducted with ear plugs.
There is now an open and nearly silent MRI, so
we look forward to a less invasive form of this
test. (The current open MRI does have resolu-
tion limitations so it may not be the test you
need. Ask your doctor.) MRI is an important
way to view the structures of the brain and even
to map functions in the brain. If the new gener-
ation of MRI can map functions, such as tinni-
tus, it may ultimately provide for the possible
elimination of the perception of tinnitus.
[Q]
This is from Mr. B. in PA: In the past I
have asked you many questions, either
by mail or by telephone but today I wish
not to ask a question but rather to provide an
answer! I have had increasingly severe hypera-
cusis and tinnitus over the past 15 years. My
major problem was that exposure to almost any
level of sound caused my tinnitus and hyperacu-
sis to increase. All outside noises were intolera-
ble to the extent that I could not attend family
affairs such as our daughter's wedding, or
reunions or gatherings of any sort. Restaurants,
shopping malls, ball games, and street traffic
were all off limits to me.
Through your suggestion, I was encouraged
to contact Mr. James Nunley of the Oregon
Hearing Research Center (503/ 494-8032). Mr.
Nunley provided me with the answer to my
hyperacusis condition. It might also have the
same effect for other hyperacusis patients. He
has devised a special hearing aid for hyperacusis
patients. Since I have normal hearing, that may
sound a bit strange. But the fact is that these
special hearing aids block the ear canals so that
minor amplification is necessary to overcome
the attenuation effect of the blocked ear canals.
These special hearing aids compress or actively
reduce loud sounds so that all loud sounds are
immediately reduced to a level of no more than
60 to 65dB. This means that I can now go out
and about with no fear of being suddenly bom-
barded by unexpected sounds. Mr. Nunley and I
have named these special hearing aids "Star-
2000."
The Star-2000 has reestablished a normal
quality of life for me. I can now go to restau-
rants, shopping malls, or anywhere I wish to go.
Recently, I picked up our grandson only to have
him scream in my ear. Previously that one sim-
ple action had laid me low for weeks, but this
time it produced no problem at all. These hear-
ing aids have given me a new life for I am no
longer a prisoner in my own home - or any-
where else.
Thank you, Mr. B., for sharing your
experiences. If other patients have
results similar to yours, the Star-2000
will likely make a significant difference for
hyperacusis patients.
Notice. Many of you have left messages requesting
that I phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9:30a.m.- noon and 1:30-4:30 p.m.
(503/494-2187). Please send your questions to:
Dr. Jack Vemon c/o ATA, Tinnitus 'Ibday,
PO. Box 5, Portland, OR 97207-0005.
Tinnitus Today/March 1997 21
Tinnitus Poetry Book- Available now!
Never Again To Know A Noiseless Shooting Star
edited by Daphne Crocker-White, Ph.D.,
paperback, 32 pgs.
From the editor's preface to the book: "It
has been my privilege to be the recipient of
so many valiant poems ... The courage and
tenacity of the authors' quest to understand
their suffering, to make a personal truce with
their unrelenting noise and in many cases to
surrender to the inevitable with good humor,
has been awe inspiring .. . I salute the authors
of this anthology."
Developed by Speech
Pathologist. Mary Kleeman.
the I See What You Say
program provides an
interesting, new approach to
acquiring speechreading
skiUs for the hard of hearing.
"Instruction and
practice are
imaginative,
easy to follow and
enjoyable."
Journal Self Help for
Hard of Hearing People
Learn Lip Reading
wirh this Fun,
Self-Help,
Easy to Use,
Lipreading Course
Video & Manual
Compensate for Noise & Ti nnitus
Aid Speech Discrimination
Enhance Communication
Stop Feeling Isolated
This clearly presented format of
i.nslruction includes practice activities
for single words to stories. Sixteen
speakers are presented.
****
Amel1can
University
Washington, D.C.
22 Tinnitus 'Ibday/March 1997
The title Never Again To Know A Noiseless
Shooting Star comes from a Lucille Whitehurst
poem, which is included in the book.
Th order, send $10 plus $1.50 shipping and
handling to:
Daphne Crocker-White
1290 Howard Ave. #323
Burlingame, CA 94010
Make checks payable to:
Tioga Trading Company
(California residents, add 85 tax per book.)
Dr. Crocker-White is generously donating all profits
from this book to ATA.
PSYCHOACOUSTIC EQUALIZER
HARMONIC FILTER
SEAWAV NOISE PROCESSOR
SINEWAVE NOISE PROCESSOR
TINNITUS DIAGNOSTIC CIRCUIT
Priced at $620. 30-day money
back guarantee and one year
warranty is included.
lATERAl CIRCUIT TO ADJUST FOR RIGHT OR LEFT EAR SENSITIVITY
ClASS A HEADPHONE AMP
CONNEaiON FOR RECORDING CAPABILITY
SEPARATE IN/OUT SWITCH FOR EACH SECTION
The Stereo Therapy Tinnlrus Masker unit contains five different function
sections. Each section can be used separately, or all sections can be used at
the same time. The various functions are easily understood and controlled.
TM five functionsections present many clifferent sounds and noises critical
in masking and treating tinnitus. Some of its major functions are:
A psydlOCKous!ic eqoolizer allows complete flexibility in lhe progromming of music for therapy
ond reloxotion. A leO"IIOVe noise processor aeotes o wide voriely of surf soonds. from plocid
rollilg waves to stormy sees, stutiHlf-lfliKJn roodulolioo tirruils mcke possible o wide votiely
of soonds. White noises or filtered noises ore mode o vorioble bandpass filter.
All effe<ts con be heord directly, or modified through lhe psycboocotmic equoizer, ol0119 wilb
individual volume settings. The sine-wove generotor con produce single IOiles from 85Hz up to
20 kHz with completely isolcted frequency ond volume A diognosli< circuit makes it
to set the ootput volune of the aeoted noise ond tone in perfe<t harmony to lhe
mUll< progrom masking the tinnitus. The dynamic heodphone Offill con be set in bolance oro
volume. Rea moonted switches used for vorious leh/rig\lr listening levels. Also a sw11th for
CD/line sensilivi1y (hi(/ljlow level) to recording outs (Stefal) i1ll toping individoolly toilored
masking programs.
Thestateoftheart design incorporated throughout the Synphonie Relax 2
makes it the most innovative and effective tinnitus masking and
system available anywhere
information 01 to place an order:
nlewr,amo g. campbell route #2 p.o.box 288 vinton, VA 24179
Targeting
I 997 ATA REGIONAL MEETINGS
~ ~ ~ ~ . - ~ ~ ~ ~ ~ ~ ~ ~ . - Tinnitus
DESIGNED TO PROVIDE AN INTRODUCTION OR REVIEW OF EVALUATION,
TREATMENT, AND MANAGEMENT STRATEGIES FOR TINNITUS, THIS MEETING WILl.
INCLUDE THEORETICAL DISCUSSIONS AS WELL AS HANDS-QN DEMONSTRATIONS FOR
PATIENTS AND PROFESSIONALS.
PARTICIPANTS WILL GAIN ENHANCED KNOWLEDGE ABOUT THE TREATMENT
AND MANAGEMENT OF TINNITUS UPON PROGRAM COMPLETION.
ATTENDEES WILL INCLUDE AUDIOLOGISTS, HEARING AID DISPENSERS,
NURSES, PHYSICIANS, AND PSYCHOLOGISTS, AS WELL AS PEOPLE WITH TINNITUS,
FAMILY MEMBERS AND/OR CARE GIVERS.
FOR PATIENTS AND PROFESSIONALS
ANAHEIM CALIFORNIA - APRI.L I
BERKELEY CALIFORNIA - APRIL 3
MURRAY GROSSAN MD TowER ENT CTR
MALVINA C LEVY MA $AN FRANCISCO HEARING CS. SPEECH CTR
STEPHEN M NAGLER MD ATLANTA GA
GLORIA E REICH PHD AMERICAN TINNITUS AssOCIATION
ROBERT E SANDLIN PHD CALIF TINNITUS ASSESSMENT CTR
RoBERT SWEETOW PHD UNIVERSITY oF CALIFORNIA SF
BARBARA TABACHNICK AMERICAN TINNITUS ASSOCIATION
PLUS OTHER PROFESSIONALS AND OUALIFIED INSTRUCTORS
FROM ALl.. ASPECTS OF THE HEARING FIELD
9 : 00AM- NOON GENERAL SESSION EXPLORING TINNITUS: PREVALENCE, DEMOGRAPHICS, PROBABLE CAUSES, TREATMENTS,
RESEARCH, AND AN OPEN PUBLIC FORUM
NOON - I : 00 PM LUNCH (THE REGISTRATION FEE INCLUDES LUNCH AND TWO BREAKS)
I: I 5- 5:00PM BREAKOUT SESSIONS
PATIENTS/SUPPORT GIVERS: UNDERSTANDING, COPING TECHNIQUES. TREATMENTS, BIOFEEDBACK,
SELF-HELP AND HELPING OTHERS.
PROFESSIONALS: PATIENT INTERACTION (INTERVIEW, HISTORY, ASSESSMENT), DIAGNOSTIC
TESTS AND MANAGEMENT STRATEGIES
YES! I WILL ATTEND THE FOLLOWING ATA REGIONAL MEETlNG:
0 TUESDAY APRIL I , I 997 AT THE ANAHEIM MARRIOTT HOTEL
0 THURSDAY APRIL 3, I 997 AT THE BERKELEY MARRIOTT HOTEL
NAME TEL _______________________ __
BUSINESS NAME FAX _______________ _
ADDRESS ____________________________________ CilY _______________________ STATE ZIP ___ -__ _
REGISTRA110N:
BY MARCH 15
AFTER MARCH I 5
CONTINUING EDUCATION CREDITS
0 ENCLOSED IS MY CHECK
0 CHARGE MY' VISA/MASTERCARD
ACCOUNT#
ATA MEMBERS
$50
$60
NC
- - - - - - - - - - - - ~ - - - - - - -
ExPIRATION DATE. ______ TELEPHONE # ________ _
SIGNATURE ______________________ _
PLEASE NOTE:
* PRE-PAYMENT OF MEETING FEES IS REQUIRED
* FEES INCLUDE MATERIALS, 2 BREAKS, AND LUNCH
* NoN-MEMBER FEES INCLUDE A ONE-YEAR INDIVIDUAL MEMBERSHIP IN ATA
NoN-MEMBERS
$75
$ __ _
$85
$ ____ _
$10
$ ____ _
TOTAL ENCLOSED $ ___ _
I AM ATTENDING BECAUSE:
I HAVE TINNITUS
A FAMILY MEMBER HAS TINNITUS
I TREAT TINNITUS PATIENTS
OTHER __________ _
* CANCELLATION POLICY: AFTER MARCH I 5, $I 5 PROCESSING FEE DEDUCTED FROM REFUND
PROFESSIONALS PLEASE INDICATE CEUs (CONTINUING EDUCATION CREDITS) DESIRED: ASHA NIHIS STATE
-- --tTT.3/071
1111
..
1111
..
1111
.. REGISTER TODAY - SPACE IS LIMITED ~
1 1 1 1 1
..
1111
..
1111
MAIL THIS FORM (OR PHOTOCOPY) TO: ATA, PO BOX 5, PORTLAND OR 97207-0005
fAX IT TO (503) 248-0024 OR CALL (503) 248-9985
Announcements
Management of Tinnitus and
Hyperacusis Patients Based on a
Neurophysiological Model
May 1-3, 1997, in Baltimore, a professional
training course offered by Pawel J. Jastreboff,
Ph.D., Sc.D., Professor and Director, Tinnitus
and Hyperacusis Center; University of
Maryland.
Per Dr. Jastreboff: The goal of the course is
to present in detail our approach for treating tin-
nitus and hyperacusis patients, including the
theoretical and practical aspects of tinnitus
retraining therapy. An outline of other methods
will be presented while focusing on the imple-
mentation of our approach, so that the partici-
pants may have the option of using our protocol
in their clinical practice.
The fee for the course is $1,250 which
includes a manual, breakfast, lunch, and coffee
breaks for each day.
The course is planned for a limited number
of participants. If you are interested and would
like to reserve a place, please call Donna Earling
at 410/706-4339 or send e-mail to:
dearling@surgery2.ab.umd.edu
Fifth Annual Conference on the
Management of the Tinnitus
Patient
September 19-20, 1997, Iowa City, Iowa USA
The University of Iowa
Department of Otolaryngology - Head and
Neck Surgery, Department of Speech Pathology
and Audiology
Guest Speakers:
Robert W. Sweetow, Ph.D., Director of
Audiology, University of California, San
Francisco, CA
Michael Bl ock, Ph.D., Director of Research
and Thchnical Services, Starkey Laboratories,
Eden Prairie, MN
Gloria Reich, Ph.D., Director of American
Tinnitus Association, Portland, OR
Soly Erlandsson, Ph.D., Clinical Psychologist,
Goteborg University, Sweden
24 Tinnitus 'Tbday/ March 1997
University of Iowa Faculty: Paul Abbas, Ph.D.,
Auditory Physiologist; Bruce Gantz, M.D.,
Neuro-otologist; Brian McCabe, M.D., Neuro-
otologist; Richard '!yler, Ph.D., Audiologist;
Christie Noval{, Ph.D., Clinical Psychologist
Epidemiology, Physiology, Audiological
Measurement, Psychology, Habituation Training,
Cognitive Behavior Therapy, Medical and
Surgical Evaluation and Management, Hearing
Aids and Maskers, Hyperacusis, Tinnitus in
Children, Support Groups, Psychotherapy,
Relaxation Therapy, Patient Forum
Registration fee:
Audiologists, Nurses, Residents, other health care
professionals, and tinnitus patients: $195
Physicians: $385
Registration after September 1, please add $25
For further information contact: Sue Templin,
Conference Secretary, The University of Iowa,
Department of Otolaryngology - Head and
Neck Surgery, 200 Hawkins Dr. C21-3GH, Iowa
City, IA 52242; ph. 319/356-2471;
fax 319/353-6739;
e-mail: sue-templin@uiowa.edu
International Noise Awareness
Day- April 30, 1997
Sponsored by the League for the Hard of
Hearing in the U.S., this day is being set aside to
bring public attention to the hazards of living in
excessively noisy environments. Many organiza-
tions, including ATA, are lending support to the
worldwide activities planned for that day. The
League asks that everyone observe "60 seconds
of no noise from 2:15 to 2:16p.m. -wherever
you are." For more information, contact Nancy
Nadler at 212/741-3147 or
http://www.lhh.org/noise.htm
Birth Announcement
Griffin Vitus Hunter, a boy, 7lbs. 2 oz.,
born January 23, 1997.
First grandchild of Phil Morton, .ATA Board
Chairman
Tributes, Sponsors, Special Donors,
Professional Associates
Champions of Silence are a select group of donors demonstrating their commitment in the fight against tinnitus by making
a contribution or research donation of $500 or more. Sponsors and Associates contribute at the $100-$499 level. ATA's trib-
ute fund is designated 100% for research. We send our thanks to all those listed below for sharing memorable occasions in
this hopeful way. Contribu tions are tax deductible and are promptly acknowledged with an appropriate card. The gift
amount is never disclosed. GIFTS FROM 10-16-96 to 1-15-97.
Champions of Silence
Gregg Birnbaum, 1\'easurer,
The LCA
Robert H. Beemer
Thomas W. Buchholtz, M.D.
Mary R. Camiller i
Arthur Cellini
Stephen Chandler
Anthony G. A. Correa
Rob M. Crichton
Katherine A. Elberfeld
Jean and Lou Pockele
Edmund J. Grossberg, C.L.U.
Christopher V. Houghton
Preston G. Johnson
Betty J. Lawrence
Vince Majerus
Stephen Moksnes
Michael O' Malley, O.D.
Roger J. And Stephanie Moulton
Peters
John R. Priebe
Jerome A. Rich
Barbara A. Rickard, Exec. Dir.,
Peacock Foundation, Tnc.
James L. Schiller, C.F.P.
Andre N. Schipper
Wanda M. Shannon
Agnes Varis
Jack A. Ve rnon, Ph.D.
Sponsor Members
Joy Agass..Smith
Richard Allegretti
Elizabeth A. Artandi
Ned K. Barthelmas
McLaren Beatty
Sanford Blaser
Mario J. Bonello
Michael L. Bowen
Robert A. Bo"ler
Bill Brice, Jr.
Charles T. Brown
Robert B. Budelman, Jr.
Helen S. Burkcv
Leffie Burton
William R. Cagney, Ph.D.
Daniel J. Carda
Robert H. Chamberlin
Robe1i D. Chambers
Gary M. Chase
Charles J. Chieffe
Glen Heather Clar k
Robert A. Cole
Robert W. Cole
Phllip S. C o l l i n ~
Roy w. Cronachcr
Chris Gronberg
Gerald M. Czarnecki
Mary Holmes Dague
Ronald H. Dailey
William F. Denson, liT
Robert Gerard Dubois
Helen L. Duffy
H. Renwick Dunlap
Tom Dupree
Leo w. Easterling
Douglas C. Erikson
Burdell S. Faust
James T. Fehon
Richard J. Fi!anc
John W. Pinger
Aline B. Fink
Eldin L. Fisher
William D. Flinchbaugh
D. Jeanne Frantt
Jerry P. Gaston
Beverly and lan Getre u
Nathan L. Gibson
w. J. and Helen Gotschall
Donna and Robert Graham
Claude H. Grizzard
John R. Hafer
Robert Hager
Wanda M. Hansen
Mary E. Harker
James L. Harkins
A. James Hei ns
John E. Held
Alfred E. Heller
Jacob w. Heller
Paul G. Hill
Daniel E. Horgan
Jonathan S. Horwitz
Gaye v. Hunt
Jerry lnfeld
James frvi ng
Howard G. Jacobs
Eric P. Janie
Lucille J. Jan tz
Bernard Kaminsky
John Kapteyn
Lois S. Keeney
Alexandra B. Keith
William C. Kim
Robert A. Kirkman
Sidney C. Kleinman
Laura P. Kleppick
Katherine C. Kline
William J. Knight
Barbara L. Kohn
Laura J . Kolinek
Larry Kopel
Ronald J . Korniski
Dr. Stuart Krasney
James Krasno
Robert Krotin
Karen a nd Floyd E. Kueh nis , J r.
RobertS. Kupor
Robert M. Kyvik
J ohn M. Lappe
Sharon Ann Lemke
Anders Lewendal
Stephen W. Lewis
William C. Licht
Robert Link
Palmer R. Long
Helen Luccnko
Douglas Marshall
Jean a nd Aaron J . Marti n
The Jean and Aaron Martin
Fund
Michael T. Matherly
Matrix Development Corporat ion
B. W. Maxey
James L. McDermott
John .M. McNamara
Robert J. Mermuys
F. N. Merralls
Andrew Metrick
Milsco Manufacturing Company
Mary Ann Morrill
Robert E. Nason
Margaret Nowacki
Charles Ohlinger, 1!1
Michael D. Olander
John K. Oscarson
Aaron I. Osherow
James L. Paradise
Felicia A. Pasero
J ohn R. Patrick
J ohn R. and Sara A. Patterson
David D. Pearce
Denise R. Joy Pelikan, R.N.,
L.M.T., B.S.
Dow V. Perry
Margaret S. Powell
Ann L. Price
Stephen M. Reece
Bill Retherford
Philip N. Rice
Cornelia Rich
Bernard Richa rds
Jerome Roth
Richard E. Rush
Lowell Sachnoff
William B. Salsgiver
Eugene Saporito
Donna Scheckla
Scheckla Company
Bruce A. Shachat
Tina V. Sherwood
Alice L. Shields
Saul N. Silbert - The Saul N.
Silbert Charitable '!rust
Don L. Six, Sr.
Raymond M. Smith, 1!1
Michael A. Spencer
Larry Spoden
Morton and Norma Steele
James M. Stine
Orloff W. Styve
Marilynn and Thomas Sullivan
Ruth M. Swan
Leon and Carol Tage<
Bernice W. Thompson
Will iam R. 1bwer, Jr.
Dr. Robert D. Utsey, Sr.
Robert F. Weimer
Chr istopher J. Weiss
Beverly J . Wells
Harold E. Wells
Margaret A. Wetter
Derwin L. Williams
Keith C. Winters
Winters &' Associates, Ltd.
Rick Zitelman
Professional Assodates
Michael A. Anderson,
B.C.-H. J.S.
Bruce S. Bloom, M.D.
Knox Brooks
Lawrence J. Danna, M.D.
Barbara Goldstein, Ph. D.
Robert A. Goldstein, M.D.
Kenneth Greenspan, M.D.
Lawrence R. Grohman, M.D.
Mary Jo Grote, Ph.D., C. C. C.-A
J ohn W. House, M.D.
Anthony F. Jahn, M.D.
Paul J. Jones, M.D.
RichardS. Kaufman, D. D.S.
Paul R. Kileny, Ph.D.
Robert Koch, B.C.-H. l.S.
Robert J . Kohlenberg, Ph.D.
Artine Kokshanian, M.D.
Valerie P. Kriney. M.A./C.C.C.-A.
Barbara 'Kruger, Ph.D.
Gordon T. McMurry, M.D.
Mary B. Meikle, Ph.D.
Gale W. Miller, M.D.
Randy Morgan
Westone Laboratories, Inc.
John D. Mowry, M. D.
Scott M. Nelson, M.D.
Meredith K. L. Pang, M.D.
Rui Penha, M. D., Ph. D.
Benjamin Perei ra, D.D.S.
Kurt T. Pfaff, M.A./C.C.C.-A.
Hollis T. Reed, M.D.
J. Thomas Roland, Jr., M.D.
J. Lewis Romctt, M.D.
Jra D. Rothfeld, M.D.
Arthur Rudd, D.D.S.
Dean Edward Schanen, M.D.
Abraham Shul man, M.D.
Thomas E. Sonne, M.D.
Hung-Chia Thng, M.D.
Elliot Wineburg, M.D.
James F. Wuth, M.S.P.A.
In Memory Of
Marge Byers
Arlo and Phyll is Nash
Abe Davis
Francine and Ray Foster
Ernest Gree nhood
Lillian and Nathan Markowitz
John E. Greve (for Chrishnas)
Mr. and Mrs. James Cooper
Florence Jackson
Arlo and Phyllis Nash
John G. Jaser
Jasper Jase<
Edith Jesfjelcl
Arlo and Phyms Nash
Leo Ketterling
Arlo and Phyllis Nash
Ida Komissaroff
Sally Rice
Paul Sestito
M1:. and Mrs. Fra ncis Bird,
James Bray,
Mickey Childs, of the Monday
Night Ladies Social League,
Sylvia Ciccolini,
Mr. and Mrs. George DiRoberto,
Fran and Pat Hickey,
Nancy and Mike Leavitt,
Eleanor Miller,
Ron a nd Julie Munger,
M1:. and Mrs. Joseph Socha,
Janet Standring
The Sherman Family and
Jack .Reich
Florence Reich
Valentine Sopko
Mary Jo Macy
Arthur B. White
Marcye B. White
Harvey Wilson
Lisa Wilson
Tinnit us Today/ March 1997 25
Tributes, Sponsors .. . (continued)
In Honor Of
Nick Andrews
Paul S. Holbrook,
Susan Holbrook
Ernest Auer
Patrice Auer - for Christmas,
Denise and Michael Soranno.
Jeanne Yunker - for your
birthday
'frudy Drucker (for your
birthday)
Rosalie and Jim 1Taver,
Patrick and Mary 11.tlly
John R. Bmmett, M.D.
Luther J. Smith, JTI, M.D.
Mr. and Mrs. Jack Harary
Bob and Debbie Harary - for
Hanukkah and Jack Hararys
birthday,
Daniel Harary,
Mike, Cindy, and Adrian Harary
- for Jack Ilarary's birthday
Michael Holbrook
PaulS. Holbrook
Al and Jane Meis (for your
35th wedding anniversary)
Joal Fischer, M.D., and Deborah
Langsam
Gaye Phillips
Mort Rosenhaft (for your work
with the Washington, D.C.
Tinnitus Support Group)
The Washington, D.C. support
group, c/o Carolyn A. Wyatt,
M.A./C.C.C.-A.
Shirley Rosenhaft (for your
birthday)
Mrs. Naomi Swerdlin
Doris and Al Schwartz
Ruth and Ludvik, Pearl and Dave,
and Judy and Dave, c/o Ruth
Bassoff
Mary Sears
James A. Deirossi, 'Treasurer,
Healthcare Strategies and
Perspectives
Judy Simmons (for Christmas)
Dianne Salzensteln
Barbara Thbachnick
Kenneth Greenspan, M.D.
Dr. Jack Vernon
Betty Webber
Corporations with Matching Gifts
Millipore
OMRON
The Charles Schwab Corporation
US WEST
Wells Fargo
Research Donors
John Abeles, M.D.
Rich Alger
Christiane Alvarez
David R. Anderson
Marjorie Geary Anderson
Alan J. Arnold, M.D.
Elizabeth A. Artandi
Morio Asato
Eunice Banks
Michael Barnhardt
Phyllis L. Barry
Charles 0. Bastien
Jeffrey R. Bauder
Rudolph Beck
A. D. Beggs
Robert F. Bell
Charlene Bennett
H. D. and Mary Benson
Kim A. Berger
Marsha and Morton Berkowitz
26 Tinnitus Thday/March 1997
Cpt. Charles G. Bohlinger, 3rd
Frank Boland
David L. Bothamly
Helen E. Bowman
D. Jean Brown
June M. Brown
Laurence Caine
Gerald Campbell, Jr.
G. Fred Charles
Carol Jean Chatterton
Loretta C. Choy
Bruce Christopher
Jess B. Clanton
J. R. Claridge
Dennis J. Clark
Glenn A. Clark
Doris W. Coccia
PhilipS. Collins
Donald J. Cook
Nellie Copeland
Etta B. Couch
Marilyn A. Criley
Martha Cross
Loretta J. Crump
Glen R. Cuccinello
Lee 0. Cunningham
Eileen M. Dambis
Charles and Jane Dare
George Dilgard
J. R. Dominik
Timothy Dorn
Thelma D. Dry
Virginia M. Dublanc
Randall C. and Elise Ducote
Susan P. Dudek
Mr. and Mrs. Harold F. Eater
Marjorie M. Ellis
Louis S. Emanuel
Douglas C. Erikson
Robert R. Fairburn
Elza Feld
Marian F. Feldheim
Joseph W. Ferioli
Stella A. Ferrari
Mary 'Tbulouse Fert
David J . Fetzner
John W. Finger
Gina Fiore
Ralph G. Fitz
Geraldine R. Foley
James E. Foley
Ernest W. Fowble
Rocco D. Fragnito
Margaret Frisch
Jim Ray Fugate
Sharon A. Furler
John M. Garinther
John D. Gately
Roy A. Ghika
Myra J. Gibson
William L. Ginkel
Howard Ginsberg
Robert A. Gold
Emma M. Gomez
Robert S. Gordon
Charles Mark Grabinski
Timothy J. Griffith
Ben Grill
Roy A. Gummersheimer
Jo Habighorst
Clyde L. Haines
Larry D. Hall
Hannah L. Hammel
Suzanne Hanson
Marta J . Hansson
Mary E. Harker
Carl L. Harrington
Alfredia J. Harris
Peter R Harry
Thomas B. Harvey
William J. Haskin
Lewis I. Hegyi
D. W. Heineking
Suzanne C. Henrion
Julia Hicks
E. Alan Hildstrom
John S. Hingtgen
Eddith M. Hinkle
Melba B. Hoover
Max Horn
Jack Huang
James Irving
Erik Jakobsen
Barbara L. Jensen
Esther W. Johnson
Mark A. Jones
Mary Joseph
Alan Jurisich
Richard J. Justin
Barney M. Kadis
Shirley E. Kane
Howard Katz
R. L. Kehcley
Catherine A. Kellit
William C. Kim
George W. J(jmmel
Howard G. King
Gerald F. Kiplinger
Laura J. Kolinek
Charles and Christine Kostel
Sherrie Koy
Dr. Ed Krol
Marie J. Kunkel
Florence Langevin
Dr. Holly Latty-Mann
Shirley C. Lavenhcrg
HowardS. Lawrence
Rita M. Lawson
Gheorghe La7..ar
Paul Lenchuk
Robert w. Lentner
Stanley D. Levin
Ann Lingos
Erwin J. Lipsky
Donald J. Lisio
Palmer R. Long
L. Curtis Luchsinger
Thelma MacNaughton
John M. Maiorano
Emily B. Markham
Sandra Mathey
Ronnie C. Mattingly
A. Helen Mauro
Dr. Jeny McCarthy
Joseph A. McCarty
James L. McDermott
Mindy McBntire
EdwardS. McLaughlin
Thomas F. McNulty
David M. McQueeny. Sr.
Robert and Kathleen Megginson
Andrew G. Mehas
,J immy C. Meyer
Paul Meyer
Mark J. Millea
Carolyn B. Miller
Dr. Wayne H. Mitchell
Loretta J. Mithoug
Anthony T. Molisse
S. R. Moore
Don L. Morrill
Stephanie Muenzberg
Edward Muserlian
Martine Naeve
Phyllis E. Nagy
Elisabeth J. Nicholson
Peter J. Nikolai
Kenneth E. Norris
Norman J. Nunes
Mary T. Oblasney
Jean Ann Olsen
Phillip J. Owens. R.N.
,Joseph S. Park
Doreen D. Parsons
Christine E. Partis
Felicia A. Pasero
Raymond F. Pauser
Barbara B. Pearson
Roi N. Peers
Thelma G. Penna
Lucille M. Petersen
David G. Peterson
Jan L. Peterson
J uclith Pisetzner
Richard J. Plotnick
Sallie Pope
Ivanell Presley
Florence D. Pyle
A. 0. Quinn
Major Leonhard Raabe
Michael M. Ragozzine
Robert L. Ralston
Nathanael Rathbone
Laurel J. Raymond
Eleanor Regula
Robert B. Roemer
Andre D. Roy
Thomas C. Royer
James G. Rudd
Amelia Rugala
Robert Salanick
William B. Salsgiver
Judith Scalyer
Joseph J. Schall
Dean Edward Schanen, M.D.
Louise Schmitt
Doreen Scott
Jrandokht Sebastian
Thrry N. Sherman
Harry Shook
William Sickle
Frederic Silberman
Mary K. Smith
Robert P. Smith
Aviva Sorkin
Robert L. Spitz
Joan A. Starr
Philip C. Stearns
James J. Steponik
Nancy Edens Swain
Ruth M. S\van
Rosemary S. Sweeting
Blizabeth Tamm
Leonard S. Thtore
Eva Thompson
KaUuyn Thompson
Marilyn L. 'Tbrgrimson
'Tbdd Alan 1\tcker
James w. Valleau
Mary VanEmbden
Brian VanPutten
Marcia H. VanRoosen
Agnes Varis
Donald A. Vassallo
Arthur Vianna-Neto
Betty Jo Voll
Robert G. Wallace
Muriel Ward
Rachel B. Ward
Gerda Wassermann
Robert G. Weigand
Sheldon Weinberg
Rita Weisner
Ben H. Welmaker, Jr.
Aubrey D. Wentworth
Ellen Werblow
Gary White
Faith L. Wicklund
Marlin D. Wilson
Robert A. Wilson
Lynn Wolf
Joseph R. Wozniak
Reynaldo T. Yap
John H. Yuen
Julie A. Zelez
Brad Zerman
Edwin J. Zieroth
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* Professionals will find this an excellent resource.
* Even with all the technical information,
this is must reading for anyone with tinnitus.
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NA
A Personal Invitation to you
from William Shatner
Please Join Me ...
March 1997
Dear Friend of ATA:
Fifty million Americans suffer from tinnitus of some kind.
Ten to twelve million suffer with distracting and unrelenting tinnitus.
While telling me I'm not the only one with tinnitus, those figures don't provide me any comfort.
What does, however is the thought that with research there might be hope for improved treat-
ment and, possibly, a cure.
I also take comfort in the thought that, as a member of ATA, I'm helping to encourage and fund
critical research. But I want to do more, and now I'm talking with friends who have seen my
suffering or have tinnitus themselves, to ask for their financial support of ATA's research efforts.
I invite you to do the same.
You see, you and I are in the position to really help. What we suffer from, no one without
tinnitus can truly understand. They can only stand by and try to keep us from losing our selves
and our minds. Just by coming forward and talking about our personal experiences with tinnitus,
we can give hope to those who have it and develop understanding among those who don't.
Most importantly, by bringing the enormity of the problem to the public's attention, we'll help
generate critical funding for research and education.
As I told the House Appropriations Subcommittee last March, the thing that keeps me going is
the possibility that there will be a magic bullet some day. They listened and granted our wish for
some research funds for this year. But it will take more, lots more. We need more private
research, right now. Additional grants from the ATA Research Fund will make that possible and
will "seed the way" for future, larger funding of many projects. This is the way to develop new
treatments and find a cure. It might take years, but ATA is committed to making it happen.
However, to maintain the current momentum and give more grants, ATA's Restricted Research
Fund needs increased and continued funding.
That is why I'm asking you to join me in this worthwhile endeavor. Give an extra research gift
to ATA, increase your current membership donation, and/or encourage five friends to con-
tribute. Please help us silence tinnitus. Send the attached reply form to ATA today. Thank you!
% fir:;
William Shatner, ATA Honorary Director
P.S. Remember that a minimum annual membership contribution is required to receive Tinnitus Today. These donations make possible
AT A's day-to-day operation, the development of a wide range of educational materials and continued advocacy on behalf of those
affected by tinnitus. Thank you for that support also. Contributions to ATA are tax-deductible within the limits of the law.