Tinnitus Today December 1995 Vol 20, No 4

December 1995 Volume 20, Number 4
Tinnitus Today
THE JOURNAL OF THE AMERI CAN TI NNITUS 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:
William Shatner and ATA -
Together in the Fight
Against Tinnitus
New ATA-Funded Research
The Miracle of Masking
Hearing Impairment and
Heredity
Every Day is a Gift
Sounds Of Silence
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... ... ... __
Tinnitus T o d ~ y
Editorial and advertising offices: AmeJican
Tinnltus Association, P.O. Box 5 Portland,
OR 97207
Execmive Director & Editor:
Gloria E. Reich, Ph.D.
Associate Editor: Barbara Thbachnick
Editorial Advisor: Trudy Drucker, Ph.D.
Advertising sales: IITAAD, P.O. Box 5,
Portland, OR 97207 (800-634-8978)
Tinmtus 1bday is published quarterly in
March, June, September and December. lt is
mailed to members of 1\me rican Tinnitus
Association and a selected list of tinnitus suf-
ferers and professionals who treat tinnitus.
Circulation is rotated to 100,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuit-
able for 1innitus 7bday. Acceptance of adver-
tising by Tirmitus 1bday does not constitute
endorsement of the advertiser, its products
or services, nor does Tinnitus 1bday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The opin-
ions expressed by contributors to Tinnitus
TOday are not necessarily those of the
Publisher, editors, staff, or advertisers.
American Tinnitus Association is a non-prof-
it human health and welfare agency under
26 usc 501 (c)(3)
Copyright 1995 by American Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
without the prior written permission of the
Publisher. ISSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph. D., Portland, OR
Jack D. Clemis, M.D., Chicago, lL
Robert 1\. Dobie, M.D., San Antonio, TX
,John R. Emmett, M.D., Memphis, TN
Chris B. Foster, M.D., San Diego, CA
Barbara Goldstein, Ph.D., New York, NY
ruchard L. Goode. M.D., Stanford, CA
John w. llouse. M.D., Los Angeles, Ct\
Robert M. Johnson, Ph.D., Portland, OR
William If. Martin, Ph.D., Philadelphia, PA
Calc w. Miller, M.D., Cincinnati, OH
J. Gail Neely, M.D., St. Louis, MO
Jerry Northern, Ph.D., Denver, CO
Robert E. Sandlin, Ph.D .. San Diego, CA
Alexander J. Schleuning, It, MD,
Portland, OR
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D .. San Jose. CA
Honorary Board
Senator Mark 0. Hatfield
1bny Randall
William Shatner
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey,
Portland, OR
Board of Directors
Edmund Grossberg, Chicago, IL
Dan Robert Hocks, Portland, OR
w. f. S. Hopmeier, St. Louis, MO
Philip 0. Morton, Portland, OR, Chnm.
Aaron 1. Osherow, St. Louis, MO
Gloria E. Reich, Ph.D., Portland, OR
Timothy S. Sotos, Lenexa, KS
The Journal of the American Tinnitus Association
Volume 20 Number 4
1
December 1995
Tinnitus, ringing in the ears or head noises, is experienced by as
many as 50 million Americans. Medical help is often sought by those
who have it in a severe, stressful, or life-disrupting form.
Contents
4 From the Editor
by Gloria E. Reich
7 William Shatner and ATA - Together in the Fight Against Tinnitus
8 Communication Awareness Day 1995
8 New in Print
9 The Miracle of Masking
by Barbara Tabachnick
15 Announcements
16 De-Stressing - Your Way
by Barbara Tabachnick
18 "For 20 Years Now ... "- ATA's New Poster
18 Hearing Impairment and Heredity
19 New ATA-Fund Research
19 Our New Support Network Volunteers
21 Every Day is a Gift
by Sidney Kleinman
23 Can you use "satisfying" in the same sentence as "tax"? We can!
by Corky Stewart
Regular Features
5 Letters to the Editor
20 Questions & Answers
25 'Ihbutes, Sponsors, Special Donors, Professional Associates
Cover: William Shatner, ATA's new Honorary Director.
Photo by Joel Lipton, Los Angeles.
Tinn itus 'lbday/December 1995 3
From the Editor
by Gloria E. Reich, Ph.D.,
Executive Director
It's amazing, isn't it, how time
flies by. This month marks my
ti.ventieth year with ATA. I
remember picking up a "red
brochure" in my hearing aid
dealer's office and mailing the
reply card for more information.
Before I knew what hit me I
was hooked. In those early days we had no '
office, no telephone, not even a typewriter. We
had only the goodwill of the dozen or so volun-
teers who met every Wednesday at the old
Kresge Hearing Laboratory, now called the
Oregon Hearing Research Center, to try to work
out a strategy for helping others with tinnitus.
Eventually ATA grew, incorporated as a national
non-profit agency, moved into its own offices
where we remain today.
For ATA's founder, Dr. Charles Unice the
dream of a cure didn't come in his nor
did it come in the lifetime of Bob Hocks ATA's
first national chairman. The dedication these
men to the cause was never diminished how-
ever, because they knew that someday
answers would come.
Each of us with tinnitus yearns so desperate-
ly for the silence we've been denied, that it's
often hard to think of the big picture. But in our
better moments we can acknowledge the great
progress these last twenty-four years have
brought. ATA's staff has grown to eight full-time
people. Instead of one or two clinicians treating
tinnitus, there arc now thousands. Support and
mutual help can be had through ATA's extensive
self-help network. Research studies have
unveiled many new ideas for looking at what
causes tinnitus and what can help take it away.
Federal support of tinnitus research through the
NIDCD will soon become a reality when they
publish an anticipated initiative incorporating
recommendations from their March 1995
Tinnitus Workshop. And ATA, through your
generous research gifts and some substantial
bequests, has been able to fund over $500 000 of
I
tmrutus studies.
In October, ATA announced grants of $55,000
for two research studies having to do with the
spontaneous activity and neurochemistry of the
cochlear nucleus following exposure to loud
4 Tinnitus lbday/ December 1995
noise. (See "New ATA-Funded Research.") If these
studies are successful, we will be much closer to
the development of drugs that will reduce or
eliminate the symptoms of noise-induced
tinnitus.
The fall season is always a busy one for ATA
because it's the time that several hearing-related
organizations have their annual meetings.
Traditionally, we represent ATA at these meet-
ings with an informational display, and we meet
with our advisory committee at the American
Academy of Otolaryngology's conference. This
year we went even further. We invited ATA's
board of directors to the advisory committee
meeting where they met committee members
and some of the principal players in the field of
otolaryngology. The effort was such a success
that we plan to do it next year as well.
Thanks to Pat Daggett, ATA's assistant direc-
tor, and Mort and Shirley Rosenhaft of Silver
Spring, Maryland who distributed tinnitus infor-
mation to the more than 1,500 delegates at the
International Hearing Society meeting. This
annual September meeting offers hearing profes-
sionals an opportunity to further their education
and learn about new products and techniques for
helping people with hearing problems.
Pat Daggett also represented ATA at the
American Academy of Family Physicians annual
meeting. This was a first-time participation for
ATA and it elicited much interest and many
requests for information.
We extend special thanks to Dr. Richard Tyler
at the University of Iowa who has for the last
three years held an annual "Management of the
Tinnitus Patient" workshop. These sessions have
been very valuable to those working with tinni-
tus patients.
Last, and certainly not least, J want to wel-
come actor Wi11iam Shatner to our group. Bill
has tinnitus and has recently become an hon-
orary director of ATA. His help will be invaluable
in letting the world know that tinnitus is some-
thing we'd like to do without. You may be getting
a personal letter from Bill in the near future.
Help him as he strives to help all of us reach our
goal of internal silence.
We hope you will all be able to some way be
involved in our 25th anniversary activities dur-
ing 1996. Watch for announcements of special
events in this magazine and in your mail.
Letters to the Editor
The opinions expressed are strictly those of the
letter writers and do not reflect an opinion or
endorsement by ATA.
I
t?ou.ght you'd be interested in my "cure" for
tmmtus. I've had tinnitus since 1964 and
tried everything I could to get rid of it. I've
talked to Jack Vernon and read everything ATA
put out, but there had been no letup until a year
and a half ago when I started treatments for
TMJ. I was prescribed Norflex, a mild muscle
relaxant. After a while, I noticed that since tak-
ing the Norflex, my tinnitus had decreased.
Sometimes it was gone completely!
Thinking that it might be the TMJ treat-
ments, I stopped taking the Norflex for about a
week, but the tinnitus came back. So now I take
Norflex twice a day, as it reduces the intensity
of my tinnitus. There seem to be very few side
effects from this drug. In fact, the only discour-
aging thing about it is the price: I pay $58 for
only 30 pills. But unless 1 find some future side
effect that I can't deal with, I plan to take
Norflex from now on. Charles Hollenbach
Richmond, 1L '
I
t is my opinion as an internist that individu-
als who consume products containing aspar-
tame (Nutrasweet"), including drugs and
supplements, should avoid them when no spe-
cHic cause can be found for tinnitus, marked
intolerance to noise, impairment or loss of hear-
ing, or marked unsteadiness or dizziness. The
same precaution is reasonable for persons for
whom these complaints are due to other disor-
ders because the symptoms could be aggravated
by aspartame, even in minimal amounts. I dis-
cuss these observations and research in my two
books, Aspartame (Nutrasweet): Is it Safe? and
Sweet'ner Dearest: Bittersweet Vignettes about
Aspartame (Nu.trasweet) . There is no bias or
malice intended against any company, distribu-
tor, researcher, or professional who may hold
contrary views.
I offer the following case report - one of
many hundreds. A 30-year-old woman drank
five or more cups of aspartame beverages daily
l 7 months and experienced ringing and pain
m both ears, dizziness, a severe headache and
considerable loss of hearing. When a
tumor was ruled out by CT scans, otology and
neurology consultants made the diagnosis of
Meniere's disease. The patient deduced that the
aspartame drinks were responsible because she
could predictably reproduce these symptoms on
rechallenge with them.
Each of the components of aspartame -
phenylalanine; aspartic acid; the methyl ester,
which promptly becomes methyl alcohol or
methanol, and their multiple breakdown prod-
ucts after exposure to heat or during prolonged
storage - is potentially toxic to the brain and
inner ear. These organs are uniquely vulnerable
to metabolic disturbances and neurotoxins
because of their unique metabolic requirements.
In my earlier report on 551 aspartame reac-
tors (the data base is now much larger), dizziness
was a major problem in 217, tinnitus in 73,
severe intolerance for noise in 47, and marked
impairment in hearing in 25. As of August 1995,
the FDA had received complaints about dizziness
and problems with balance from 737 aspartame
consumers, and a change in hearing from 36.
I welcome reports of such reactions, and
results of the "no aspartame test" for our inde-
pendent registry. A survey questionnaire can be
obtained by calling ( 407) 832-2400, or
Fax: (407) 832-2400. H. J. Roberts, M.D., FA.C.P,
FC.C.P, West Palm Beach, Florida
!
acquired tinnitus a little over two years ago
after exposure to loud music at a local bar. I
normally wore earplugs to musical concerts,
but this time I did not, and paid dearly for it. At
first, I felt a blockage in my ears. Then came
dull aches and sharp pains, followed eventually
by high-pitched, shrill, piercing sounds coupled
with lower-pitched hissing sounds. 1 also became
congested and developed hyperacusis.
I went to an ear specialist who told me it was
all stress and sleep deprivation and gave me a
prescription for Xanax. One-half of a tablet sedat-
ed me to the point where I could not function
and so I discontinued its use. I also went to a
ropractor and an acupuncturist but to no avail. I
went to a general practitioner who gave me a
decongestant and antibiotics that did no good.
Another doctor told me I was depressed (who
wouldn't be by this time?) and gave me antide-
pressants to try. Those didn't work either. In the
meantime, I attempted to heal myself with
Tinnitus 'Tbday/ Dccember 1995 5
Letters to the Editor (continued)
herbs, vitamins, minerals (such as manganese),
and foods (such as blueberries and apricots)
especially helpful in the treatment of tinnitus.
Over the course of a year, many of my
symptoms lessened dramatically. Today, all I
experience is a slight ringing, which can become
more intense depending on the noise level of
my environment.
I want to thank Tinnitus 7bday for helping
me see that I am not alone, that I wasn't crazy
or hallucinating. It really makes a world of dif-
ference to know that there are people out there
who understand the pain and stress associated
with tinnitus. Sonia Bukosky, Boise, ID
l
am a sufferer of severe tinnitus, following an
accident on the job on March 15, 1992. I was
a fire fighter for 30 years and was four
months from retirement when this happened.
The noise 1 experience in my head drove me
very close to suicide at first. I really didn't think
I could stand it for another minute, much less
for the rest of my life, but by the grace of God
and the help of some wonderful people, I've
learned to live with my problem.
I would lil<e to share some of the things that
have helped me. I was referred by my ear doc-
tor to Dr. Berlin at LSU Medical Clinic in New
Orleans. Dr. Berlin conducted a series of tests
and documented the noise I hear at llS dB. He
fitted me with special hearing aids that add a lit-
tle background noise and take away from the
noise I hear. However, the volume of the hear-
ing aids must be kept very low.
Another thing that really helped was coun-
seling from some wonderful, caring people who
taught me to deal with stress. Stress and loud
noise are the two things that really seem to
aggravate my problem and make the noise
louder. By avoiding them, I have some degree of
control over the tinnitus. Another important
weapon against tinnitus has been a good pair of
earmuffs like the type shooters wear. (The best
ones I've found were at a hardware store. Brand
name: Pelter.) I carry these everywhere I go.
I keep busy and keep my mind occupied
with pleasant, stress-free activities. It took a
long time to learn to get my mind off the noise
and onto something else. Even though it's not
6 Tinnitus Thday/ December 1995
100%, it is a great help and it can be done. Don't
lose hope! Dick Currow, Molino, FL
I
had never heard of tinnitus until last
November when my right ear starting roar-
ing. Prior to the onset of tinnitus, I'd had
facial surgery. I was also bothered by fullness in
the right ear after the surgery. That October, I'd
had wax removed by suction from my right ear.
Approximately three weeks later, the tinnitus
started and has been more or less continuous
since.
After getting little help from the local spe-
cialist, I decided to do my own research. I found
an article about Xanax that was used to reduce
tinnitus. I followed the protocol and found that
it was helpful in lowering the level of my tinni-
tus. The disadvantage was that I developed a tol-
erance to Xanax and had to increase the dosage
to get results. I also experienced withdrawal
symptoms when I stopped using it.
I finally went to a specialist who was listed
by ATA, and he determined that I had atypical
Meniere's disease. He put me on vasodilators, a
low-salt diet, and recommended exercise and
avoidance of stress (whenever possible). This
proved helpful in reducing the tinnitus and the
fullness in my ear until this May. Apparently,
the onset of allergy season and the increase in
humidity made my symptoms worse. I found
that Atrohist Plus was helpful, and that the
Atrohist in combination with .Smg of Xanax
would frequently stop the tinnitus for an hour
or so.
The Tinnitus 7bday journal has been
extremely helpful. I look forward to every issue.
M. D. Mozley, 'Iitscaloosa AL
F
or about eight years, I have experienced a
pulsating tinnitus along with high frequen-
cy buzzing. I have gone the same route
many of my fellow sufferers have: to ENT physi-
cians, neurologists, allergists, and dentists. In
the last couple ofyears, I have definitely
noticed that my symptoms coincide with baro-
metric and humidity changes in the weather.
Usually my tinnitus predicts the change at least
24 hours in advance. My family jokes that I have
a barometer in my head. It would be of great
interest to me to know that perhaps others expe-
rience these same reactions. Anita F Eisenstein,
Columbus, OH
William Shatner and ATA
Together in the Fight Against Tinnitus
William Shatner has recently joined forces
with ATA as an Honorary Director of the organi-
zation. His goals for national fund raising and
for making the American public aware of tinni-
tus' prevalence are humanitarian, and very per-
sonal. He says, "For many years, I have had a
ringing in my ears. Recently it has gotten worse
and affects my thinking, my future, my life.
What you and I suffer from, no one without tin-
nitus can truly understand. They can only stand
by and try to keep us from losing our selves and
our minds. By bringing the enormity of the
problem and the work of ATA to the public's
attention, we can find a way to alleviate this
tragic condition."
Shatner has produced a series of video PSA's
for our use, that should soon be ready for distri-
bution. In the meantime, we will be distributing
press releases to all major newspapers and
magazines nationwide with his ardent plea for
research funding. "We need to make it happen,"
says Shatner. We are very excited and hopeful
that with his help, we can.
Letters to the Editor (continued)
S
itting in church one Sunday, I couldn't help
but notice a high pitched sound in the right
sanctuary speaker, or so I thought. I was
about to locate the custodian when l noticed I
was hearing this sound in the hall as well. As a
hearing aid specialist, I regularly ask clients
about tinnitus. Imagine my surprise when I real-
ized that this high pitched noise was in my ears.
I have never had any measurable hearing loss or
any other problems with my ears.
r saw the ENT physician at the clinic where
I send clients, and he felt that a nose spray for a
possible sinus problem might help. It didn't and
I felt as many do - a sinking resignation that I
was one of many who for unknown reasons are
suddenly afflicted by this unwanted sound.
At my yearly physical a month later, I men-
tioned the tinnitus to my doctor who strongly
suggested that I see a cranial osteopath. I resist-
ed, but he insisted that I call for the appoint-
ment. This physician, an MD and a DO, manip-
ulated my neck, jaw, and cranium for over an
hour. It was incredibly sore the next day, but the
second day brought almost total relief from the
tinnitus. I have had two other treatments. This
physician cautioned me not to send her my
noise-damaged tinnitus patients as she probably
could not help them. She felt my problem was
related to a minor car accident I'd had two
months earlier. By trial and error, I have also
found that using a smaller cervical pillow has
helped me to stay noise-free. I had been given
a large pillow by the physical therapist after
the accident, and it seemed to be part of the
problem. Marsha Lovitt, Medford, OR
Tinnitus 11>day/ Dccember 1995 7
COMMUNICATION AWARENESS DAY
October 18, 1995
The American Tinnitus Association and
Dr. Gloria Reich were invited guests at the
Communication Awareness Day program spon-
sored by Friends of the NIDCD. ATA's booth at
the Washington, D.C. event offered not only
tinnitus brochures for the members of congress
who came by, but also headphones with the
sounds of tinnitus for them to "sample." Senators
John Glenn and Charles Percy, Congressman
John Porter, Miss America 1995 Heather
Whitestone, deaf comedienne Kathy Buckley,
and former New York Yankee Gil McDougald
were also in attendance.
Gil McDougald, New York Yankees 3rd basemen (retired) and
Gloria Reich
Newln Print
The International Tinnitus Journal, edited by
Prof. Dr. C. F Claussen, Germany, and Abraham
Shulman, M.D., U.S.A., is a twice yearly "peer
review" journal in the areas of neurophysiology,
audiology, otology, neurotology, and otolaryn-
gology. The goal of the publication is to facilitate
the exchange of ideas and information among all
interested professionals in these tinnitus-related
fields. Annual subscription rate for two issues:
$49.50U.S. Call 718/773-8888 or
fax 718/465-3669 in the U.S.A.;
call 49(0) 971-64832 or fax 49(0) 971-68637 in
Germany.
Kathy Buckley, Deaf Comedienne
Senator fohn Glenn
The personal reactions to the symptoms of
Meniere's (dizziness, tinnitus, and hearing loss)
and the myriad of treatments for it are included
in a book called simply Meniere's Disease. This
small book is a clear and helpful primer for
those with the disease, and for their families,
colleagues, employers, and friends. Published by
Meniere's Australia Inc., it is available by con-
tacting them directly at PO Box 202, MOONAH,
Thsmania 7009, Australia at a cost of
$25Australian or about $18U.S. Shipping and
postage are included.
The Miracle of Masking
by Barbara Th.bachniclc,
Client Services Manager
"When I hear the tinnitus,
it's me and there's something wrong
with me. When I hear your masker;
it's you and it doesn't bother me."
Rich Whalen, tinnitus patient
References to tinnitus inhibition by external
sounds dat e deep into ancient times. Greek liter-
ature (attributed to Aristotle by some,
Hippocrates by others) from the 3rd century
B.C. contained the question, "Why is it that
buzzing in the ears ceases if one mal<.es a
sound?" Over time, many would stumble upon
the same phenomenon without knowledge of
this earlier observation or of each other.
In 1883, Urbantschitsch in Vienna found that
when a tinnitus-affected ear was exposed to the
sound of a tuning fork, the tinnitus was usually
diminished, and in some cases suppressed, for
up to a minute.
In Paris in 1921, Itard reported case studies
of his patients whose severe tinnitus could be
made bearable by covering up the internal noise
with an "analogous and equally continuous
external noise." He detailed the case of a young
woman quite troubled by her tinnitus. His sug-
gested regimen included riding in a coach on a
bumpy road, or listening to a crackling fire or
the dripping of water from one vessel to anoth-
er. When he finally suggested that she move to a
noisy part of town, she moved into a water mill
and found profound relief from her tinnitus.
By 1947, Saltzman and Ersner were experi-
menting with hearing aids as tinnitus suppres-
sors, having noticed that ambient sounds had a
subduing affect on tinnitus. They made another
significant observation - extraneous noise was
more readily tolerated by the human nervous
system than the least amount of tinnitus.
In 1969 in Germany, Harald Feldmann
began to study the masking of tinnitus with nar-
row band and pure tone sounds noting three
reactions to this treatment: 1) a steady state of
tinnitus masking as long as the masking signal
was present; 2) a reduction of tinnitus ("tinnitus
fatigue") enabling the masker to be turned down
or off briefly; or 3) a reappearance of tinnHus
("masker fatigue") against the sustained stimulus
of the masking signal.
Jack Vernon began research in Oregon in
1971 to develop an animal model of tinnitus
using Rhesus monkeys. Three months later, the
National Institutes of Health contacted him to
see if he would work with a patient whose tinni-
tus was quite severe. Involved in research only,
Vernon knew of no workable treatment to offer
a tinnitus sufferer, and flatly refused. Ignoring
Vernon's refusal, however, Dr. Charles Unice
arrived in Oregon four days later and insisted on
being seen by him. It was a serendipitous meet-
ing, one that within five years would lead to
fundamental changes in tinnitus remediation
and research worldwide.
Vernon decided to use Dr. Unice in his
research to help identify the actual sounds of
tinnitus - something the monkeys could not
do. ln kind, Vernon led Unice to Oregon Health
Sciences University's medical school, under
whose wing Unice's tinnitus research organiza-
tion, the American Tinnitus Association, began
to flourish.
On one of Unice's visits to Portland, he and
Vernon made their way to a park for lunch.
Unice's attention was inexplicably held by a
cascading fountain nearby. He stood transfixed,
then announced to Vernon that for the first time
he could not hear his tinnitus. Understanding
the significance of Unice's discovery - that
external noise could interfere with tinnitus -
Vernon contacted the Zenith Hearing Aid Co.,
Vicon, and then Starkey Labs to discuss designs
for a wearable hearing aid-like device that would
generate its own sound. But because no one
knew what sound the devices should make, this
simple idea was marred by many trials and
nearly as many errors.
Guesswork and experimentation led to the
first clinical successes with external sound
devices to cover tinnitus. The wearable devices
'
now called maskers, emitted a broad band width
of sound that included the pitch of the tinnitus.
Narrowing the band width further to approach
the tinnitus, on the other hand, proved unsuc-
cessful: the sound was too tonal and patients
didn't like it. (Exact pitch matching of tinnitus is
Timtitus Thday/ Dccember 1995 9
The Miracle of Masking (continued)
a difficult task for the clinician and for the
patient. Fortunately the need for precision in
this area is minor. 'TYpically tinnitus responds to
a wide range of masking sounds rather than to
its own pure sound, making "pitch approxima-
tion" sufficient.) According to Robert Johnson,
Ph.D., director of the Oregon Hearing Research
Center (OHRC) Tinnitus Clinic in Portland, a
band width of 3000Hz-12,000Hz is the working
parameter used today. But is not a parameter
carved in stone.
In 1985, Kitajima, K:itahara, and Kodama in
Japan tested the theory that the band of mask-
ing sound need not include the pitch of the tin-
nitus. Each of the 117 tinnitus patients in the
study was tested with one-minute-long masking
sounds delivered through headphones. Seventy-
two percent found relief with bands of masking
noise around but not inclusive of their tinnitus
while 70% found relief with masking that '
included the tinnitus frequency.
Both Johnson and Vernon adhere to the
notion that patients should decide for them-
selves what they prefer. Starkey's new tuneable
in-the-ear (ITE) devices - adjustable up to
18,000Hz - offer patients and clinicians the
flexibility to adjust both the frequency and the
volume. The volume of masker noise is general-
ly set to a low level but can be increased to the
maximum output of the masker (95db) if neces-
sary. This output is limited by the manufacturer
to limit the chances of damage to the auditory
mechanism. In studies by Vernon, the loudness
of the tinnitus and the loudness of the masking
needed to cover it did not significantly deter
patients from accepting the treatment.
How Does One Sound Mask
Another?
In acoustics, an external sound activates
human nerve fibers in the peripheral and cen-
tral nervous system. Another external sound
introduced as a masking signal, presented simul-
taneously, can activate the same neural chan-
nels. When the neural channels are responding
to the new masking signal, and are not able to
convey the electrical discharge of the original
signal, masking has occurred. The masking of
the tinnitus signal might happen similarly. It is
still a conjecture.
10 Tinni tus 'Tbday/ December 1995
But some things are known. An external
tone can only be masked by a tone very close to
its own pitch, whereas tinnitus can be inhibited
by multiple frequency spans. (A broad band
sound resembles the "shhh" of a running faucet.
While it is nothing like a high-pitched ringing, it
can contain the frequency of the ringing in its
several thousand Hertz span of sound.)
Residual Inhibition (RI)
Residual inhibition is the temporary suppres-
sion of tinnitus after the masking signal is
removed. The effect of RI usually does not
exceed 60 seconds but has in rare instances last-
ed several hours. Vernon, Griest, and Press note
that in a sample of 797 tinnitus ears, 82%
showed some signs of post-masking RI. This
phenomenon, often tested for in tinnitus evalua-
tions, is not predictive of masking success or
acceptance.
Johnson and Sandlin recently conducted a
study to measure RI using pure tones and
sweeping pure tones. The results: masking with
4000Hz and 8000Hz tones specifically demon-
strated greater RI - up to six minutes for some
- than did masking with 1000Hz, 2000Hz or
broad band sounds. However, of the 20 in the
trial, seven had a worsening of their tinnitus
and did not complete the study. The researchers
concluded that the tinnitus exacerbation and the
minimal length of RI resulting from pure tone
masking did not warrant the therapeutic use of
it. An identical study in Denmark produced the
same results.
A study by Tyler, Kuk, and Mims suggests
that RI is more likely to occur when masking is
used in the tinnitus ear (ipsilateral masking) as
opposed to the non-tinnitus ear (contralateral
masking). Another Johnson study indicated a
greater incidence of RI with the use of tinnitus
instruments (hearing aids and maskers in com-
bination) rather than with maskers alone. But
why residual inhibition happens at all still is
unknown.
Clinical Use of Maskers
Since 1976, OHRC has recommended
hearing aids, tinnitus maskers, and tinnitus
instruments for 70% of their patients. Of those
patients, 16% have been helped with hearing
aids, 21% with maskers, and 63% with combina-
tion units. Long-term masker use was addressed
in a follow-up study on 100 patients who wore
masking devices for an average of 3.34 years. No
deleterious effects to their hearing were found.
On the rare occasion that an increase in tinnitus
was experienced, the masking program was ter-
minated and the tinnitus returned to its original
level.
In Abraham Shulman's clinical work at
SUNY's Martha Entenmann Tinnitus Research
Center in Brooklyn, the patient selection for
masker use is narrowed to a specific patient cri-
teria (positive maskability, identification of a
cochlear and/ or neural type of tinnitus, absence
of ear disease, absence of central or in-the-head
tinnitus, adequate aeration of the middle ear,
etc.). Masking appears more successful when
this patient selection criteria is followed, though
not to the degree reported by Vernon and
Johnson. Shulman reports overall positive mask-
ing in 19% of his patients.
Shulman's work closely followed the reasons
for masker failure for patients who otherwise
met the criteria for the treatment. Some patients
objected to the devices for cosmetic reasons, or
because total residual inhibition wasn't pro-
duced. Some rejected the maskers because of
the costs involved, or because they feared the
devices would increase their tinnitus or worsen
their hearing.
Occasional complications were noted includ-
ing ear blockage, hyperacusis, and vertigo, all of
which resolved within two days once the
maskers were removed. One case of tinnitus
reportedly remained elevated, however. No
patient experienced hearing loss because of the
devices.
Hearing Aids as Maskers
Usually when the hearing loss and the tinni-
tus are both in the 3000Hz-6000Hz range (the
range of hearing aid effectiveness), hearing aids
provide reliefby masking with the newly heard
ambient sounds. More often, though, tinnitus
and hearing loss are in the higher frequency
ranges, and the masking benefit of aids alone is
limited.
Sweetow, Cato, and Levy conducted a study
in 1991 to determine if specialized high frequen-
cy hearing aids could attenuate high frequency
tinnitus. Although most patients preferred the
more natural sounds brought in by standard
aids, the results were otherwise inconclusive.
The researchers suggested that the new hearing
aid was another tool for clinicians to try when
other tools failed.
The invention of the tinnitus instrument is
credited to John Guliksen, a patient of Vernon's
in the clinic's early years. Guliksen, who was
not finding tinnitus relief with his hearing aids
alone, asked for and got a pair of the maskers to
try overnight. He returned the next day with
maskers and hearing aids bound clumsily but
effectively together behind his ears. "Our
patients teach us what works," says Vernon.
Hearing loss that accompanies tinnitus in
90% of the cases could, in and of itself, produce
enough stress to boost the tinnitus volume.
When a hearing aid improves verbal communi-
cation, stress and the resultant tinnitus can be
reduced. Johnson and Vernon believe that a
hearing test should be the first test in the clini-
cal assessment of tinnitus.
The Psychology of Masking
The impact of expectations on the success of
masking cannot be overlooked. Goldstein and
Shulman's longitudinal study on masker use
reveals that success is often based on what a
patient expects to happen. From 1977-1980,
778 tinnitus patients in Group #l exhibited great
enthusiasm for this brand new tinnitus treat-
ment. For 41% of the patients for whom mask-
ing was recommended, 71% followed through.
And of those, 86% purchased the devices. The
523 patients in Group #2 from 1981-1986, who
for several years had been exposed to the experi-
ences of others, knew that masking was not a
cure and that RI was a limited and unpre-
dictable event . Although masking was recom-
mended to 52%, only 39% followed through.
Eighty-three percent of those did purchase the
devices, however. The 273 patients in Group tf.3
from 1987-1990 were more accepting ofthe limi-
tations of this
treatment, and
53% followed
through on the
masker recom-
mendation.
Tinnitus lbday/ Oecember 1995 11
Hyperacusis and ''Pink Noise"
Desensitizing
Hyperacusis, a reduced tolerance for the
loudness of sound, is a rare, often disabling dis-
order. Vernon developed a hyperacusis desensiti-
zation program that uses low frequency
(200Hz-6000Hz) "pink noise" audio tapes for
retraining ears to tolerate normal sounds.
Patients listen to the tapes for two hours a day
with the volume set at the maximum comfort
level and, at their own readiness, increase the
volume incrementally. It can take two years to
accomplish this retraining.
Auditory Habituation
This method of tinnitus attenuation was
born out of the observations of the masking phe-
nomenon, but distinguishes itself strongly from
it. According to this treatment's protocol
designed by Hazell and Jastreboff, behind-the
ear (BTE), low level (400Hz-8000Hz) Viennatone
AMTi noise generators are worn in both ears for
a minimum of six hours each day for up to two
years. During this time, the brain is being
retrained to listen for the quieter external sound
of the Viennatone devices and ultimately ignore
the tinnitus. Jastreboff and Hazell report that
hyperacusis is also responsive to this treatment.
According to Gold, Grey, Hu, and Jastreboff,
the approach of masking is counterproductive to
tinnitus habituation and care is taken to set the
noise generators at frequencies below that of the
patient's tinnitus. For patients whose hearing
loss creates problems with communication
(about 10% of their patients), hearing aids are
prescribed instead. The habituation process
takes longer, though, when aids are used.
According to Sheldrake, Coles, and Foster,
this "retraining therapy" has affected a 61%
reduction in tinnitus awareness in their
patients, and abolished the tinnitus in 16% of
the cases. They recommend open earmold
designs (BTE's) fearing that occlusion of the ear
canal can make the tinnitus appear louder.
Although they use very low levels of noise in
their sound generators, their findings indicate
that the generator's spectrum of noise is not
nearly as important as the patients' confidence
in the instruments, their ability to set the vol-
ume, and their physical and cosmetic comfort
with the devices.
Robert Sandlin, Ph.D., director of the
California Tinnitus Assessment Center in San
Diego, uses an eclectic approach to tinnitus
treatment offering, among other therapies, both
masking and habituation. His rationale: If a
patient is psychologically unstable upon evalua-
tion, it would be unwise to start with a treat-
ment that offers hope for improvement so far
down the road - like auditory habituation. For
those patients who need more immediate inter-
vention and relief, masking would be pre-
scribed. Sandlin feels that once a patient's
tinnitus is attenuated, long-term treatment of
habituation could be considered.
How to Mask
Drs. Vernon and
Johnson outline the
goals of OHRC's
19-year-long tinnitus
masking program:
1) to find a sound that
masks or inhibits the
tinnitus sound, and
2) to find a sound that is an acceptable substi-
tute for the tinnitus. They offer these sugges-
tions for those who want to fit maskers and
tinnitus instruments successfully:
J) Have two tuneable maskers and tinnitus
instruments available to try on patients at the
initial evaluation. Some tinnitus can be masked
with a synthesizer or an audiometer but not
whh actual in-the-ear (ITE) devices. It is also
the case that some patients who do not experi-
ence relief with synthesizers or audiometric
masking, can experience relief with ITE devices.
2) Adjust the hearing aiel part of the tinnitus
instrument first, the masker second.
3) Prescribe two maskers or tinnitus instru-
ments when a patient has bilateral tinnitus and
needs relief for both ears.
4) Let patients select what they like. Unusual
frequencies - outside the range of the expected
-can help.
5) Let patients know that there is a 30-day
money-back trial period on the devices, and that
they can ask for (and usually get) a longer trial
period if it's needed.
6) If the tinnitus is relieved by the ambient
sounds brought in by hearing aids during the
day, but is disrupting the patient's sleep at
night, tinnitus instruments are a more beneficial
choice. (The amplification can be turned off and
only the maskers used at night to aid sleep.)
7) Ask patients what type of sounds help their
tinnitus. (Often it is a shower sound or FM radio
static.) Suggest making and listening to audio
tapes of those sounds in a "walkman"-style tape
player.
8) Give patients personalized audio tapes of the
masker sound as an evaluative tool. If it is use-
ful to patients, it points to success with ITE
maskers. If the patients choose, just the tapes
can be used.
9) Encourage patients to wear the maskers for as
long or as short a time as they need.
Robert Sweetow, Ph.D., relates that the
shape of the earmold itself is a factor in masking
success, and one of several tools for profession-
als to consider as they customize masking
devices for patients. Open earmolds, he sug-
gests, reduce the amount of low frequency
masking and increase the amount of high fre-
quency masking.
Some types of tinnitus are often resistant to
masking, such as pulsating tinnitus synchronous
with the heartbeat, involuntary clicking of the
soft palate, or Llnnitus with indicai..ion of tem-
poromandibular joint disorder. Patients at OHRC
who present with these symptoms are usually
refened on for other medical treatment first.
Tinnitus also tends to be difficult to mask if it is
caused by a single incident such as whiplash or
a gunshot blast near the ear.
How to be Masked
Nature provides clues to an inctividual's
chance for tinnitus remediation with masking.
The ocean's roar or the sound of falling rain
will, for some, quell the intensity of tinnitus.
Tabletop, bedside devices generate those and
other environmental sounds, and there are pre-
made environmental audio tapes for portable
stereo use. (See "De-Stressing- Your Way.")
Other patients find that music - and only
music - will mask their tinnitus.
Some find the masker sound annoying; oth-
ers hear the same sound as pleasant. And there
are those for whom the idea of introducing yet
another sound to the existing clamor is unthink-
able. To stay with this therapy, or even to con-
sider it, is a personal decision - neither right
nor wrong.
Mike Ayers, a sel f-proclaimed "masking
success story," has been wearing his maskers
24-hours-a-day for the past 13 years, removing
them only to bathe. Ayers also avoids noisy situ-
ations, wears custom filtered ear plugs and,
when he can't control the ringing, takes a
shower and practices self-hypnosis to bring the
noises down.
This raises the question of how a "masking
success story" is defined. If it is defined as a
complete neutralization of tinnitus with extend-
ed residual inhibition afterwards, few would
qualify. If it is defined as some tinnitus relief
while the maskers are worn, many would
qualify.
Further, the statistics of relief can be mis-
leading. A person's ability to be masked in a
clinical setting does not guarantee that the
maskers will be a practical success, that they
will not be relegated to the dresser drawer (right
next to the hearing aids) . Masking is probably a
true success when the patient experiences a
reduction in tinnitus intensity and accepts the
substitute sound, is able to push through the
awkward slages of adjusting to devices in or
around the ears, and looks not for miracles but
for help.
As a tinnitus treatment, masking is often
life-saving, often abandoned when success does
not come quickly, often immediately beneficial,
often unsuccessful in the bands of the most
skilled. It is a treatment brimming with vari-
ables: its myriad of forms, the expectations sur-
rounding it, and the differing definitions of what
constitutes its success in the first place.
Whether scrutinizing it closely or marvelling
casually at its mystery, masking appears to be
largely a benign treatment that, with care, does
no harm. At its best, it offers a hopeful possibili-
ty for those who have not tried it.
Tinnitus Today/ December 1995 13
The Miracle of Masking (rontinued)
Tinnitus Masker/
Instrument
Manufacturers
Audio Medical Devices Ltd.
Enterprise House
511-513 Upper Eimers
End Rd.
Beckenham, Kent
England BR3 3DB
44-81-663-0760
BTE, Canal maskers/
instruments.
GN Danovox, Inc.
5600 Rowland Rd H250
Minnetonka, MN 55343
8001432-7835
BTE tinnitus instruments.
Omni Hearing Systems
3418 Midcourt Rd.
Carol/ton, TX 75006
214-934-2961
ITE/ CanaJ tinnitus maskers,
lTE tuneable tinnitus
maskers/ instruments,
range 6000Hz-15,000Hz.
Starkey Laboratories
PO Box 9457
6700 Washington Ave. S.
Eden Prairie, MN 55344
800/ 328-8602
ITE, BTE tuneable tinnitus
maskers/ instruments (TM3)
with volume controls and
dispenser-adjustable
potentiometers to vary
frequency (high frequency
model TM5 available with
band width range of 2000Hz-
18,000Hz.)
Dishibutor for Viennatone
AMTi noise generators.
Starkey Laboratories Limited
Meridian House, Bramhall
Technology Park
Pepper Rd., Hazel Grove
Stockport, Cheshire
England SK7 5BX
0500-262131
Distributor of Silentina, a
wireless intra-aural device
with an induction pad for
under-the-pillow placement.
Pad is connected to a sound
generating source (tape
player, radio, etc.) for
personalized masking that
no one else can hear.
Tinnitech Vertriebs GmbH
Waldstrasse 31
76133 Karlsruhe
Germany
49-721-229-31
BTE timritus masker, range
250Hz-10,000Hz.
Tabletop maskers,
environmental
sound machines
Marpac Corp.
PO Box3098
Wilmington, NC 28406-0098
800/ 999-6962
Marsona 1550 bedside
tinnitus masker, electronic,
with 3000 settings.
"Sound Conditioners,"
rushing air and a variety of
environment sounds
digitally recorded.
Radio Shack
1400 One Tandy Ctr
Pt. Worth, TX 76102
800/ THE SHACK
"Sleep Machine," rainfall
and other e1wironmental
sounds on a one-hour timer,
with earphone jack and
pillow speaker.
Saitek Industries
2295 Jefferson St.
7brrance, CA 90501
800/ 452-4377
"Sound Asleep," digital
environmental sounds (surf,
mountain stream), alarm
clock awakens with a "dawn
chorus" of birds and water
sounds.
The Sharper Image
650 Davis St .
San Francisco, CA 94111
800/ 344-4444
Portable or digital"Sound
Soothers," digital recordings
of seaside, countryside,
white noise, with built-in
AM/ FM 1adio.
References
Agnew, J., and R. Johnson.
1993. New Tinnitus
Masking Devices Allow
Patient, Clinician 1\ming.
Hear. lnstr. 44(1 ):25-26.
Cassel, M. 1978. Music
Masker for Severe Tinnitus:
A Case Report. Hearing Aid
}. April:l2 & 44.
Feldmann, H. 1987. Masking
Phenomena in Tinnitus.
Proceedings III inti. Tinnitus
Sem. 224-228.
Feldmann, H. 1987. Masking
of Tinnitus-Historical
Remarks. Proceedings III Inti.
Tinnitus Sem. 210-213.
Gold, S., W. Gray, S. Hu,
and P. Jastreboff. 1995.
Selection and Fitting of
Noise Generators and
Hearing Aids tor Tinnitus
Patients. Proceedings v Inti.
Tinnitus Sem. In publication.
Goldstein, B., and A.
Shulman. 1995. Tinnitus
Masking - A Longitudinal
Study of Efficacy/ Diagnosis.
Proceedings V Jntl. Tinnitus
Sem. In publication.
Johnson, R. 1995. The
Masking of Tinnitus.
Unpublished.
Johnson, R. 1987. Effects of
Long Thrm Masking of
Tinnitus on Hearing
Sensitivity. Proceedings III
Inti. Tinnitus Sem. 261-264.
Johnson, R., S. Griest, L.
Press, K. Stortet; and B.
Lentz. 1989. A Tinnitus
Masking Program: Efficacy &
Safety. The Hearing J. 42(11)
November: 18-25.
Johnson, R., and R. Sandlin.
1995. Residual Inhibition
Produced by Pure-Tone
Signals and Bands of Noise.
Proceedings v Tntl. T i n n i h ~ s
Sem. In publication.
Kemp, S., and R. George.
1992. Masking of Timritus
Induced by Sound. f . Speech
Hear. Res. 35:1169-1179.
Kitajima, K., M. Kitahara,
and A. Kodama. 1987. Can
Tinnitus Be Masked By Band
Erased Filtered Masker?
Masking Tinnitus with
Sounds Not Covering the
Tinnitus Frequency. Am. J.
Otol. 8:203-206.
Mitchell, C., J. Vernon, and
T. Creedon. 1993. Measuring
Tinnitus Parameters:
Loudness, Pitch, and
Maskability.}. Am. Acad.
Audiol. 4:139-151.
Sheldrake, J ., R. Coles, and
J. Foster. 1995. Noise
Generators ("Maskers") for
Tinnitus. Proceedings v Intl.
Tinnitus Sem. ln publication.
Shulman, A. 1991.
Instrumentation. Tinnitus:
Diagnosis/ Treatment. ed. Lea
& Febiger. 503-513.
Smith, P., V. PaLT, M.
Lutman, and R. Coles. 1991.
Comparative Study of Four
Noise Specha as Potential
Tinnitus Maskers. The British
}. of Audiology. 25:25-34.
Sweetow, R. , P. Cato, and M.
Levy. 1991. The rnteraction
of Earmold Acoustics, Real
Ear Resonances. and
Tinnitus Masker Responses.
Tinnitus Tbday . 17(1)
March. 4-8.
Sweetow, R. , P. Cato, and M.
Levy. l 991. The Tinnitus-
Masking Efficiency of High-
frequency Hearing Aids.
The Hearing f. 4(4)April.
24-34.
JYler, R., F. .Kuk, and L.
Mims. 1987. Ipsilateral and
Contralateral Postmasking
Recovery ofTinnitus.
Pmceedings III Inti. Tinnitus
Sem. 275-279.
JYlet; R. 1995. Research
Needs for the Treatment of
Tinnitus through
Instrumentation. Proceedings
V Inti. Tinnitus Sem. In
publication.
Vernon, J., S. Griest, and
L. Press. 1990. Attributes of
Tim1itus and the Acceptance
of Masking. Am. J.
Otolaryngol. 11:44-50.
Vernon, J. 1991. Common
Errors in the Use of Masking
for Relief of Tinnitus.
Tinnitus Diagnosis/ Treatment.
ed. ShL1hnan, Lea, & Febiger.
50-66.
Vernon, J., and M. Me ikle.
1988. Measureme nt of
Tinnitus: An Update.
Tinnitus, Pathophysiology and
Management, ed. Kitahara.
36-52.
Vernon, J. 1981.The History
of Masking as Applied to
Tinnitus. }. Lary11gol. Otol.
4:76-79.
Announcements
The 16th European Instructional
Course on Tinnitus and Its
Management"- April14-18, 1996
This 16th annual course to be held at the
University of Nottingham, England, addresses
the causes, scientific background, investigation,
and management of tinnitus. It will consist of
lectures with case discussions, practical demon-
strations, and a workshop session. The course is
designed for otologists, ENT's, scientists, techni-
cians, and hearing therapists involved in or plan-
ning to become involved in clinical or research
work on tinnitus. The course fee of 500
includes comprehensive notes, accommodation
in a university residence hall for four nights,
lunches, and three dinners. Attendance will be
limited to 48 delegates.
The course organizer is Jonathan Hazell
(Middlesex Hospital and RNID, London). The
faculty includes Ross Coles, Adrian Davis, David
Baguley, Jean Baskill, Altan Kayan, Thrry Buffin,
Laurence McKenna, Jacqueline Sheldrake,
Catherene McKinney, and Dafydd Stephens.
This event is being organized in collaboration
with the Office for Professional and Industrial
1taining (OPIT) at the University of Nottingham.
For registration information, contact:
Dianne Rooksby, OPIT, University of
Nottingham, University Park, Nottingham
NG7 2RD, United Kingdom, Tel: (0115) 9513763,
Fax: (0115) 9513722.
International Noise Awareness Day -
April 24, 1996
Sponsored by the League for the Hard of
Hearing in the U.S., this day is being set aside to
bring public attention to the hazards of living in
excessively noisy environments. Many organiza-
tions, including ATA, are lending support to the
activities planned for that day worldwide such as
the dissemination of hearing protection, media
coverage about the hazards of noise exposure,
and observing "60 seconds of no noise from 2:15
to 2:16pm- wherever you are." me assured the
League that our membership wanted this more
than theirs.) For more information, contact
Nancy Nadler at the League for the Hard of
Hearing at 212/741-7650.
AN IMPORTANT MESSAGE FROM THE
ATA MAILING BUREAU
By Century Direct Marketing, Inc.
ATA relies on volunteers for responding to
requests for information, but they use our ser-
vices for sending out renewal notices.
Following AT A's normal membership and/ or
subscription procedures, the cycle of mailings
begins two months prior to the member's
anniversary date - the date of their last
membership (or unrestricted) donation. This
reminds the member early enough to plan for
the next annual contribution and assures
uninterrupted continuation of membership
benefits such as receiving Tinnitus 'Ibday .
Most ATA members realize the importance
and value of their membership and respond
immediately. However, if a renewal gift is
not received, subsequent reminder letters are
sent - at very lengthy intervals.
Wben processing the January anniversary
renewals, an error occurred at our bureau.
Somehow, instead of a first reminder, many
ATA members were inadvertently sent the
final letter in the long cycle. We can just
imagine the surprise felt by these members in
good standing when they received notice that
they "are no longer on the ATA membership
list." If you received such a letter, we hope
that you will forgive our faux pas. ATA is an
important and worthwhile organization that
values and appreciates its members. We are
proud of our association with them and apolo-
gize for the confusion.
De-stressing Your Way
by Barbara 'Thbachnick,
Client Services Manager
All of our senses become
heightened when we perceive
that we are in danger. For
example, when we walk on a
dark street, our ears make the
footsteps we hear sound louder.
It as a primWve neurological
response designed to keep us
Because our lives are unavoidably touched
by outside stressors, with or without tinnitus,
the practice of daily stress reduction is a good
idea. In all likelihood, it is a necessity.
Last year, our network of support groups and
volunteers responded to a survey to help us
compile an (unofficial) list of relaxation books,
tapes, and stress reduction techniques. They
were asked, "How do you relax?'' The following
is the sum of their generous response.
safe, but one that can bad:fire on those with tin-
nitus. Many who experience stress and fear
because of their tinnitus will attest: fear can cir-
cle back to elevate the already troubling noise.
While ATA does not necessarily endorse the
products or techniques listed, we offer this
smorgasbord of ideas from you, to you.
Relaxation Techniques:
Masking with an overhead
Relaxation Tapes:
+ A half-hour nap
fan
(The infonnation below is irz
+ A warm shower
Meditation
some cases incomplete and may

Art work, crafts, water color

Modified progressive
require you to do some further
painting
relaxation
investigation.)
Backyard sounds: pond with

Prayer
+ Bach, Mozart, Chopin, and
trickling water, birds, cars in
Reading
other classical flute works
the background

Saying autogenic phrases

''Coping With Tinnitus"-
Bike riding
(like "I am at peace" or "I
Stress Management &
Browsing at the shopping
feel quite relaxed")
Treatment (3 tape set),
center

Sex
Associated Hearing
Bubble baths with candles

Shooting scenic outdoor
Instruments, 6796 Market
and soft music
photography
St., Upper Darby, PA 19082,
Chamomile tea

Shting quietly with my eyes
610/ 352-0600
Counting my blessings
closed

"Deep Relaxation" and
Creative writing
Stitchery, knitting,
"Visualization Power" -

Deep breathing
crocheting, quilting
Effective Learning Systems
Driving with radio music on
Swimming
Inc., The Love Thpes, 5255
Eating vanilla ice milk
Thlking on the phone
Indusbial Blvd., Edina, MN
Enjoying my family

Using an aquarium for
55439, 612/ 893-1680.
Exercise requiring
masking and visualization
"Effortless Relaxation,"
concentration
Using a 100 degree spa for
"Inner Peace," "Letting Go
Finding a balance betv,reen
20-30 minutes
of Stress," "Meditation for
"keeping busy" and "taking
Walking in a forest
Personal Growth" by Steven
it easy"

Walking, running, or
Halpern/ Inner Peace
Getting a back rub/ massage
"racewalking"
Music, PO Box 2644,

Going to the country alone

Watching TV (but only as a
San Anselmo, CA 94979,
Listening to relaxation tapes
last resort)
800/ 909-0707.
and COs (see next list)
Wearing ear plugs

Environmental audio
Listening to tapes that
Wood carving
tapes, Natural Wonders,
require a response
Writing letters
503/ 653-5633 or
Yoga
503/ 620-6422
16 Tinnitus Today/ December 1995
De-stressing Your Way ccontinuedJ
+ Enya, Chip Davis, Paul

"Relaxation & Meditation
Books you,ve recommended:
Sutin, William Ackerman with Music & Nature"
+ A Practical Guide 7b Self-
+ "Hear We Go" - traditional (mountain streams) by
Hypnosis, Melvin Powers
American children's songs Laser Light, Delta Music Inc.

A Layman's Guide to
by Jeff Bradetich and Judi

"Solitudes" by Dan Gibson,
Tinnitus & How 7b Live With
Rockey (low-pitched for environmental sounds of
It, Robert Slater
hearing impaired) ocean with gulls
+ Ageless Body, Timeless Mind,

"Meditation" by Louise Hay,

"Sounds of a Summer Deepak Chopra, M.D.
Hay House lnc., PO Box Evening" - The Nature Co. + Anatomy of an fllness,
6204, Carson, CA 90749,

"Sounds of the Everglades" Norman Cousins
310/ 605-0601 and "Train Ride" by Silver

Feeling Good - The New Mood

Michael Jones, Nancy Bells Music, Nashville, TN
Therapy, David D. Burns
Rumbel, Richard SouLher,

"Stretch and Relax'' and
M.D., Signet Books, New
David Arkenstone - "Relaxation Thpe" -
American Library, 1633
InstrumentaJ new age National Headache
Broadway, NY, NY 10019
contemporary tapes, Narada Foundation, 5252 N.

Getting Well Again, Carl and
Distributing, 4650 N. Port Western Ave., Chicago, IL
Stephanie Simonton
Washington Rd., Milwaukee, 60625, 800/843-2256

Good News (ATA's support
WI 53212, 414/ 961-8350

Thpes by Joan Borysenko,
network newsletter)

"Migration" (all Ph.D., Mind/Body Health
+ Minding the Body, Mending
instrumental) by Peter Sciences Inc., 393 DL'Con
the Mind, Joan Borysenko
Kater and R. Carlos Nakai, Rd., Salina Star Rte., (in limited quantities
Canyon Records & Indian Boulder, CO 80302, available through ATA)
Arts, 4143 N. 16th St. #4, 303/440-8460

Quantum Healing, Deepak
Phoenix, AZ 85016,

Thpes from The Conscious
Chopra, M.D.
602/ 266-4823 Living Foundation,

The Road Less Traveled,

Nature Recordings' PO Box 9, Drain, OR 97435,
M. Scott Peck
"NW / Pacific Wilderness" 503/836-2358

The Relaxation Response,
and other environmental

"The Best of Kitara"
Herbert Benson M.D.
tapes, 360/ 378-3979 (instrumental new age

Tinnitus- What Is That

Nature sounds, guided music) Noise in My Head?, Joan
imagery tapes by Emmett

"The Healer's Thuch" by
Saunders
Miller, M.D., Source Max Highstein

Tinnitus 7bday
Cassette Learning Systems
Miscellaneous:
Tinnitus - Learning to Live
lnc., PO Box W, Stanford, With It, Sheppard and
CA 94309, 800/ 528-2737

Classical music 'i'\Tith animal
Hawkridge

New Age (music)
sounds in the background

7Welve Steps and TWelve
Collection, PO Box 3333,

Easy-listening music from
Traditions, Alcoholic
Altid Park, Chelmsford, MA
the 1940's
Anonymous World
01824-0933, 800/ 333-4220

Hymns and sacred music
Services Inc.

Pachelbel's "Canon in D"

National Public Radio

When Silence Is A Stranger,

Progressive relaxation tapes

Native American music,
Leslie Sheppard
by Paul Duckro, Ph.D., St.
especially flute

Yoga: 28 Day Exercise Plan,
Louis Behavioral Medical

old Mary 'JYler Moore
Richard Hittleman
Institute, 1129 Macklind
re-runs
Ave., St. Louis, MO 63110,

Soft male voices
314/ 534-0200.
Hearing Impairments and Heredity
The National Institutes on Deafness and
Other Communication Disorders has developed
a Hereditary Hearing Impairment Resource
Registry (HHIRR) to identify the potential genet-
ic component in hearing disorders.
1b accomplish this, the Registry: 1) collects
information (via detailed, 11-page question-
naires) from individuals with hearing impair-
ments who would also consider participating in
research that might benefit them, 2) dissemi-
nates information about advances and research
in hereditary hearing impairment to the lay and
medical communities, and 3) uses the collected
information to match families with appropriate
research projects. Involvement in research pro-
jects, however, is not mandatory in order to join
the Registry. The HHIRR further guarantees
complete confidentiality of all collected data.
Dr. Paul Ing, HHIRR project director, says,
"We are not aware of any specific research in
the hereditary aspects of tinnitus. But we would
welcome the inclusion of families with tinnitus
in hopes of inspiring the initiation of such
research."
Questionnaires are available to the public by
contacting the NIDCD HHIRR, Boys Town
National Research Hospital, 555 N. 30th St.,
Omaha, NE 68131-9909, 800/320-1171.
Do you hear it? A high-pitched ringing, low hum or seashell roar? Does it break your
concentration? Does it inte1fere with your sleep? If so, you're one of 10 million Americans who
suffer from tinnitus. Thankfully, there is help. Ask your doctor for information. Or contact
us: The American Tinnitus Association, P.O. Box 5, Portland. Oregon 97207.
ATA
!1
Our sincere thanks to Brian Woolsey - creative consultant, copywrite1; and ATA member - for his generous donation of time and
talent for much of ATA's printed publicity. Copies of Brian's recent poster (above) are being distributed nationally to hearing health
professionals for their offices and clinics. Ccntact ATA if you would like to receive one of our 16x20' b&w posters. (Shipping and
handling costs: $3 for up to 3 posters)
18 Tinnitus 1bday/ December 1995
New ATA-Funded Research
+ A $30,000 research grant was recently award-
ed to James A. Kaltenbach, Ph.D., at Wayne
State University School of Medicine, Detroit, MI,
for his study Changes in spontaneous activity and
neurochemistry of the cochlear nucleus following
exposure to high intensity sound. Dr. Kaltenbach
expects that this research will
11
COntribu te to
an understanding of the neural mechanisms
underlying the phenomenon of noise-induced
tinnitus."
+ A $25,000 grant was awarded to Donald A.
Godfrey, Ph.D., at the Medical College of Ohio
in Toledo for his related research into the
Neurochemistry of the cochlear nucleus following
exposure to high intensity sound. Dr. Godfrey's
study hopes to provide information about the
chemical changes that occur with loud-sound-
induced tinnitus.
+ Jos. J. Eggermont, Ph.D. at the University of
Calgary in Alberta, Canada, was awarded a
$52,000 (Canadian) research grant for his two-
year study on the Effects of salicylates and qui-
To Our New Support
Network Volunteers- A
warm and grateful welcome!
Support Group Coordinators
Becky Reinstein, Guilford College, PO Box 17508,
Greensboro, NC 27410, 910/ 316-3596
Dierdre Anderson, MA, Holy Family Hospital,
70 East Main St., Methuen, MA 01844, (Boston
area) 508/ 687-0156 x2225
Telephone & Letter Contacts
Michael Cohen, 505 N. Lake Shore Dr., #5412,
Chicago, IL 60611, 312/ 321-0783
Suzanne Martin, 1406 E. Gary Pl.,
Anaheim, CA 92805, 714/ 535-5053
Wayne Maxon, PO Box 7131, Oxnard, CA 93031,
805/ 486-6460
If you have an interest in lending support to
others with tinnitus, let us help you organize a
local support group or include you on our list of
telephone and letter contacts. Write for details
and our packet of self-help information.
nine on neural activity in the auditory cortex. Dr.
Eggermont's study is designed to test three
hypotheses: 1) tinnitus is based on synchronous
activity within and between auditory cortical
areas, 2) this activity is caused by disturbances
in the calcium conductance in cortical/subcorti-
cal cells, and 3) the effectiveness of specific cal-
cium blockers to counteract the effect can be
validated.
+ Aage M0ller, Ph.D., at the University of
Pittsburgh Medical School, Pittsburgh, PA,
received a $59,000 research grant for his study,
Tinnitus and neuronal plasticity in the ascending
auditory pathway. Studies in the rat of the electro-
physiological, metabolic, and molecular manifesta-
tions of factors known to induce tinnitus in
humans. Dr. MeHler states, "Our previous studies
have already shown hints about how to better
treat tinnitus with a combination of medica-
tions. I am convinced that (this research) is
likely to lead to practical, useable results that
can improve treatment of tinnitus."
Oh boy, were we overly
optimistic!
If you ordered a copy of the Proceedings
of the Fifth International Tinnitus Seminar,
we must ask for your continued patience. It
probably will not be available until the first
ofthe year.
We're truly sorry because we know how
anxious you are to get it. What we didn't
know was how long it would take to typeset
and proofread such a compendium of facts
and figures. We're hard at work on it,
though, and promise to get it to you as
quickly as possible. Please note: credit card
charges will not be processed until we're
ready to mail the book to you.
Thank you for your understanding.
Questions & Answers
by Jack A. Vernon, Ph.D., DiYector,
Oregon Hearing Research
("Rl Many of you have written to ask if stress
tension have any effect upon tinnitus.
Some ask if it can cause tinnitus.
f"Al'There is no doubt that stress can easily exac-
tinnitus, although I doubt that stress
can cause tinnitus. We recommend that any tin-
nitus patient unable to handle stress should seek
professional guidance to acquire the coping skills
needed to minimize stress effects.
Investigators at the University of Florida stud-
ied the effect of acoustic stress upon the inner
ear. They exposed rats to 85dB ofwhite noise for
four hours a day for three consecutive days.
After this experience, they measured the number
of the glucocorticoid (GR, the recognized stress
hormone) receptors. They found a 27% decrease
in GF in the inner ear organ of Corti for the
exposed animals, compared to the non-exposed
control animals. These investigators conclude
that there is a specific tissue reaction for the GR
receptor within the inner ear that responds to
acoustic stress. They go on to suggest that these
same receptors are related to Meniel7 17re's
disease. In as much as tinnitus is one of the
three symptoms characterizing Meniere's disease,
they also conclude that acoustic stress has a
direct bearing on tinnitus. Indeed, one wonders
if tinnitus as a constant auditory sensation may
not feed upon itself by the generation of stress.
The investigators from Florida go on to
briefly suggest that dexamethasone (a synthetic
glucocorticoid) has been used in the treatment _of
Meniere's disease. 1b my knowledge, glucocorti-
coid treatment has not been tried for tinnitus. Do
any of you readers have infonnation on this
topic?
("RlMr. F. in New York writes to say, "Sometimes
hear a sound very direct into my ear.
Does that sort of thing damage the ear and/ or
make tinnitus worse?"
f"AlThe ear canal has "resonance" means
certain sounds will be amphfied by the
act ofbeing in the ear canal. No, I don't think
this is damaging, unless the sound is exceedingly
loud. Remember that acoustic damage is a time-
intensity function. The louder the sound the
more the damage, and the longer the sound is
present the more the damage. Thus, ear protec-
tion involves reducing sound intensity and sound
duration as much as possible.
20 Tinnitus lbday/ December 1995
("RlFrom Mr. P. in Florida: "I have heard about
tinnitus into a chord. What does
that mean and is it something I could try?"
m converting tinnitus into a chord is yet
example of something I tried long
ao-o that failed. I was working with a pati ent and
f;und that it was very easy to mask her tinnitus.
We only had to get the masking sound just bare-
ly loud enough for her to hear it and it com- .
pletely covered her tinnitus. While the maskmg
was present, however, she informed me that she
did not like the masking sound and preferred
her tinnitus which greatly surprised me. I asked
her why. she said, "your masking
sound is not as melodious as my tinnitus."
I began to think about how tinnitus could be
melodious. I came up with the possible conclu-
sion that she was hearing not one but two tones
separated by an octave to produce a chord.
When I presented to her two tones separated by
an octave, it was an exact match of her tinnitus.
I decided to try to convert people's tinnitus into
a chord by adding the missing tone - either one
octave above or below the tinnitus. Of the nine
patients with whom I used this approach, eight
immediately rejected the resulting chords, say-
ing it was worse than their tinnitus and not
nearly as good as ordinary masking. The one
patient who considered the ch?rd
better had tinnitus at the relabvely low p1tch of
2000Hz.
("Rl From Mr. S. in Minnesota, "I have tried the
test' and the tinnitus can be heard
above the sound of the water. Does that mean
that masking is not a possibility for me?"
f"Al it may mean that your tinnitus is kind
cannot be masked. However, 1t may
also mean that you have sufficient hearing loss
in the high frequencies (pitches) so that you are
unable to appreciate the high frequency por-
tions of the water sounds needed to mask your
tinnitus. You could be tested with Starkey's tin-
nitus instruments, combination units that con-
tain both a hearing aid (high frequency
emphasis) and a tinnitus masker. The hearing
aid portion is adjusted first, then just
masking sound is added to cover up the tmmtus.
If the masking sound needed is too loud, the
patient will concluded that this form of
is not for them. It is the patient who determmes
whether or not masking relieves the tinnitus.
Send your questions to Dr. Vernon cl o ATA,
Tinnitus Toclay! Q&A, PO Box 5, Portland, OR
97207-0005.
EVERY DAY IS A GIFT
(Although some days the gift is a little worn around the edges)
by Sidney Kleinman
In 1967, during a two-day episode ofwhat
the medical profession calls "the sudden hearing
loss syndrome," I lost all hearing in my right
ear. The loss was catastrophic. (I could only
"feel" the sound rather than hear it.) Along with
the hearing loss, I was left with a substantial
level of tinnitus, which has over time increased
in volume. Furthermore, as the hearing levels in
my "good" left ear decreased, the tinnitus gener-
ated from the left ear increased.
Over the years, I have developed a number
of strategies that have made it possible for me to
engage actively in a private law practice;
become an avid, vigorous long distance bicyclist;
and spend time, effort, and funds supporting
various non-profit groups with which I strongly
identify. One of those groups is ATA.
My newest "opportunity" to utilize those
strategies and test my resolve occurred early
one morning in March of this year when I began
to experience the symptoms of Meniere's dis-
ease - dizziness with each head movement,
lurking nausea, and a sense of not feeling well. I
have always believed that each problem we face
in life is in reality just another opportunity,
although I sometimes wish that there were not
quite so many of them.
The challenge of dealing with Meniere's is
not much different than the challenge of dealing
with my continuing, invasive, tinnitus that has
been my constant companion for all of my adult
life. This is how I live and how I cope with the
"opportunities" of Meniere's and tinnitus.
1) Every day is a gift. Notwithstanding that
my plans were turned upside down on the day
the Meniere's symptoms emerged, that my doc-
tor was not available, and that the doctor cover-
ing for my doctor could not see me until the
very end of the day, the day was still a ''gift" to
be enjoyed. For example, I found that if I lay
very still, the symptoms were reduced. So 1 took
that opportunity to finish reading a book I had
started. Later in the morning I discovered that if
I moved slowly while sitting in a chair I could
tolerate the dizziness. So I made some telephone
calls and worked on a document at my desk. I
did whatever my symptoms allowed me to do
during the day.
The level of my tinnitus generally rises to a
conscious level after about one and a half hours
of sleep, then wakes me up. Instead of fighting
it or becoming upset by the intrusion, I will get
up and eat ice cream, read, listen to classical
music, or lie down again to try to drift back to
sleep. Sometimes I will be up for the rest of the
night, but usually I will drift back to sleep for a
time.
2) Keep the focus short. As I sat at home on
that first day of symptoms and as I sit here now,
I do not have any idea how long the dizziness or
tinnitus will continue. Rather than consider the
prospects of a lifetime of Meniere's or tinnitus I
I
try to keep as specific a goal in mind as I can.
On that fateful day, I decided to better under-
stand the symptoms and my reaction to them,
and to see how well I could walk with the sensa-
tion of dizziness. I began walking from down-
town Chicago to my home, about seven miles
away. I decided that if walking became too diffi-
cult, I would tal<e a cab. My focus was narrow:
to see if I could walk with the symptoms as they
then existed.
As I write this, my tinnitus is roaring. Yet I
am concentrating on completing this article
within the next 20 minutes and I know that I
can work through it. When I reach that 20
minute goal, I can develop the strength to take
each of the future 20-minute periods as they
come. It is not necessary for me to worry about
how the rest of my life will unfold.
3) Be thankful for what I have, not resent-
ful of what is missing. With invisible condi-
tions like tinnitus, hearing loss, or Meniere's, it
is easy to dwell on the question of "Why me?" I
quickly remind myself that life is inherently not
fair or just, and that there are many others in
our world who suffer much more.
I am thankful in the most positive sense for
what I have and what I can do and
I
not mournful of what I have
lost. As a result, I am very
grateful that my nausea ~
was fleeting and that
the sensation of dizzi-
ness has subsided. I am
grateful each day that I
have the opportunity to
respond to the challenge of tin-
Tinnitus 1bday/ Dccember 1995 21
fi LONGWOOD DIVISION
~ AllYN f.. BACON
1995 Available Now hardcover
ISBN: 0205- 14083-1
Order #H40835 $44.50
AN IMPORTANT BOOK IN
THI STUDY Of TINNITUS ...
ORDIR YOUR COPY TODAY!
CALL 1-800-278-3525
fAX l-515-284-2607
!:MAIL AHLONCWOOD@IAOL.COM
WRIT[ P.O. BOX I 0695
DES MOINES, lA 50336-0695
Mechanisms of Tinnitus
Jack A. Vernon and Aage R. MfJller, editors
Distinguished contributors at the frontiers of tinnitus research tnoroughly explore the
mechanisms and source of ti nnitus in this important new book. Alt hough tinnitus is a
serious problem for the millions of people in the U. S. who are affected by it, treatment
options are limited because its cause is not wel l understood. Jack Vernon and Aage
M0ller invited the leading researchers to share their evolving hypotheses and ideas-
the result is a stimulating view of tinnitus theory and research in progress. Chapter
authors discuss why adults usuall y experience tinnitus as constant while in children it is
almost always intermittent, how patients' belief that tinnitus is a serious health threat
may infl uence their level of tinni t us-rela ted distress, and how initial medical counseling
may actuall y increase a pa tient's anxiety, resul ting in more intense tinnitus perceprions.
Contents Ps)chophysiological Dimensions of Tinnitus. Raimund Brix A M<:chanism for Tinniws?
Robert E. Bmmme/1 Classification of Causes, Mechanisms of Pati ent Disturbance. and Associated
Counsding, Ross Coles Correlated Neural Activity and Tinnitus, los J. .qgermont and Yvonne Sininger
Mechanisms of Tinniws, Harald f<"eldmaun Tinnitus in Children with Hearing Loss, John M. Graham
Models of Tinnitus: Generat ion, Perception: Cl inical Implications . .Jonathan W P. Hazell Tinnitus as a
Phamom Perception: Theories and Clinical Tmplicat ions. Pawel.l . .lastreboff Tinnitus and Spontaneous
Activity in the Auditory System, Masaaki Kitaltara, 1-liroya Kirano. Mikio Suzuki. and Kazutomo J<itajima
Neural Mechanisms of Tinnitus with Special Rcfcrence to the Pathological Ensemble Spomaneom Activity
of the Auditory System, Thomas f.,euarz. Christoph Schreiner. Russell L. Snyder. and Arne Ernst A Model for
Cochlear Origin of Subjective Tinnilus: Excitatory Drift in Operating Poim of lnn<:r Hair Cells, Eric l.. LePage
A Conversation About Tinnitus, Robert A. Levine and Nelson Y.S. Kiang Spectral Analysis of Brain Activity
in the Study of Tinnit us, William Hal MarTin The Interaction of Central and Peripheral Mechanisms in
Tinnitus, Mary B. Meikle Pathophysiology of Ti nnitus. Aage R. M11ller Psychophysical Observations and the
Origin of Tinni tus, M.J. Penner and R.C. Bilger The Analogy Between l'innirus and Pain: A Suggestion for a
Physiological Basis of Chronic Tinnitus, Juergen Tomtdorf Cochlear Motor Tinnitus. Transduction Tinnitus
and Signal Transfer Tinnitus- Three Models of Cochlear Tinnitus, H a i L ~ Pttter Zenner and Arne Ernst Lndex
Every Day is a Gift (continued)
nitus and contribute to society. While I wish I
did not have these problems, I am thankful they
exist at their present levels.
4) Keep trying - Never, never, never give up.
My goal is to continue the process of coping and
living as best I can, not to
11
Win the game" or
hear every word. That is where strength lies.
That is how better minutes, hours and days can
follow the ones that are not very pleasurable.
l've learned that coping takes discipline.
About seven years ago, I recognized that I need-
ed a way to constantly renew my discipline in
dealing with my tinnitus. Long distance bicy-
cling provided me with the way. With bicycle
touring, I found that I am genera11y hot or cold
or wet or all three, that I go up six hills for
every one I come down, and that the wind
22 Tinnitus 'TOday/ December 1995
always seems to be in my face. Nevertheless, i.f l
persevere, I will arrive at my destination.
Consequently, after cycling 100 miles or more a
day in New Zealand, and through extremes of
heat and humidity on the Island of Bali, I have
found the strength and discipline to ignore the
tinnitus.
The strategies set forth above are both easy
(one needs only to take that first small step) and
difficult (one must string together a number of
those small steps which is particularly difficult
to do when one is discouraged, tired, upset, or
feeling isolated). The fact remains that we con-
trol our own lives and destinies. I urge each of
you to take that first step and each necessary
additional step in the fulfillment of your own
life's work.
Can you use the word "satisfying" in the
saine sentence as "tax''? We can!
by Corky Stewart,
Special Projects Coordinator
Whether making pessimistic
predictions or opining optimisti-
cally, everyone is talking about
tax reform. Headlines trumpet
the latest proposal (often before
it is made) while talk shows dis-
sect the differences between
"flat'' and "consumption" taxes
or discuss eliminating deductions, if not income
taxes themselves. Clearly it is going to take
some time to work out an acceptable plan.
Meanwhile, the IRS expects to hear from all of
us in April, so it is still a good idea to do year-
end planning following traditional strategies.
In that vein, we came across a tip we
thought we should share: accelerate deductions-
postpone income.
The general consensus is that it is better to
itemize deductions rather than use the standard
deduction (short form). And when you itemize,
look for ways to boost 1995 deductions or to
speed up payment of future deductible expens-
es. (This advice only applies to people who
expect to be in the same or lower tax bracket
next year).
Needless to say, we think this is a very good
idea, especially in regard to charitable deduc-
tions. In other words, this is an excellent time to
make an important contribution to benefit ATA.
A gift of $1000 before January 1 could reduce
your 1995 taxes by $280 if you are in the 28%
Correction
The "Incidence and Awareness of
Tinnitus in University Students" article on
p.l9 in the September 1995 Tinnitus Tbday
should read, "When all of these results are
extrapolated to include the total student
body, it is a probability that 468 students
out of the 3755 students in the 14-24 year old
age range have tinnitus ... "
tax bracket, or $310 if you are in the 31% brack-
et. You can deduct gifts of cash up to 50% of
your adjusted gross income, 30% for gifts of
securities or real estate. And, there is a five-year
carryover period for "excess" donations.
Your thoughtful support of ATA can save
even more taxes if you contribute "capital gain"
property - securities or real estate - in which
you have a paper profit and which you have
held more than one year. You will receive a
deduction that includes your cost plus your
paper profit, but you won't have to pay any capi-
tal gains tax. (Do discuss this with your adviser
or accountant.)
Just remember, year-end gifts to ATA will
generate a 1995 income tax charitable deduction
only if they are "delivered" before 1996.
Unfortunately, pledges are not deductible until
actually paid. A check wi11 be considered deliv-
ered on the date you mail it, even as late as
December 31. The same rule applies to gifts of
stock certificates mailed in the proper form. If
you really want to
cut it close, you
can call or fax us
to charge your gift
to your VISA or
MasterCard.
You'll help your-
self even as you
help ATA. That's what
I call a saLlsfylng tax
strategy!
Have you moved?
Please let us know your new address!
We incur an additional postal charge of up
to $1.50 for each item that is returned to us
and resent to a new address. Surprisingly,
we spend thousands of dollars every year
this way. With a little advance notice from
you, this considerable sum could be pain-
lessly channeled into tinnitus research.
TiJm it us 'Ibday I December 1 995 23
WANTED
'

HEARING AIDS AND/OR MASKERS
IN ANY CONDITION
If you have ever wondered what to do
with those aids that are just sitting in the
drawer think no further. ATA will be happy
I
to receive them. Donations to ATA are tax
deductible, and we'll provide a receipt.
Simply package them up carefully (a small
padded mailing bag is fine) and send to:
ATA, PO Box 5, Portland, OR 97207. If
you are using UPS or another shipper, ship
to our street address: 1618 S.W 1st Ave.,
#417, Portland, OR 97201.
Guidelines for Writers
Tinnitus Tbday, the Journal of the
American Tinnitus Association welcomes
submission of original articles about tinnitus
and related subjects. The articles should speak
to an audience of people with tinnitus, and to
audiologists, otolaryngologists, otologists,
hearing aid specialists, and other medical,
legal, and governmental specialists with an
interest in tinnitus.
Manuscripts should be typewritten, double-
spaced, on plain paper and should include
title; author(s) name(s) and biographical
information; and (when appropriate)
footnotes, references, legends for tables,
figures, and other illustrations and photo
captions. Our readers like to "see" you. Please
include a reproducible photo. Generally,
articles should not exceed 1500 words and
shorter articles are preferred. If possible,
submit manuscripts on 3.5" diskette in
WordPerfect 5.1 or higher format (IBM
compatible).
24 Tinnitus Today/ December 1995
What happens to the aids that you turn
in? In some cases they can be repaired and
given to needy people or used in charitable
missions to underdeveloped countries.
Even if they can't be re-used as is, the parts
are needed for repairing other aids. (And
the plastic is recycled.) Your old aid could
give someone the gift of hearing!
Please do not submit previously published
articles unless permission has been obtained
in writing for their use in Tinnitus Today.
(Please attach a copy of the written release to
the article submitted.)
All letters accompanying manuscripts sub-
nutted for publication should contain the fol-
lowing language: "In consideration of Tinnitus
Tbday taking action in reviewing and editing
my (our) submission, the author(s) under-
signed hereby transfer(s), or otherwise con-
vey(s) all copyright ownership to Tinnitus
Tbday in the event that such work is published
by Tinnitus Tbday."
Tinnitus Tbday also welcomes news items
of interest to those with tinnitus and to tinni-
tus healthcare providers, and information or
review copies of new publications in the field.
All such items should contain the name and
telephone number of the sender or person to
contact for further information.
Please address al l submittals or inquiries
to: Editor, Tinnitus Tbday, P. 0. Box 5,
Portland, OR 97207-0005. Thank you for your
consideration.
Tributes, Sponsors, Special Donors,
Professional Associates
Champions of Silence are a select group of donors demonstrating their commitment in the fight against tinnitus by making
a contribution or research donation of $500 or more. Sponsors and Associates contribute at the $100-$499level. AT A's trib-
ute fund is designated 100% for research. We send our thanks to all those people listed below for sharing memorable occa-
sions in this hopeful way. Contributions are tax deductible and are promptly acknowledged with an approp1iate card. The
gift amount is never disclosed. GIFTS FROM 7-16-95 to 10-24-95.
Champions of
Silence
Joseph G. Alam and Trudy
Drucker
Jean and LOLl f'ockele
Claude H. Grizzard
Edmund J. Grossberg
Dr. Khairy A. Kawi
Mrs. Marian B. Lovell
McDonnell Douglas ECF
James L. Schiller
Arthur Schoenstadt
Sponsor Members
Julia R. Amaral
Veronica Asbury
Steve D. Barrett
Allen R. Bernstein
Mark A. Bleich
Robert H. Boemer
Robert W. Booth
Alain G. Boughton
Ronald R. Bowden
Charles T. Brown
Raymond L. Buse
Frederick W. Champ
Charles J. Chieffe
Wesley Harris Collins
Michael L. Connolly
Ronald H. Dailey
L. D. Daugherty
Pierre David
Richard J. De Phillis
Michael D. Deakin
Joseph Decker
Jeffrey J. Derossette
Brenda D. Deweese
H. Renwick Dunlap
Donna G. Fijolek
Marvin Freedman
Robin R. Fuller
Stephen Gazzera, Jr.
Beverly & lan Getreu
Nathan L. Gibs011
Charles W. Gilbert
L. Kirk Glenn
Jordan Graham
Mark Graham
Marlene Greenebaum
Raymond P. Harris
Avis S. Hartley
James G. Hayward
Shitma M. Huizenga
Gloria Hunter
Jesse Hunter
John H. Jessen, Sr.
Howard R. Katz
Paul S. Kaytes
Emi ly S. Kerley
Thomas R. Keske
Sidney C. Kleinman
Laura P. Kleppick
William J . Knight
Ronald J. Komiski
Marvin Kowit
Mrs. Judith K. Kroll
E. Joseph Kubat
Gary E. Lanterman
Evelyn Schrader Lee
Frances L. Lerch
Dr. Herbert A. Levin
Romulus Z. Linney
John Malcolm
Vince A. Mangus
Aaron J. & Jean Martin
M. Richard May
Peter A. Marrinan
Ernest V. Marsh
Mindy McEntire
Ed Leigh McMillan 11
Stewart Mott
Mike Murphy
Sara Beal l Neal
Teresa L. O'Halloran
Nancy Oettinger
Dr. Allan F. Pacela
Bobby R. Payne
Dow W. Perry
Kenneth A. Preston
James K. Quire
Jerome A. Rich
Ludie G. Richard
Marta Ridd
Joseph A. Robinson
Ellen R. Sabiers
Jack E Sassone
Donna Schcckla
John H. & Faye Schleter
Jean L. Schmidt
Bruce A. Shachat
Marlene K. Shaw
Raymond C. Simon
J. Daryl Slate
Patricia Smith
Raymond & Sylvia Smith
Malcolm Sneed
Joseph. Souto
Douglas H. Steves
Robert Gerard Sullivan
Josephine Thcconi
Jerry R. Thompkins
Dan & Sally Vallimarescu
Megan Vidis
Paul W. Zerbst
Research Donors
CWO & Mrs. Dean Kroll
The Jean & Aaron Martin
fund
Madeli ne G. Okano
Dean Edward Schanen, M.D.
Douglas H. Steves
Professional
Associates
Warren Brandes, D.O.
Philip Brubaker
Eva A. Dimitrov, M.D., P.A.
Lawrence T. Eschel man,
M.D.
Roberl S. Feehs, M.D.
Elio J. Fornatto, M.D.
Chris B. foster, M.D.
Anne C. Galloway, MS/CCC
Norman Goldstein, M.D.
Robert A. Goldstein, M.D.
Richard L. Goode, M.D.
Robert R. Harmon
Theng Hung-cheng, M.D.
Dr. Stuart Krasney
Les P. Leale
Bernard Lipin, MA/ CCCA
Guy E. McFarland, M.D.
Mary B. Meikle, Ph.D.
Dr. Maurice H. Miller
Stephen E. Mock, Ph.D.
Dennis M. Moore
Carl M. Nechtman, M.D.
Barry S. Novel<
Michael M. Paparella, M.D.
Gl01ia E. Reich Ph.D.
Edward J. Riedinger, BC-HlS
David J . Sand, M.D.
Dean Edward Schanen, M.D
Juli ette Sterkens, M.S.
Jack A. Vernon, Ph.D.
James T. Yates, Ph.D.
In Memory Of
Claire Blanchard
Constance E. farrell
Alvin Borego
Jack & Pauline Michael
Brother - Sol Goldfarb
Sally Rice, Tessie Cooper, &
Mollie Hoffman
Twin Brother -
John E. Greve
Jim & Joanne Cooper
Marcus Kapelovit:"L
Arlo & Phyll is Nash
Amita Kempler's
mother Rosie
Jacques R. Simon
A1 Morganelli
Margaret K. Leventis
Renee Parker's Dad
Jacques R. Simon
DicJ-. Pattet-son
Jacques R. Simon
In Honor Of
Special Birthday -
Evelyn Abramson
Nicki & Leo Wolk
Special Birthday - Honee
Abramson
Sara & Al Meirovitz
Birthday - Adele B. Al am
Joseph G. Alam & Trudy
Drucker
Birthday - Joseph G-
Alam
Adele B. Alam
Julie & John A1am
Jules Drucker
Trudy Drucker
Mora Emin
Rosali e & Jim Traver
Mary & Patrick 'TI.IIly
Birthday - J ul es H.
Dntcker
Joseph G. Alam & Trudy
Drucker
Engagement - Julie Motto
& John Lung
Joseph G. Alam & TI-udy
Drucker
50th Wedding
Anniversary- Mr. &
Mrs. Ray Laby
Mr. & Mrs. Jack Harary
Retirement of Dr. Jack A.
Vernon
Trudy Drucker
Marjorie J. Youngen
J . Richard Youngen .Jr.
Tinnitus Thday/ Dccember 1995 25
NEW!
Unique 3-D Virtual Reality Help For Tinnitus
Scientific sound wave composites create soothing musical tapes
Tradltional methods of relieving ringing
and buzzing in the ears include broad band,
narrow band, and white noise devices to mask
tinnitus symptoms.
Now, Visual Sound Technologies introduces a
revolutionary new audio tape program that is
unlike any masking on the market today.
Using a unique new technology, this
program differs from other forms of tinnitus
masking through:
! Recording auditory information in exclu-
sive 3-Dimensional Virtual Reality sound
to enable a distraction phenomenon to
occur.
! Creating computerized sound wave
composites to produce a neutralizing
masking effect.
! Blending soothing melodies and sounds
(not static white noise) to relax and
entertain.
This program is unlike any other system
available!
Order your introductory package contain-
ing 3 one-hour tape cassettes. Each cassette
blends different sound wave composites so
you can find the wave pattern that works best
for you.
Major credit card holders call toll free.
Or send a check or money order for $54.95
($49.95 plus $5.00 shipping & handling) .
Michigan residents add $3.00 (6% sales tax). If
you find the Visual Sound Technologies tapes
do not meet your needs, we offer a thirty (30)
day money back guarantee.
Call Toll Free
(800) 511-0364
Visual Sound Thchnologies
P.O. Box 1505, Bir mingham, MI 48012-1505
Tinnitus Today Advertising Rates
As ofDecember l, 1995 (rates subject to change
without notice)
+ Full Page back cover outside - color $2500
( 4x = $2000 @)
+ Full Page back cover outside - b&w $2000
(4x=$1500 @)
+ Full Page cover inside - b&w $1750
(4x=$1250 @)
+ 1/2 Page inside - b&w $550 ( 4x = $425 @)
+ 1/4 Page inside - b&w $300 (4x=$225 @)
+ Classified ad (1/8 page) - b&w $130
(4x=$115 @)
(Note discounts for 4 consecutive ad place-
ments)
+ Black and white ads may have 2nd color
added at the discretion of the editor at no
extra charge.
26 Tinnitus 'TOday/ December 1995
Disk (IBM or MAC) with hard copy need to
be received: by January 1 for the March
issue, by April 1 for the June issue, by July 1
for the September issue, by October 1 for the
December issue.
Border to border maximum size for full page
ad - 7 1 I 2" x 10"
Halftone screens - 133 line or better
For additional information, contact:
Editor, Tinnitus Tbday
American Tinnitus Association
PO Box 5
Portland, OR 97207
503/248-9985 (voice) 503/248-0024 (fax)
Happiest of Holidays
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Forward and Address Correction

Tinnitus Today December 1995 Vol 20, No 4

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Tinnitus Today December 1995 Vol 20, No 4

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