March 1999 Volume 24, 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
Education - Advocacy - Research - Support
In This Issue:
Tinnitus 'Thrgeted
Therapy
Tinnitus in Coll ege
Acoustical Effects of
Air Bag Deployment
Internet Links to
Tinnitus
ATA Researchers to
Study Drug Effects
A Salute to Bravery
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Tinnitus T o d ~ y
Editorial ond Advertising offices: American Tinnitus Association, P.O. Box 5, Portland, OR 97207 503/2489985, 800/6348978 tinnitus@ata.org, hHp:j /WIWI.oto.org
Executive Direcror &' Editor:
Gloria E. Reich, Ph.D.
Associate Editor: Barbara Thbachnick
Tinnitus Today is published quarterly in
March, June, September, and December. It is
mailed to American Tinnitus Association
donors and a selected list of tinnitus suffer-
ers and professionals who treat tinnitus.
Circulation is rotated to 80,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuit-
able for Tinruws Tbday. Acceptance of adver-
tising by Tinnitus Thday does not constitute
endorsement of the advertiser, its products
or services, nor does Tinnitus Tbday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The
opinions expressed by contributOrs to
Ti1mitus 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 1999 by American Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
withOltt the prior written permission of the
Publisher. ISSN: 0897-6368
Executive Director
Gloria E. Reich, Ph.D., Portland, OR
Board of Directors
James 0. Chinnis, Jr., Ph.D., Manassos, VA
Claude H. Grizzard, Sr., Atlanta, GA
w. F. S. Hopmeier, St. Louis, MO
Gary P Jacobson, Ph.D., Detroit, Ml
Sidney Kleinman, Chicago, IL
Paul Meade, Tigard. OR, Chmn.
Philip 0. Morton, Portland, OR
Stephen Nagler, M.D., F.A.C.S., Atlanta, GA
Dan Purjes, New York, NY
Aaron l. Osherow, Clayton, MO
Susan Seidel, M.A., CCC-A, Towson, MD
Tim Sotos, Lenexa, KS
Jack A. Vernon, Ph.D., Portland, OR
Megan Vidis, Chicago, IL
Honorary Directors
The Honorable Mark 0. Hatfield,
U.S. Senate, Retired
Thny Randall, New York, NY
William Shamer. Los Angeles, CA
Scientific Advisors
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, IL
Robert A. Dobie, M.D .. San Antonio, TX
John R. Emmett, M.D., Memphis, TN
Chris B. Foster, M.D., La Jolla, CA
Barbara Goldstein, Ph.D., New York, NY
John w. House, M.D., Los Angeles, CA
Gary P. Jacobson, Ph.D., Detroit, MI
Pawel J. Jastreboff, Ph.D., Atlanta, GA
William H. Martin, Ph.D., Portland, OR
Calc w. Miller, M.D., Cincinnati, OH
J. Gail Neely, M. D., St. Louis, MO
Robert E. Sandlin, Ph.D., El Cajon, CA
Alexander J. Schleuning. Tl, M.D.,
Portland, OR
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D., Sa11 Jose, CA
Robert Sweetow, Ph.D., San francisco, CA
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey,
Portland, OR
The Journal of the American Tinnitus Association
Volume 24 Number 1
1
March 1999
Tinnitus, ringing in the ears or head noises, is experienced by as many as
50 million Americans. Medical help is often sought by those who have it in
a severe, stressful, or life-disrupting form.
Table of Contents
7 New ATA Board Members
8 Tinnitus Thrget ed Therapy: A Medical/ Audiological Approach
by Barbara Goldstein, Ph.D., and Abraham Shulman, M.D.
12 Mile After Mile
by Barbara Thbachnick
13 Announcements
14 A Salute to Braver y
by Mary Meikle, Ph.D.
15 ATA Researchers to Study Drug Effects
17 Acoustical Effects of Air Bag Deployment
by James 0. Chinnis, Jr. , Ph.D.
19 Federal Funds Available for Altemative Tinnitus Research
by Barbara Thbachnick
20 Tinnitus in College - A Comparison of the Incidence
of Tinnitus in College Music Majors and Non-music Majors
by Mark Zeigler, Ph.D.
22 Intemet Links to Tinnitus
by Barbara Thbachnick
Regular Features
4 From the Editor
by Gloria E. Reich, Ph.D.
6 Letters to the Editor
23 Questions and Answers
by j ack A. Vernon, Ph.D.
25 Special Donors and 'fributes
Cover: 'Cottage Interior (acrylic on canvas, 36'x36") by Barbara Markle, 1083 Norway Dr.,
Columbus, Ohio 43221, 614/451-4441. Ms. Markle is an artist andATA member:
FROM THE EDITOR
by Gloria E. Reich, Ph.D.,
Executive Director
The most exciting event
related to tinnitus for the year
1999 is the Sixth International
Tinnitus Seminar, a quad-
rennial meeting of tinnitus
researchers, which will take
place in Cambridge, England
from September 5th through
9th. This meeting, like the
five that preceded it, will draw the best tinnitus
presentations worldwide and will give both
researchers and laymen the opportunity toques-
tion one another and share the latest theories and
discoveries. If you'd like to attend this meeting,
please see the announcement on the back cover
of this issue. There will also be a meeting of the
International Tinnitus Support Association on
September 5th, in Cambridge just preceding the
Sixth International Tinnitus Seminar.
On the home front, ATA is busily planning
programs for next year. (Our fiscal year starts on
July 1st.) The Strategic Plan, which was adopted
and implemented in 1997, outlines programs relat-
ing to Education, Advocacy, Research and Support
(EARS). While most programs are ongoing, the
plan calls for certain additions in fiscal year end-
ing June 2000. Audiologists, hearing instrument
specialists, neurologists, and psychologists are
targeted for professional outreach this year.
Healthcare curriculum programs are to be expand-
ed, especially in terms of prevention. Partnerships
with other health care organizations and with
corporations vvill be pursued. Research funding
will be increased, self-help leadership training will
commence, and the ATA board vvill continue to
expand its membership.
ATA has been overwhelmed with requests for
research grants in the last several months and
many of the projects look very promising. A few
years ago we received a large bequest that made it
possible for us to fund more than our usual num-
ber of grants. We'd like to be able to fund worthy
studies at a greater rate but our resources, princi-
pa11y from that one bequest, have been depleted
considerably and we are now dependent on the
restricted research donations you make. These can
be in the form of bequests, stock transfers, tribute
donations commemorating special events, or sim-
ply as an extra check or Visa charge that you want
to be applied directly to tinnitus research. Here
4 Tinmrus 7bday/ March 1999 American Tinnitus Association
are some of the research topics that we've recently
been asked to support:
Cochlear pharmacology of lidocaine and
ZD7288
Determination of normative data for loudness
discomfort levels (LDLs) for the tinnitus and
hyperacusic patient
Effectiveness of tinnitus retraining therapy
Gene discovery in tinnitus
Involvement of the non-primary auditory
nervous system in severe tinnitus and a
possibility to develop a diagnostic method
Mechanisms of hyperexcitability in the inferior
colliculus: GABA and protein kinase Cs
New in vitro system to study the effects of
tinnitus-inducing and tinnitus treatment drugs
Tinnitus amelioration using 100% digital
completely-in-canal hearing instruments
Use of functional MRI to localize brain activity
related to tinnitus
Use of auditory reorganization to minimize
tinnitus perception
Spontaneous activity in cat auditory cortex after
acute and early-age induced pure tone trauma:
are mechanisms for transient and long-standing
tinnitus different?
The role of the trigeminal ganglion and cochlear
nucleus in the modulation of tinnitus
The amount of research donations we receive
will determine the extent to which we can fund
these projects.
Other research about the auditory system will
benefit the tinnitus sufferer, too, although not as
directly as the kinds of projects listed above. We
read about new discoveries almost every day on
the Internet. In January, a sampling of this infor-
mation revealed that:
1) tissue graft surgery might help the hearing
impaired by aiding in the regeneration of damaged
auditory pathways - from the journal
NeuroReport; http:/ / www.foxnews.com/ js
Gloria Reich,
Ph.D., and Bob
Johnson, Ph.D.
FROM THE EDITOR {continued)
2) hearing might be restored after noise exposure
through the application of antioxidants; similar
techniques might also benefit some Meniere's
sufferers - from the New York Times,
http:/ / search.nytimes.com/search/ daily/bin/
fastweb?getdoc +site+ site + 20623 + 2 +
w AAA +cochlea
3) certain proteins, Del ta and Notch, are instru-
mental in arranging the pattern of hair cells in
experimental animals. "These findings will aid in
bringing scientists closer to the day when they will
be able to restore hair cells in the human ear," says
Dr. Edwin Rubel at the University of Washington-
in Nov. Science Magazine, www.sciencemag.org
4) a breakthrough in genetic research that may ulti-
mately benefit public health by identifying muta-
tions that are affiliated with specific disease -
from Wired magazine, http://www.wired.com
5) cochlear implants have resurfaced with new
technology designed to improve the function of
older implants. Some of the ones from the 1970's
have deteriorated in performance over the years.
Dr. Michael Dorman at Arizona State University
works with old cochlear implants updating them
with new processors. He can be contacted at
aomfd@asuvm.inre.asu.edu
These and other scientists will be quick to
remind us that jumping from here to a promising
cure for tinnitus is like jumping over the Grand
Canyon without a means of transportation or a
bridge. Tinnitus research is the bridge, from the
ringing we hear to the silence that one day will be
ours.
A last and sad note: ATA lost a champion this
year. Bob Johnson, who died in January, was a
friend to all who suffered with tinnitus. Almost
20 years ago, colleagues dubbed his successes in
caring for tinnitus patients as "the Johnson effect."
Those of us who knew Bob always got the full
effect - 100% of his effort whether as friend, col-
league, or patient. His wish to perpetuate care and
research for tinnitus patients will thankfully live
on. You may join us in honoring Bob Johnson
through remembrances for treatment and research
as described in the centerfold insert of this issue. ml
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American Tinnitus Association Tinnitus 'Ibday/ March 1999 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
byATA.
A
fter years of trying everyth ing from acupuncture
to Xanax, I read about a medical doctor in Israel
who successfully treats noise-induced tinnitus.
Particularly convincing was an article in "The
Jerusalem Post" which stated: "In a study of 200
soldiers, [Zacharya Shemesh, M.D.] and colleagues
in the Israel Defense Forces found a notable
improvement in the quality oflife of tinnitus
patients. They reported an overall success rate of
90% -higher than anywhere else in the world-
and many patients said the noise had completely
disappeared .... " I contacted an Israeli patient of Dr.
Shemesh's. A fellow teacher, she swore that Dr.
Shemesh had made her life worth living again. This
encouragement led me to Israel to seek his help.
When I anived, I received a comprehensive med-
ical evaluation, which included protracted, empa-
thetic, one-on-one consultations (in English) and
body chemistry tests. On the basis of the results,
Dr. Shemesh and I built an individualized treat-
ment program for me - a program which I am
pleased to report has brought my tinnitus under
control.
Should readers wish to know more about Dr.
Shemesh's program for foreign visitors (conducted
by him at Hadassah Medical Center Jerusalem
and recently approved by Blue Cro;s/Blue S h i ~ l d ,
and others), they can contact him directly.
phone: 011-972-2-677-6078,
e-mail: debbiel@hadassah.org.il, or web site:
www.hadassah.org.il/ hmo/tinnitus/tinnitus. htm
I now reside in Israel and look forward to hearinv
from you. Shalom! o
Mike Cohen, e-mail: nu@netvision.net.il, phone:
011-972-9-955-6606, 52 Yehoshua Ben Nun St.,
Herzliya Pituach, 46763, ISRAEL
I
have had tinnitus for almost three years. It start-
ed when I had a tooth extracted and at the same
time learned through blood work that I have
hypothyroidism. 'TWo weeks ago, my ENT specialist
prescribed Transderm Sc6p (scopolamine 1.5 mg)
to help resolve the new symptom of dizziness. Th
6 Tinnitus 7bday/ March 1999 American 'Tinnitus Association
my great surprise, the scopolamine patch stopped
the tinnitus when I wore it behind my left ear
(which has the tinnitus). I wear the patch for three
days, take it off, then wait three days before apply-
ing another one. When I don't wear the patch, the
tinnitus resumes. Within two hours of applying the
patch, the tinnitus disappears. I hope this can help
others - if only temporarily. This patch has given
me tremendous relief.
John D. Perkins, 7667 N. Wickham Rd. , #508,
Melbourne, FL 32940, 4071242-6599,
KS4SO@webtv. net
I
'm not afraid to dry my hair anymore! In the
past, the noise of my blow dryer exacerbated the
noise of my tinnitus. Th counter it, I used to wear
earmuffs (under my chin) as well as earplugs. Not
only was I extremely uncomfortable wearing
these, but the noise of the dryer still got through.
Then in a catalogue, I read about the Whisper
Quiet #2 Hair Dryer distributed through
Brookstone (model #224113, $40 plus $5.95 ship-
ping, 800/846-3000). I bought it and at last I can
dry my hair without plugs or muffs or loud hair
dryer noise. Happy hair drying!
Alice J. Mandel, Philadelphia, PA
I
developed pulsatile tinnitus several months ago,
to the extent that I scoured my house for the cul-
prit machinery that was pounding away! The con-
dition persisted - loudly. I then read the letter to
the editor in the September 1998 Tinnitus Today,
which related the use of St. John's Wort by a suf-
ferer of pulsatile tinnitus, and began taking St.
John's Wort, one 300 mg. capsule, four times daily.
After a month, the pounding subsided to barely
audible. I've continued taking the product daily,
with no recurrence of the hard pounding. An occa-
sional soft pulsation does occur - but rarely. My
usual high-pitched whistle has not changed, but
the relief has been remarkable for the pulsations.
John E. Hart1ein, 12224 Ash St.,
Shawnee Mission, KS 66209
T
wo years ago, I began to have an incredibly
loud and frightening ringing in my head. After
visiting three otolaryngologists over six months, I
felt I was alone. But I would not accept that I had
to "go home and learn to live with it." I intended to
gain some control over this constant ringing that
was causing me to lose sleep and have debilitating
anxiety attacks, and that was affecting my social
life and my maniage. I tried acupuncture and
myofacial therapy, and endured testing that elimi-
nated the possibility of MS or a brain tumor. But I
was back where I started. Realizing that I could
letters to the Editor (continued)
not do anything to eliminate the ringing, I had to
do something for the anxiety. I tried taking Xanax
but it made me very tired.
I finally visited a naturopathic doctor who gave
me a dose of "aconite.'' I quickly stopped having
my debilitating anxiety attacks which allowed me
to be less aware of the ringing, and has enabled me
to enjoy life again. I was uneducated about homeo-
pathies, but have changed my approach to health
issues as a result of my incredible success with the
aconite.
Laura R. Enright, 150 FW Hartford Dr. ,
Portsmouth, NH 03801, 603/ 427-1431
Jack Vernon wrote to Stephen Martinez, M.D.,
Director of the National Highway Thaffic Safety
Administration, regarding air bags and auditory
damage. Dr. Vernon asked that we share his letter
with Tinnitus Today readers.
D
ear Dr. Martinez:
I have four patients each of whom have pro-
found hearing loss and severe untreatable tinnitus
due to exposure to air bag explosions. In each case,
the precipitating accident was a very simple fend-
er bender. Life and limb were not at risk for these
people but they will pay wHh a seriously reduced
quality of life for the rest of their lives because of
an overly cautious safety regulation.
I would like to propose to you that air bags
should be on an operator-controlled switch. When
in local traffic where very minor accidents are the
primary hazard, the switch could be turned off.
And then when in highway or freeway driving
where more serious accidents are possible, the
switch could be turned on as a preparatory mea-
sure. I seriously feel we should have the option of
activating or not activating our air bags which pre-
sent sur.h a serious r isk to hearing. At the sound
level at which the air bags are exploded, ear and
hearing damage is almost guaranteed.
Respectfully submitted, Jack Vemon, Ph.D.
Professor of Otolaryngology (Emeritus)
New ATA Board Meinbers
Timothy S. Sotos, lenexa, KS
A'D\. gratefully welcomes Tim
Sotos to the Board of Directors,
again. Tim joined ATA's Board
of Directors once before - in
March 1994. But in 1996, a
family emergency interrupted
his term. Now, three years later,
with the emergency resolved,
Tim decided to return to his work as an ATA board
member. He told us why:
"The combination of my being ready and the
progress made by the board in my absence has
brought me back. I liked what I was reading and
what I was hearing about ATA's growth. I was
encouraged by Jack Vernon's fund raising efforts,
and by his being on the board. I was encouraged
by Sid Kleinman's report about ATA's financial
direction. I was encouraged by Phil Morton's
involvement as a liaison with other hearing associ-
ations. The board has also grown to include Dr.
Nagler, Dr. Chinnis, and researcher Dr. Jacobson,
plus audiologist and support group leader, Susan
Seidel. It seems to contain the perfect balance of
business and medical talents and it is tremendous.
I' m available again and I' m pleased to be back."
Claude H. Grizzard, Sr., Atlanta, GA
ATA board member Aaron
Osherow knew of a Claude
Grizzard through professional cir-
cles. (Both are in the "direct mail"
business.) But when a Claude
Grizzard made a substantial
donation to ATA and his name
appeared on the Champions of
Silence tribute list in Tinnitus 7bday, Osherow
saw it and decided to contact him to see if the two
Grizzards were one and the same. They were.
We asked Claude about his reason for joining
ATA's Board of Directors. He says: "Basically, I
want to be helpful. Aaron [Osherow) thought I
could bring my professional background to ATA.
And if that can play a part in increasing ATA's
membership, then that's what I want to do. I also
want ATA members to feel that this organization is
being run as best as it can be. And I'm not speak-
ing of myself. I'm speaking of the others on the
board and the scientific advisory committee who
donate time and energy and expertise and money
to the cause of tinnitus. Me, I just want to be help-
ful." Welcome Claude!
Ameri can Tinnitus Association Tinnitus 'Thday/ March 1999 7
Tinnitus Targeted Therapy: A
by Barbara Goldstein, Ph.D., and Abraham Shulman, M.D.
The symptom of tinnitus is considered first
and foremost to be a medical/ audiological problem
involving the cochleovestibular (hearing and bal-
ance) system in the peripheral and/or central
nervous system. ("Peripheral" refers to the ear;
"central" refers to the brain.) Conditions such as
cardiovascular disease, hypertension, high choles-
terol, thyroid disease, and diabetes can cause
tinnitus. Therefore, prior to any treatment of
tinnitus, we recommend a complete medical as
well as audiologic work-up to establish an accurate
tinnitus diagnosis. We believe that successful
tinnitus treatment is based on the accuracy of
the tinnitus diagnosis.
Realities 1999
Both the professional and the patient must face
some realities about tinnitus in 1999.
1. There is no cure for tinnitus at this time.
2. There are different types and subtypes of tinni-
tus. Further, it is necessary to differentiate between
patients with severe disabling tinnitus and the gen-
eral tinnitus population. Severe disabling tinnitus
causes a serious interference in activities of daily
living - e.g. sleep, work, and social skills.
3. There is no general agreement about a definition
of tinnitus, a classification system of tinnitus, or
mechanisms of tinnitus production.
4. There is no one treatment appropriate for all
tinnitus patients.
5. There are many options for the relief/control
and treatment of tinnitus.
6. Instrumentation offers significant tinnitus
control to the tinnitus patient.
Since not all tinnitus is the same, not all
tinnitus patients need the same medical/ audio logic
work-up. However, most patients with the primary
complaint of tinnitus want to know the following:
What do I have? Is this a life-threatening condition?
Do I have a brain tumor? Does this mean I am
going deaf, or losing my mind? Will it get worse?
What caused it? What can I do to get rid of it?
Protocols of Diagnosis and Treatment
At our clinic, the patient with tinnitus Nor of
the severe disabling type can expect to receive:
l. Neurotologic examination (of the ears, nose,
throat, and cranial nerves) to exclude major
diseases of the head and neck (e.g., acoustic
neuroma).
8 Tinnitus 1bday! March 1999 American Tinnitus Association
2. Hearing screening test.
3. Tinnitus questionnaire to identify tinnitus by its
characteristics: location, intensity, etc.
4. For asymmetric (one-sided) sensorineural hear-
ing loss: a magnetic resonance imaging (MRI)
test of the internal auditory canals to identify the
presence or absence of an acoustic tumor.
5. Follow-up office visits for treatment.
We believe that successful tinnitus
treatment is based on the accuracy of the
tinnitus diagnosis.
We strongly believe that individuals WITH
severe disabling tinnitus, who have seen several
health care providers and are still suffering require
a comprehensive evaluation. In our practice, we
perform the Medical Audiologic Tinnitus Patient
Protocol (MATPP).(I) This is a team approach that
attempts to identify the medical significance of the
symptom of tinnitus, the clinical type(s) of tinnitus,
and the identification and treatment of factors
known to influence tinnitus. In this manner the
physician and the audiologist establish a basis for
tinnitus control. The MATPP includes:
1. A neurotologic history (a review of the patient's
complaints of hearing loss, tinnitus, vertigo, and/or
ear blockage which might reflect a disorder of the
central nervous system).
2. Hearing screening test.
3. Consultation with the patient and physical exami-
nation of the head, neck, and cranial nerves.
4. Individualized tests to measure the sensitivity of
the nerve of the ear for hearing and balance.
5. A live trial of instrumentation - to give the
patient the acoustic experience of masking,
habituation, and/or amplification.
6.Evaluation to identify the parameters oftinnitus.
7. Questionnaires - including a tinnitus question-
naire, a stress test, a depression scale, and the
tinnitus handicap inventory.
Our patients are also given an explanation and
understanding of their tinnitus, plus counseling
about avoidance of loud noise exposure and the use
of ear protectors in the presence of loud noise.
Medical/ Audiological Approach
TESTS
Patients who have been to other doctors fre-
quently ask, "Why do I need another hearing test?
I had all of these tests last year. I'm here for my
tinnitus, not my hearing. And why do I need bal-
ance tests? I only have occasional unsteadiness
when I get up too fast, but it doesn't bother me."
Tinnitus is closely associated with the hearing
and balance system. And because the nerve of the
ear has two parts - one for hearing and one for
balance -both parts of the system need to be
evaluated.
Many patients with severe disabling tinnitus
are anxious and fearful that testing will increase
their tinnitus. This is always a possibilHy! Patients
must decide if they are willing to take the chance,
no matter how small. This has been an infrequent
occurrence in our practice. Generally if tinnitus
increases in intensity, it will return to its usual
level. However, no one can guarantee it.
The following is an explanation of the specific tests we
perfonn for cases of severe disabling tinnitus.
Audiologic Evaluation
1. Site-of-lesion testing. This is a series of hearing
tests that attempt to establish the location of the
tinnitus. Tests consist of pure tone audiometry,
speech audiometry (including speech recognition
threshold), tone decay testing, and short increment
sensitivity index.
Central auditory speech testing is not routinely
performed. It is performed, however, for individu-
als who complain of hearing difficulty because of
their tinnitus but whose hearing tests and Auditory
Brainstem Response Thsting are satisfactory, and
for individuals whose site-of-lesion test results do
not explain their complaint of difficulty in hearing
or understanding. C2l
2. Impedance audiometry. This battery of tests
consist of tympanometry, acoustic reflexes, reflex
decay, and the Metz test for detecting lesions
in the inner ear. These tests help establish the
presence or absence of hearing loss, the type and
degree of hearing loss, and the presence or absence
of recruitment (a sensitivity to sound). They also
help the audiologist evaluate the functional condi-
tion of the patient's middle ear, eardrum, and
Eustachian tube. For the patient complaining of ear
blockage, these tests can determine if the source of
the blockage is the middle or inner ear.
3. Tinnitus Eva1uahon. It is important to "quantify,"
or specifically define, the patient's tinnitus experi-
ence to provide a basis for communication about
the tinnitus between the examiners and the
patient. Establishing the tinnitus paran:teters .-
quality, location, duration, frequency,
maskability, and rebound (an increase in tmmtus
intensity following sound presentation) - also
enables us to monitor any changes that result from
treatment. The tinnitus evaluation includes: pitch
matching, loudness matching, and the measure-
ment of residual inhibition (temporary, post-mask-
ing tinnitus suppression), the Feldmann Masking
Curves (Minimal Masking Levels), and loudness
discomfort levels.
After the results are analyzed, an individualized
trial of live instrumentation is offered. We hope
that individuals who experience residual inhibition
when they're tested will have the same experience
following the use of instrumentation for masking.
If rebound occurs, the otologist attempts to med-
ically control the condition. From masking
testing we can determine if maskability is pos1twe
or negative and which ear (or ears) should be fitted
with devices. (J) Loudness discomfort levels are
established for each ear individually at frequencies
from 250-8000Hz to assess the presence or absence
of hyperacusis and other sound sensitivities.<
4
>. The
outcome of these tests also influences the ch01ce of
instrumentation.
Ear and Balance Function Tests
1. Auditory Brainstem Response 'Jesting (ABR). The
ABR test records the brain's electrical firing capa-
bility in the central auditory system by measuring
its response to sound. This "evoked is.
recorded (via an electrode on the scalp) Immediate-
ly after a brief click or tone is It .is t?e most
sensitive and objective test for d1stmgmshmg
between a cochlear lesion and a retrocochlear
lesion (one between the cochlea and the brain).<
5
)
2. Otoacoustic Emissions (OAE's) Otoacoustic emis-
sions are low-level sounds generated by the outer
hair cells of the cochlea.C6) The test is a non-inva-
sive objective method of evaluating
auditory pathway function. OAEs are a sens1t1ve
indicator of cochlear status, especially outer hair
cells which are sensitive indicators of change in the
cochlea. For the tinnitus patient, this improved
accuracy of a cochlear diagnosis helps in the selec-
tion and monitoring of the therapy.
3. Ultra High Frequency Audiometry (HFA).
HFA permits an evaluation of the total of
the auditory system from 1000-20,000Hz. It ts used
to identify the tinnitus, establish octave confusions,
and monitor hearing in patients undergoing exter-
nal electrical stimulation for tinnitus suppression.
Using HFA, significant hearing losses in the high
frequencies - above 8000Hz - have been found
continued on page 10
American Tinnitus Association Tinnitus 'Tbdayi March 1999 9
Tinnitus Targeted Therapy ,, .. ,; ... dJ
in tinnitus patients whose previously recorded
hearing levels were "normal" when tested with
conventional audiometry .F>
Vestibular and Balance Tests
Vertigo and/ or balance complaints are not
infrequent in patients with tinnitus. When the
chief complaint is tinnitus, our clinical experience
with respect to vertigo indicates that a significant
number of patients ( 20%) have an associated
complaint of imbalance. Also, approximately 60%
of tinnitus patients - with or without symptoms
of vertigo - demonstrate a vestibular abnormality
when tested.
Secondary endolymphatic hydrops, often
found during vestibular testing, requires treatment
by an otologist. It can adversely influence tinnitus,
result in an increased loss of hearing, and cause
the patient to be more sensitive to sound. The
identification and treatment of secondary
endolymphatic hydrops (a syndrome of delayed
Meniere's-like attacks) positively influences tinni-
tus control in approximately 35% of our patients.
In our experience, use of maskers, hearing aids,
or other devices in the presence of this condition
tends to aggravate the tinnitus, cause rebound, and
reduce or negate the usefulness of the devices.
(Patients often reject the instrumentation.)
Treatment of the hydrops reduces recruitment and
increases the efficacy of instrumentation.C
8
>
l. Electronystagmography (ENG). ENG is a recording
of eyeball movement in response to a series of bal-
ance tests. The tests include tracking, optokinetics,
the Hall pike maneuver, and positional testing with
eyes opened and closed.
2. Computerized Rotary Chair and Pursuit 'ltacking
'Jests. These are used to screen for vestibular
abnormalities by identifying peripheral and cen-
tral vestibular function.
Additional Procedures
Other tests are advised on an individual basis
and can include laboratory tests (like blood work),
x-rays, CAT scan and MRI of the brain and tempo-
ral bones, and Single Photon Emission Tomo-
graphy (SPECT).<
9
> SPECT scanning of the brain is
a functional imaging technique which our center
introduced for the identification of abnormalities
of regional blood flow in patients with severe and
disabling central tinnitus. SPECT has also shown
us an area of hyperexcitability in the brain identi-
cal to that identified for epilepsy. This has a practi-
cal application for selected tinnitus patients. For
example, we can narrow down the selection of
drugs to a specific group, i.e. anti-seizure drugs, to
increase the effectiveness oftreatment.l
1
0) SPECT
1 0 Tinnitus Tbday/ March 1999 American Tinnitus Association
has also provided objective support for the specula-
tion that, for some, tinnitus is a sign of central ner-
vous system disease with associated complaints of
anxiety, depression, and fear.
Management Plan - Tinnitus Targeted Therapy
After completing the MATPP, our patients have
a follow-up visit with the nemotologist and the
audiologist dming which an individualized plan of
treatment, or Tinnitus Thrgeted Therapy, is recom-
mended. Current treatments include instrumenta-
tion (amplification with hearing aids, habituation
with Tinnitus Retraining Therapy, electrical stimu-
lation, and masking), surgery (e.g.,intratympanic
drug infusion), drug therapy, counseling, and cogni-
tive therapy. Individualized patient plans usually
combine medication and instrumentation. During
follow-up visits, patients and their significant others
can ask questions about the test results and the
plan of therapy.
Instrumentation
In our experience, the following medical
criteria usually suggests a patient's suitability for
instrumentation.
l. Absence of active ear disease (fluid in the ears,
mastoiditis, etc.).
2. Satisfactory aeration of the middle ear (proper
functioning of the Eustacian tube).
3. Peripheral site oflesion.
4. Absence of, or control of, vestibular disorder.
5. Patient is emotional1y stable.f
11
>
When an identified medical condition is treated,
the chance of success with instrumentation is
improved.
Medications
The introduction and application of new
drug therapies have increased the success of our
Tinnitus Thrgeted Therapy since 1997. These
medications include calcium channel blockers,
free radical scavengers, corticosteroids, glutamate
antagonists, and anti-seizure drugs. Surgical inser-
tion of a new microcatheter can deliver drugs
through the eardrum to the round window of the
inner ear. This procedure increases the possibility
of tinnitus relief for cochlear-type tinnitus.
This audiologic/ medical approach lets us
individualize and target the therapy for tinnitus.
Approximately 75-80% of our tinnitus patients
(more than 5000 patients) have achieved some
degree of tinnitus control: 30-35% with medication
and 60-65% with instrumentation. Approximately
15% have persistent problems.P
2
) The percentage
of problems that persists reflects the complexity of
the tinnitus in the patients who visit our practice.
Tinnitus Targeted Therapy ,, .. ,; ... d,
Our goal and the goal of the Martha Entenmann
Tinnitus Research Center is to improve the accura-
cy of tinnitus diagnosis and the modalities of tinni-
tus control therapy. We also support educational
programs both for the professional and the patient.
The ultimate goal of our center is to achieve a cure
for all clinical types of tinnitus. 9
Bibliography
I. Shulman, A., Medical audiological tinnitus patient protocol.
Tinmtus-Diagnosis/ 'Ireatment , pp. 319-321, l 991.
2. Goldstein, B., and A. Shulman, Central auditory speech test find-
ings in individuals with subjective idiopathic tinnitus, Proceedings of
the Pifth International Timitus Seminar, eel. G. Reich and .1. Vernon,
pp. 488-493.
3. Feldmann, H., Homolateral and contalateral masking of tinnitus,
Br [ Laryngol Otol: Suppl 5:60-70, 1981.
4. Goldstein, B. , and A. Shulman, Tinnitus - Hyperacusis and the
loudness discomfort test: A preliminary report, The International
Tinnitus Journal, vol. 2, no. 1, pp. 83-89, 1996.
5. Shulman, A. , and M. Seitz, Central tinnitus - Diagnosis and treat-
ment. Observations simultaneous binaural auditory brain responses
with monaural stimulation in the tinnitus patient,
The LanJngoscope, Vol. XCI, No.l2, pp. 2025-2035, December, 1981.
6. Shulman, A., and B. Goldstein, B. Bhatcl, Spontaneous evoked
otoacoustic emissions and tinnitus - its conclation/ uncorrelation
with specific clinical types of tinnitus, Proceedings of the Fourth
International Tinnitus Seminar, ed. J .M. Aran, et al., pp. 95-99, 1991.
7. Goldstein B., and A. Shulman, Electrical high frequency audio-
metry - Preliminary medical audiologic experience, Audiology
26:321 -333, 1987.
8. Goldstein B., and A. Shulman, Tinnilus masking- A longitudi-
nal study - 1987-1994, Proceedings of the Fifth International Tinnitus
Seminar, cd. G. Reich and J. Vernon, pp. 315-321, 1995.
9. Shulman, A., and B. Goldstein, A final common pathway for
tinnih1s - Implications for treatment, The International Tin
Journal, Vol2, No 2, pp. 132-142, 1996
10. Shulman A. , Neuroprotective Drug Therapy, The international
Tinnitus Journal, Vol. 3, No. 2, pp. 77-94, 1997
ll. Goldstein, B., and A. Shulman, Tinnitus masking: A 20-year
perspective, Presentation of 25th Meeting of the NES.
12. Shulman, A., A final common pathway for tinnitus- The
medial temporal lobe system, The International Journal
Vol 1, No 2, 115-126, 1996.
Barbara Goldstein, Ph.D., is Research Assistant
Professor in the Department of Neurosurgery;
Abraham Shulman, M.D., FA.C.S., is Professor
Emeritus of Clinical Otolaryngology and Research
Professor of Neurosurgery. They are with the Martha
Entenmann Tinnitus Research Center, Health Sciences
Center at Brooklyn State University of New York, Box
1239, 450 Clarkson Avenue, Brooklyn, New York
11203. Both also serve as Scientific Advisors to ATA.
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American Tinnitus Association Tinnitus Thdlly/ Mafch 1999 11
Mile after Mile
by Barbara Tabachnick, Client Services Manager
Since 1976, Dr. Gloria Reich has traveled more
than one million miles around the world - the
distance to the moon and back - for ATA. She
attended one professional meeting in that first
year: the conference of the American Academy
of Otolaryngology and Ophthalmology (AAOO),
now the AAO. Her modest purpose was to let ENT
doctors know that ATA existed. The response to
Gloria's (and ATA's) presence at that prestigious
meeting was lukewarm. Undaunted, she went
again the following year, and the year after that.
And the year after that.
ATA's annual presence at AAO meetings is now
sought by the meeting organizers, and of consider-
able interest to the thousands of physicians who
attend it. At the 1998 AAO conference in San
Antonio, ATA's booth was swamped with visitors
for four non-stop days. Dr. Reich, her husband Thd,
ATA's Assistant Director Pat Daggett, and Dr. Billy
Martin, Oregon Hearing Research Center's tinnitus
clinic director, all helped staff the booth. Says
Daggett, "Every shred of material, every brochure,
Tinnitus Tbday, everything that we brought with us
was taken by the people at the meeting. And they
told us how pleased they were we were there."
Pat Daggett began her traveling days for ATA
in 1988 when the number of national meetings
increased and they began to overlap. "Originally,
doctors were condescending because we didn't
have 'the answer: Now they use ATA as a way to
help their patients. I think the field is attracting
more interest and higher quality researchers
because we're not sitting in an ivory tower sending
out information. We're out there!" Since 1988, Pat
has logged a quarter of a million miles herself on
behalf of ATA.
"It's all about connecting," says Gloria Reich
when she reflects on her extensive travel for ATA.
"When we meet people, we establish relationships.
Our traveling has strengthened the whole tinnitus
network." There seems to be something to it. What
was once an organization of 250 members is now
one of 20,000 members. And what was once brush-
ed off as a something "all in one's head" is now
known to be a physical, psychologically intrusive,
and neurologically based symptom.
Establishing a national mind-set about the
credibility of tinnitus is a huge task, one that is
taking diligence and a persistent presence to make
so. With airplane tickets and ATA brochures in
hand, Gloria, Pat, their spouses, staff members,
and volunteers continue the forward momentum
- one hopeful mile at a time - towards educating
doctors, influencing researchers, and bolstering
support for all who are affected by the calamity of
tinnitus. Ia
Visiting the Central Institute for the Deaf, St. Louis, MO -
Michele Hartlove,
Director; Better
Hearing Institute
Malvina Levy, M.A., and Robert
Folmer; Ph.D.
7bp row, I. tor: : Bi11 Clark; Mary Meikle, Ph.D.; Jack Vernon,
Ph.D.; Stephen Nagler; M.D.; Paul Meade; Aaron Osherow;
Sam Hopmeier; BC-HIS. Front row, l. to r.: Carol Jude, Support
Group Leader; Gary Jacobson, Ph.D.; Jim Chinnis, Ph.D.; Pat
Daggett; Susan Seidel, M.A., CCC-A; Gloria Reich, Ph.D.
Left: Gloria Reich,
Ph.D., and Nelly
Nigro, Support
Group Leader
12 Tinnints 'TOday/ March 1999 American Tinnitus Association
Milly Walker, M. A.,
CCC A
Where We've Been - Fall 1998
Sept. 10-12, International Hearing Society, Nashville, TN
Sept. 12-16, American Academy of Otolaryngology,
San Antonio, TX
Sept. 14, ATA's Scientific Advisory Committee meeting
and Public Forum, San An tonio, TX
Sept. 17, American Academy of Family Physicians,
San Francisco, CA
Sept. 17-19, Management of the Tinnitus Patient,
Iowa City, IA
Sept. 12, 1st Community Conference on Balance &
Hearing, Austin, TX
Sept. 24. National Hearing Conservation Association.
Seattle, WA
Oct. 8-10, Academy of Dispensing Audiologists,
Monterey, CA
Nov. 13, Central lnstitute for the Deaf, St. Louis, MO
Nov 13-1 4, ATA Board of Directors meeting, St. Louis, MO
Where We' re Going - 1999
Feb. 6, Univ. of Miami Medical School. Public meeting
and research seminar, Ft. Lauderdale, FL
Feb. 13-17, Association of Research in Otolaryngology,
St. Petersburg, FL
Feb. 25-27, National Hearing Conservation Association,
Atlanta, GA
March 4-6, National Health Council & American Auditory
Society, Phoenix, AZ
March 17-18, Meniere's Society, Aspen, CO
April 17, Sounding Off on Tinnitus, Los Angeles, CA
April 1 7-21, National Counci1 on Aging, San Diego, CA
April 20-24, Community Health Charities, Clearwater, FL
April 22-25, American College of Physicians,
New Orleans, LA
April 25-26, Combined Otolaryngological Spring Meeting,
Palm Desert, CA
April 29-May 2, American Academy of Audiology,
Miami Beach, FL
June 1-3, American Academy of Physicians Assistants,
Atlanta, GA
Sept. 5, International Tinnitus Support Association,
Cambridge, England
Sept. 5-9, Sixth International Tinnitus Seminar,
Cambridge, England
Sept. 16-19, American Academy of Family Physicians,
Orlando, FL
Sept. 26-29, American Academy of Otolaryngology,
New Orleans, LA
Sept. 30-0ct.2, Tinnitus Patient Management,
Iowa City, TA
Oct. 13-17, International Hearing Society,
Philadelphia, PA
Oct. 27-31, Association of Dispensing Audiol ogists,
Bermuda
Nov. 17-21, American Speech Hearing Language
Association, San Francisco, CA
If we are headed for your city and you'd like to meet
with one of us, please let us know well in advance
(8001634-8978 or e-mail: tinnitus@ata.org). We'll do
our best to make the time.
ANNOUNCEMENTS
Sounding Off on Tinnitus
Date: April17, 1999, 8:15a.m.- 12:30 p.m.
Location: UCLA, NPI Auditorium, 720 Westwood
Blvd., Los Angeles, CA
The Los Angeles Tinnitus Group is sponsoring a
half-day seminar to celebrate 15 years of support and
education for individuals with tinnitus. Designed for
patients, family members, and healthcare providers,
the program features informative lectures and interac-
tive discussions.
Guest Speakers: Stephen Nagler, M.D., F.A.C.S.,
Gloria Reich, Ph.D., Akira Ishiyama, M.D., and
Marcia Harris, family therapist.
Registration: $10 fee before April 9, 1999
Pre-register: Send your name, address, phone
number, and check (no cash please) payable to
the L.A. Tinnitus Group, UCLA Rehabilitation Ctr.,
Rm.15-54, 1000 Veteran Ave., Los Angeles, CA
90095-1651.
Contact Organizers: Nelly Nigro 310/474-9689,
Marjorie Harris 310/825-4101 for more information.
International Hearing Aid Conference V:
''Beyond Traditional Amplification"
Date: June 4-6, 1999
Location: The University of Iowa, Iowa City, IA
Guest of Honor: Mead Killion, Ph.D.
Speakers: Harry Levitt, Ph.D.; Victor Bray, Ph.D.;
Larry Humes, Ph.D.; Pamela Souza, Ph.D.; Marshall
Chasin, M.Sc.; Steve Armstrong, M.Sc.; Jerry Yanz,
Ph.D.; Don Schum, Ph.D.; Rich 'JYler, Ph.D.; Ruth
Bentler, Ph.D.; and Chris Thrner, Ph.D.
Contact: Rich 'JYler at 319/356-2471,
fax: 319/ 353-6739, rich-tyler@uiowa.edu,
http:/ / www.medicine. uiowa.edu/ otolaryngology I
news/ news.html.
Attendees are encouraged to submit presentations.
6th International Tinnitus Seminar Cambridge, UK
Date: September 5-9,1999 (See back cover of this
issue for details)
Seventh Annual Conference on the Management
of the Tinnitus Patient
Date: September 30-0ctober 1, 1999
Location: The University of Iowa, Iowa City, IA
For professionals and tinnitus patients.
Guest of Honor: Jack Vernon, Ph.D.
Speakers: Michael Block, Ph.D.; Gloria Reich, Ph.D.;
Meredith Eldridge, M.A.; Soly Erlandsson, psychia-
trist; Anne psychologist; Paul Abbas,
Ph.D.; Bruce Gantz, M.D.; Brian McCabe, M.D.;
Rich 'JYler, Ph.D.; David Young, M.A.; and Richard
Smith, M.D.
Contact: Rich 'JYler at 319/ 356-2471,
fax: 319/ 353-6739, rich-tyler@uiowa.edu,
http:/ /www.medicine.uiowa.edu/ otolaryngology I
news/ news.html.
American Tinnitus Association Tinnitus Thday/March 1999 13
A SALUTE TO
BRAVERY
by Mary Meikle, Ph.D.
A
U of us are taught at an early age that courage
is a virtue and that we should try to act
bravely if the need arises. Few of us, though,
are ever severely tested. For the most part, life
presents us with brief episodes that may require
some moderate degree of courage, episodes that
are soon over and that do not leave us with any
lasting hardship.
This story is about someone who was forced to
deal with the need for great courage and bravery,
every day of his life for many years. Life dealt him
a terrible challenge, one that most people would
have found overwhelming. He met this challenge
head-on, every day, without giving in. He did so
cheerfully, with grace, with energy, with opti-
mism, with never-failing good humor. He was a
true hero, and his name was Robert Johnson.
Bob Johnson was my close friend and col-
league at the Oregon Health Sciences University
for nearly 20 years. Our offices were side-by-side.
And so I saw him in his day-to-day combat with
severe, intractable pain caused by degenerative
disk disease, one of the most severe and crippling
disorders that can affect the spine, and with the
constantly worsening effects of that disorder.
It was an intense struggle between what
seemed like two opposing teams. There was the
"Bob" team - Bob himself the captain aided by his
wife and family; his doctors with their surgical
teams; and the pharmaceutical companies who
kept bringing in new medications hoping to find
one that would subdue the pain. And then there
was the "Pain" team - the spinal damage that
started the pain; the nerves that got damaged by
the deteriorating spinal disks, making his leg and
foot numb; the muscle atrophy in his leg that
forced him to limp no matter how hard he tried
not to; the burning pain in his leg and foot that
made him unable to sit or stand or even lie down
for any length of time.
No matter how hard the Bob team rallied itself
and fought back, the Pain team was always ahead.
No one could outwit the Pain team or force it into
submission. And the Pain team was insidious.
14 Tinnitus 'lbday! March 1999 Ametica11 Tinnitus Association
After each new back surgery, it would seem for a
while as though the Pain team was defeated only
to have it come charging back after a brief pause,
stronger and more vicious than ever. No amount
of reinforcement by the medical members of Bob's
team, no new medication or surgical procedure,
could ever keep the Pain team at bay.
This grueling battle went on before our eyes,
every day for the last twenty years. We learned
from Bob's family that it also went on at night,
because the Pain team never slept and never per-
mitted relaxation.
One might think that Bob, as the captain of a
team that kept on losing year after year, besieged
by setbacks and losses at every turn, might give up
trying. Faced with such a long and unequal strug-
gle, one might expect Bob's team to become angry
and embittered, or that Bob might now and then
complain, raise his voice, or feel unjustly treated.
But that never happened. Instead, the captain kept
rallying his troops. He kept charging back onto the
field, calling a new play. He kept trying not to
limp despite the ungovernable pain. And he would
again and again summon forth his key maneuver,
the one that always helped him to counter the set-
backs and defeats. His key stratagem was called
"helping others."
The more the pain pushed its heavy-handed
advantage, the more Bob fought back with diver-
sionary tactics. He knew that he could forget the
pain for brief intervals if his attention was diverted
to providing help for someone else's troubles. As a
clinician, he was a superb listener, someone who
always put his patient's needs before his own.
When people needed his help for their hearing
problems and their tinnitus, Bob was there for
them. He gave them his complete and undivided
effort. He became the captain of their team. He
tried to fashion a winning strategy for them, to
bolster morale, and rally their families and their
support teams to help them. In this way, he took
it upon himself to be as victorious as possible in
defeating problems of hearing and tinnitus.
M
any, many people who came as patients
to the Tinnitus Clinic in Oregon will
remember Bob Johnson as someone who
was totally devoted to their needs. He was devoted
in a way that few clinicians ever achieve, sensing
a great deal about each patient without having to
be told; offering advice in the gentlest, most sensi-
ble ways; and throughout all, maintaining an
unfailing and genuine good humor, delight in
interacting with people, and a true and informed
concern for their well being. He was practical,
experienced, and always constructive. He was
intelligent, honest, and sincere. He was above all
"on your side."
continued on page 15
ATA Researchers to Study Drug Effects
K
ejian Chen, Ph.D., and Donald
Godfrey, Ph.D., at the Medical
College of Ohio in Toledo, recently
received a $33,000 grant from ATA to study
the effects of drugs on nerve cells of the
auditory system in laboratory animals that
have been exposed to loud sounds. Drs.
Chen and Godfrey shared their thoughts
on this new research with us:
"One idea of how central tinnitus occurs is
that some nerve cells of the auditory system have
increased activity. This increased background, or
'spontaneous,' activity might be interpreted by
higher brain centers as the occurrence of tones,
because auditory nerve cells normally respond to
tones by increasing their activity. When rats are
exposed to very loud tones - tones which would
likely produce tinnitus in people, the result is
increased spontaneous activity in nerve cells
of their dorsal cochlear nuclei. The mechanism
of this increase in spontaneous activity remains
to be discovered.
"We have been studying the spontaneous
activity of dorsal cochlear nucleus nerve cells in
rats exposed to loud tones (125-130 decibels). We
will be applying drugs that affect the communica-
tion between nerve cells by neurotransmitters,
including the amino acids glutamate, glycine, and
gamma-aminobutyrate or GABA, as well as acetyl-
choline. Drugs we will be testing include kynurenic
acid, NMDA, and AMPA, which affect glutamate
transmission; strychnine, which affects glycine
transmission; muscimol, bicuculline, baclofen, and
saclofen, which affect GABA transmission; and
carbachol and scopolamine, which affect acetyl-
choline transmission.
"We are first looking for differences in the spon-
taneous activity of nerve cells in loud-tone-exposed
rats as compared to normal rats. Then we will look
for differences in the drug effects between exposed
and normal rats. We hope to identify changes in
neurotransmitter receptor properties that may be
related to the development of tinnitus. If we can
identify specific receptor types that are involved,
then drugs affecting those receptors could be tried
for relief of central tinnitus. If a specific drug looks
useful in this animal
study, it would
progress to a clinical
study. If that trial
shows positive results,
the drug could be
approved for use. That
process could likely take
about two years." a
A SALUTE TO BRAVERY (continued)
A
mong those who read this story, there will be
some who have to deal with lingering and dif-
ficult problems, perhaps even with problems
that trouble them severely every day. Such readers
may be able to learn an important thing from
Bob's story: he showed that giving ofhimselfwas
the best and surest way to step away from his own
troubles and difficulties, to put them behind him
no matter how bad they grew.
It was a true act of courage that may be very
hard at first to do. But like all things in life it
grows easier with practice. And there is a substan-
tial reward for such acts ofbravery. The reward is
that the enemy - the other "team" - your prob-
lem, whatever it is and however bad it is, will
seem to grow smaller and weaker for a while. It
may even seem at times to have departed from the
field, perhaps only temporarily, but nevertheless
gone from your consciousness for a time.
It is hard to be courageous like Bob, to act
bravely even when it hurts. Bob's gift to all of us
was to show that helping others is a way to help
yourself. If you can follow Bobis lead, if you can
try as he did to act bravely in the face of over-
whelming difficulty, you too may receive the
blessed respite that you seek. 19
Dr. Meikle is Professor of Otolaryngology at Oregon
Health Sciences University, Portland, Oregon.
Correction
The address for Phoenix Promotional
Products was misprinted in the December 1998
Questions and Answers column. The correct
address is: 2935 Thousand Oaks .#6-269, San
Antonio, TX 78247.
American Tinnitus Association Tinnitus 7bday! March 1999 15
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16 Tinnitus 'Ibday! March 1999 American Tinnitus Association
Acoustical Effects of Air Bag Deployment
by James 0. Chinnis, Jr., Ph.D.
The air bag debate continues. The Acoustical
Society of America, at its annual meeting in
Norfolk, VA, devoted an October 13th session
exclusively to air bag noise. Elliott H. Berger,
Senior Scientist, Auditory Research, E-A-R
Products, chaired the session.
Richard L. McKinley. M.S., (AFRL/ HESN at
Wright-Patterson Air Force Base in Ohio) reported
on a study performed over 30 years ago that used
prototype air bags and 91 military volunteers.
The average peak noise level of the air bags was
168 dB, now judged to be a low estimate by at least
several dB due to microphone limitations. A small,
closed, and partially sealed car was used to maxi-
mize the air bag pressure effect.
Results showed that many subjects experienced
very substantial temporary threshold shifts: the
sound level necessary for them to detect tones in
an audiology booth increased by as much as 60 dB.
When retested at a later date, one subject showed a
permanent hearing loss.
G. Richard Price, Ph.D., (U.S. Army Research
Laboratory) reported on a general mathematical
model of auditory hazard. Model predictions
include that the greatest hazard is present when
the individual does not see the accident coming,
is in a vehicle with windows open, is turned so
that an ear faces the air bag, and is naturally more
susceptible to damage. It is thought that the pres-
sure in a closed vehicle might protect hearing by
pressing the stapes inward against the restraining
pressure of a ligament thus reducing the sound
energy transmitted to the inner ear. (The model
for this theory has been validated in animal tests
only.) Thsts have found that 1 - 2% of those
exposed to test air bag deployments will experi-
ence permanent tinnitus or hearing loss.
Kathleen Yaremchuk, M.D. (Dept. of Otolaryn-
gology, Head and Neck Surgery, Henry Ford
Hospital, Detroit, MI), reported on the results of
two published requests for otolaryngologists to
provide information about patients who had been
exposed to air bag deployments and developed
otologic symptoms. 'TWenty physicians replied with
reports of 29 patients who had been . .
Tinnitus and hearing loss were present m a maJon-
ty of the 29. There were two reports of eardrum
perforations and one report of a perilymph fistula
(an abnormal opening in the inner ear). 'IWo .
patients complained of vertigo and two of recrmt-
ment. Dr. Yaremchuk acknowledges that the ear
mechanism is Jess jostled from an air bag explosion
if car windows are closed. "You are safer," she says,
"but are you safe? Keeping windows up doesn't
overcome the effect of the noise. And the addition
of side air bags raises the ear-level noise inside a
car to 1 78 dB! Unbelievable."
James E. Saunders, M.D., (University of
Oklahoma Health Science Center, Department of
Otorhinolaryngology, Oklahoma City), reported on
actual cases of air bag-induced otologic symptoms.
He and his co-researchers report that they have
encountered six patients with ear-related symp-
toms related to air bag noise. Five patients have
documented hearing loss, one reported persistent
tinnitus, and two have significant dizziness.
Following the technical papers, Janet C.
Garman described her life-altering experience of
tinnitus and hyperacusis following an air bag
deployment. She also cited a study recently pre-
sented at the American Academy of Otolaryn-
gology's annual meeting. In the study, researcher
McFeely, et al., followed 20 patients whose otologic
injuries resulted from air bag deployments.
Seventeen of the 20 patients reported tinnitus as
the most common complaint.
In discussions that followed the session, a
question was raised: Would the risk of otologic
damage, including tinnitus, be higher in a car with
disconnected air bags due to the increased risk of
head injury? It is generally agreed that air bags
improve safety overall, as compared with seatbelts
alone. Seatbelts alone reduce fatalities by about
45%. Adding air bags to seat belts reduces fatalities
by an additional 9%. What is wrong is that air bags
can injure while performing their function. They
can injure even in minor accidents that pose no
hazard. They can injure in rare cases when they
deploy accidentally.
The National Highway Traffic Safety
Administration (NHTSA) did not send a repre-
sentative to the session on air bags. Their web site
(www.nhtsa.dot.gov/ airbags) includes an indepen-
dent panel's statement that " ... the phenomenon
of hearing loss has not been noted to occur due to
air bags."*
Those of us with tinnitus, hearing loss, or
hyperacusis need to inform those who make the
rules and design the safety systems that these sub-
jective complaints have been documented, are not
minor, and must not be ignored.
National Conference on Medical Indications for Air Bag
Disconnection conducted by The Ronald Reagan lnstiture of
Emergency Medicine Departmeni of the
National Crash Analysis Center George Washmgton Umvers1ty
Medical Center Washington, D.C. July 16-18, 1997
Dr. Chinnis is President of Decision Science
Associates, Inc. and a member of ATA's Board
of Directors.
American Tinnitus Association Tinnitus Tbday/ March 1999 17
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18 Tinnitus 7bday/ March 1999 American Tinnitus Association
Federal Funds Available for
Alternative Tinnitus Research
by Barbara Tabachnick, Client Services Manager
The National Center for Complementary and
Alternative Medicine (NCCAM) is the newest
research funding agency of the National Institutes
of Health. In 1992, the NCCAM (then called, the
Office of Alternative Medicine) was given its first
budget of $12 mil1ion to spend for alternative med-
ical research. Today, its budget has expanded to
SSO million.
What research have they funded so far? .A $1.9
million clinical study on hypericum (St. John's
Wort) - Duke University. A $375,000 study on
acupuncture for dental pain - University of
Maryland. A $1 million study of alternative medi-
cine for the elderly- Stanford University. Dozens
of other esteemed research institutions received
funding for a wide assortment of therapies for an
equally wide assortment of ailments. No, tinnitus
is not yet one of them.
I contacted the NCCAM to find out how tinni-
tus could be included in this new research arena.
Mark Stern, of their office of communications,
responded: "Encourage [tinnitus researchers] to
submit proposals! Make sure they follow the grant
application process carefully. Not all of the $50 mil-
lion has been used. Tell them the money is out
there. There is an opportunity for this to happen."
He wanted to be clear that the NCCAM cannot tell
researchers - or even suggest to them - which
diseases or disorders to study. The NCCAM cannot
solicit, for instance, a research proposal specifically
for tinnitus.
The NCCAM research grant application
is available on the Internet (http:/ / www.nih.gov/
grants/ funding/ funding.htm) and from the Center
for Scientific Review (Grants Information Office,
Center for Scientific Review, National Institutes of
Health, 6701 Rockledge Ave., #3032, Bethesda, MD
20892-7762).
Researchers are invited to look on NCCAM's
web site for a very clear grant application prepara-
tion guide: http:/ / www.altmed.od.nih.gov/
nccam/ research/ preparation/ quick-guide.shtml
The site offers the following suggestions (and
more) to research applicants:
1) Be brief and concise. Use diagrams to help
explain complex models and ideas.
2) Do not exceed the specified page limits or type
sizes. The application will be returned unreviewed
if the specifications are exceeded.
3) Be logical and organized, and explain your
thought processes.
4) Clearly state how your work goes beyond
previous research.
5) Contact the NIH staff for guidance. They are
experienced with research proposals and are ready
to help.
Those interested in voicing opinions about
alternative medical approaches for tinnitus relief
are invited to contact Geoffrey P. Cheung, Ph.D.,
Deputy Director of the NIH National Center for
Complementary and Alternative Medicine at
31 Center Dr., Bldg. 31, Rm. 5B36, Bethesda, MD
20892-2182.
A word to researchers: We urge you to tap
into the available pools of research money - the
NCCAM for alternative research, the National
Institute of Deafness and other Communication
Disorders for conventional research, hospitals,
universities, private foundations, and the
American Tinnitus Association - and study
tinnitus. Millions of people are waiting and
hoping that you do. B
Autographed Books Now Available
Tinnitus: What is That Noise in My Head
by Joan Saunders, 104 pages, softcover
$14.50 ATA members/$18 non-members
On a recent jaunt to the states from her home
in New Zealand, Joan Saunders (and husband
Peter) stopped in Portland for a quick visit and,
of course, to sign her books!
Tinnitus: What is That Noise in My Head is
a heartening guide for the tinnitus patient from
the tinnitus patient. Some of the topics covered:
medical treatments; relaxation techniques;
non-medical treatments with a notably clear
description ofbiofeedback; and nutrition and
dietary supplements (what to avoid and what to
consider).
Saunders has coped phenomenally well with
severe tinnitus for 40 years and with profound
lifelong deafness. In spite ofboth, she earned
her masters degree and worked to establish the
New Zealand Tinnitus Association.
Signed copies of Tinnitus: What is That Noise in
My Head are available in a limited quantity. Please
see the form on the inside back cover of this issue
of Tinnitus 7bday to place an order. a
American Tinnitus Association T! nnitus TOday/ March 1999 19
Tinnitus in College - A Comparison of
the Incidence of Tinnitus in College
Music Majors and Non-music Majors
by Mark C. Zeigler, Ph.D.
Millions of Americans suffer with tinnitus.
Slightly more men than women have it and its
prevalence seems to increase with age, the aver-
age age being 59 years. However, tinnitus affects
all age groups. A survey conducted by the
National Center for Health Statistics reported
that approximately 1.3 million people 18 years
old or younger have tinnitus. It's a worrisome
observation that the incidence of tinnitus among
young adults appears to be on the rise.
Researcher J. M. Graham attributes the
increase in tinnitus cases among the youth in
America to excessive, loud recreational noise
exposure and, in particular, to music. Graham
writes, "This form of tinnitus [noise-induced tin-
nitus] is also increasingly reported by children
without pre-existing hearing loss as the result of
'recreational noise' as the intensity of amplified
music increases in discotheques and live perfor-
mances and as the use of personal stereo head-
phones becomes more common." In a 1996
survey of 479 tinnitus sufferers, Alf Axelsson
found that noise exposure was by far the most
common cause of tinnitus.
Recent research suggests that some musi-
cians might be at risk for developing tinnitus.
In 1995, Kathy Peck, co-founder and executive
6
director of the Hearing Education
o and Awareness for Rockers
~ (H.E.A.R.) organization, conducted
a survey of 400 San Francisco Bay
Area rock musicians. She questioned
subjects about their daily recreational
listening habits, number of
weekly performances, inci-
dence of tinnitus and hearing
loss, and hearing conservation
efforts. The results: nearly
SO% ofthose surveyed indicat-
ed the presence of tinnitus.
20 Tinnitus Tbday!March 1999 American Tinnitus Association
Since most forms of tinnitus are not curable
and current treatments are often inadequate, it
would seem that the prevention of tinnitus is
critical. As a music student with tinnitus, I
decided to examine the potential link between
being a music major and the incidence of tinni-
tus. The data that follows became part of my
doctoral thesis on the subject.
The purpose of my study was to not only
investigate the prevalence of tinnitus in college
music majors but to investigate the probable
underlying cause of the student's tinnitus. I also
wanted to learn if music majors are developing
tinnitus from ensemble rehearsals or other relat-
ed musical activities. Finally, the study sought
to determine if college music majors and non-
music majors are practicing any hearing conser-
vation measures when they are around loud
non-music activities.
Data for this investigation was obtained via
surveys. 'IWo one-time-only questionnaires were
developed and distributed to first-year music
students and non-music students at selected
colleges in Florida. Both surveys contained
several closed-ended (yes or no response)
questions designed to glean information about
each respondent's background in four areas:
(a) demographics, (b) noise exposure history,
(c) tinnitus history, and (d) bearing conserva-
tion history. A total of 498 surveys were com-
pleted and returned: 249 music major and 249
non-music major.
The results indicated that significantly more
music majors than non-music majors (188 vs.
145) had some form of ear noise. The majority
of respondents with tinnitus in both groups
indicated experiencing only temporary tinnitus.
However, 20 of the music majors as compared to
only six of the non-music majors reported their
tinnitus generally lasted three or more hours.
And of six respondents indicating permanent
ear noise, all were music majors.
The most common causes of tinnitus listed
by both groups were exposure to excessive noise
for an extended period of time, followed by
exposure to a brief intense sound, followed by
Tinnitus College

Ill
ear or sinus infection. When the two noise-
induced categories were combined, they
comprised nearly one half of the students'
responses.
Of the 198 music majors reporting tinnitus,
about 20% (40) reported that they sometimes
experienced tinnitus immediately following
rehearsals or concerts. A small percentage, 4.5%,
indicated that they regularly developed tinnitus
from musical activities.
Among other things, the students were asked
about their hearing conservation efforts - in
particular, their usage of hearing protection
(earplugs) when exposed to excessive noise.
Both groups of students - non-music and music
majors - reported nearly the same incidence of
earplug usage: in noisy environments, 2-5%
wore earplugs regularly; 17-20% wore them
occasionally; and 75-80% never wore them at alL
lt was surprising to me to learn that three
out of four music majors surveyed had prior
experience with tinnitus. It represents a real
concern for these young musicians, especially
considering their age (average age of the music
majors was 21) and that, as musicians, they are
highly dependent upon their ears. While the vast
majority of students reported only temporary
tinnitus, many are experiencing the symptom so
often that they appear to be at risk for develop-
ing permanent tinnitus. TWenty percent of the
music majors and 14% of the non-music majors
reported regularly developing tinnitus once or
more per week.
Although we can speculate as to why music
majors appear to be developing tinnitus more
often than non-music majors, it is likely that the
cause is related to their musical activities. Nearly
one-fourth of the musicians surveyed reported
developing tinnitus from ensemble rehearsals.
When asked how often they were around noisy
environments that made normal conversation
difficult, 40% of the music students indicated
that they were exposed to potentially hazardous
sound levels daily as compared to only 11% of
the non-music majors. Yet, when it comes to stu-
dents' recreational music listening habits (i.e.,
stereo usage, attending rock concerts, etc.), the
two groups exhibited almost identical responses.
It appears that the combined exposure to exces-
sive sound levels in and out of the ensemble
environment might be responsible for the higher
incidence of tinnitus among music majors.
(continued)
The vast majority of students were not
aware that auditory stress is a potential problem
for college students. For example, 65% of the
music majors and 66% ofthe non-music majors
had not had an audiometric evaluation in the
last five years, and nearly half of the music
majors (49%) and two-thirds (70%) of the
non-music majors had never heard of tinnitus
before completing this survey.
Clearly there is a need to inform college
students of the potential auditory hazards they
face daily and to educate them about hearing
conservation techniques. Perhaps if incoming
freshmen completed a survey such as the one
used in this study, they could avoid years of
stress and fmstration due to noise-induced
auditory injury. Institutions of higher learning
could also encourage music students to take
steps to protect their ears when they are around
excessive noise outside of the rehearsal and
performance environment. As a musician with
tinnitus, I might have followed and greatly
benefitted from such advice. B
References
American Tinnitus Association. Results of the 1992 tinnitus
patient survey [Brochure]. Portland, OR: Author, 1992.
American Tinnitus Association. tnformation about tinnitus
[Brochure]. Portland, OR: Author, 1994.
Axelsson, A. Tinnitus epidemiology, G. E. Reich and J. A. Vernon
(eds.), Proceedi11gs of the Fifth Jmemational Tinmtus Seminar,
pp. 249-254, 1996.
Chasin, M., Musicians and the prevention of hearing loss, 1996.
Graham, J. M., Tinnitus in children V.' ith hearing loss, J. A. Vernon
and A. R. M0ller (eds.), Mechanisms of tinnitus, pp. 51-56, 1995.
House, P. R. , Psychological issues of tinnitus, A. Shulman (eel.),
Tinnitus: Diagnosis/treatment, pp. 533-534, 1991.
Leske, M. C. , Prevalence estimates of communicative disorder in
the U.S.: Language, healing and vestibular disorders. American
Speech and Hearing Association, 23 (3). 229-237, 1981.
Luxon, L. M . Tinnitus: lts causes, diagnosis, and treatment,
British Medical joumal, 306, 1490-1491, 1993.
Peck, K., and P. Ball, Musicians and music listeners hearing loss
and tinnitus survey. Poster session at the Society for Scholarly
Publishing meeting, 'Thmpa, FL, 1995.
Shulman, A., Tinnitus: Diagnosis/treatment, 1991 .
Vernon, J .A., and A. R. M0ller, Mechanisms of Tinnihts, 1995.
Williams, R. D, Enjoy, protect the best ears of your life,21
FDA Consumer. 26 (4), 25-28, 1992.
Dr. Zeigler is Director of Choral Activities at Nazareth
College of Rochester; 4245 East Ave., Rochester; NY
14618-3790
American Tinnitus Association 7bday/March 1999 21
Internet Links to Tinnitus
by Barbara Tabachnick, Client Services Manager
If you go on the Internet and do a "net search"
for tinnitus, you will find over 8,000 tinnitus-
related web sites (including ours: www.ata.or g).
Clinics, universities, hearing health organizations,
and private citizens have generated a huge body
of electronically published infom1ation about
tinnitus.
In addition to these sites, "newsgroups" and
interactive real-time "chat rooms" have been
started and maintained by tinnitus patients to
streamline the exchange of ideas about tinnitus.
Often the groups are avenues to camaraderie.
For the most part, these assemblages of
tinnitus patients are unchaperoned - not over-
seen by a doctor, audiologist, or other health pro-
fessional - so the information generated is often
more personal than professional. Occasionally,
health professionals post their responses on these
sites. While it's important to sift through the post-
ings to sort out the "good'' from the "not so good"
information, it's often hard to do. If you access
these information sources, and have a question
about what you read, please ask us or a doctor
familiar with the disorder for clarification.
Stephen Nagler, M.D., director of the
Southeastern Comprehensive Tinnitus Clinic in
Atlanta, is one of those professionals who from
time to time visits the cyber-support groups and
posts his comments. He's offered us the following
instructions on How-To Access Internet Tinnitus
Groups:
1) alt.support.tinnitus is a UseNet newsgroup.
The most efficient way to access it is with a news-
reader such as Agent (by Forte). There is a free
version of Agent readily available by downloading
from the Forte web site. Visit www.forteinc.com
and download "Free Agent." In Free Agent, sub-
scribe to the alt.support.tinnitus newsgroup. You
can then refresh (update) the threads as desired.
The new posts are very easy to identify and follow.
If you do not wish to use a newsreader, visit
www.dejanews. com and do a search on
alt. support. tinnitus whenever you wish to
check out the newsgroup. Threads are a bit
more difficult to follow in this manner.
2) Most Thursday and Friday nights at 9 p.m. EST
there is an ongoing tinnitus chat group. You need
some form of interrelay chat to participate. One
excellent (free) program is miRC, which can be
readily downloaded. Do a search on mi RC on
Yahoo, and download miRC. Then connect to the
NewNet server from Seattle (irc.eskimo.com),
and join the #tinnitus channel by typing the
following: / join #tinnitus
22 Tinnitus Thday/ March 1999 American Tinnitus Association
You will also need to assign yourself a nickname.
The process is self-explanatory on miRC.
3) For a tinnitus chat group, visit:
http:/ / www.chat.yahoo.com
Then establish an "identity" or change your
''identity" if you choose. (Most people on chat
groups use nicknames rather than their real
names.) Then click "Start Chatting." Go to the
bottom of the page and click "Change Room,"
then click "Health and Family," then click "User
Rooms," then click "Tinnitus." The group is active
Wednesday nights at 10 p.m. EST although people
occasionally show up to chat at other times.
4) The URL for the Tinnitus Message Board is:
www. visi.com/ rv weibergc/ tinnitus/ tinnitus.html
This useful site is in jeopardy due to lack of
funding.
5) Th e Internet Tinnitus Community has a nice
site of its own, maintained by Carol Brown. The
URL is www.eskimo.com/ rv carol!T.html
6) There is a Tinnitus FAQ (frequently asked ques-
tions) site. It is nicely maintained by a lay person
and has medical disclaimers throughout. The URL
iS WWlV.CCCd.edu/faq/tinnitus.html r/J
Our one-on-one "people links" are still
the lifelines to thousands. We gratefully wei-
- come our newest additions to the Tinnitus
Support Network. Please write or call us if
you would like information about becoming a
tinnitus support giver too.
Telephone Contacts Support Group Leader
Richard D. Curtis Marsha Johnson,
251 Rainier Lane M.S., CCC-A
Port Ludlow, WA 98365 Oregon Tinnitus/
3601437-9694 Hyperacusis Treatment
Linda M. Hastie
24 Castleton St.
Jamaica Plains,
MA 02130
617/ 524-2329
Helen J. Hersrud
1002 33rd St. S.
Spearfish , SD 57783
605/ 644-0695
Shirma M. Huizenga
9 Pear Tree Lane
Franklin, MA 02038
508/520-6641
Harvey Joanning, Ph.D.
2910 N.E. Briarwood Dr.
Ankeny, IA 50021
515/964-1713
Ceneer
9272 S.W. Beaverton-
Hillsdale Hwy.
Beaverton, OR 97005
503/296-7870
QUESTIONS AND ANSWERS
Jock Vernon's Personal Responses to Questions from our Readers
by Jack A. Vernon, Ph.D., Professor Emeritus,
Oregon Health Sciences University
Q
Ms. B. in Alabama reports that removal of a
tumor on her right eighth nenre has ren-
dered her completely deaf in that ear and
that her tinnitus in that ear has gotten significantly
louder. She asks the following questions:
1) Is it common for tinnitus to become louder after
eighth nerve surgery? If one cannot hear in that
ear how then can one hear tinnitus in that ear?
2) I am now just beginning to hear some tinnitus in
the good ear. Is the system trying to balance itself?
Should I be alarmed about this additional tinnitus?
3) I wear a CROS hearing aid. Could the
electronics or the battery or the FM signal in
the CROS aid cause the tinnitus in either or
both ears?
A
Ms. B., it was essential that your tumor be
removed. Although these tumors are always
benign and slow growing, they nevertheless
can cause death. One of my patients died as a con-
sequence of a non-removed eighth nerve tumor.
It is very common for tinnitus to be louder
with removal of an 8th nerve tumor. Remember, as
hearing ability decreases tinnitus increases. Also
remember that although you perceive your tinnitus
in the left ear, it is actually being perceived in the
brain which in turn is referred to the ear. That you
are beginning to hear your tinnitus in the other ear
is very common. As you trace the route of sound
from the ear up through the brain, there are four
places where the hearing nerves of each ear are
directly connected together. Thus it seems to me
that it would be easy for the tinnitus on one side to
be perceived on the other side. Because of this
interconnection, I wonder if masking in the good
ear might reduce the tinnitus in the deaf ear.
Would you try the faucet test on the good ear and
observe if there is any effect upon the tinnitus in
the other ear? Also, I am confident that the elec-
tronics of your CROS hearing aid had nothing to do
with your tinnitus. Keep using that hearing aid. In
time you will even learn to localize sounds. Besides
with the CROS hearing aid, you no longer have to
put people on your good side and you no longer
get surprised by sudden events on your bad side.
Q
Mr. L. from New Jersey writes to say that
hyperacusis is becoming more and more
demanding in his life. He asks if there is
any device that would protect him from loud and
sudden sounds.
A
Microtek Co. (3500 Holly Lane North, Suite
10, Plymouth, MN 55447, 800/745-4327)
makes a special hearing aid called the
"Refuge Hyperacusis Hearing Aid." This unit was
designed by Dr. David Preves and is especially for
hyperacusis patients. It contains input compres-
sion which can be adjusted to your specific loud-
ness tolerance.
Q
Mrs. R. in California indicates that she has
had no success with health care profession-
als. They've told her that nothing can be
done for her tinnitus. She also indicates that she's
called me on Wednesdays but could not get
through due to a busy signaL
A
Mrs. R., we most ceTtainly want to be of help
to you and I hope you will continue to try to
call me. It is not surprising that you got a
busy signal. Sometimes I get more than 30 calls
in a given day. Let me infOTm you that there is
effective treatment for tinnitus regardless of what
some of the "professionals" tell you. The first thing
1 would suggest is for you to do the "faucet test."
(Listen to running water to see if it covers the
tinnitus sound.) Do that before you call me. It
would also help if I could know the results of your
most recent hearing test. I look forward to hearing
from you.
Q
Mr. L. from Michigan indicates that he has
a masker which he has been using for three
months. He is trying to "adapt" to it but
with poor results. He asks if he should continue
trying for a longer period.
A
If you are doing Tinnitus Retraining
Therapy (TRT), ask the clinician involved
what you should do. I've heard that some
patients need several months to adapt to the TRT
sound generators. If you are on a masking pro-
gram, it might be that the masker is improperly
fitted. Also, ifyou have some hearing loss it is
American Tinnitus Association Tinnitus Thday/ March 1999 23
Questions and Answers (continued)
likely that you should be using a tinnitus instru-
ment (a combination of masker and hearing aid)
rather than a simple masker. If you have no hear-
ing loss but have bilateral tinnitus, it is likely that
you should have two maskers instead of one.
Many hearing aid dispensers will fit a single hear-
ing aid on a patient with dual hearing losses, and
that thinking often spills over to the fitting of tin-
nitus maskers. They incorrectly reason that adapt-
ing to only one unit is easier than adjusting to two
units. The fact is, in many cases, only by the use
of two maskers will patients experience the relief
they seek.
Q
Dr. 0. in Minnesota states that by using tl1e
Moses/Lang CD he can cover up his tinni-
tus completely with band #7 (8000-14,000
Hz) and receives some residual inhibition (tempo-
rary cessation of tinnitus after the masking sound
is removed) with that masking. He adds, however,
that the "pink noise" (200-6000Hz) on band #l is a
much more pleasant sound even though it doesn't
completely mask his tinnitus. Despite the produc-
tion of only partial masking he prefers the pink
noise. I wonder how many other readers who have
received the Moses/Lang CD find the same effect?
Q
Mr. P. from Kentucky indicates that upon
ascent and descent in airplanes he is
temporarily deaf for a brief period. Would
continuing to fly cause permanent hearing loss?
A
I assume that what you experience is a
failure of the Eustachian tubes to function
properly. And if that is so, then continued
flying will not produce any permanent hearing
loss. You can correct the problem of pressure
changes by wearing tightly fitted earplugs for both
takeoffs and landings. Foam plugs work just fine.
You can even insert the earplugs before boarding
the plane and remove them after you de-plane in
the terminal.
24 Tinnitus 'lbday!March 1999 American Tinnitus Association
Q
Mr. N. in Arizona asks if it is possible to
have health insurance companies pay for
tinnitus maskers.
A
Much depends upon the kind of coverage
your health insurance company offers. As
a general rule, health insurance companies
do not cover the cost of prosthetic devices. Thus
it is very important that your insurance company
know that tinnitus maskers are classified by the
FDA as therapeutic devices, not as prosthetic
devices. You might also point out that had you
gone to a psychiatrist for treatment of your
tinnitus, the cost would have been many times
the cost of maskers. I'm told you should not accept
rejection by your company until after you have
approached them at least three times.
Q
Mr. L. in Minnesota comments that finding
the brain area responsible for generating
tinnitus is most interesting. He wonders
what problems or consequences might result from
deadening this area.
A
You are correct that finding the brain area
responsible for the perception (not the
generation) of tinnitus is important.
Deadening or removal of this brain area might
mean the end of tinnitus. Or it might mean that
other brain cells will eventually take over this func-
tion, since the brain is very "plastic" or adaptable.
Or it might mean that the patient might lose the
ability to perceive certain sounds. Or it could mean
that the tinnitus would simply change the way it
sounds and be perceived elsewhere. Thking out the
tinnitus brain perceptual area could mean many
things. Much work is needed before the proper
cure procedure can be determined.
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- 4:30p.m.
PST (5031494-2187). Or mail your questions to:
Dr. Vernon c/o Tinnitus Thday, American Tinnitus
Association, PO Box 5, Portland, OR 97207-0005.
SPECIAL DONORS AND TRIBUTES
ATA's Champions of Silence are a remarkable
group of donors who have demonstrated their
commitment in the fight against tinnitus by
making a contribution or research donation of
$500 or more. Sponsors and Professional Sponsors
have contributed at the $100-$499 level. Research
Donors have made research-restricted contribu-
tions in any amount up to $499.
ATA's Thbute Fund is designated 100% for
research. Tribute contributions are promptly
acknowledged with an appropriate card to the
honoree or family of the honoree. The gift
amount is never disclosed.
Our heartfelt thanks to all of these special
donors!
GIFTS FROM 10-J 6-98 to 1-15-99.
All contributions to the American Tinnitus Association are tax-deductible.
Champions of Sponsors
Donald W. Davis Lawrence E. Happ, Sr. Guy Madison Connie E. Reed
Silence
(llldiuidual
Li nda Deane Laura E. Hardy Vince Majerus Philip N. Rice
(Contributions o[$500
Contributions from $100-
Jeffrey J. Derossette Mary E. Harker John P. Malone Jerome A. Rich
$499)
Mary Ann Desutter Robert R. Harmon Vince A. Mangus Bernard Richards
and above)
Betty Adams
A. J. Diani Charles B. Hauser Robert March Mary D. Roberson
Julia R. Amaral
Susan Bently
Richard Allegretti
Larry Dil'vlarzio Richard H. Haws Douglas Marshall Philip L. Robinson
Betty J. Anderson
John L. Dosen Ray Haydock, Jr. Richard L. Martin Linda Ronaldson
Robert B. Berry
David R. Anderson
Mary M. Doyle David Hayes W. Gordon Martin Edward P. Rosenberg
Wolf Creek Charitable
Foundation
Lauy P. Anduss
Michael J. Doyle A. James Hei ns Joe Mastagni, Sr. Andrew J. Rosser
Robert H. Boerner
Alberta Mash
Randall C. and Elise Alfred E. Heller Mr. and Mrs. John Howard Rothenstein
Stephen Chandler
Stephen Axelrad
Ducote Paul L. HeUman Mathey Richard E. Rush
Anthony G. A. Correa
Joseph Axelrod
Sherman E. Dugan Charles M. Helzberg Mary K. Matson Lowell Sachnoff
George Crandall, Jr.
Joseph F. Bader
Thomas P. Dupree, Jr. DoroU1y R. and John Stuart I. Mayer William B. Salsgivet
Rob M. Crichton
Stanley Balick
Ralph C. Dutchi n Hiltner Kristin E. McAbier Eugene Saporito
Michael Field
George D. Bane
Gwen G. Eagle Howard Hirschy Carol P. McCurdy Joseph J. Schall
James and Donna
Phyllis L Barry
Susan H. Earl Jan C. Hoffmaster Edward F. McLaughlin Donna Scheckla
Fijolek
Brian Bartsch
Eric D. Eberhard Ray A. Hopp Ed Leigh McMillan, JJ AndreN. Schipper
Jean and Lou Fockele
Thelma P. Batchelder
Robert Eberle Kenneth A. Hovland John M. McNamara Craig w. Schnur
D. Jeanne Frantz
David P. Becker
Eleanor G. Egli Gaye V Hunt Dr. Duane D. Mead Stephen M. Schwarcz,
Ronald K. Granger
Tina Bischoff
RobertS. Epstein Timothy J. Jacoby Richard L. Meiss D.D.S.
Claude H. Grizzard
Sanford Blaser
Douglas C. Erikson Frank H. Jellinek Richard Melms Robert F. Sears
Josephine K. Gump
Richard A. Bolt
Carl Esposito Roben L. Jeske F. N. Meualls Kathleen M. Seibel
Donald L. Herman
Charles D. Bowling
Nancy Essington Michael E. Johnson George A. Meyer Hilmer H. Shackelford,
w. f. Samuel Hopmeier,
Patricia A. Brands
Burdell S. Faust John C. Johnston Carolyn B. Miller Jr.
BC-HIS
1 ra F. Breiter
'Ibm E. Fawcett Ruth M. Johnston Robert L. Minelli Alice L. Shields
Christopher V.
Glenn M. Brewer
James T. Fehon Bob Jones Sarah P. Minges JosephS. Simone
Houghton
Ruth H. Brisbois
Marian F. Feldheim Ron Jorgensen David C. Mitchell Gary Singer
Jerry r nfeld
Riccardo Z. Brognara
Robert L. Feller Jan Jozefak Russell Moody, Jr. Don L. Six, Sr.
Khairy A. Kawi, Ph.D.
Mattie J. Brooks
Richard J. Filanc Bernard Kaminsky Mr. and Mrs. Charles Georgia C. Smith
Sidney C. Kleinman
Ralph C. Brown
John W. Finger John Kapteyn Moon Marshall C. Smith
Jean R. Lju ngkull
Kristin J. Bruno, Ph. D.
Will iam D. Finnell Lois s. Keeney Mary T and James Patricia A. and Richard
Francis R. May
Charles Buckner
Helmut A. Fishcher K.D. Kennedy, Jr. Moran Smith
John L. Mercer
Leffie Burton
Robert S. Flaum John B. Kent Albert Mostrangeli Raymond and Sylvia
Stephen Moksnes
Michael L. Byers
Margaret Fleming Wayne M. Kern Ralph Muniz Smith
Steven A. O'Brien
William R. Cagney,
Janet E. Florentin William C. Kim Ruby S. Muniz Martin V. Socha
Aaron T. Osherow
Ph.D.
Mary A. Floyd Donald King James C. Murphy Margaret C. Solomon
Sheila A. and William
John N. Carlson
Jean and Lou Fockelc Mary Lee Kirk Martine Naeve Richard V. Sowa
F. Owen
Mary J. Cavins
Curry Ford Robert A. Kirk man Robert E. Nason Lar ry Spoden
Robert Pence
Robert D. Chambers
JackR. Fox Luann F. Ki rsch Gail L. Neale Mrs. Theodore R.
Hubert G. Phipps
Isabelle Chapman
Elliot S. Frankfort Laura P. Kleppick Glenna L. Neilsen Stanley
Barbara A. Rickard,
Gary M. Chase
Isaac Frishman Katherine C. Kli ne Phyll is G. Nexon Monon and Norma
Pres. & CEO
Charles J. Chieffe
Laura J. Fuller Rich Koch Elisabeth J . Nicholson Steele
Peacock foundation,
Sam Churchman
Jeremy T Garland Laura J. Kolinek M. Frank Norman David A. Stephens
Inc.
Mary Coffey
Perry Gault Larry Kopel Patrick A. O'Boyle Natalie P. Stocking
R. Peter Rutsch
Nina A. Colbert
Larry L. Gentry Ronald J. Korniski Jean Ann Olsen Andrew Stout
Marion H. Schenk
Basil Cole
Beverly and Ian Getrcu Stuart Krosser John K. Oscarson Glenn J. Straus
James L Schiller, CFP
Robert w. Cole
Harriet L. Glazer Robert Krotin Jerome Ott Orloff W. Styve
Wanda M. Shannon
Robert E. Collawn
F. K Gleason Pete Kubena William E. Paland Robert J. Suchomski
Saul N. Silbert
Philip S. Collins
Andrew Good Floyd E. and Karen Robert w. Palchanis Loretta L. Sweet'S
Charitable Trust
Michael L. Connolly
David H. Goodman Kuehnis, Jr. James L. Paradise Richard F. Swenson
Martha M. Smith
Kathleen J . Converse
The David H. Robert L. Kumler John D. Parsons Leon and Carol Thger
Timothy S. Sotos
Donald J. Cook
Goodman Foundation Robert S. Kurz John R. Patrick Pat Thuer
Sheldon Stein
Patrick M. Costigan
Agnes Goss Robert M. Kyvik John R. and Sa1a A. Judith J. Tharrington
Donald V Thompson
Rose Cottrell
W. J. and Helen Clide V. Sonny Patterson Jerry R. Thompkins
Don Crichton
Gotschall Landreth, Ill David D. Pearce J. E. Tinney
William E. 'TIHiey
Richard v. Cripe
C. Rod Granberry, Jr. John M. Lappe Jean E. Pepper Will iam R Tower, Jr.
Paula French
VanAkkeren
Chris Cronberg
Seymour Greenstein John C.Larkin Carolyn H. Peters Anthony Tropeano
French Family
Mary F. Crosier
Carolyn Grogan Eric C. Larson Harvey A. Pines, Ph.D. Manuel Udko
Foundation
Henry Cunningham,
Richard P. Gross Harris Laskey John C. Pogue Jerry Underwood
Agnes Varis
fli
Edmund J . Grossberg, Anders Lewendal Jay L. Pomrenze Dr. Robert D. Utsey, Sr.
Jack A. Vernon, Ph.D.
Willian1 E.
CLU Stephen W Lewis Daniel Pritchett Jacqueline Verdier
Mr. and Mrs. Raymond
Cushenberry, Jr.
Roy A. Gary W. Lightner Dan PuJjes Julian Vcrdina
L. Wells
Mary Holmes Dague
Gummersheimer Gary L. Lombardi A. 0. Quinn Megan Vidis
Keith C. Winters
Ronald H. Dailey
John R. Hafer Sandy Lubin Ruth Rasor Linda A. Wajnhouse
Dennis M. Daly
Robert Hager John R. Lucas Joseph R. Raudenbush David J. Walsh
Pierre David
William D. Hagerty Van A. Luoma Stephen M. Reece Susan T. Wargo
American Tinnitus Association Tinmtus 7bday/March 1999 25
SPECIAL DONORS AND TRIBUTES (continued)
Gary w. Weddel
Fred and Sharon
Weinhaus
Christopher J. Weiss
Robert J. Werner
Margaret A . Wetter
Robert M. 'v\lhittington
Rosalie Wicsenthal
Bryan B. Williams
Derwin L. Williams
Joseph H. Williams, Jr.
Neil E. Williams
Ann R. Will ner
Jer ry L. Wilterding
Rober t R. Windelspecht
John W. Young, Jr.
Adelaide w Zabriskie,
Ed D., CFA
Patricia A. Zapp
Paul W. Zerbst
Robert K. Zold
Rkhard A. Zubrycki
ProfessionaJ
Sponsors
(Pro[ess1011t1l
Contributions from $100-
$499)
John H. Abeles, M. D.
Nancy J. Ahrens, BC-
HlS
Juan J. Eermejo, Ph.D.
Knox Brooks
Jack D. Clemis, M.D.
Lawrence J. Danna,
M.D.
Chris B. Foster, M.D.
Robert A. Goldstein,
M.D.
Dr. Elhanan Greenberg
Chris Gustafson
TSeng Hung-Cheng,
M.D.
Barbara Jenki ns, M.S.,
CCC-A
Darrell A. llmmer, Jr.,
M.D.
Richard S. Kaufman,
D.D.S.
Leon W. Lipson, M.D.
Alan H. Lockwood,
M.D.
Frank H. Long, M.D.
David L. Mehlum, M.D.
Michael D. Mellow,
D.M.D.
Carl M. Nechtman,
M.D., PC
Barry S. Novek, BC-HIS
Meredith K. L. Pang,
M.D.
Ruy Penha, M.D., Ph. D.
Milagros E. Rios-
Wal ker, M.A. , CCC-A
Jay T. Rubinstein,
M. D., Ph.D.
Arthur Rudd, D.D.S.
Susan J. Seidel, M.A.,
CCC-A
Donna S. Wa)rner,
Ph.D.
Fred Zemke
Corporations with
Matching Gifts
Aspect
John Hancock
Omron Foundation
Hoechst Celanese
Quad Graphics
Special Friends
Fund In Memory
Of Dr. Robert M.
Johnson
Michael H. Ayers
Robert E. Brummett
Phyllis M. Harriman
Robert and Barbara
Harriman
Ed and Mymie Hefty
Pat and Sam Hopmeier
T.H. Lang/ Journal
Publ ishing Co.
Barbara S. Lentz
John and Penny
Merkel
Stephen M. Nagler,
M.D., F.A.C.S.
Einar M. Nordahl
Wayne Olsen
Lynn K. Pratt
Robert v. Wilcox
Dr. and Mrs. David J.
Wrighl
TRIBUTES
In Memory Of
Karen Bagley
Arlo and Phyll is Nash
Christopher Braaten
Arlo and Phyllis Nash
Jane Burkard
Pauline Gleason
Chuck and Sara
Johnson
Bruno Kisala
Mark Shepardson
'li'udy Drucker
Jim and Rosalie 'fraver
Rose Feu erberg
Kim Rippetoe
Kay Sauls
Hugh Grogan
Carolyn Grogan
George Hendricks
Arlo and Phyllis Nash
John G. Jaser
Jasper J . Jaser
George Jesfjeld
Arlo and Phyllis Nash
Charles Locking
William J. Haskin
Jack Reich
The Sherman
Family
Florence S. Reich
Nat Rubin
Sylvia Eisenberg
J . Don ald Vaughn
Donald H. and Brenda
B. Lathrop
Patricia L. McMahon
Roger Paradis
In Honor Of
Nick Andrews
Michael and Susan
Holbrook
Paul S. Holbrook
Ricltard R. Chutter
Cynthia C. llhn
1\lr. and Mrs. Fred
Cimbol
(Happy Chanukah)
Jack R. Harary
J ohn Delucca
David f. Sternlieb
John R. Emmett,
M.D.
Luther J. Smit h, Til ,
M.D.
John Flavio, Sr.
Joh n J . Flavia, Jr.
Jack Harary
(Happy Birthday)
Michael and Cynthia
Harary
Bob Luthmann
Thny Tires Sofo
Dr. Haitham Masri,
FAGS
Mrs. Preston L. Plews
Stephen M. Nagler,
M. D., RA.C.S.
Mrs. Lyla Berkoff
John and Faye
Schleter
Sandra F. Schleter
J ack A. Vernon,
Ph.D.
Mrs. Lyla Berkoff
Betty Webber
A l l i ~ o n Weber
Charles 0 . Bastien
Research Donors
John H. Abeles, M.D.
John J. Accordino
Evelyn C. Adams
Richard L. Ahrens
Rich Alger
James E. Allen
Betty J. Anderson
Elizabeth T. Anderson
Patty Andrews
Elizabeth A. t\rtandi
Natalie Aust
Sylvia Aviles
Wil liam C. Babcock
Ken Ballinger
Roy Barna
Rudolph Beck
Adele Engel Behar
Richard Behli ng
1-loward G. Bernett
Joseph Berson
Jack R. Bertram
Gary A. Billey
Edward Bloom
David W. G. Bond
Mario .r. Bonello
Robert R. Borden
Marie V. Borell ini
Douglas A. Bosma
Philip D . .Bowman
Donald M. Bowman
Sharon E. Bowyer
E. Ayres Boyd
Lillian Brabander
Ertis J. Bradley
Raymond J . Brejcha
Ronald C. Bricker
DavidS. Bromberg
Constance Brown
Donna F. Brown
David W. Bryan
Yvonne M. Bryant
Robert B. Budelman, Jr.
Gerald f. Bur ke
Michael W. Burnham
El izabeth L. Burnham
James C. Cachcris
Timothy P. Caire
Myrla Caldwell
Leo Caluori
Peggy B. Campbell
Mildred Carluccio
J ohn W. Carr
George Cheren
Barbara Christenson
Dennis J . Clark
Lawrence G. Clayton,
M.A., FAAA
Laura M. Cole
26 TinnituS '7bday/March 1999 American T innitus Association
Dale R. Conant
Fox Conner
Rev. David A. Cooling
Mary A. Crouse
Glen R. Cuccinello
Shirley Cullen
Mary Holmes Dague
Lillian Dangott, Ph.D.
Kevin W. Davidson
Thelma L. Davis
Helgi Davis
Joel Defren
Chris A Degerness
Wilburn F. Delancey
Carroll Devine
Lynn Ditlove
Thelma D. Dry
Virginia M. DuBianc
Ron Dumdei
Margaret A. Dunn
Gretchen Durki n, M.D.
James H. Dyer
Matjorie M. Ellis
Abraham i::ly
Louis S. Emanuel
Rosie Esquivias
Robert R. Fairburn
Thomas J. Fallon
Harold M. Familant,
Ph. D.
Mary Ann Fantasia
E. Lillian Feldstein
William L. Ferrara
Babara J. Fogar ty
Carolyn J. Fey-
Stromberg
Stephen C. Frai n
Hugh Fraser
Joe Friedman
Jim Ray Fugate
Pat Garibaldi
Jerry P. Gaston
Stephen P. Gazzera
Michael Geis
John Gerardi
Frank L. Giancola
Maurice J . Gifford
Howard Ginsberg
L. Kirk Glenn
Benny Goodman
Bob Goodman
Lori Grace
William R. Green
Arlene H. Griest
John M. Grilles
Toni Hakim
Eugene Hale
James D. Haney
Nancy A. Hartnett
Paul W. Hastey
Jean E. Havens
Dr. Jess Hayden
Thomas L. Hemminger
E. Alan Hildstrom
Margaret J. Hoffmann
AnneS. Hol mes
Holland
Dorothy M. Hom
John W. House, M.D.
Robert K. Hoy
Jack Huang
'Ibm l nderbitzen
Les lsaacowitz
Lucille J . . Jantz
Pamela S. Johnson
Roger Johnston
Maryann M. Jordan
William R. Just
Lynn R. Kaeding
Howard R. Katz
R. L. Keheley
Leon A. Keith
Alice Keller
Catherine A. Kellit
K. D. Kennedy, Jr.
Emily S. Kerley
Ronald D. Klein
Ann Klimczak
Sandra Kohl
Barbara L. Kohn
Ronald J . Korniski
Steve Krant
Phyllis G. Kreider
Jim Laney
Margaret Larson-Everitt
Markus Larsson
Joseph P. Leahy
Sharon Ann Lemke
Paul Lcnchuk
Catherine T. Leonard
Mary Jane Lillis
Rick Lindner
George Lombardi
Karen K Lovato
Stan M. Lumsden
James E. Lyons
l{obert 1::. Lyons
Kevin D. Mackey
Jack H. Mahan
Walter W. Mal inowski
Carole A. Maloney
Gurdev Mangat
Emanuel Maris
Nancy C. Martin
Imelde Masi ni
Michael T Matherly
Mary K. Matson
Steve Maxi n
James R. May
Barbara B.
Mazurkiewicz
Michael C. McCullough
Peter J. McDonagh
Warren McKinzie
Gordon T. McMurry,
M.D.
Charles L. McNulty
Michael L. McQuinn
Robert and Kathleen
Megginson
Evelyn A. Metzgar,
M.A., CCC-A
Christopher
Montgomery
Joseph Mora
Donald D. Morrison
Samuel R. Newsom
Chris D. Niemeyer
Patrick O' Hara, .Jr.
llren M. Oliveri
Jerome Ott
Barbara Lee Parsons
Joseph Passalacqua
Felicia A. Passero
Raymond F. Pauser
Donald E. Peters
David G. Peterson
Kurt T. Pfaff. M.A. ,
CCC-A
Josephine Piccoli
Raymond Plocharczyk
Mamie Poggio
John Pollock
Suzanne Portner
Susan Post
Cynthia Postlewait
lvanell Presley
Elliott Press
John R. Priebe
Judith A. Principe
Burtis R. Pritchett
Deborah t\. Pullin
Michele Quere
Marjorie Quisenberry
Maj . Leonhard Raabe
Matthel-\ T. Read
Eleanor Regula
Aaron B. Remley
Gerald B. Renyer
Venida f. Reynolds
Richard C. Rice
Sharon Richardson,
M.A., CCC-A
Gary Riches
Steven Roback
Vernon Robinson
William G. Roe
I. W. Rogers, Jr.
Max Rose
Amelia Rugala
Laura M. Russ
t\ 1 frieda A. Russell,
R.N.
Ruth 1-l. Santore
Peter 0. Schultz
Sandra Scott
Ronald A. Seelye
Raphael F. Segura, Jr.
Di ck Seifert
Ulona E. Senno
Arthur Serwer
Michael J. Sestrich
Amy Shaffer
Thelma M. Sjostrom
Mary K. Smith
Regina P. Smilh
Richard F. Smith
William P. Smith
Sherwin Snyder
Sandra Solomon
Darl ene Somody
Larry Spoden
William W. Stanford
Frank X. Staudinger
John T. Steele
Francis E. Stein
Susan Steinerman
Sedalise S. Stoute
David P. Sywak
Minnie Thrrill
Richard G. Teutsch
Gino Tozzi
MarianaS. 1\1pper
Jan J. Vanarnam
Baltfriet Verderber
Donna M. Vieth
Marcia E. Volk
Robert H.
Vollmerhausen
Dorothy M. Waddell
Lavetta Wallis Fossen
Frank E. Weaver
Rita Weisner
Edward R. Weiss
Roger L. Wentz
Gilbert R. Whitlock, Sr.
Lawrence S. Wick
Phyllis Ann Wiley
Roland H. Wilkerson,
Jr.
Theta Wilkinson
Jamee Wolf
Richard !'. Woodbury
Joseph R. Wozniak
Shirley A. Wrzesi nski
John A. Wunderlich
We mer E. Zarnikow
P. Richard Zitelman
Jrving M. Zorowitz
Correction to
Tributes
Bequest (from
December 1998)
should read from
the Estate of
Frances T. Men
6th International
Tinnitus Seminar
Cambridge UK
September 5 - 9, 1999
Hosted by the British Society of Audiology
Plenary Sessions: Mechanism and Models
(tinnitus and hyperacusis); 'Iteatrnents: TRT;
Medical, Surgical; Role of the Psychologist;
New Advances in Research and Methods
of Detection.
Scientific Program: 'Ibnndorf Lecture, Award
Lecture, Technical Exhibition, Free paper
sessions.
Social: Gala dinner in St. John's College with
choir, extensive "accompanying persons"
program. Combine with a holiday!
Deadlines: April lst submission of abstracts,
June 16th late registration.
Registration Fee: 350; College accommodation:
33 per day (first cmne, first served).
Scholarships available.
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Address Service Requested
Further information and registration:
Website: www.tinnitus.org
Ann Allen, BSA secretary, 80 Brighton Rd. ,
Reading, Berks RG6 1 PS, United Kingdom
Tel: 44 + (0) 118 voice 9660622 fax 9351915.
bsa@b-s-a.demon.co. uk
Chairman and academic program: Jonathan Hazell,
FRCS, 32 Devonshire Place, London
WlN lPE, UK, j.hazell@ucl.ac.uk
3rd International Tinnitus Support
Association Meeting
Cambridge, UK, September 5, 1999
For information, contact:
Gloria E. Reich, Ph.D., g1oria@ata.org
Non-Profit Org.
U.S. Postage
PAlD
American Tinn itus
Association
Robert M. (Bob) Johnson Ph.D.
May 1, 1932- January 10, 1999
A
TA and tinnitus patients the world over lost a dear friend when Bob
Johnson died of pneumonia in January. Bob served ATA in many
capacities. Appointed to the Scientific Advisory Committee in 1980,
he remained active even after his retirement from OHRC and he was Chairman
of the ATA Board of Directors from 1985 until 1994. He set the standard for
outstanding clinical work in research and teaching about tinnitus for which he
received ATN.s prestigious Hocks Memorial Research award in 1992.
But Bob's position with ATA was far more than an official one; he was an
integral part of the fight to silence tinnitus. Whether working with ATA to
determine a point of policy or personally piecing together an instrument for a
tinnitus sufferer, he was always available to help.
Bob's memory and inspiration will forever be a part of ATA and will be
especially commemorated through our SPECIAL FRIENDS FUND.
Contributions to the SPECIAL FRIENDS FUND in Bob's memory will help
maintain his primary concerns:
assuring tinnitus treatment at Oregon Hearing Research
Center (OHRC) for those who cannot afford it and
continuing the important clinical research to develop better
tinnitus treatments
Robert M. Johnson was born in Arnegard, North Dakota, served in the U.S. Air Force, and attended
North Dakota State University and Northwestern University from which he received his doctorate.
He was chief of audiology and director of the audiology program at the University of Denver prior to
coming to Oregon in 1978 as professor of otolaryngology at the Oregon Health Sciences University.
At that time he was appointed director of the Oregon Hearing Research Center's (OHRC) Tinnitus
Clinic, a post he held until his retirement in 1997. Bob and his family were active members of Our
Savior Lutheran Church in Lake Oswego, Oregon. He is survived by his wife Margaret, and children
David and Jeannie, grandchildren Kelli Ann and Elijah, and five brothers and sisters.
While initially established to benefit needy patients at the Oregon Hearing Research Center in Bob Johnson's
honor, the SPECIAL FRIENDS FUND welcomes donations honoring others as well. As funds become
available, AT A wiJI work to establish patient treatment assistance points nationwide.
Please note that the clinic or treatment center will determine patient need, not ATA.