JUNE 1990 VOLUME 15, NUMBER 2

Tinnitus Today
THE JOURNAL OF THE AMERI CAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear."
TONY RANDALL
TESTIFIES FOR
TINNITUS
TINNITUS AND
AMPLIFICATION
COGNITIVE THERAPY
WEEK-END WORKSHOP
A VOLUNTEER ' S
POINT OF VIEW
ONE LIFE IN THE DAY
OF TINNITUS
AVIATION HEADSET,
ANTI-NOISE
TECHNOLOGY,
SHOW PROMISE
reputation
Two names you know you can trust.
ACIIVAIR. Q DURI'CE' ,.
. Sound Leadership 'I'M
Editorial and advertising offices:
American Tinnitus Association,
P.O. Box 5 Portland, OR 97207
(503) 248-9985
Executive Director & Editor:
Gloria E. Reich, Ph.D.
National Chairman:
Robert M. Johnson, Ph.D.
Editorial Advisor:
Trudy Drucker, Ph.D.
Advertising sales: AT A-AD, P. 0.
Box 5, Portland, OR 97207 (800-
634-8978)
Tinnitus Today is published
quarterly in March, June, Septem-
ber and December. It is mailed to
members of American Tinnitus &-
sociation and a selected list of tin-
nitus sufferers and professionals
who treat tinnitus. Circulation is
rotated to 175,000 annually.
The Publisher reserves the right to
reject or edit any manuscript
received for publication and to
reject any advertising deemed un-
suitable for Tinnitus Today. Ac-
ceptance of advertising by Tinnitus
Today does not constitute endorse-
ment of the advertiser, its products
or services, nor does Tinnitus
Today make any claims or guaran-
tees as to the accuracy or validity of
the advertiser's offer. The opinions
expressed by Contributors to Tin-
nitus Today 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 1990 by American Tin-
nitus Association. No part of this
publication may be reproduced,
stored in a retrieval system, or
tramsmined in any form, or by any
means, without the prior written
permission of the Publisher ..
ISSN: 0897-6368
TINNITUS
TODAY
The Journal of the American Tinnitus Association
Volume 15 Number 2 June 1990
CONTENTS
4
7
10
11
13
16
ACfOR TONY RANDALL TESTIFIES FOR TINNITUS
By Gloria E. Reich, Ph.D.
TINNITUS AND AMPLIFICATION
By Max Chartrand, M. A.
COGNITIVE TiffiRAPY WEEK-END WORKSHOP
By DonnaS. Wayner, Ph.D.
A VOLUNTEER'S POINT OF VIEW
By Andrew W. Neher, M. A.
ONE LIFE IN Tiffi DAY OF TINNITUS
By Sydney Hunt
AVIATION HEADSET-ANTINOISE TECHNOLOGY
SHOW PROMISE By Cliff Collins
REGULAR FEATURES
12 Upcoming seminars
14 Bibliography Service
17 Tributes, Sponsor Members
19 Books Available
19 Annual Donations
Cover photo of Senator TomHarkin,JA, Tony Randall, and Gloria Reich,
and photos on pages 4, 5 by Mattox Photographers, Alexandria, Virginia.
Illustration on page 16, by artist Stan Mott. The photos on page 10, by
Donna Wayner,PhD.
3
ATA TESTIMONY BEFORE THE
SENATE APPROPRIATIONS SUB-
COMMITTEE- MARCH 29,1990
Mr. Chairman and Committee Members:
My name is Gloria Reich and I am the Executive
Director of the American Tinnitus Association. I
would like to take this opportunity to thank our
volunteer, Carl Ross, who has worked with your
committee staff, and with Senator Moynihan and
his staff to bring us to this day.
Dr. Gloria Reich testifies before the sub-committee.
Our special guest today, Tony Randall, has
acknowledged his own tinnitus in the media and has
provided ATA with an excellent series of Public
Service Announcements to help educate the public
about tinnitus. He will tell you more after we listen
briefly to these synthesized sounds of tinnitus.
Tony Randall follows Senator Paul Simon.
AT A has been in existence since 1971 and
has been incorporated since 1979. I have seen the
organization grow from providing services to 125
people at the beginning of 1976 to more than
175,000 people today. More than 30,000 people
4
contribute to AT A, supporting our goals of research
and education about tinnitus and other hearing dis-
orders. Each year more than a quarter million of our
brochures help to educate the public about tinnitus
prevention, noise which can damage the ears,
coping with tinnitus, hyperacusis (a condition
sometimes called super-sensitive hearing),
demographics of tinnitus sufferers, and other
topics. ATA has more than one-hundred self-help
and support groups throughout the country. Our
constituency overlaps the hard of hearing and deaf
communities as well as the normal hearing public.
Tony Randall emphasizes a point of testimony.
Mr. Chairman, on behalf of more than 50
million people who have tinnitus and especially the
12 million people who suffer from severe tinnitus,
I appreciate the opportunity to be with you today to
share some concerns and recommendations related
to the National Institute on Deafness and Other
Communication Disorders (NIDCD); to the costs
of tinnitus to our society, and to the education and
treatment of people with tinnitus and other hearing
disorders.
We know and appreciate the budgetary con-
straints facing the new institute and the competition
for the available funds. Tinnitus is probably the
singlemost distressing condition associated with
hearing loss and yet it is poorly understood and
poorly treated. Even in the advisory boards and
councils of the new institute there are no repre-
sentatives whose specialty is tinnitus.
Because of this long history of neglect and
the desperate need to "catch-up", now is the time to
address this invisible, but distressing problem. We
urge you to approve the $165,000,000 NIDCD
Continued on page 5.
Continued from Page 4.
budget and ask that you set aside 20 to 30 million
dollars for the study of tinnitus.
Senator Harkin asks Carl Ross for more information.
Modest research projects over the past
decade have produced promising results. Armed
with this knowledge NIDCD can instigate research
designed to learn much more about tinnitus and to
produce clinical measures to benefit sufferers now.
Some areas that should be investigated include:
1) The evaluation and refinement of
therapeutic processes.
At present the promising therapies for tin-
nitus include the use of masking (substitution of a
more acceptable sound for the patient's internal
noise); hearing-aids (which produce a kind of
masking by making it possible for the person to hear
environmental sounds); biofeedback and other
psychological interventions which have been help-
ful in teaching some patients how to adjust to their
affliction.
2) Search for and identify underlying
mechanisms of tinnitus. Current studies using state-
of-the-art imaging techniques are leading towards
an objective test for tinnitus. Currently tinnitus
presence is subjective, which, particularly in litiga-
tion, generates inadequate identification of the con-
dition.
3) Develop behavioral and physiological
animal models for tinnitus. Current studies at Yale
University (NIH funded), are directed toward
animal model development.
4) Better understand the relationship between
various drugs and tinnitus drugs (a variety of drugs
are routinely prescribed for tinnitus patients to help
them control their anxiety, depression, vascular
5
disorders, and a host of others used in somewhat of
a hit-and-miss fashion), unfortunately, some of
these drugs have severe side effects -- not the least
of which is the worsening of the person's tinnitus.
Current studies of ototoxic drugs at the Oregon
Hearing Research Center have produced valuable
insights regarding drugs and tinnitus.
5) Better understand the relationship between
dental anomalies and tinnitus. A small research
project, funded by AT A, at the TMJ Foundation
seeks to establish these relationships.
6) Develop effective, standardized clinical
measures of tinnitus sensation. The Tinnitus Data
Registry of the Tinnitus Clinic in Oregon, funded
originally by ATA, then by Nlli, and currently by
the Department of Education, has provided excel-
lent information on more than 5000 patients.
7) Develop or refine present measures of
tinnitus severity and psychological consequences.
Several individual researchers have provided infor-
mation that can be used as a basis for this develop-
ment.
In order to achieve these goals, A TA recom-
mends the establishment of tinnitus clinical re-
search programs at the new regional research
centers of the NIDCD. This research !llilS1 be inter-
disciplinary. Tinnitus does not belong solely to one
specialty. In order to move forward there must be
involvement by otolaryngologists, otologists,
audiologists, psychologists, dentists, neurologists,
engineers and many others.
8) Initiate prevalence studies for tinnitus in
the general population utilizing information already
available from existing tinnitus surveys conducted
on segments of the tinnitus population. The
prevalence figures currently cited have been
derived from a study published in 1968 by the
National Center for Health Statistics. Questions in
the present Census bureau's National Health Inter-
view are woefully inadequate to provide com-
prehensive statistics about tinnitus. Incidence
estimates are not available at all because tinnitus is
not a "reportable" condition (unlike scarlet fever or
AIDS). Without prevalence studies we cannot cor-
rectly estimate society's costs and without in-
cidence reports we cannot know the extent to which
Continued on page 6.
Conlinuedfrompage 5.
tinnitus is increasing.
9)Initiate public awareness programs to control
noise exposure, particularly directed toward the
school-age population. Prevention is our only
weapon until we have the ability to cure tinnitus. It
is likely that people will always be afflicted with
tinnitus, the realities of modem life are such that
people cannot avoid either noise or stress, cir-
cumstances which often lead to tinnitus. People
must be educated about the damage noise can do.
An astonishing number of musicians, for example,
are now reporting severe tinnitus and hearing
deficits. Industry standards for noise are also inade-
quate to protect ears rendered sensitive by environ-
mental noise exposure.
Tinnitus is not considered a life threatening
condition. That statement is of little comfort to the
sufferer who can no longer concentrate at work or
maintain pleasant social relationships with family,
friends and colleagues. It is of even less comfort to
the family of a sufferer who has committed suicide
because of the incessant noise.
There are organized tinnitus associations in
. ...
England, Canada, Australia, Japan, Germany,
Spain, France, New Zealand, Italy, and Israel, but
people from most countries of the world look to the
U.S. for help and knowledge about tinnitus relief.
The United States has an opportunity to extend its
preeminence in medical research and to help
humanity by solving this problem which has been
called the third worst thing that can befall
mankind,the first two being unrelenting pain and
dizziness.
Please help by funding these important
programs. Thank you.
WE
SUPPORT
"COPING WITH TINNITUS""
STRESS MANAGEMENT & TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STRESS Of' TINNITUS WITHOUT COMPLEX
INSTRUMENTATION & VALUABLE OFFICE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids, tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered and can be performed daily in the
patient's home environment. It has been demonstrated that the relaxation response can release muscle
tension, lower blood pressure and slow heart and breath rates.
A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
has successfully treated for many years chronic pain, tension headaches, insomnia and many other
conditions.
The program consists of one cassette tape of Metronome Conditioned Relaxation and two additional
tapes of unique masking sounds which have demonstrated substantial benefit whenever the patient
AASSOCJJ>JfD '"'' tho md of add;uooal cll<< Th<" ""'""""' an b< u"d 1o Indue< >lplog
0
, ., a ooothlng
~ ~ J A ~ backdrop for activity and can be played on a simple portable cassette player.
AU. ORDeRS MUST sr; ACCOMPANieD 6Y 6796 T ST., UPPER DARBY, PA 19082
CHr1\ VISA. M A S ~ . OR INSTrrtmONAL P.O. Phone (215) 528-5222
6
TINNITUS AND AMPLIFICATION
by Max S. Chartrand, M. A.
Statement of the Problem
It is now estimated that 20% of the adult U. S.
Population experiences some degree of tinnitus,
either of an intermittent or constant nature. Of these
people about 20% suffer severe tinnitus and often
require professional help.
Taking into account that these figures include
all types of tinnitus involving both normal hearing
and hearing impaired populations, it must be noted
that the array of treatment protocols utilized today
on the general tinnitus population may not be suf-
ficient in effectively meeting the needs of the more
narrowed group that is in contact with the services
of the hearing aid dispenser.
For instance, if we were to take a sampling
of the possible causes of tinnitus in the general
population, we would find a wide array of
physiological, neurological, and psychological
manifestations: food and inhalant allergies, hyper-
tension, toxicity, vascular constrictions, al-
coholism, and depression, to name a few. However,
tinnitus sufferers who are commonly in the care of
the private practice hearing aid dispenser manifest
more selective categories of causes, primarily those
resulting from epithelial atrophy (presbycusis) and
noise damage. Hearing impaired patients exhibiting
pulsatile, spasmodic, or vascular tinnitus generally
fall into the medical realm.
During a seven-year study of tinnitus in cases
of hearing aid users with sensorineural losses
and/orpresbycusis, several"common threads" were
found to describe their tinnitus complaints. They
complained of varying degrees of intensity, from
mild to severe, and with descriptions of the actual
sound of the tinnitus such as "ringing", "hissing",
"frying", "buzzing", "sirens", and so forth. By the
traditional definition of tinnitus these cases would
be classified as subjective tinnitus (i.e. not heard or
observed by any but the sufferer). Several points of
thesis were arrived at during the course of this study
that we feel may be of significant interest to the
professional dispenser.
7
Hearing aid dispensers may more thoroughly
evaluate a patient's tinnitus from a carefully taken
case history, tinnitus "matching" procedures
(matching pitch, intensity, and type of sound) using
audiometric equipment and specialized tinnitus
analyzers, and certain observations during testing
and fitting of hearing instruments or tinnitus instru-
ments.
Comparing Populations
Tinnitus sufferers in general and the hearing
impaired population served by the hearing aid dis-
penser differ in many respects. Those patients
without hearing impairment have benefitted from a
variety of approaches. Hoover ( 1987) reponed 7 6%
of patients in her study to have tinnitus related to
allergies. House and Johnson (1979) reponed sub-
stantial success utilizing biofeedback and tinnitus
maskers. Marchiando et al ( 1983) report successful
procedures to relieve stapedial spasms activated by
noise. Arenberg and Balkany (1979) have
described elaborate medical procedures for vas-
cularpulsatile tinnitus. Still others report treatments
for tinnitus relating to tension, injury, tumors, and
infection.
The hearing aid user who is seen in a regular
hearing aid dispenser practice rarely complains of
these conditions. At the least, it was found in our
study that when any of these conditions were ob-
served during the normal course of dispensing ac-
tivities, the patient was immediately referred for
medical evaluation.
Reports on Hearing Aids
Vernon (1977) reported the relief of tinnitus
through the use of hearing aids, and House and
Johnson (1979) reported "in patients with hearing
loss whose chief complaint is tinnitus, the use of
hearing aids can be dramatic." Indeed, from their
two-year study of patients who were referred and
subsequently fitted with hearing aids, 78% reported
some degree of relief from their tinnitus.
Numerous other reports have mentioned the
effectiveness of hearing aids for certain groups of
hearing impaired tinnitus sufferers, but it is evident
from reviewing the literature that there is still a lack
of information about the effects of hearing aids on
Continued on page 8.
Continuedfrompage 7.
tinnitus, or systematic, yet practical, methods
whereby the dispenser may observe the effects of
amplification on the tinnitus, particularly when the
prescription formula of the circuitry was aimed at
correction of hearing impairment. Therefore, our
main focus was upon those tinnitus sufferers with
accompanying sensorineural loss or presbycusis
and the effects of fitting hearing aids to the affected
ear(s).
Tinnitus and Hearing Aid Users
A sample of more than 2000 hearing aid
user records were used as a resource for our study.
From these, 100 were designated as the focus
group, with ages ranging from 22-97 years. Seven
percent of the focus group had conductive losses
and the remaining 93% exhibited mixed and sen-
sorineural impairments. This represents a fair sam-
pling of what we believe is a typical hearing aid
dispensing practice clientele population.
Patient reports regarding tinnitus were ob-
tained from both written and verbal case histories
immediately before and during the routine hearing
evaluation. Descriptions of the tinnitus were further
substantiated, where possible, by a matching pro-
cedure for pitch, bandwidth, and intensity of the
tinnitus as closely as possible using pure-tones,
narrow-band, and wide-band noise on a two chan-
nel audiometer. Out of the mixed and sensorineural
cases 55% reported tinnitus in the following
categories.
TABLE I SELF REPORTS OF TINNITUS
AND AUDIOMETER COMPARISON
Percentage Description Audiometer Range of
of group of tinnitus Comparison Frequencies
63% "Ringing" Pure-tone 1.5-8K Hz.
27% "Buzzing" Narrow-band .53-3KHz.
11% "Pulsating" Wide-band N/A
7% "Crickets" Narrow-band 1K-4KHz.
7% "Multi-band" Wide-band N/A
(Note: Totals more than 100% because of
multiple descriptions. Most common frequency
description was from 3K-6K Hz.)
8
In most cases where the bandwidth of the
tinnitus was identifiable, we found that the point of
greatest progression in a high-frequency impair-
ment(usually2K-6KHz.) and the description of the
tinnitus often correlated or nearly matched. Further
monitoring of cases revealed that the pitch of the
tinnitus often followed the drop in precipitous los-
ses while often simultaneously increasing in inten-
sity.In almost all bilateral hearing loss cases the
tinnitus was eventually found to be bilateral. How-
ever, many patients were initially unaware of the
tinnitus in one of the ears because of the differential
in thresholds and/or tinnitus. Therefore, when these
cases were fitted monaurally, the client often com-
mented that they noticed tinnitus in the unfitted ear
where they had not noted it previously.
Residual Inhibition and Masking with
Hearing Aids
Vernon (1988) has published several
reports regarding a phenomenon called residual
inhibition, which means a lowering or cancellation
of tinnitus for a period of time after stimulation of
the ear with pure-tones or masking sounds. Other
reports have noted the evidence of masking tinnitus
with hearing aids but residual inhibition has not
been noted when only hearing aids are worn.
During our study we noted reports of residual
inhibition by users of hearing aids under the follow-
ing conditions:
1. The fitted instrument(s) response range
must be capable of producing effective gain cover-
ing the frequencies of the accompanying tinnitus.
In most cases the required response range was
above 6KHz. Less than 6KHz. rarely produced
residual inhibition.
2. Residual inhibition was found to be pos-
sible only after regular wearing of the hearing in-
struments. Intermittent or short-term users rarely
reported the phenomenon.
3. The tinnitus correlated with the peripheral
audiogram and was not complicated with
otosclerosis, high blood pressure, ototoxicity, or
vascular conditions.
A report by House (1984) brought our at-
tention to the matter of correlating high-frequency
Continued on page 9.
Continuedfrompage 8.
hearing loss accompanied with tinnitus and the
effects of hearing aid use. In part the report stated,
" ... many of the patients with unrelenting tinnitus
have a high-tone sensorineural hearing loss ... when
hearing aids were tried, the tinnitus and hearing
ability improved."
Using the focus group of hearing aid users,
a method of analysis was developed for matching
the tinnitus and identifying its intensity using stand-
ard audiometric equipment. Once the bandwidth
was identified and approximated to a narrow-band
of noise or pure-tone, ten seconds of narrow-band
noise at 10-20 dB above threshold was presented,
preceded by instruction given to the patient to indi-
cate whether the tinnitus was softer, louder, or
completely absent after the stimulation was ter-
minated. Sometimes, because of difficulty in com-
municating these instructions, the test would be
repeated.
If the patient indicated that their tinnitus
was much softer or absent after stimulation with
narrow-band noise, they were instructed to notify
us if and when the tinnitus came back to its original
intensity. Further, notations were made on the
evaluation form in regard to intensity, bandwidth,
and possible residual inhibition as a result of mask-
ing stimulation. At times, wide-band noise was
used in place of the narrow-band stimulus.
Seventy-one percent of those tested
reported a lessening of intensity as a result of the
1 0-second stimulation. Thirty percent of that group
reported the tinnitus was absent for the remainder
of the evaluation. Additionally, 27% of all those
reporting tinnitus reported "no change" resulting
from the stimulation procedure, and 2% reported an
increase in the tinnitus.
Post-fitting evaluations generally affirmed
the initial expectations for the hearing instruments
on the tinnitus condition. In summary, we affirm
what other investigators have already ascertained:
hearing aid use has been found to be a very effective
"masker" of tinnitus for people exhibiting hearing
impairment. However, the masking effect is only
available during actual wearing of the instruments.
9
Tinnitus and Hearing Aid Response
As noted earlier, response range of hearing
aids often has a direct effect on tinnitus. Conclusive
data is not yet available, but our findings indicate
several factors.
1. The masking effect of hearing aids was
particularly pronounced when low-frequency
amplification (100-SOOHz) was present in the hear-
ing aid.
2. Tinnitus above 6K Hz rarely exhibited
any inhibition from the use of hearing aids.
3. The stimulative effects of hearing aids
could best be predicted as a result of the narrow-
band test when the tinnitus centered around 500Hz
-2000Hz.
4. For tinnitus between 2KHz and 6KHz, a
wide-band instrument producing usable gain up to
7KH.z-8KHz was essential to realize inhibition.
The hearing aid dealer is advised to make
special notations on orders to the factory regarding
the frequency and intensity level of the tinnitus.
Manufacturers need to be aware of the relationship
between hearing aid response and tinnitus in order
to produce an instrument best suited to the client
Generally speaking, the best frequency configura-
tion for tinnitus is the one that best accommodates
the actual impairment. However, special configura-
tions and/or earmold designs are sometimes called
for in cases requiring constant instrument wear.
Conclusion
We have found that hearing aids have been
overlooked as a potential treatment for tinnitus. Our
experience has shown them to be the most univer-
sally effective form of treatment for peripheral
based tinnitus in the hearing impaired. Moreover,
we feel that dispensing and audiology are the best
poised disciplines to provide a greater level of relief
for a greater number of tinnitus sufferers who are
also hearing aid users because of their established
delivery system of services and instruments to the
private market. To further accommodate and har-
ness this advantage, however, we feel it is the time
for all who are involved in dispensing hearing aids
to add tinnitus evaluation and prediction to their
Continued on page 12.
COGNITIVE THERAPY FOR
TINNITUS: A WEEK-END WORKSHOP
IN ALBANY, NY
DonnaS. Wayner, Ph.D.
Funding received from the American Tin-
nitus Association in Portland, Oregon was made to
Dr. DonnaS. Wayner at the Hearing Rehabilitation
Center at Albany Medical Center in Albany, New
York and Dr. Richard Hallam of the Royal National
Throat, Nose and Ear Hospital in London, England
to conduct a clinical study entitled "Cognitive
Therapy for Tinnitus". An intensive Cognitive
Therapy Week-end Workshop was held on April6,
7 and 8 at the Franciscan Center, St. Anthony-on-
Hudson in Rensselaer, New York. A group of seven
participants from across New York State and Pen-
nsylvania with severe tinnitus were selected to par-
ticipate. Dr. Robert Johnson, from the Oregon
Hearing Research Center, who also is Chairman of
the American Tinnitus Association joined the group
as an observer.
Facilitators of Cognitive Therapy Week-end Workshop
Meeting from Friday evening through Sun-
day afternoon, the essentials of cognitive therapy
were explained and directed towards increasing
understanding of how a person's beliefs might
cause much of the distress that tinnitus sufferers
experience. Techniques were reviewed to help
10
reduce this by applying an appropriate challenge of
these beliefs, replacing them with more realistic and
less fearful attitudes. Role-playing activities and
relaxation therapy were used.
Participants in Cognitive Therapy Week-end Workshop
The treatment process does not alter the
tinnitus, but does help to bring about a different
level of understanding and coping ability among the
participants. One participant reported that the
workshop allowed him to verbalize his deepest
fears and helped him to realize that they are com-
mon to most tinnitus sufferers. Another said that the
most important part of the workshop was that it
allowed him to lose some of his fear of tinnitus. The
group experience was especially beneficial to all
who participated in that it provided mutual support,
affection, respect and most importantly hope.
(hJ
American Tinnitus Association
is a participant in the
Combined Federal Campaign
#0514 in the CFC Brochure
Thank You For Helping
To Fight Tinnitus
A VOLUNTEER'S POINT OF VIEW
by Andrew Neher, Aptos, California
I am a relative newcomer to AT A--and to
tinnitus, and I've been dismayed, as most tinnitus
sufferers probably have been, to learn of the "or-
phan" status of tinnitus. In spite of the fact that it
disrupts millions of lives, tinnitus seems relatively
neglected by the medical profession, funding agen-
cies, and other groups as I will explain below.
For example, I learned, from materials fur-
nished by A TA, that chronic tinnitus commonly
results from excessive noise exposure. Now I knew
that noise exposure could produce hearing loss, and
even temporary tinnitus. But somehow I had never
learned that noise exposure could lead to chronic
tinnitus years after the fact. If I had known this, I
probably would have done more to protect my ears
from noise (the high frequency hearing loss that
typically results I was willing to risk, but I w o u ~ d
not have knowingly risked tinnitus). Could this
information be in general circulation, yet I had
somehow failed to run across it? So I decided to do
a survey of health education materials, from
elementary to graduate school level, and--lo and
behold--! discovered that, while almost all
materials mentioned hearing loss as a possible con-
sequence of noise exposure, almost none men-
tioned the risk of tinnitus. No wonder I had never
heard of it; one of the most important, preventable
causes of tinnitus was being kept a "secret."
The upshot was that, with the cooperation of
AT A, letters were sent to approximately forty pub-
lishers of about eighty health education texts, in-
forming them of this oversight and including
materials they might wish to incorporate in the next
edition of their textbooks.
Since my career field is medical psychology,
this effort was a "natural" for me. But then it oc-
curred to me that, among AT A Newsletter readers,
there are probably people in other fields who could
make a contribution to "solving" the problem of
tinnitus. I can tell you from my own experience that
"doing something" that might have some impact on
the problem is VERY good therapy, compared with
sitting around feeling frustrated. For example:
1. We now know that tinnitus is generally
neglected in health education materials that reach
the general public. Are there health educators
among Newsletter readers who could do some
educational work within their national and regional
organizations? AT A would be glad to help you in
these efforts.
2. Given that tinnitus research is under-
funded, what efforts can be made to increase fund-
ing? Who among Newsletter readers have
connections with foundations, government agen-
cies, legislatures, etc. that make decisions regarding
grants for medical research? Perhaps they could
advise the rest of us concerning effective political
action along these lines.
3. Most sufferers probably are unfamiliar
with the legal picture with regard to possible com-
pensation for tinnitus resulting from, e.g., noisy
working conditions, or rock concerts, or drugs that
lack appropriate warning labels. A Newsletter
reader who is also an attorney might write an article
informing us of these possibilities.
4. A related issue has to do with laws regard-
ing workplace noise, rock concerts, drug warnings,
and other preventive measures. What laws exist, are
they adequate, and, if not, how can they be
strengthened? Perhaps a reader--attorney, legis-
lator, etc.--who is familiar with such matters could
look into this issue. If reform is needed, are there
readers skilled in political activism who could help
organize such an effort?
11
5. Many Newsletter readers are undoubtedly
physicians, and some physicians probably have
some "hunches," based on clinical experience,
about what "treatments" seem to help tinnitus but
that, so far, haven't turned up in the medical litera-
ture. If they wrote to A TA about these possibilities,
AT A could then serve as a clearing house to help
identify approaches that are promising and deserv-
ing of additional research.
6. Perhaps a neurologist or neurosurgeon
could comment in the Newsletter on the role of the
brain in tinnitus, from the point of view of causa-
tion, diagnosis, and cure. It seems common-sensical
Continued on Page 12.
Continued from Page II.
that, if the (small) areas of conex involved in the
perception of narrow-band tinnitus were removed,
the perception of tinnitus would cease. For ex-
ample, what have surgeons noticed concerning the
effect on tinnitus of lesions or tumors in the tem-
poral (hearing) region? Or concerning the effect on
tinnitus of surgical removal of areas of the temporal
conex? Understandably, few experimental data
exist concerning these issues; hence the importance
of clinical experience. And, if brain surgery is
theoretically feasible as a cure for tinnitus, what are
the practical difficulties involved?
Indeed, tinnitus is an orphan, too often
neglected by the medical profession and others. We
have a choice. We can either sit around dis-
couraged, or we can pool our effons to help tinnitus
receive the attention it truly deserves.
So, if you have something to contribute,
along these or other lines, write and let ATA know.
Together we can make a difference.
lb
UNDERSTANDING AND TREATING
TINNITUS: SEMINAR SERIES
AT A is presenting a series of professional
seminars to provide useful information about tin-
nitus to those having professional and clinical inter-
est in its cause and treatment. These seminars
present a basic core of knowledge permitting the
hearing health professional to construct or recom-
mend an effective patient management program
which best meets the needs of those served.
The seminars are being held at various loca-
tions. The next scheduled seminar will be in
Chicago, Tilinois on October 12-13, 1990.
Continuing education credit from ASHA,
NHAS, and state examining boards is available.
Each seminar lasts a day and a half. Tuition is
$150.00 which includes an extensive syllabus.
Please write or call for further information.
ATA, P. 0. Box 5, Portland, OR 97207. (503)
248-9985.
Continued from Page 9.
routine test protocol for patients reponing the
presence of tinnitus.
The tests are simple and reproducible and
should become a vital focus of the dispenser or
audiologist. In so doing, a needed service will be
provided and manufacturers and researchers in the
hearing health field will focus more effective atten-
tion to this area. Most of all, hearing impaired
persons will have greater incentive to seek
amplification correction and, as a bonus, enjoy
more consistent relief of their tinnitus.
References
Arenberg, L. K. and Balkany, T. J., Objec-
tive Pulsatile Tinnitus: Vascular Basis, Journal of
Otolaryngology, Supplement #9, 1979.
Hoover, S., Tinnitus and allergy. Proceed-
ings ill International Tinnitus Seminar, Muenster,
West Germany. 1987
House, J. W. and Johnson E. W., Tinnitus:
Tinnitus Masker and Biofeedback Training. Trans-
actions of the Pacific Coast Oto-Opthamological
Society, Vol60, 1979.
House, J. W. , Tinnitus Evaluation and
Treatment. American Journal of Otology, Vol5 No
6, 1984.
Marchiando, A., Per-Lee, J. H., and Jack-
son, R. T., Tinnitus Due to Idiopathic Stapedial
Muscle Spasm. Ear Nose and Throat Journal, Vol
62, 1983.
Surr, R. K., Montgomery, A.A. and
Mueller, H. G., Effect of Amplification on Tinnitus
Among Hearing Aid Users. Ear and Hearing, 6:71-
75, 1985.
Vernon, J.A. and Schleunning, A., Tinnitus:
A New Management, Laryngoscope, 88:413-419,
1978
12
Vernon, J.A., Current Use of Masking for
the Relief of Tinnitus. Tinnitus, Pathophysiology
and Management, Kitahara, Ed., pp 96-106. 1988.
lb
ONE LIFE IN THE DAY OF TINNITUS
Syd Hunt, British Virgin Islands
After every medicine (conventional,
homeopathic, Chinese); after herbs, acupuncture,
CAT scan, spinal tap, being prayed over,
psychosynthesis, Feldenkrais, meditation, yoga,
T'ai Chi: my tinnitus only worsened over the years.
With diets like a contest between Davis and Pritikin
for "First Place" in organic Cordon Bleu, I've gone
the route of total cleanliness so often my liver,
kidneys, gallbladder, spleen, lungs are so shiny
clean food needs dark glasses for the trip.
I'm 80, a paragon of geriatric health with
blood pressure 110 over 70, pulse 55, temperature
97 .8. I still have TIN!
Some mornings I wake to life busting to get
going. On other mornings, by far the most, there it
is already installed, a buzzing, wheezing, a mind-
consuming demon in my head. I am tired before I
get up. Dizzy, stumbling into furniture, I feel
nauseated but it is dry heaves, nothing comes up.
Do I feel horrible because I have tinnitus or
do I have tinnitus because I feel horrible? Is tinnitus
a symptom, a cause, or a curse? Tinnitus has you.
You don't have tinnitus.
It comes and goes irrationally, without warn-
ing but always with threat that it may stay forever.
My medical record of tinnitus goes back for
more than 20 years. About six years ago I became
friends with three doctors. Each separately gave me
his time because I would keep a diary, write detailed
reports and stay with the project till the end. After
years of trying, each concluded independently, that
the source must lie in the constant tension in my
neck cutting off blood to a part of my head. I did
not know my neck had been tense.
Tinnitus used to be occasional sounds, mostly
in my ears. Twice I jumped from bed and ran to the
phone, alarmed that any one should be phoning in
the middle of the night, only to realize that I had no
phone. This was a bitter time of life when I was
made widower a second time. I struggled alone to
finish a house I no longer wanted. This was when I
13
started to wonder how bad could the noises be-
come? How long would they last? Would I end in
an asylum?
Over the years the noises have seized my
whole head, day and night. They may die down
while I am working hard, or otherwise am pleasant-
ly occupied, or it may be that I do not then stay
aware of them for they come again especially when
I lie down. I try to stay upright until I drop because
if I lie down THE TIN will crawl into my head,
threatening to remain forever.
My first specific clue to the tension came
from a Swedish masseuse. She told me to roll over
face down. Immediately she exclaimed, "Why Syd,
that's fear!" How she could look at the back of my
neck and read "fear" I still don't know. The doctors
agreed that tinnitus was not a cause. It was a
symptom. The tension was not a cause either.
Something was basic to the tension. I learned that
in England they maintain only one cause for tinnitus
--- anxiety. Anxiety, worry, dread, they are all
facets of fear, one of our two elemental emotions.
I no longer reject any proposal, but fear was
hard to accept. Long ago I crossed Europe and
North Africa trying to out-Haliburton Haliburton:
diving off cliffs, photographing a forbidden
mosque, being chased across roof tops by a giant
Arab with a large knife; fleeing Andorra under
luggage on top of a bus just before the first bombs
of the Spanish Civil War. Physical dangers have
always been for me "adventures." Fear had to take
on a different definition.
The T'ai Chi and yoga helped me to become
more objective about myself, to communicate with
my parts. After a lot of trying I have become objec-
tive about emotional reactions. When I would reach
for my wallet on the dresser and it was not there ,
my life-long reaction used to be "Oh God! A pick-
pocket!" For the phone at night, my reaction was
"Which one? Which child has been hurt?" How-
ever, once I became fully, honestly aware of this
fear pattern I recognized it for habituated fear.
Full-blown, belly clutching fear without justifica-
tion. I admitted to myself I was a fear addict. Just
as addicted and in the long run almost as destructive
as any other kind of addiction. I could then pause
Continued on Page 14.
ContinuedfromPage 13.
and accuse myself of not even looking for whatever
was the problem. "Look frrst, fear later." Repeated-
ly I found my wallet in yesterday's pants. I would
make myself numb long enough to answer the
phone- and receive a loving family call. Getting
control over fear was easier than I had anticipated.
The reward has been a much happier life.
But I still have tinnitus.
A recent incident has shown me how diverse
are hidden fears. For twelve years I had been unable
to do the inverted posture in yoga: standing on the
neck and shoulders while the legs are stretched
straight up. I was convinced I had a weak back.
There was the danger of breaking my neck. A few
weeks ago I was so rock-bottom depressed with
tinnitus that, as I lay on the mat, the thought came
to me. What if I do break my neck? It will be quick.
Isn't that why I am thinking of buying a gun? In that
moment of abandon, I threw my legs into the air,
balanced perfectly on my shoulders, then rolled out
slowly. The teacher stood over me for a moment.
"Nothing wrong with your back," he said. "For
twelve years you've been afraid." My back fear
came originally from a doctor who read a spinal
x-ray and said! had the worst back he had ever seen.
"Don't ever let anyone touch it." Years later another
doctor said the first had misread a shadow on the
x-ray. My spine was normal. But by then the fear
had become habitual.
Paracelsus said imagination causes man's
diseases.
Tinnitus is not a straightforward illness that
can be traced to overeating or a quarrel or a bug with
a name. The consensus of doctors working with my
case is that tinnitus is the result of negative thinking,
self doubt, lack of faith in life, causing something
of which tinnitus is a symptom.
My journal shows the greatest periods of
quiet in my head come following a deep sense of
achievement. This suggests the cure must come
from the cure of fear and not from the suppression
of dizziness or joint pains.
Here are some observations that may help
others through this vague elusive labyrinth of head
noises. A nap soon after eating brings on tinnitus.
However, if I am deeply depressed the tinnitus
comes regardless of nap. If tinnitus awakens me and
I am still tired, trying to force myself back to sleep
makes the tin worse. Now when I awaken, regard-
less of being still tired, I do something satisfying
and then the tinnitus at least is not increased.
There seems to be about an eight hour lapse
between changes from or to tinnitus. If I am in a
quiet period and undergo a strong depressing ex-
perience, the tin will change about eight hours later,
gradually replacing quiet with a crescendo of noises
and despair. Conversely, ifi work well despite the
noises, and enjoy a day of satisfaction, the tin will
subside about eight hours later.
Disciplining myself to break the fear habits
has brought its own reward. But, I still have tinnitus
most of the time. And, despite the great progress, I
have one constant great fear that has not abated in
the slightest. I am afraid of the tinnitus. Will it go
on forever?
Researchers of the world: How do you get rid
of fear of fear?
BIBLIOGRAPHY SERVICE
ATA's Tinnitus Bibliography service may
be used in two major ways:
1) Purchase of the complete bibliography (a list
of approximate! y 1800 writings relating to tinnitus,
including author, where published and date of pub-
lication) at a price of $30 to AT A members, or $55
to non-members.
2) Specific topic list. You may request a subject
search list (if you want only one or two specific
topics) at a charge of $5.00 per topic.
Hard copies of articles may be selected and
ordered from these lists. Our charge for copying the
articles is $0.10 per page, plus postage and handling.
The bibliography update for 1990 is under-
way and will be available in the fall. Those people
requiring updates may write for information. (At-
tention: Patricia Daggett)
14
TINNITUS: QUESTIONS AND ANSWERS
JackA. Vernon, PhD., Director, Oregon Hearing
Research Center
With this column we have reopened a section on ques-
tions and answers about tinnitus. Q!A will remain as a
regular offering in Tinnitus Today as long as questions con-
tinue to be received from you the readers. In certain cases,
to use the term 'j4,nswer", may be something of an exag-
geration but we will always attempt to provide the best in-
formation currently available.
In addition to your questions, we would be interested in
receiving your reactions to any "answers" with which you
may disagree or for which you have better or contrary in-
formation.
Question: "Is there any research information
on the topic of the Temporomandibular Joint (TMJ)
and tinnitus?" From Ms. G. in Michigan.
on the relationship
between tinnitUs and TMJ problems dates back over
50 years, and many clinicians claim that correcting
TMJ problems can relieve tinnitus. The more press-
ing problem, however, is to determine which tin-
nitus patients have, or are suspected to have, a TMJ
problem. If you know of no other cause for your
tinnitus, and you have reason to suspect TMJ
problems, then you should see a dentist who special-
izes in the correction of TMJ. One might suspect a
TMJ problem if there is pain or clicking in the jaw
joint, or if deliberate and exaggerated jaw move-
ments change the tinnitus. Current investigations of
the relationship between tinnitus and the TMJ in-
clude one by Dr. Douglas Morgan, at the TMJ
Foundation in California. Another by The Oregon
Hearing Research Center is attempting to determine
if certain aspects of tinnitus are related to TMJ
dysfunction.
Question: "I suffer from extreme sensitivity to
sound. I cannot tolerate any normal sound environ-
ment. I believe it is called hyperacusis. Would
separating the conductive middle ear bones help this
condition?
Answer: To disarticulate or separate the middle
ear bones will produce about a 60d.B hearing loss
15
which might help hyperacusis. However, I know of
no one who has tried this approach. As I see it, there
are disadvantages to such a procedure. In the first
place, you would have to have the operation on both
ears and would almost assuredly need hearing aids
in order to perform as a normal social human being.
(A 60d.B hearing loss would probably prevent you
from understanding speech even in a quiet environ-
ment.) Next, if you also have tinnitus, and that is
highly likely, the impaired hearing would probably
greatly exacerbate the tinnitus. Third, there is no
assurance that the disarticulation would improve
the hyperacusis. The patients we have seen using
ear plugs in combination with ear muffs, which
produces about 30 to 35d.B drop in hearing have
received little help. Thus, to reduce the sound levels
by a greater amount may have no effect on the
hyperacusis. Finally, we have assumed that the
disarticulation operation would be reversible, and
that is the case when the time interval between the
operation and the repair is very short. However,
when there is a long interval between the operation
and the attempted repair, there is no assurance that
the repair can be effected. I would strongly en-
courage you to discuss your ideas further with your
otologist.
Question: "Is there research to reveal a
relationship between nutrition and tinnitus?" Ms.
K. from Rhode Island
Answer: Much has been written on this
topic, and there are many claims as to the repair of
hearing loss and tinnitus by special diets. Unfor-
tunately, independent studies have not been con-
ducted, and as long as one is eating a normal
balanced diet, I doubt that "special diets" can have
much of an effect upon either hearing loss or tin-
nitus. Allergy may be a different matter where
elimination of certain offending foods can relieve
tinnitus caused by an allergy. If, Ms. K., you have
any reason to suspect an allergy, then I would
recommend that you keep a diary about what you
eat and its relationship to your tinnitus, and then be
seen by an allergist knowledgeable about tinnitus.
(bJ
NEW AVIATION HEADSET,
ANTI-NOISE TECHNOLOGY,
SHOW PROMISE
Cliff Collins, Freelance Writer, Portland, Oregon
Tinnitus patients are encouraged over the
news that several high-technology companies are
working to develop devices that cancel unwanted
sounds. Known as antinoise, the technology
employs sophisticated computer chips to intercept
incoming noise and block it away from the person's
ears.
Antinoise came to the attention of the AT A
when Time magazine ran an article on the technol-
ogy in its December 4, 1989 issue. The story high-
lighted a new aviation headset manufactured by
Massachusetts-based stereo-maker Bose. The head-
sets, according to the company, were designed for
the aviation industry to help pilots eliminate cabin
or cockpit noise and still be able to communicate
with others in the aircraft. An attachment in the
headset also connects the pilot's radio and
microphone.
Time said at least a dozen other U. S. and
European companies are working on antinoise sys-
tems for use in industrial settings where noise is a
problem. That covers a lot of people: at least 9
million American workers are exposed to hazardous
noise levels at work, according to the American
Medical Association.
But such technology also is of interest to
people with tinnitus, who must avoid loud noises at
all costs or suffer the consequence of worsened
tinnitus. In addition, a small percentage of tinnitus
sufferers also have hyperacusis, an extreme sen-
sitivity to everyday sounds as well as loud noises,
and these people show an even greater interest in
finding devices that shut out noise more effectively
than standard earplugs and earmuffs. Earlier this
year, Phil Morton, an ATA board member who has
tinnitus and hyperacusis, spoke with Bose, which
agreed to lend a pair of its aviation headsets to the
ATA so that several hyperacusis patients could try
out the device to see if it might help them. Four
Portland-area patients, including Monon, wore the
headset in situations such as driving in a car, flying
in a plane or helicopter, or running a vacuum
cleaner or power tools.
The results were mixed, mainly because the
device does not as yet block high-frequency sounds
or impulsive noises, both of which are particularly
damaging to most hyperacusis patients. None felt
that the headset was sufficient for blocking out the
sounds they normally encounter in daily living.
However, all of the patients felt encouraged that the
technology will advance within a few years to
expand the frequency range of noise it can
eliminate.
In the meanwhile, whether antinoise
devices in their current state of development can
help people with tinnitus but not hyperacusis is
unclear. Presumably, since the devices are made for
people with normal hearing, headsets such as the
Bose might serve as good, albeit expensive, sound
protection. Morton, who asked two people with
normal hearing to wear the headset in a factory, said
they reported that noises were virtually eliminated.
The potential for antinoise will be closely watched
by people with tinnitus
{bJ
16
TRIBUTES
The ATA tribute fund is designated 100% for research. Thank you to all those people listed below for sharing
memorable occasions in this helpful way. Contributions are tax deductible and are promptly acknowledged with
an appropriate card. The gift amount is never disclosed.
IN MEMORY OF CONTRIBliTOR IN HONOR OF CONTRIBliTOR
Michael J. Alfarano Anthony De Biase Daphne Robert J. Architect
Father-inlaw Len Mayer Norman BrokaW"Renewal of Cosby ShoW" Jean & Joe Wolfson
John Christos Norma Christos Bob & Russ Dallmeyer"Good Health" Jean & Joe Wolfson
W. H. Daniel M. Maxine Palmer Cora Deutchman"New Position Jean & Joe Wolfson
Michelle Dear Melvin & Marilyn Kirsch Mora C. Emin"Birthday Joe Alam & Trudy Drucker
Rebecca Feigenbaum Julius H. Gerson Frank & Barry Epstein Mrs. Berti Epstein
Herman (Sonny) Raids Julius H. Gerson Steve Epstein"Promotion Jean & Joe Wolfson
Glenn Funk Mr and Mrs J. H. Schlater Scott's"New Baby" Jean & Joe Wolfson
Michael Galgano Anne & Bernard Silverman Kenneth H. Farrell, M.D. E. J. Vitale
Phyllis Gilbert Gary Gilbert Fred Feldman"New Job" Jean & Joe Wolfson
Erva Hopusch Frances Janiga George M. Frichter Ill Bernice Rombach
Albert & Belle Horn Dr Dorothy Horn Nancy Gardner & Dr. Benjamin Rubin Joe Alam & Trudy Drucker
John M. Jacoby, S. J. John M. Jacoby James E. Gelman, Esq. Bergen Tinnitus Group
Bertha M. Keehn Pauline A. Keehn Elias Herschmann, M.D."Marriage Jean & Joe Wolfson
Harold Ught Jean & Joe Wolfson Howard House, M.D."Kind Understanding M. Gabriel Machado
Harold Ught Jean & Joe Wolfson Michael G. Kassab"National Honor Soc" Bergen Tinnitus Group
Bessie Marcus Leonard Marcus Christopher Killion "Birth" Kevin Killion
Renee Oliver Mr and Mrs Dennis Oliver Harold Ught"Speedy Recovery Jean & Joe Wolfson
A L Pastor lUane Cooper Dr. Louis Ughton"Successful Surgery" Jean & Joe Wolfson
Richard Pomeroy Adelle Bratsos Rita Londoner"Good Luck-Good Health" Jean & Joe Wolfson
Robert Posner Mr and Mrs Ezra Lorber Betty Miller"Beautiful teachings Jean & Joe Wolfson
Alicia E. Raleigh Edward J. Coughlin, Ed.D. Vivian Nervegna"Birthday Alfred Nervegna
Father Redmountain Jean & Joe Wolfson Marilyn Peltzman"Wonderful Friend" Arleen Erber
Ida Lena Rudick Rose Schielman Mariana Smith"Successful Surgery Jean & Joe Wolfson
Edna Shaw Mr and Mrs Sam Eisenberg Marlene Smith"Mothers Quick Recovery Jean & Joe Wolfson
Arlie Teague Mike & Pauline Michael S. L Stiles"Noisy Ears" S. L Stiles
James S. Thornton Bond & Virginia Blackman Richard H. Tyler, M.D. Stephen Dephoure
ATA PROFESSIONAL ASSOCIATES> MARCH TO MAY 1990 Jack Vernon, Ph.D. Mr & Mrs Clifford Collins
Elio J. Fomatto, M. D. Forrest H. Kendall, Jr., M. D. Steve Weiss"Success of Murphy Brown Jean & Joe Wolfson
Michael Foltz, M. A Meredith Pang, M. D. Steve Weiss"New Baby' Jean & Joe Wolfson
Milton lngerman, M. D. Richard T. Zimmerman, Esq. Bergen Tinnitus Group
< AT A SPONSOR MEMBERS MARCH TO MAY 1990 - - - >
Jack Aldrich Josephine K. Gump Robert W. Lenart Lydia S. Robinson
Robert J. Architect Abraham Guidry Jed Margolin J. Virginia Schurz
Leigh E. Christensen Dennis D. Heindl Stanley E. Moore Kenneth 0. Scott
James Clarke Chris E. Hertz Norman H. Mueller RobertSillins
Donald Collum J. R Horton, Ill Erling D. Naess Sylvia and Raymond Smith
David L Covey Raymond Houghland Richard Neldner Barbara R. Stanley
Anthony Debiase James Irving Ruth E. Ochs Morton and Norma Steele
Dr. Trudy Drucker Patty John Edward Palin Ruth M. Swan
H. Renwick Dunlap George C. Juilfs Norma Pentney-Pask James C. Totten
Frey Dye Kevin & Deborah Killion Ruth M. Philpott Virgil Vanatta
Barbara J. Elko Laura P. Kleddick Bernard Richards Varian Continental Emp.Ch.Fund.
Mrs. Stewart Greenebaum Lakeshore ENT Center, PC W. C. Rickard Paul Zerbst
YOUR GIFT REALLY HELPS!
ATA members can be proud to be part of an organization which has helped thousands of tinnitus sufferers.
Your questions have stimulated the research community to work harder to find answers. Your association, AT A,
has been able, with your donations, to fund a number of important studies about tinnitus. Our bibliography
service provides extensive information about this and other tinnitus research. The continuing education courses
we offer provide the up-to-date information health professionals need to help you. Public awareness of tinnitus
has increased because of ATA programs, and our participation in national organizations. ATA support groups
bring help and understanding to your own community.
Only through our combined efforts can we hope for an end to tinnitus. Use the form on page 19 to send
your contribution in any amount, today. Please be as generous as you can. Thank you.
17
If You Suffer From Tinnitus,
You Need To Hear This.
Feel the ocean's spray ... go barefoot
by a swift mountain stream ... or take
a walk in the summer rain.
Are You One Of The
Estimated 36 Million People
Suffering From Tinnitus.
The soothing, natural sounds of
the Marsona 1.200 can substitute
or the frustrating, ringing sounds
caused by tinnitus. The frequency
and intensity of the simulated SOWld
of rain, surf and waterfalls match
the tones heard by many tinnitus
suffers. This masking device has
proven extremely effective in
assisting patients in adapting to
their tinnitus. Even though
it's not possible to predict
whether or not Marsona is
appropriateforyou, the
probability of successful
masking is well worth taking
advantage of our30 day money back
guarantee.
Because it weighs less than three
pounds, you can conveniently take
the Marsona 1200with you on trips.
Accomodating 110volt the Marsona
consumes less power than a small
night light. Further, you can connect
the Marsona 1200 to your stereo
system or use your stereo head-
phones for such realistic sound you
can let your imagination run wild as
you travel from the mountains to the
seashore.
If you are not on the Ambient Shapes
mailing list ... you should be ... Calltodayto
receive our unique catalog.
Control your audible ambience with
Marsona 1200fromAmbientShapes.
Don't wait! Call Now-TOLL FREE.
ORDER TOLL FREE
r-------t
M2jorcreditcard holders please call toU free.
I Orderproduct#TMAl20fortheMarsooa I
1200. Orseodacheck for SI29.00(FR.E
I shipping& handling). NCresidentsadd 5% I
sales tax. One{l)yearwaiT3nty- Thiny
I {30)day money back guarantee. I
I ORDERTOU.FREENOW I
I 800/438-2244 I
1 NCresidentscall704/324-S222 I

1 Ambient Shapes, Inc. 1
PO Box 5069 Hickory, NC 28603
I I
These satisfied customers
offered their comments
on the Marsona 1200
sound conditioner:
*Purchased tomasknoiseoftinnitus.
It really helps!
D.S., San Anselmo, CA
*Excellent for masking tinnitus
noises.
J.I., Lynn, MA
*Myhusbandhastinnitus. Our
doctorrecommended this and it has
helped him tremendously.
P.A. Van Wert, OH
Fantastic- Best sleep in years-got rid
ofheadllches from lack of sleep.
M.B., N. Hollywood, CA
Whatistinnitus?lt'sasubjective
experience of hearing a soWld, ring,
or a noise when no such external
physical sound is present. Some call
it head noises, ringing", orother
similarthings. TheOregonHealth
Science University.
Welcome To The
New Generation
of plification
Excellence.
Exceptional Aesthetics. The 7 Series' ITE and canal faceplates' spe-
cially contoured exterior surfaces blend smoothly with the shape of
the ear and concha. With efficient spacing gained from the fixed mic,
fixed VC, and smaller battery contacts, the 7 Series' family of hearing
aids provide the ultimate cosmetic and acoustic complement to the
ear's natural design and function.
AMERICAN TINNITUS ASSOCIATION
P.O. BOX 5, PORTLAND, OR 97207
ADDRESS CORRECTION REQUESTED
A New Generation of
Reliability. The 7 Series intro-
duces a whole new generation of
design excellence. A completely
new faceplate with isolated mi-
crophone and amplifier position-
ing increases manufacturing
efficiency while virtually elimi-
nating mechanical feedback.
The smaller, more stable high
tensile gold-plated contacts
along with the new, ultra-durable
VC and socket assembly both
ensure a more reliable perfor-
mance with virtual elimination
of intermittency problems.
Welcome to the New Gener-
ation. Never before has the in-
dustry experienced this level of
amplification excellence- all
designed to enhance your own
high standards of service excel-
lence. Because we are dedicated
to providing the very best for you
and those you serve, we believe
ALL your patients should benefit
from this newest generation of
unequaled sophistication, no
matter what they presently wear.
Starkey products, including
tinnitus maskers, are available
from your local hearing
health care professional listed
in the Yellow Pages under
"hearing aids".
NON-PROFIT ORG.
U.S. POSTAGE
PAl 0
American Tinnitus
Association