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September 1991 Volume 16, Number 3

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear."
In this issue:
The NIDCD and
Tinnitus Research
Tinnitus in the
Nursing Home
Information about:
Cochlear Implants
ProZainE
Ear Protection
Regular features:
Media Watch
Questions & Answers
Feel the ocean's spray ... go barefoot
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tnnt
Editorial and advertising offices:
American Tinnitus Association, P.O. Box 5
Portland, OR 972f17 (503) 248-9985
Executive Director & Editor:
Gloria E. Reich, Ph.D.
National Chairman:
Robert M. Johnson, Ph.D.
Editorial Advisor:
Trudy Drucker, Ph.D.
Advertising sales: AT A-AD, P. 0. Box 5,
Portland, OR 972f17 (800-634-8978)
Tinnitus Today is published quarterly in
March, June, September and December. It
is mailed to members of American Tinnitus
Association and a selected list of tinnitus
sufferers and professionals who treat tinnitus.
Circulation is rotated to 175,000armually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuit-
able for Tinnitus Today. Acceptance of ad-
vertising by Tinnitus Today does not
constitute endorsement of the advertiser, its
products or services, nor does Tinnitus
Today make any claims or guarantees as to
the accuracy or validity of the advertiser's
offer. The opinioos expressed by contributors
to Tinnitus Today are not necessarily those
of the Publisher, editors, staff, or advertis-
ers. American Tinnitus Association is a non-
profit human health and welfare agency
under 26 USC 501 (c)(3)
Copyright 1991 by American Tinnitus
Association. No part of this publication
may be reproduced, stored in a retrieval sys-
tem, or transmitted in any form, or by any
means, without the prior written permission
of the Publisher. ISSN: 0897-6368
Scientific Advisory Board
Alfred Weiss, MD, Boston, MA
Abraham Shulman, MD, Brooklyn, NY
George F. Reed, MD, Syracuse, NY
John R. Emmen, MD, Memphis, 1N
Gale W. Miller, MD, Cincinnati, OH
Jack D. Clemis, MD, Chicago, IL
W. F. S. Hopmeier, St. Louis, MO
Harold G. Tabb, MD, New Orleans, LA
J. Gail Neely, MD, Oklahoma City, OK
Jerry Northern, PhD, Denver, CO
John W. House, MD, L>s Angeles, CA
Robert E. Sandlin, PhD, San Diego, CA
Chris B. Foster, MD, San Diego, CA
Richard L. Goode, MD, Stanford, CA
Mansfield Smith, MD, San Jose, CA
Robert M. Johnson, PhD, Portland, OR
Honorary Board
Senator Marie 0. Hatfield
Mr. Tony Randall
The Journal of the American Tinnitus Association
Volume 16 Number 3 September 1991
Contents
4
6
7
8
10
11
13
16
17
The NIDCD and Tinnitus Research
by James B. Snow
Cochlear Implant Information
by Claudia Ostepenko
Media Watch:Tinnitus in the News
by Cliff Collins
Questions & Answers
by Jack A. Vernon
Tinnitus (Poem)
by Lila Baron
Tinnitus in the Nursing Home
by J. C. & Evelyn Hartley
One Hundred & Growing: Self-Help Group Update
by Laurie Bauer
Dr. Vernon Speaks about ProZainE
by JackA. Vernon
Ear Protection Info: More Noise Doesn't Work
from "Audiology in Practice"
Regular Features
6
16
18
19
Calendar
Classified
Tributes, Sponsor Members, Professional Associates
Books Available, Donation Form
Cover painting by Manuel Izquierdo, Portland, Oregon. Izquierdo's work is in both
private and corporate collections nationwide. Inquiries may be directed to
(503)244-1524.
The NIDCD & Tinnitus Research
James B. Snow, M.D., Director, National Institute on
Deafness and Other Communication Disorders
The National Institute on Deafness and
Other Communication Disorders (NIDCD) sup-
ports biomedical and behavioral research andre-
search training in normal and disordered
processes of hearing, balance, smell, taste,
voice, speech, and language. Within this spec-
trum of research, NIDCD considers research on
tinnitus to be of high priority. While relatively
little is known about the prevalence and causes
of tinnitus, we are aware that millions suffer
from this disorder. At least 15% of the Ameri-
can population have frequent or constant tinni-
tus, and some lives are completely disrupted
(10% of the 15% just mentioned) by tinnitus in
its severest form. It is from this perspective that
NIDCD has made its commitment to tinnitus re-
search, and we are hopeful that new discoveries
will yield substantial advances in what we
know about the condition.
The NIDCD's primary planning document,
The National Strategic Research Plan (NSRP),
was developed in January 1989 by one hundred
distinguished scientists and clinicians charged
with providing a three-year and a long-range re-
search plan for the Institute in the areas of deaf-
ness and other communication disorders.
Specifically, the NSRP identifies six areas of re-
search for the NIDCD: Deafness and Hearing
Disorders, Balance and the Vestibular System,
Voice and Voice Disorders, Speech and Speech
Disorders, Language and Language Im-
pairments, and Smell, Taste, and Touch. The
Deafness and Hearing Disorders section calls at-
tention to six tinnitus related areas needing fur-
ther inquiry: I) Documenting the prevalence of
tinnitus and its relation to all forms of hearing
loss; 2) Developing effective clinical measures
of tinnitus sensation and the impairment it pro-
duces; 3) Understanding the psychophysical
consequences of tinnitus; 4) Developing animal
models for the elucidation of the sites of origin
4 Tinnitus Today/September 1991
and mechanisms of tinnitus production; 5) Un-
derstanding better the relationship among
otoacoustic emissions, hair cell motility, aspirin
toxicity, and tinnitus; and 6) Testing of thera-
peutic strategies such as drugs, acoustical mask-
ing, and electrical suppression.
The NSRP is being revised on a regular
basis by scientific review panels, panels who
will update two of the six research areas in the
NSRP each year. The balance and vestibular
system and the language sections were updated
this year; the hearing and voice sections will be
updated next year; and in 1993 the sections on
speech and the chemosenses, smell and taste,
will be updated.
The NIDCD is currently supporting a num-
ber of tinnitus projects. The Institute awarded
grants of approximately $1.2 million during FY
1990 and FY 1991 for studies of tinnitus.
(E<i.note, this represents approximately .009,
less than 1%, of the Institute's budget.) One
study focuses on tinnitus in patients with senso-
rineural hearing loss, and, as a result, scientists
hope to develop a comprehensive database re-
garding the phenomenon of tinnitus that
accompanies the numerically greatest problem,
sensorineural hearing loss.
Animals are being used in another project
to study the mechanisms of tinnitus and to test
the that calcium imbalance may be
responsible for inducing cochlear tinnitus. This
project could provide insight into tinnitus based
upon the abnormal mechanisms as well as the
normal function of the auditory system. Investi-
gators are optimistic that a new approach to the
treatment of tinnitus can be developed from
these findings.
Under a third area of investigation, current
research strongly suggests that animals are able
to perceive what have been called "phantom"
continued on page 5
Vol.16 No.3
The NIDCD & Tinnitus Research (continued)
auditory sensations and that it is possible to in-
duce and detect this state in animals. Scientists
are hopeful that this project can shed light on
the relationship between the external environ-
ment and internal perception, a key element to a
better understanding of tinnitus.
In FY 1993, depending on available appro-
priations, the NIDCD will issue a request for
proposals for a research contract to determine
the feasibility of a tinnitus suppression prosthe-
sis. Recently a number of investigators studying
cochlear implants have noted tinnitus suppres-
sion in some of their patients, suppression that
ranged from partial to complete. Researchers in
several recent clinical studies, however, have
failed to pinpoint a reliable method of suppress-
ing tinnitus through the stimulation of various
regions of the ear (e.g. the tympanic membrane,
the promontory, the round window, and within
the cochlea). Under this contract, the Institute
will examine the mechanism of tinnitus suppres-
sion using animal models and modem electro-
physiological techniques of recording and
stimulation. The results of this project may pro-
vide valuable information for eventual use in
clinical studies of prostheses to suppress tinni-
tus.
Apart from tinnitus-specific research, the
NIDCD awards grants and contracts for re-
search into other problems of normal and disor-
dered hearing. In FY 1990, $62,000,000 was
used to support hearing research. While these
studies may not directly address tinnitus, the
insight they provide into the functioning of the
normal and disordered auditory system are
likely to enhance our knowledge of tinnitus.
Indeed the cure for many forms of tinnitus will
probably result from discoveries of cures for
various hearing disorders.
Through the NIDCD Clearinghouse, infor-
mation will be made available about current
research on tinnitus and results of studies under-
Vol.16 No.3
way. The Clearinghouse is a national informa-
tion resource on hearing, balance, smell, taste,
voice, speech, and language, and inquiries are
welcome. You may write to: NIDCD Clearing-
house, PO Box 37777, Washington, DC 20013-
7777.
The NIDCD is striving to expand our
knowledge about tinnitus: what causes it, how it
affects those who have it, and how it can be
treated. Research results will eventually be
transformed into tangible applications for those
affected by tinnitus. Living with tinnitus is diffi-
cult, and living with something about which lit-
tle is known makes it more difficult.
I am optimistic because of the high quality
of our funded research. The NIDCD will con-
tinue to build its research program in tinnitus.
Through outstanding research, what is known
about tinnitus can be brought out of its infancy
into a more developed, comprehensive under-
standing of the "hows" and "whys" of its occur-
rence, and eventuauy effective means of
treatment will evolve. 0
American Tinnitus Association
is a participant in the
Combined Federal Campaign
#0514 in the CFC Brochure
Thank You For Helping
To Fight Tinnitus
Tinnitus Today/September 1991 5
Cochlear Implant Information
Claudia Ostapenko, American Academy of
Otolaryngology-Head and Neck Surgery
Worldwide, approximately one person in a
thousand is born deaf. Almost an equal number
of people born with hearing will develop
deafness during their lifetime.
The American Academy of Otolaryngol-
ogy-Head and Neck Surgery has published a
new leaflet, "Cochlear Implant: A Device to
Help the Deaf Hear," which describes the
cochlear implant, how it works, and patients
who are possible cochlear implant recipients.
"Approximately 250,000 to 500,000 peo-
ple in the United States could benefit from a
cochlear implant," said Dr. Thomas Balkany,
chairman of the Academy's subcommittee on
cochlear implants. So far, fewer than 3,000
devices have been implanted.
A cochlear implant is an electronic device
which restores partial hearing to totally deaf
people. Part of the device is surgically im-
planted in the ear and part is worn externally
like a hearing aid. However, a cochlear implant
is not a hearing aid in the sense of making
sound louder or clearer. It is a medical device
which bypasses damaged parts of the inner ear
and electronically stimulates the nerve of hear-
ing.
Implant surgery is performed under ami-
croscope. An electromagnetic coil the size of a
quarter is implanted in a bone just behind the
patient's ear. The coil is connected to thin plati-
num wires which are inserted into the cochlea,
the core of the inner ear. Sounds are picked up
by a tiny microphone and processed by a pocket
computer into electronic impulses which are re-
layed to the nerves of the inner ear through the
coil and wires.
Cochlear implants are designed for people
who cannot benefit from a hearing aid or other
6 Tinnitus Today/September 1991
surgery because of severe damage to nerves in
the inner ear, caused by disease or other factors.
The Academy is an organization of more
than 9,000 physicians concerned with both the
medical and surgical treatment of the ears, nose,
throat, and related structures of the head and
neck.
For a free copy of the new leaflet, send a
self-addressed, stamped #10 envelope to:
"Cochlear Implant"
AAO-HNS
One Prince Street
Alexandria, VA 22314.0
TINNITUS EVENTS SCHEDULED
FOR REMAINDER OF 1991
September 21-26, 1991 International Tinnitus
Study Group meeting, ATA medical advisory
board meeting and public forum in conjunction
with the American Academy of Otolaryngology
annual meeting. Kansas City, MO. ENT doctors
attend this meeting offering an opportunity to
share current tinnitus information.
October 25-27, 1991 National Hearing Aid So-
ciety annual meeting. Reno, NV. Pat and Walt
Daggett will represent AT A withdisplay, offer-
ing literature to the hearing-aid dispensers who
attend.
November 21-24, 1991 American Speech Lan-
guage & Hearing Association annual meeting
Atlanta, GA. ATA will be represented by Dr.
Robert Johnson who will consult with audiolo-
gists attending the meeting. He and a group of
experts will be available to answer questions at
the AT A's Public Tinnitus Forum.
Vol.16 No.3
Media Watch: Tinnitus in the News
by Cliff Collins
Some people should be arrested for im-
personating parents. Stopped at a traffic light re-
cently, I was shocked to hear a pulsating bass
emanating from the car behind me. The stereo
noise was deafening, even though the "parent,"
with two small children in tow, had the win-
dows rolled up along with the music volume.
When you consider that I was wearing ear-
plugs and earmuffs at the time -- and had my
windows rolled up, too -- and still heard the
car's sound-system loud and clear, you begin to
understand the degree of the offense. Adults
who have no regard for their own hearing
health (not to mention safety and sanity) are one
thing; but to subject children to such is obscene.
State legislatures are introducing bills that
would regulate these rolling boom boxes. The
(Portland) Oregonian reported June 4 that the
Oregon Legislature was considering a bill that
would allow police officers to cite drivers
whose amplification systems were "plainly
audible outside of a vehicle from 50 or
more feet." Los Angeles and many other cities
are plagued with this form of noise pollution,
which legislation sponsors say disturbs commu-
nities night and day. Not to mention abuses children.
Office calls: When syndicated columnists
cover. tinnitus, the ATA hears the results. Paul
Donohue, M.D., whose column runs in various
national papers, and Lawrence E. Lamb, M.D.,
writing in The Retired Officer Magazine, de-
voted space to the topic in June, and Donohue
included AT A's address. However, both doc-
tors failed to include mention of noise as a
principal cause of tinnitus, or to warn those
with tinnitus to avoid loud noise, which can
make tinnitus worse.
Roll over, Beethoven: Medical historians
are enjoying a heyday. In just this year, we have
heard reports of scientists trying to link the be-
Vol. 16 No.3
havior of personages such as the artist van
Gogh and Abraham Lincoln -- and now even
George Bush -- with medical problems they ex-
perienced. Now comes word (in the May Better
Homes and Gardens) that the famous composer
Beethoven, who was known to suffer severe
hearing loss, was "driven to near madness" with
tinnitus, according to Paul R. Lambert, M.D.,
an otolaryngologist at the University of Vir-
ginia. The article goes on to give a short, accu-
rate tutorial of tinnitus.
Other composers, including Schumann,
were believed to have tinnitus, but this is the
first I've heard of Beethoven' s. (I previously
had read, though, that some modern doctors be-
lieve his hearing loss was due to otosclerosis.)
One ATA correspondent, a classical musician,
noted that it was probably not until the emer-
gence of large concert halls and huge sympho-
nies that musicians and their audiences began
suffering ear problems from exposure to music.
Before that, such loud volumes weren't at-
tained. Of course, with the emergence of electri-
cally amplified music, the problem was
compounded.
Noise volumes in classical music can be
loud: In an Associated Press story a few years
back, a viola player who developed tinnitus said
sounds can range up to 130 decibels. Bernard
Fleshier, a member of the Buffalo Philharmonic
at least at the time of this story, told of his in-
vention: Acousti-shield, a foam-rubber cushion
a musician can attach to a chair and that curves
around to absorb sounds from other instru-
ments. Several orchestras were trying out the
device, the story said.
More noisy news: A reporter at a pro bas-
ketball playoff game measured the crowd noise
at levels up to 112 decibels, and holding ... The
Dallas Morning News April 15 devoted its Med-
ical Consumer column to tinnitus, and Lear's
continued on page 8
Tinnitus Today/September 1991 7
Media Watch: Tinnitus in the News (continued)
(April) had a short write-up on noise pollution,
mentioning tinnitus. In the latter story, William
Clark, Ph.D., of the Central Institute for the
Deaf in St. Louis, said kitchen counters serve as
"loudspeakers" for home appliances and can be
toned down with rubber mats. The Mercury
(Pottstown, PA), the Rappahannock (VA) Re-
cord and Northern Neck News (Warsaw, VA) all
ran articles on tinnitus, thanks to ATA members
in those areas.
Cliff Collins, an Oregonfreelance writer,
welcomes news clips and reports of TV and
radio broadcasts. Include source and date, and
send to Media Watch, ATA, PO Box 5, Port-
land, OR 97207.0
Questions & Answers
Jack Vernon, Ph.D., Director,Oregon
Hearing Research Center, Portland OR 97201
Q uestion: Recently I read in Tinnitus Today
about the use of Xanax to reduce tinnitus.
My primary physician had not heard of Xanax
for tinnitus. He prescribed 0.25 milligrams
three times a day which made me too lethargic.
I reduced to one-half a tablet three times a day
with one full 0.25 mg at bedtime. I now experi-
ence some tinnitus relief and on a few occa-
sions, the tinnitus is barely audible. What
should the dosage of Xanax be? Mr. H., Canada.
A nswer: It is essential that any tinnitus pa-
tient who wishes to try Xanax do so only with
the consent and cooperation of their primary
physician. In our tests of Xanax, each patient
received 0.5 milligrams three times a day. That
is a total daily dose of 1.5 mg (the daily maxi-
mum is 4.0 mg). People vary in their suscepti-
bility to medication and often it is necessary to
reduce the amount of Xanax to prevent exces-
sive drowsiness while still attempting to main-
tain tinnitus relief. It is important to realize that
8 Tinnitus Today/September 1991
Xanax provided little or no relief of tinnitus for
most patients during the first week of medica-
tion and that the major relief occurred in the sec-
ond week. This fact suggests that a certain
blood level must be reached before the drug be-
comes effective. Moreover, it indicates that one
cannot suddenly take a dose of Xanax at a tinni-
tus flare-up and expect relief. The dosage
should be tailored to the individual patient's tol-
erance and level of relief obtained. To date, we
know of only one patient who had a temporary
exacerbation of tinnitus from Xanax, while
roughly one-half of the patients trying it have
experienced substantial relief, even to complete
disappearance for a few.
Some patients do not experience any
drowsiness from Xanax while others can be in-
capacitated by it. If drowsiness is produced, the
affected patient should exercise caution about
driving or operating power tools and machinery.
In addition to drowsiness, Xanax can be
habit forming which means that sudden cessa-
tion of the drug may produce withdrawal symp-
toms and these can be very unpleasant. We
have one letter from a lady who experienced se-
vere withdrawal symptoms as a result of Xanax
treatment. One should proceed to take and to
cease taking the drug only according to their
physician's
instruction.
We
would like
to receive
reports of
results
from those
who try
X an ax
such as the
one were-
ceived
continued on page 9
Vol.16 No.3
Questions & Answers (continued)
from Mr. V. in San Francisco. He informs us
that 0.25 mg three times a day gave some relief
of tinnitus but when the dose was increased to
0.5 mg three times a day, he developed "mi-
graine headaches." This is the only report of
headaches in over 40 patients using Xanax. I
would suggest, Mr. V., that you return to there-
duced dose and if that produces no headaches,
then gradually increase the dose to see if the tin-
nitus relief can be increased at a dose level
below that producing the headaches. Mr. V.
also reports that Xanax did not make him
sleepy. Remember, gentle reader, everyone dif-
fers in their reaction to drugs.
Q uestion: Many patients have written to say
that their tinnitus is worse after sleep. Some
qualify it to mean only a cat-nap type of sleep.
Some indicate that 'the exacerbation can last as
long as several days while others indicate that
the return to normal is more rapid. Almost all
say that the sleep effect does not always occur.
A nswer: I have no information to offer about
this odd and unexpected effect of sleep. Indeed,
at this point I don't even know what questions
to ask, so I'll ask each of you to help. We need
to know more about what else happens at those
times of the sleep effect. For example, was
there neck strain or muscle tension which might
be involved? Would those of you who experi-
ence the "sleep effect" keep some very careful
records, please? Record the prevalence of the
occurrence as well as any other relevant
changes such as changes in the quality of the tin-
nitus and its location. Do medications that in-
duce sleep alter the effect? Have any of you
consulted with investigators who srudy sleep?
As you provide information, we will continue
to report.
Q uestion: Mrs. M. from Pennsylvania indi-
cates that she has had tinnitus in the left ear
which has begun to subside and now she hears
Vol.16 No.3
tinnitus in the right ear. Her physician told her
she had tinnirus all along in the right ear but she
denies this. The two sounds now seem to inter-
sect at the top of her head.
A nswer: What you describe, Mrs. M., is a
very common occurrence among the tinnitus pa-
tients we have seen in our Tinnitus Clinic. It is
frequent that a patient will present claiming tin-
nitus in one ear only. Then during our routine
testing, the tinnitus will be put into residual inhi-
bition, which means that temporarily the tinni-
tus either disappears or is reduced. Very often,
during the residual inhibition period, the patient
will notice for the first time that there is some
tinnitus in the opposite ear. The presence of the
louder tinnirus was sufficient to mask the lesser
tinnirus until the louder tinnirus was reduced. I
suspect this is what happened to you, Mrs. M.
You simply had no opportunity to observe the
right ear tinnitus until the left ear lost some of
its loudness.
That the tinnitus now appears to be located
in the center top of your head means that the tin-
nitus on each side is exactly balanced as to qual-
ity and intensity. The result is that the tinnitus
appears to be located not at the ears but in the
top of the head. This is a common experience.
What does it mean? Nothing special except that
perhaps special ~ a s k i n g may be required, if
masking is to be successful for you. Neverthe-
less, you should try bilateral tinnitus maskers
(Starkey TM-1 or TM-3) or, if there is hearing
loss, then try bilateral tinnitus instruments
(Starkey MA-l or MA-3). If this form of mask-
ing does not work for you, then diotic masking
may be required but that gets a bit complex for
discussion here. Let me know how things prog-
ress for you and, if necessary, I'll indicate how
to proceed with diotic masking.
continued on page 10
Tinnitus Today/September 1991 9
Questions & Answers (continued)
Q uestion: I have been diagnosed as having de-
pression for which the anti-depressant
Deseryl was prescribed. For the ftrst time in
my life, tinnitus appeared after the dosage of
Deseryl was increased. I stopped the Deseryl
and the other side-effects disappeared but the
tinnitus has remained. I began taking As-
endin for sleeping. Does Deseryl cause per-
manent tinnitus? Does Asendin prolong it?
A nswer: Many tinnitus patients have noticed
that anti-depressant medication exacerbates tin-
nitus but I know of none for whom the medica-
tion caused the tinnitus. I predict that if the
tinnitus was produced by the Deseryl it will
gradually go away once you have been off the
drug long enough. Sometimes these things take
a long time so do not be impatient.
According to the Physician's Desk Refer-
ence, Asendin is an anti-depressant so it may
have picked up where the Deseryl stopped.
Also, tinnitus is listed as one of the possible
side-effects for Asendin.
I would recommend (actually insist) that
you discuss this matter with your prescribing
physician in an attempt to find a medication
which will take care of the depression and, at
the same time, not produce any tinnitus. There
are many anti-depression drugs to try. The anti-
depressants which most frequently seem to ex-
acerbate tinnitus are in the tri-cyclic family but
there are anti-depressants not in the tri-cyclic
family, such as Wellbutrin, which may be tried.
Q uestion: Mr. S. from Chicago reports an in-
teresting observation. The tinnitus he has had
for 20 years fluctuates and on some days, it is
extremely bad, as he says, "so loud it is almost
impossible to think." Out of desperation one
day he took one Tylenol caplet with the result
that the tinnitus "dropped at least 90%." He has
now repeated this procedure five times, obtain-
ing the same measure of relief four times.
10 Tinnitus Today/September 1991
A nswer: Four out of five trials is a success
rate of 80% and, for tinnitus, that is very good.
For Mr. S., this is a welcomed relief, and he
will undoubtedly continue to use it. The ques-
tion which arises is how many other patients
have tried Tylenol and of that number, how
many obtained relief? No doubt reading this ac-
count will cause many of you to try Tylenol. If
you do try it, would you please write in to tell
us the results? It would help if you could indi-
cate a bit about your tinnitus, such as whether it
is constant or fluctuating, a ringing or a noise,
located at the ears or in the head, and any other
descriptions you think relevant. Then, of
course, tell us the effect of the Tylenol.
Finally, Mr. S., it is good that you have
found something which helps you but please be
careful and do not extrapolate from your result
so as to assume that increased amounts of
Tylenol will provide even greater relief. Also, I
hope you have infonned your primary physi-
cian about your findings. 0
Tinnitus
by Lila Baron
This sound that keeps buzzing constantly in my head
Slowly is driving me out of my mind instead
The doctors say there is nothing to fear
Tinnitus is a disorder of the inner ear.
The condition is nothing to fret about
It's a quiver in the soft palate of my mouth
The noises like a waterfall or escaping steam are awful sounds
But they say, "you must bear it, no cure has been found."
It's not easy to live with this buzzing in my head
But I keep myself busy singing, laughing and writing instead
I keep hoping, praying every day to end this horrible sound
And that with Gocf s help a cure for Tinnitus soon will be fouru!.O
Vol.16 No.3
Tinnitus in the Nursing Home
by J. C. and Evelyn A. Hartley. ATA members Mr. and
Mrs. Hartley serve on numerous civic boards in the At-
lanta area and are active advocates for service to the
hearinJ? impaired.
Prevalence of tinnitus in older people
Why do we consider tinnitus important in
nursing homes? The median age of the resi-
dents of nursing homes is 81 years. People over
65 years old are seven times more likely to suf-
fer from tinnitus than those under forty-five.
There are more older people in the population
today because of the great strides in health and
medical sciences. In 1900 only 4.1% of the
United States population were over sixty-five.
Currently that figure is over 10% and it is esti-
mated that by the year 2000 there will be over
28,000,000 people who have reached sixty-five
or older. Nursing homes are already filled with
our elderly. What will it be like in the years to
come?
Caring for older people with tinnitus
Helping residents with tinnitus and hearing
impairment is frustrating because these are con-
ditions for which nursing home staff members
have little, if any, training. Hearing is one of the
most important factors of communication.
Tinnitus is one of the elements that can pre-
vent satisfactory communication. Simply
communicating with hearing impaired residents
presents problems, but when tinnitus is present
there is the additional problem of trying to un-
derstand what is causing the noise. Some people
may fear unnecessarily they are going crazy or
becoming senile.
People who are nursing home residents
today have lived in the most stressful times in
American history. They experienced the great
depression, World War TI, the Korean War, Viet
Nam and now health care costs are eating away
whatever savings they have. Many of these peo-
ple have gone from a state of independent living
to an almost child-like dependence in a short
Vol.16 No.3
space of time. They deserve all the relief and
comfort we can give.
Communication is a key to understanding
With proper attention the welfare of our el-
derly nursing home residents can be improved.
More efficient communication can be estab-
lished through understanding and education for
both the residents and the attendants. The atten-
dants must first understand that the problem ex-
ists. This can be accomplished by observing the
individual resident to determine whether they:
1) lose their balance, 2) ask "What's that
noise?" when there's no noise. 3) have trouble
sleeping, 4) have trouble understanding conver-
sation. Any of these symptoms could indicate
tinnitus.
Additionally, the individual should be
asked if they hear noise in their head or ears. At
the same time they should be informed about
tinnitus and assured that it is a common occur-
ance among people of their age, they are not los-
ing their mind, and that there are things that will
be done to help them.
Relief strategies
What can be done to help? One of the first
steps should be a medical examination to rule
out problems that may be treatable with medica-
tion or surgery. Possibly correctable causes of
tinnitus may be as simple as excessive wax
build-up in the ear or (rarely) as complex as a
brain tumor. Some causes, such as stress, medi-
cations being taken for other conditions (such
as arthritis), and TMJ (jaw problems), should
also be considered, even if they seem unrelated
to the ear.
After ruling out physical causes, the
person's environment should be investigated
Excessive noises may be triggering the p r ~ b l e m
such as air conditioning units, vacuum cleaners,
continued on page 12
Tinnitus Today/September 1991 11
Tinnitus in the Nursing Home (continued)
nearby construction work, or any other loud or
unusual noises.
Once it has been determined that a
resident's tinnitus cannot be treated by any of
the above measures, it is time to see if some-
thing can be done either to relieve the tinnitus
or to help the person cope with it. If noise is the
problem, the resident can be moved or the noise
eliminated. For example, when a person's room
is being vacuumed they can be taken to another
area. There is no established noise level that
triggers tinnitus. Any noise that is uncomfort-
able to a person with normal hearing should be
suspect. Sometimes inexpensive ear plugs can
be used very effectively against noise.
There are various masking devices avail-
able which substitute a more pleasant sound for
the tinnitus. Sometimes this can be as simple as
a radio or television in the background. A pil-
low speaker is ideal for helping at bedtime be-
cause the sound does not disturb anyone else.
Many people are not bothered with their
tinnitus if they are engaged in an activity which
they enjoy. Residents should be encouraged to
participate in crafts and recreational sessions to
possibly benefit their tinnitus as well as other
problems they may have.
Attendants need to be especially aware of
residents who wear hearing aids or ear-level
maskers. Everyone who sees to the needs of the
resident should know where the aids are kept
when not being worn and where to find fresh
batteries and how to change them.
The role of drugs
Some medications tend to increase the
noise of tinnitus. Information about all drugs
that a tinnitus resident is taking, including over-
the-counter drugs as common as aspirin, is es-
sential for monitoring possible changes in the
tinnitus. For some people, caffeine, nicotine,
and alcohol have an effect on their tinnitus.
12 Tinnitus Today/September 1991
There is no known medication that is helpful in
all cases of tinnitus but there are drugs that may
be tried for possible relief. The person's pri-
mary doctor should be consulted before starting
or stopping any medication. There is no sur-
gery specifically for tinnitus.
Counseling, both individual and group,
can be a helpful adjunct to supportive treatment
for tinnitus. Relaxation procedures, meditation,
and exercise are just a few of the ways that peo-
ple gain better control of their bodies and often
of their tinnitus.
In the nursing home, communication be-
tween staff and residents is vital. Attendants
should be aware of techniques for communicat-
ing with hearing impaired people. Too many
think that louder is the accepted method.
We have tried to summarize the need for
better care and communication in our nursing
homes. Training attendants to recognize and un-
derstand resident's hearing problems can not
only make their work more rewarding, but also
the residents much more comfortable.
Communicating with people who are
Hard-of-Hearing
From materials supplied by Gallaudet College,
Washington, DC 20002
DO move away from noisy areas or the source of noise --
loud air conditioning, loud music, TV and radio.
DON'T stand with bright light (window, sun) behind you --
glare makes it difficult to see your face.
DO get the hearing impaired person's attention and face in
full v i e w ~ talking.
DO face the person when you are speaking.
DON'T chew gum, smoke, bite a pencil, or cover your
mouth while talking -- it makes speech difficult to under-
stand!
DO rephrase sentences or substitute words rather than repeat
yourself again and again.
DON'T shout! Speak clearly and at a normal voice level.
DO be patient.
Vol.16 No.3
One Hundred & Growing: Self-Help Update
by Laurie Bauer
One Hundred Thank-Yous ... Currently,
our tinnitus support network consists of one
hundred people throughout the country; one
hundred people willing to share their time,
knowledge, and experiences dealing with tinni-
tus. To each one hundred of you, we wish to ex-
press our appreciation and congratulations for a
job well done!
These 100 support networks range from
people like Wilbur Klotz of South Williams-
port, Pennsylvania, Ray Taylor of Central City,
Iowa, and Ms. Ruble Bolling of Pound, Vir-
ginia, who act as telephone contacts and receive
maybe 10 or 15 phone calls and letters per year,
to informal groups like the one organized by Ni-
cole Hoffman in South Glens Falls, New York,
in which 5- 10 people gather informally every
6 to 8 weeks, as they desire, to groups such as
the Bergen County (New Jersey) Tinnitus Self-
Help Group, which was established by Trudy
Drucker in 1982. An average of approximately
30 people attend regular meetings, and the
group's mailing list numbers near three hun-
dred.
This variation shows that each support net-
work is unique, which is not only fine, but the
way it should be! For the group to grow and
flourish, and also just to survive, participants
must be happy with the functioning of the net-
work, which requires that they be involved with
its design. By working together to organize a
support system locally, people implement a pro-
gram of mutual help from the beginning, which
sets an example that can guide the group as it
grows.
Continued on page 14
"COPING WITH TINNITUS"
e STRESS MANAGEMENT & TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STRESS OF TINNITUS WITHOUT COMPLEX
INSTRUMENTATION & VALUABLE OffiCE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids, tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered and can be performed daily in the
patienrs home environment. It has been demonstrated that the relaxation response can release muscle
tension, lower blood pressure and stow heart and breath rates.
A
ASSOOATED
HEARING
CENTERS
A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
has successfully treated for many years chronic pain, tension headaches, Insomnia and many other
conditions.
The program consists of one cassette tape of Metronome Conditioned Relaxation and two additional
tapes of unique masking sounds which have demonstrated substantial benefit whenever the patient
feels the need of additional relief. These recordings can be used to induce sleeping or as a soothing
backdrop for activity and can be played on a simple portable cassette player.
AU. ORDeRS MUST Be ACCOMPANieD 6Y
CHr:cl\ VISA. MASTliPC.ARD, OR INSTnuTJONAL P.O.
6796 ~ T ST., UPPER DARBY, PA 19082
Phone(215)52&5222 13
Self-Help Group Update(continued)
Another big difference among groups lies
in the philosophy behind the purpose of the
group. Common to all groups, of course, is the
first priority of continually learning to better
cope with tinnitus through the sharing of ideas
and experiences. In addition, many groups take
an interest in acquiring as much knowledge as
possible about tinnitus - they gather literature
for discussion at meetings and often invite
health professionals to address the group and an-
swer questions. Still further, some groups also
decide to take action within their communities,
usually with the intention of furthering people's
awareness of tinnitus. We certainly encourage
such activity and appreciate these efforts im-
mensely, as we believe strongly in education
and awareness.
Helping Spread the Word ... Without
being able to cover the accomplishments of ev-
eryone, we'd like to recognize the work of a
few particular groups. Members of the new
First Coast Area group (based in Jackson-
ville, FL) will visit local hospitals, physicians,
and ENT clinics to introduce themselves and
promote their group personally. At the same
time, they'll distribute ATA literature, i n c l u d ~
ing pamphlets and a copy of "Tinnitus Today."
The St. Louis, MO group has similar plans.
Also helping generate publicity in Florida
is Lester Lemke, who initiated a group in the
Ft. Myers/Cape Coral area in July of 1990. A
health segment on local television will feature a
report on tinnitus and their support group, and
they hope to follow up with a second story on
how tinnitus affects other members of the fam-
ily. Members of this group have also distributed
our radio announcements to approximately 20
nearby stations.
The Bergen County Tinnitus Group
takes a strong interest in noise prevention.
Guided by their "Loud Noise Hurts" slogan, a
card has been devised that members can use to
14 Tinnitus Today/September 1991
explain their hurried departure if they must
leave a setting because of high noise levels.
These wallet-sized cards not only offer an expla-
nation, but also take advantage of an opportu-
nity to educate others about the dangers of
exposure to loud noise. The Bergen County
group hopes others will either duplicate their
cards or develop something similar.
AT A member and telephone contact Larry
Brown, of Ft. Lauderdale, recently addressed
tinnitus on a late-night radio talk show. The
host also has tinnitus, and they used the opportu-
nity to answer questions from callers and also
let people know about ATA. Similarly, Mrs.
Ann Revere, interested in starting a support
group in Warsaw, Virginia, has spent much of
her time encouraging local newspapers and
magazines to cover tinnitus, and has been suc-
cessful in helping spread the word in her area.
Many thanks to all of you!
Please note: These efforts are both essen-
tial and much appreciated, but we do not mean
to discount the importance of the basic support
and self-help the groups are designed to pro-
vide.
Welcome to Our Family ... We are happy
to report that since our last self-help group up-
date (December 1990), we have added 5 tele-
phone contacts, and 3 new groups have been
established! The new groups are located in:
Boca Raton, FL. Contact: Neta Kolasa at
( 407) 392-8881.
(Meetings will resume in October)
Jacksonville, FL. Contact: Diane Bootz at
(904) 791-8269.
Seattle, WA. Contact: Barbara Williams at
(206) 881-1696.
Continued on page 15
Vol.16 No.3
Self-Help Group Update(continued)
Groups are now being formed in:
Richmond, VA. Contact: Carol Moorhead at
(804) 745-0952.
San Fernando Valley, CA. Contact: Joe Stevens,
(818) 989-5098.
The following groups have renewed en-
ergy and would particularly like to increase par-
ticipation and attendance at meetings:
Columbus, OH. Contact: Joyce Knapp at
(614) 497-2633.
West Covina, CA. Contact: Norm Baker at
(818) 967-8815.
Maitland, FL. Contact: Betty Fisher at
( 407) 645-4024.
Our only complaint ... is that there aren't
more of you! People often report feeling that
"no one around here understands tinnitus- no-
body realizes what I'm dealing with." We love
being able to say, "Oh, but someone does under-
stand, and can offer the reassurance that people
are coping with it, and you can, too." Please
contact the national office if you'd like to be-
come involved. Currently, states marked on
the map below especially need more friendly
people to participate in our support system.
Please contact the national office for infor-
mation on setting up a support network in your
area. We're anxious to help!
To request a list of support networks in
your region, please send a #10 self-addressed
stamped envelope to the national office. Clearly
write "SHG'' on the lower left corner.O
Support groups need your help, especially in shaded states.
Vol.16 No.3
Tinnitus Today/September 1991 15
Dr. Vernon Speaks about ProZainE
by JackA. Vernon, PhD.,Director, Oregon Hearing Re-
search Center
In the March, 1991, "Questions & An-
swers" column, I asked readers for information
about ProZainE. ProZainE is advertised as a
natural drug which brings relief for tinnitus by
increasing the blood supply to the "hearing
nerve." Sounds good doesn't it? I must com-
ment here that I would wager a great deal that
the manufacturer of ProZainE has not measured
the blood supply to the hearing nerve and thus
has no idea if it is increased. This kind of state-
ment makes the product appear to be based on
scientific fact. However, no one really knows
whether increased blood supply to the hearing
nerve will relieve tinnitus.
To date, I have had replies from eight pa-
tients who have tried ProZainE. Seven say it
has provided no help and one thought it made
the tinnitus worse. Seven out of eight patients
is admittedly a small sample but if seven of
eight obtained relief, I would require our labora-
tory to do a study of that drug.
One of the people in our laboratory asked
the local Food and Drug Administration agents
about ProZainE with the result that the FDA has
now classified ProZainE as a "new experimen-
tal drug." That classification means that the
drug must be withdrawn from the market
until efficacy and safety is proven.
It is undoubtedly the case that other mirac-
ulous "cures" for tinnitus will appear on the mar-
ket from time to time and you, the patient, will
be confronted with the same claims as those
made by the makers of ProZainE. That situa-
tion can present a real problem for the tinnitus
sufferer. On the one hand you do not want to
be taken in by false advertising but on the other
hand, you do not want to miss out on the chance
that it might help you. Remember that those
without scruples count on your desperation to
enhance their gain. In the future, I think you
16 Tinnitus Today/September 1991
might be guided by the ruling of the Food and
Drug Administration. If the drug has passed
their requirement of safety and efficacy, then it
is reasonable to try it. You have only to write
the manufacturer of the drug requesting evi-
dence that their drug has passed the FDA
requirements. When a drug passes the FDA
safety and efficacy tests and becomes approved,
it does not mean they endorse the drug. It does,
however, mean the drug will probably do no
harm.O
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people who have tried it. Their testimonials are avail-
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To order, send$14.95 +$3.00ShippingHarrllingto:
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EXPLORE THE ALTERNATIVES
A new 8-page booklet, "Treating Tinnitus: What
Doctors Don't Tell You," presents a comprehensive
roundup of recent published alternative treatments for
tinnitus. Information covers vitamin/minerals, diet, bo-
tanicals, ear drop formulas, homeopathic remedies, se-
crets of maximizing herbal effectiveness, accounts of
successful alternative therapy and more.
For your copy send $4.50 to:
HORIZONS RESEARCH
PO BOX2117
FT. BRAGG, CA 95437-2117
Vol.16 No.3
Ear Protection: More Noise Doesn't Work!
A summary from Audiology in Practice of an article
by D. Waugh andN. Murray published in the Australian
Journal of Audiology,1989;2:107-J4.
THE AUDITORY HAZARDS OF USING
MUFF-LIKE PERSONAL RADIO HEAD-
SETS IN HIGH AMBIENT NOISE LEVELS
Enquiries have indicated that some work-
ers in noisy industrial locations are wearing
muff-like headset radios instead of earmuffs in
the belief that these devices protect equally well
against external noise. A study was therefore
performed to assess the risk of hearing damage
caused by the use of these personal headset
radios (PHR) in areas of moderate to high ambi-
ent noise levels.
The study involved six men with normal
hearing. They were tested while seated in a dif-
fuse, pink noise sound field (equal sound pres-
sure level per octave) which could be set to 40,
80, 85, 90, or 95 dB A. While wearing each of
six different PHR models playing popular
music, sound pressure levels (SPLs) inside the
ear were measured by means of a miniature mi-
crophone located in the concha. SPLs were also
measured in the 80 d.BA field with the ears un-
covered as a reference value. To assess the risk
of hearing damage, the measured SPLs were re-
calculated as sound field sound pressure levels
(sound field SPLs).
When tested in an 80 dB A sound field
with the radio switched off, the measured in-the-
ear canal sound levels showed that the radio
muffs provided very little noise protection
below 1000 Hz and that five of the six tested
PHR models actually amplified sounds in the
500 Hz region. Tests with lightweight industrial
earmuffs showed that these did, in fact, provide
protection against noise.
At higher external noise levels, the sound
field SPLs obtained while wearing the radio
headsets with the radio switched off showed that
Vol.16 No.3
five of the six headsets actually increased the
subject's sound exposure, but that one headset
did provide some protection, although again in-
ferior to that provided by an ordinary pair of
lightweight muffs.
When the subjects switched the radios on
and adjusted them to a comfortable level with a
natural noise level of 40 dB A in the experimen-
tal room, it was found that the frequency level
delivered by the headsets showed a broad peak
centered in the 500-Hz octave, i.e. precisely
where most headsets already tend to amplify ex-
ternal noise. After calculating a sound field SPL
and applying A-weighting corrections, the aver-
age equivalent diffuse field listening level set
by the subjects under quiet external conditions
was 75 d.BA (range 65-82 dBA).
When the subjects listened to the radios in
conditions of high external noise levels, the
headsets provided no protection against the ex-
ternal noise but actually increased the sound
field SPLs. The increase in total noise exposure
caused by listening to the headsets was influ-
enced more by the subject's preferred listening
levels than by the model of radio-headset used.
It was found that the subjects accepted a poorer
signal-to-noise ratio rather than increase the
radio sound level when the external sound level
rose.
In conclusion, typical personal radio head-
sets provide minimal or no protection against
external noise and even increase noise exposure.
These devices should therefore not be
worn in noise exposure levels greater than an 8-
hour equivalent continuous A-weighted SPL
of about 80
d.BA (average
street-traffic
noise level).O
Tinnitus Today/September 1991 17
Tributes, Sponsors & Professional Associates
The AT A tribute fund is designated 100% for research. Thank you to all those
people listed below for sharing memorable occasions in this helpful way. Contri-
butions are tax deductible and are promptly acknowledged with an appropriate
card. The gift amount is never disclosed.
IN MEMORY OF Sharon Brettschneider Jay and Bebe Novich Guy E McFarland Ill, MD
Phyllis Abamonte Norman "Dad" Birthdays Frank R McGrady
Anthony Statuto Brettschneider J Aiam/T Drucker Tom McGuirk
Alphonse E Albanese Bruce/Sharon Ralph Revere- Birthday Ed Leigh McMillan II
Earl Louis Bell Brettschneider Mrs Ann Revere BJ Meek
Delores Bacon Norman "Dad" Jonathan Stone Steven J Millen, MD
MiloW Bacon Brettschneider Graduation Edward Miller
Rose Blais Leslee Cassel Birthday Joseph AlamJTrudy Earl R Moore
John H Schlater Joseph AlamJTrudy Drucker Beri L Morris
Garrett Buchanan Drucker Ro and Jim Traver John D Mowry
Mr/Mrs Anthony De Charles Carlucclo, MD Birthdays Philip Myers, MD
Biase Bergen County Group J Alam/T Drucker John Noye
Ben Frank Jules H Drucket Birthday Mrs Mary Tully - Birthday Ruth E Ochs
MIM Efrom Abramson J Alam/T Drucker J Alam/T Drucker Helen Pappas
Brother of Art Haglund Dr Richard Gardner Dr Jack Vernon S M Rawnsley
MIM Efrom Abramson Birthday R Schweitzer Ann Revere
Theodore Hewltson Carolyn Gardner Mrs Nat Weissberger- Jerry L Rodrigues
Caroline Hewitson Dr Richard Gardner Birthday Marion H Schenk
Carl Hunter Birthday Jean & Joe Wolfson Roger A Simpson, MD
Ruth Hunter Marilyn & Ronald Birke Robert Wetherall Michael W Smith
Irvin C James Or/Mrs R A Gardner- Father's Day Mr & Mrs Morton Steele
Jerry & Nanci Fagemess Anniversary Mrs Ruth W Wetherall Orloff W Styve
John G Jaser J AlamJT Drucker Mrs Jean Wolfson Larry Sweeden
Jasper J Jaser Mrs Larry Greenfield - Sharon Kom Arthur L Teague
Mr Mcallister Birthday Marjorie Youngen Jack Vernon
Len Mayer Jean and Joe Wolfson Richard Youngen Thomas F Viner, MD
Helen C Parish Jack R Harary Peter L Zemo Ill, MD
J Alamrr Drucker Father's Day ATA SPONSOR MEM
Ben Phillips Dan Harary BERS MAY 1991 to ATA PROFESSIONAL
Edith Phillips Jack R Harary AUGUST 1991 ASSOCIATES
Irving Podolsky Father's Day John Adel, Sr. Warren Brandes, DO
Gerry Podolsky Mike Harary Joseph G Alam Stanley Cannon, MD
Samuel Spiegel Jack R Harary Kristin Bayless Bruce Chatterton, MA
Albert & Mae Feluren Father's Day Harry Bloom William T Chen, MD
Thomas B Taylor Robert Harary Robert Boerner Richard E Conley
Mary L Paschal Dorothy Hingten Maurice H Brown Anne LCurtis
JlmVIIem John Hingten Raymond L Buse J Edward Dempsey, MD
Arvera & Dan Wilson Dr Joseph Horvath Rollyn M Butler, MD Richard H Fitton Jr, MD
Dorothy Weiner Norman Brettschneider Laura A Carson John A Fushman, MD
M/M Bernard Chenkin Mrs Jack Huber Yen-Sheng Chao Edward W Gallagher MD
Russel Wicks Recovery Douglas E Dawson, MD Elliott Goldofsky, MD
Wm & Rae Flynn Jean & Joe Wolfson John Dunlop Donald Hansen, MS
Michael Kassab Mark L Fox MD Gary P Jacobson, PhD
Graduation William U Giessel, MD Kenneth R Johnson, PhD
IN HONOR OF Bergen County Group Marlene Greenebaum Forrest H Kendall, Jr, MD
John G A lam Birthday Mr Jeffrey Kendls Josephine K Gump George M Kornreich, MD
J Alam/T Drucker Jean & Joe Wolfson James R Hartel Richard C Laucks, MD
Julie A Alam Birthday Korn Sharon's Jeffrey Hoffman, MD J Patrick Lynch, MD
J Alamrr Drucker Graduation Jac Holzman Steve Martinez, MA
Michael Aldlsh Birth Jean & Joe Wolfson Philip H Ingber Anton P Milo, MD
day Dr Elliot Latts Jasper J Jaser William H Moretz, Jr, MD
MIM Lucius H Bracey MIM Efrom Abramson Barry V Johnson Roberta Simpson, MA
Norman Bamberg, MD Joel F Lehrer, MD R J Kramer, MD Joseph P Velek, MD
Kindness Bergen County Group Alfred A Levin DonnaS Wayner, PhD
Regina Wolfson Londoner-Corey' s Gustav Lipp Richard J Wiet, MD
Osmar Barreras- Graduation Dr Leon W Upson Richard D Zujko, MD
Citizenship Jean and Joe Wolfson Virginia Lobsinger
Mr and Mrs Wolfson A Martin
18 Tinnitus Today/September 1991 Vol.16 No.3
Welcome To The
New Generation
of plification
Excellence.
Exceptional Aesthetics. The 7 Series' ITE and canal faceplates' spe-
cially contoured exterior surfaces blend smoothly with the shape of
the ear and concha. With efficient spacing gained from the fixed mic,
fixed VC, and smaller battery contacts, the 7 Series' family of hearing
aids provide the ultimate cosmetic and acoustic complement to the
ear's natural design and function.
AMERICAN TINNITUS ASSOCIATION
P.O. BOX 5, PORTLAND, OR 97207
ADDRESS CORRECTION REQUESTED
A New Generation of
Reliability. The 7 Series intro-
duces a whole new generation of
design excellence. A completely
new faceplate with isolated mi-
crophone and amplifier position-
ing increases manufacturing
efficiency while virtually elimi-
nating mechanical feedback.
The smaller, more stable high
tensile gold-plated contacts
along with the new, ultra-durable
VC and socket assembly both
ensure a more reliable perfor-
mance with virtual elimination
of intermittency problems.
Welcome to the New Gener ..
ation. Never before has the in-
dustry experienced this level of
amplification excellence- all
designed to enhance your own
high standards of service excel-
lence. Because we are dedicated
to providing the very best for you
and those you serve, we believe
ALL your patients should benefit
from this newest generation of
unequaled sophistication, no
matter what they presently wear.
Starkey products, including
tinnitus maskers, are available
from your local hearing
health care professional listed
in the Yellow Pages under
"hearing aids".
NON-PROFIT ORG.
U.S. POSTAGE
PA l 0
American Tinnitus
Association

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