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June 1995 Volume 20, Number 2

Tinnitus Today
THE JOURNAL OF THE AMERI CAN TINNITUS ASSOCIATION
"To carry on and support research and educationaJ activities relating to the treatment of
tinnitus and other defects or diseases of the ear."
In This Issue:
A Chronicle of
Electrical Stimulation
Ginkgo Biloba and
Animal Research
Fifth International
Tinnitus Seminar
Schedule of Events
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------------------------1-L.- - - - __
Tinnitus T o d ~ y
E<litorial and advertising offices:
American Tinnitus Association,
P.O. Box 5, Portland, OR 97207.
Executive Director & Editor:
Gloria E. Reich, Ph.D.
Associate Editor: Barbara Thbachnick
Editorial Advisor: 1i'udy Drucker, Ph.D.
Advertising sales: ATAAD, P.O. Box 5,
Portland, OR 97207 (800-634-a978)
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 100,000
annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed
unsuitable for Tinnitus 'TOday. Acceptance of
advertising by Tinnitus 7bday does not con-
stitute endorsement of the advertiser, or its
products or services, nor does Tinnitus
Thday make any claims or guarantees as to
the accuracy or validity of the advertiser's
offer. The opinions expressed by contribu-
tors to Tinnitus 7bday are not necessarily
those of the Publisher, editors, staff, or
advertisers. Amerkan Tinnitus Association
is a non-profit 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 perm is
sion 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, IL
Roben A. 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
Richard L. Goode, M.D., Stanford, CA
John W. House, M.D., Los Angeles, CA
Robert M. Johnson, Ph.D., Portland, OR
William H. Martin, Ph.D., Philadelphia, PA
Gale W. Miller, M.D., Cincinnati, OH
J. Gail Neely, M.D., St. Louis, MO
Jerry Northern, Ph.D., Denver, CO
Robert B. Sandlin, Ph.D., San Diego, CA
Alexander J. Schleuning, II, MD,
Portland, OR
Abraham Shulman, M.D., Brooklyn, .NY
Mansfield Smith, M.D., San Jose, CA
Honorary Board
Senator Mark 0 . Hatfield
Mr. Thny Randall
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, Chmn.
Aaron I. 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 2
1
June 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
6 Seashell
by James W May
7 A Chronicle of Electrical Stimulation Therapy
by Barbara Thbachnick
13 Ginkgo Biloba and Animal Research
by Pawel f. Jastreboff
14 'Thmporal Bone Organ Donations
15 Road to Recovery - One Year Later
by Stefan P Kruszewski
17 Your Letters to Barbra Streisand
18 Thlking It Out
by Barbara Thbachnick
19 Health Meetings Across the U.s.
by Pat Daggett
20 Is Our Help Wanted?
20 New Tinnitus Support Network Volunteers
20 Our New PSA's
Regular Features
5 Letters to the Editor
16 Questions & Answers
21 Tributes, Sponsors, Special Donors, Professional Associates
Cover artwork: Watercolor painting 'Flowers in the Mountains#
by Janet Louvau Holt. Inquiries to 2768 SW Thlbot Rd., Portland, OR 97201
(503) 227-7000
This painting, donated to ATA, is the logo for the Fifth International
Tinnitus Seminar
Tinnitus 1bday/June 1995 3
From the Editor
by Gloria E. Reich, Ph.D ,
Executive Director
On March 22, 1995, the
National Institute on
Deafness and Other
Communication Disorders
held a tinnitus workshop
-- for defining future direc-
~ ~ ~ = = ~ ~ ~ tions for tinnitus research.
b This was a much sought
after effort to involve the NIDCD specifically in
the field of tinnitus. Your letters to your congres-
sional representatives were extremely helpful,
and I encourage you to keep writing to ensure a
continued push by Congress for tinnitus
research.
The participants, invited by the NIDCD, are
mostly active in basic hearing research. The
meeting was called to order by Dr. Ralph F.
Naunton, Director of the Division of Human
Communication. Participants and guests were
welcomed by NIDCD Director, Dr. James B.
Snow, Jr. In attendance were Drs. Alfred Nuttall,
Richard Bobbin, Pamela Burch-Sims, Donald
Godfrey, Charles Liberman, Mary Florentine,
Joseph Santos-Sacchi, Richard Schmeidt, Donota
Oertel, Rinaldo Canalis, and Pawel Jastreboff.
Other NIDCD representatives were Drs. Judith
Cooper, Larry Shetland, Jay Moskowitz, Amy
Donahue, Kenneth Gruber, and Mr. W. David
Kerr. Guest observers included myself, my hus-
band Ted Reich, Dr. Margaret Jastreboff, Dr.
Erleen Elkins, and Mr. and Mrs. Patrick O'Meara
(ATA members).
The morning session was devoted to an
overview of current knowledge and of problems
specific to performing tinnitus research.
Participants spoke about their recent laboratory
work on tinnitus or a related field and how that
work might provide an insight into the pathologi-
cal mechanism producing tinnitus. A discussion
followed about the need for increased tinnitus
research, both basic and clinical.
Research approaches were created that could
be presented to NIH staff, Congress, potential
researchers, and to individuals and foundations
interested in funding research. A final summary
report is available from the NIDCD. Contact
Kenneth A. Gruber, Ph.D., Health Scientist
Administrator, Division of Communication
4 Tinnitus Thday/ June 1995
Sciences and Disorders, NIDCD/ DHC, Executive
Plaza South, Room 400C, Bethesda, MD 20892,
or telephone (301 )402-3458.
There have been quite a few changes at ATA!
Thomas Wissbaum, C.P.A. resigned from the
ATA board after 15 years of service. Tbm has
been more than helpful in providing accounting
services at no cost to ATA. His dedication is
greatly appreciated and we thank him for
serving such a long time.
New to the ATA medical advisory committee
is researcher William H. Martin, Ph.D.,
Director of Audiology and Auditory Research at
the Garfield Auditory Research Laboratory of
Temple University Medical School, Philadelphia,
PA. We appreciate Billy's new commitment to
work on our behalf.
At our national office we have both lost
and gained staff. Those who are no longer with
us are:
+ Lisa Cochran, our mail and volunteer
coordinator for the last two years.
+ Marina Czapszys, our client services
representative for more than four years.
+ Brent Mower, our development director for
nearly two years.
+ Priscilla Reed, our front office secretary for
the last year.
Thanks to all of these wonderful people for
the time and devotion they gave to ATA.
New on the scene are:
+ Robin Jennings, who will be handling the
ATA mail and working with our volunteers.
+ Evelyn Peasley, who will be helping with
data processing and general office procedures.
+ Corky Stewart, who is helping with the Fifth
International Tinnitus Seminar and other
special projects.
+ Anne Young, who is helping on a temporary
basis witl1 general secretarial duties.
Please welcome these new voices when you
call. We're very glad to have them working
with us.
This issue contains an insert about the Fifth
International Tinnitus Seminar. We thought you'd
like to know a bit more about the meeting itself
even though you might not be able to attend.
Remember that the proceedings of this meeting
will be published in book form and will be avail-
able from ATA. We'll let you know details about
ordering the book in a future issue.
Letters to the Editor
The opinions expressed are strictly those of the letter
writers and do not reflect an opinion or endorse-
ment by ATA.
E
ach time I find myself feeling completely
hopeless, along comes my Tinnitus 'Ibday
and the feeling of aloneness goes away.
I lost most of my hearing in December 1992, and
the terrifying noise began a few weeks later.
Having tried everything known to man, I have
finally decided to try to handle this on my own.
By keeping a journal, I am able to identify the
days when the tinnitus is worse. For me it seems
to occur after exposure to noise. Being an extro-
vert, it has been extremely difficult to avoid
crowds, but I know it is the only way I can han-
dle the situation.
Phyllis Flesher, Shreveport LA
I
n 1993, I began to experience rapidly pro-
gressing hearing loss in both ears and period-
ic mild tinnitus, coincidental with the failure
of my liver which had been under assault by
hepatitis C. After my total loss of hearing, which
coincided with my liver transplant, I experi-
enced tinnitus to varying degrees of severity. I
attempted to correlate my tinnitus with a num-
ber of variables, e.g. blood pressure, stress, eat-
ing, talking, and medications. (As a transplant
patient, I take 12 different medications, many of
which are included on the list of suspected tinni-
tus causes.) Talking had the most significant
effect on the variability of my tinnitus.
Six months after my liver transplant, I under-
went surgery for a cochlear implant in my right
ear. When the device was "turned on," my tinni-
tus immediately disappeared. I hear remarkably
well with my implant. I think I'm in the top tier
of those benefitting from this incredible technol-
ogy. I have since found that if I talk on the
phone for an hour or more without turning on
my Spectra 22 Speech Processor, the tinnitus
starts coming back. It can get pretty bad if I talk
for a couple ofhours.
Recently I have started experiencing a mild
to medium severity of tinnitus in the left ear
only, even when the speech processor is turned
on. It is annoying but doesn't interfere with liv-
ing my life which I am now able to do with gusto
since the liver transplant. Although it is not pre-
scribed solely for that purpose (alleviating tinni-
tus), I understand from my otolaryngologist that
others have also benefitted as I have from a
cochlear implant.
Ronnald E. McElvogue, La Porte, TX
(Editors Note: See "A Chronicle of Electrical
Stimulation Therapy" in this issue)
I
have been taking rutalin for the past six
months and found that it helped me concen-
trate. I'd had no noticeable side effects
except for some muscle soreness in my neck
from a previous injury. About two months ago I
noticed some intermittent ringing in my ears
that gradually became louder and more constant.
My internist said it was probably nasal conges-
tion and prescribed spray. AnENT did a hearing
exam and told me I had a hearing loss and tinni-
tus. When I asked about the fullness in my ears,
he said I was just thinking too much about them.
I cried for two days and then sought another
opinion. Another ENT suggested that I take
niacin and have TMJ ruled out. I next asked a
psychopharmacologist if there was any correla-
tion between Ritalin and tinnitus. He said there
was and suggested that I try another medication.
I then went to a chiropractor/nutritionist who
suggested a correlation between my stiff neck
and tinnitus. I went to a TMJ dentist who told
me that the sensation of fullness in the ears is a
TMJ symptom, but he didn't know a great deal
about tinnitus and suggested we do some
research. In a medical book, I read about the
sterno- cleido- mastoideus muscle and asked him
where it was. He said, "That muscle is the one
that runs from your shoulder up to behind your
ear." The light went on- That was the muscle
that had been sore for months!
I began massage therapy and a regime of vit-
amins. The ringing went away after the first
hour of massage and only comes back intermit-
tently and much more quietly. I have also cut
out some stress-causing activities, am eating
more sensibly, take Motrin for muscle inflamma-
tion, and have stopped taking Ritalin.
Clearly the MD's do not have all of the
answers. I urge people to do their own research
and treat themselves as if they were puzzles.
Doctors may only provide one piece of that
puzzle.
Daphne Suzanne Crocker-White PhD,
San Mateo CA
Tinnitus Today/ June 1995 5
Letters to the Editor (continued)
I
h.ave suffered very severely from tinnitus
smce 1988. Throughout this period I have
done everything I know of- experimented
with relaxation therapy, self-hypnosis, exercise,
sma1l doses of herbs and vitamins, megadoses of
herbs and vitamins, Xanax, various types of anti-
depressants, and on and on. I had grown to
accept the intensity of the ringing, but when the
pulsating began a few years ago and continued
to get worse, I simply could not deal with it.
Desperately seeking help, I experimented with
the antidepressant Effexor which made me very
nauseated at first. But I noticed that the pulsat-
ing went away for at least 85% of the time.
I now take one-half of a 37.5 mg tablet at bed-
time and have been doing so for two months.
I felt it my moral obligation to pass this good
fortune on.
Kerry Jensen, Price, UT
I
have been given a renewal gift oflifet It has
to do with my tinnitus and my attempt at
suicide when I could no longer stand the
Seashell
We shall see
if this is a sound
that comes and goes.
We shall see
what no one else knows;
the echoes in the ears
resound my deepest fears
when no one else is near;
no one hears what I hear.
by James W May
6 Tinnitus Today/ June 1995
affliction. I am now 62 and have had tinnitus
since my army days in 1954 but it was hardly
noticeable until December 1992 when I had
three pieces of hardened wax removed from my
right ear. I began suddenly suffering from severe
loud noises in both ears. Last summer, the tinni-
tus went into a remission that only lasted until
September. It then worsened to the earlier
degree. I could not sleep, was prescribed Xanax
and Valium but nothing helped. On November
8th, I took an overdose of four medications and
alcohol but lived to tell my tale! I was taken by
ambulance to our nearest hospital and was
given new medication - Paxil (20mg) and
Stelezine ( 4mg) which I take each night at bed-
time with the addition of Lorezapam (1 mg) and
Doxepin (lOOmg) that I had been taking. The
noises have decreased almost 90% and I feel
like a human being again. I know now that
there is a silver lining up there. Thank you for
all your help.
Ed Rosenberg, Rochester, NY
I CORRECTION
Th the ''Drugs and Tinnitus Relief' article
from the March 1995 Tinnitus Tbday:
On page 12, protriptyline should be listed
as an antidepressant rather than as an
antianxiety agent.
Also, fluoxetine, sertraline, and
bupropion are antidepressants, but not of the
tricyclic variety.
From Volta's Battery to Cochlear Implants
A Chronicle of Electrical Stimulation Therapy
by Barbara Th.bachnick,
Client Services Manager
The medical use of electricity has a surpris-
ing - and a surprisingly long - history. The
first historical mention of it, albeit static elec-
tricity, pre-dat es the American Revolut ion. In
1801, barely one year after the invention of the
battery (the first device to harness and generate
a continuous electric current), a German scien-
tist tenaciously placed electrodes from the bat-
tery into the canals of tinnitus-affected ears to
observe the effects. For the following 100 years,
researchers regularly conducted electrical stimu-
lation (ES) experiments and published
articles that advocated its use as a tinnitus treat-
ment. By the end of the 19th century, ES was
the therapy of choice for dozens of physical ills.
In 1901, this "Golden Age of Medical
Electricity" came curiously to a full stop and
remained stopped for more than half a century.
Some historians attribute the ES hiatus to the
medical charlatans of the time who, trying to
take advantage of a no-longer-innocent
populace, promised miracles they couldn't
deliver. For the next 59 years, therapeut ic use of
electricity for tinnitus relief was at a standstill.
Interest in ES therapy eventually was renewed
in the midst of astonishing advances in
electrical science, and quite by accident.
Note: The types of electrical current and the place-
ment of electrodes are primary variants in the body
of published articles on ES, and are therefore given
emphasis in this article. Other factors (electrical
frequencies, amperes, voltage, type of electrode,
duration of stimulation, modulations, wave lengths,
tinnitus etiology, specific patient variations - and
all of their combinations) are addressed in the
referenced articles.
A Brief History:
17 45 - In Ho11and, the electrical capacitor was
invented. It was the first machine to store and
release a charge of electrostatic energy (static
electricity).
1768 - Georg Daniel Wibel reported successful
treat ment of tinnitus with electticity.
1800 - Alessandro Volta invented the direct
current (DC) battery, a stack of thin metal plates
separated by brine-soaked pasteboard, with two
extending wire electrodes (a negative cathode
and a positive anode) of different metals. After
placing the two probes from the battery into his
own ear canals to see what would happen, Vol ta
received a shock to his head and heard a loud
"disagreeable" noise.
1801 - In Berlin, Grapengiesser began exten-
sive experiments with Volta's battery in an
attempt to cure deafness, but was careful to note
the changes that occurred with his patients'
tinnitus. He found that ES from the positive zinc
pole was more effective than from the negative
silver pole in the occasional and short-lived
suppression of tinnitus. He also noted that some
patients who didn't have tinnitus before ES, had
it afterwards.
1842 -de Lamballe combined DC with needles
(he called it "acupuncture"): one needle through
the tympanic membrane touching the promon-
tory and another in the wall of the Eustachian
tube. He claimed good results in treating
tinnitus.
1855 - Duchenne de Boulogne claimed that he
cured tinnitus in eight out of 10 patients using
electrodes inserted in ears half-filled with water,
using Faraday's new induction coil that pro-
duced alternating electric current (AC).
1868 -In Germany, Rudolf Brenner returned
to the use of direct current because of patients'
"unbearable reactions" to alternating current
stimulation. He recommended that an individu-
alized approach toES therapy was most effica-
cious because patient reactions varied so widely.
1901 - In Vienna, Urbantschitsch advocated
both direct and alternating currents with slow
current variations for tinnitus treatment.
The value of this early research information
may seem more historical than medical - in
most cases, no data exist to authenticate or
explain it. But when trends of the present echo
those of the past, and today's studies find confir-
mation in the outcomes of ancient experiments,
the relevance emerges.
Tinnitus Thday/ June 1995 7
Electrical Stimulation Therapy (continued)
In 1960, American researchers Hatton,
Erulkar, and Rosenberg were observing DC
electrical stimulation as part of a vestibular
functioning test. Coincidentally, they noticed
that tinnitus intensity was lessened in 15 out of
33 cases. Their research showed more:
+ Only the anodal (positive) current
suppressed tinnitus.
+ Suppression meant complete elimination of
the tinnitus.
+ The majority of patients who responded had
severe hearing loss.
+ Only one of the 15 responders had
presbycusis (hearing loss as a result of
aging) compared to 10 of the 18 non-
responders.
+ When electrodes were placed on the
zygomatic arches (cheek bones) of patients
with "bilateral tinnitus" or noises in both
ears, tinnitus was suppressed by the anodal
(positive) electrode and exacerbated by the
cathodal (negative) electrode.
+ When patients first noticed the beginning of
tinnitus reduction, electrical intensity
needed only to be increased by 1/1000 of an
amp or less to achieve complete
suppression.
+ Tinnitus suppression lasted only as long as
the electrical stimulation occurred.
Because the relief was short-lived and often
at the expense of healthy tissue, Hatton did not
see ES as a viable tinnitus therapy. (It was
known at that time that tissue damage resulted
from direct current stimulation.) Nevertheless,
the research of Hatton and his colleagues
piqued the interest of the worldwide science
community and more studies were attempted.
In 1979, the French research team of
Chouard, Meyer, and Maridat studied 64 unilat-
eral and bilateral tinnitus patients using a
variety of electrical currents (direct, alternating
or "sinusoidal," biphasic pulses, etc.), electrode
sites (inner ear, behind the ear lobe, cathode on
the affected then unaffected side, etc.), and
electrode types. Patients were able to control the
increasing voltage until they experienced a "pins
and needles" sensation. From that point, stimu-
lation lasted approximately 20 minutes. If specif-
ic configurations of sites and currents didn't
work, others were tried. Placebo stimulation was
tried in 12 cases but failed each time, presum-
8 Tinnitus Thday/June 1995
ably because patients knew - by the absense of
tingling - that they were not receiving ES.
In this study, 30 ofthe 64 patients had
tinnitus suppression that lasted from a few days
to a few weeks, with no complaints of worsened
tinnitus or aggravated vertigo during or after
treatment. Researchers noted that positive
results were most often obtained with biphasic
pulses and that electrode site was not critical to
success.
Further studies were conducted in France
that same year by Portmann, Cazals,
Negrevergne, and Aran. When 15 tinnitus
patients had "trains" of negative DC pulses
applied to their cochleas via needle electrodes
that rested on either the round window or
promontory of their affected ears, all experi-
enced auditory sensations such as ringing,
tapping, or a worsening of their tinnitus. When
the polarity of the electricity was changed to
positive, 80% experienced tinnitus suppression.
All effects stopped when the hour-long electrical
stimulations ended. (This therapy was ineffectu-
al for patients with "central tinnitus" or head
noises.) The researchers noted that in an earlier
animal study by Aran (1977), guinea pigs
developed cochlear lesions when low amperage
negative DC stimulation was applied for several
hours.
Between 1979 and 1985, ES studies were
conducted in Belgium by Gersdorff, Thibert, and
Robillard. In one study where bursts of AC were
applied to the skin of 39 patients, 26% had slight
improvement and 20% had prolonged
disappearance of their tinnitus.
In 1981, Aran noted that when a platinum
electrode was surgically implanted in the round
window and positive DC stimulation was
delivered to it, complete tinnitus suppression
was produced in 60% of his patients. Positive
DC stimulation to the promontory produced
suppression for 43%. In all cases, tinnitus
suppression occurred in the stimulated ear only
and lasted only as long as the ES occurred. He
theorized that round window stimulation more
effectively directed the current to the cochlea
and the eighth nerve than did stimulation to the
promontory or external ear. Because DC
electricity destroys cochlear hair cells, its use,
he cautioned, should be limited to the ears of
deaf or nearly deaf patients.
Electrical Stimulation Therapy (continued)
In 1985, Shulman introduced the Audimax
Theraband, an AC electrical stimulation headset
with external electrodes that rest on the mastoid
bones. Reported results were exce11ent: 13 out of
21 patients who wore the device for up to two
weeks had tinnitus suppression. Seven ofthe 13
had complete relief. (These results, however,
have not been replicated.) Shulman stressed the
importance of selecting patients who have
maskable and peripheral (in the ears) tinnitus,
and who have an absence of active ear disease
or vestibular asymmetry to increase the
chances of success with this
treatment.
A newer Theraband model was
tested in 1987 by researchers
Thedinger, Karlsen, and Schack in
Kansas City. Because the Thera band
delivers inaudible and undetectable
electric current, 30 tinnitus patients
were involved in a double-blind,
crossover placebo study (in which
patients received both the actual
and the placebo treatments
alternatingly, and neither the patient
nor the physician knew which
treatment was being administered- or
when). During the two-week study, five of
the 30 patients reported relief using the
Theraband device. Interestingly, two of the five
had tinnitus relief during actual stimulation and
three of the five had tinnitus relief during the
placebo treatment but not during ES treatment.
Side effects of headache, dizziness, and
worsened tinnitus were experienced
temporarily. The researchers admitted that
Shulman's patients wore the devices longer, and
consequently conducted an additional test on
six of the original 30. (The two patients who had
previously responded to the ES declined further
treatment stating that the improvement was too
mild to warrant wearing the uncomfortable
device.) None of the six who received 25
additional hours of Thera band ES reported any
relief.
In 1987, Portmann commented on his nine
years of ES research: "Despite good results, we
are still very disappointed because it is difficult
to give the patient continuous help. Th achieve
suppression of tinnitus, you have to give
positive direct current. .. but the structure of the
ear is such that [with DC] there is destruction of
the hair cells. If we give AC, results are very
poor.'' In some patients, DC implants were tried
but eventually abandoned. As with addictive
drugs, patients found that they needed more
and more intensity of the potentially damaging
current to relieve the tinnitus. As a whole,
scientists moved away from DC research and
began innovative explorations of AC for tinnitus
relief.
Kuk, 'TYler, Rustad, Harker, and lYe-Murray
tested AC stimulation on the tympanic
membranes of 10 patients with maskable
tinnitus in a 1989 study. The
researchers used a variety of
electrical wave forms (square,
\ triangle, and sinusoidal) to learn
~ l which, if any, was most effective.
Their findings: Five of the 10
patients tested experienced up to
four hours of tinnitus relief following
10 minutes of ES. Also, square and
triangle waves were found to be the
most effective.
In 1991, researchers Okusa,
Shiraishi, Kubo, and Matsunaga
studied the effects of promontory
stimulation on the ears of 52
patients (54 ears) whose tinnitus
did not previously respond to drug
therapy. The electrical current
intensity was kept low to avoid cochlear
damage. Okusa and his colleagues found that
bursts of alternating biphasic square waves
produced tinnitus reduction in 65% of the cases,
or 35 ears. Tinnitus that accompanied idiopathic
(of unknown cause) sudden deafness or
Meniere's disease, or that resulted from
ototoxicity or labrynthitis, responded to this
treatment with post-stimulation suppression
lasting from 30 seconds to one week. No relief
was experienced by patients whose tinnitus
resulted from acoustic neuromas.
Cochlear Implants
The leap from Volta's battery-induced
"disagreeable" noise to the purposeful and
permanent implantation of electrodes into the
human cochlea for sound enhancement took
more than 150 years. Pioneering work, first
done in France in 1957 and then in the 1960's
by William House in the United States, offered
profoundly or totally deaf patients a restoration
' finnitus Thday/ June 1995 9
Electrical Stin1ulation Therapy <continued)
Implanted Receiver/
Stimulator
Microphone (outline)
behind ear
Cord to Speech Processor - - - - - ~
Cross-section of the ear with Nucleus 22 Channel Cochlear
Implant System.
of some usable sounds with an AC single-
channel implant.
Cochlear implants, however, are certifiably
imperfect: The perception of distorted environ-
mental sounds and garbled voices as an aid to
lip reading is a realistic post-implantation out-
come, although some patients fare better.
(People deaf from birth vs. later-deafened indi-
viduals typically do not reap as great a benefit
from hearing sound without a previous frame of
reference.) But the technology is ingenious: A
small microphone is worn behind the ear (in the
Nucleus implant) like a hearing aid. Sounds
picked up by the microphone are sent via a thin
cord to an externally worn speech processor -
about the size of a pocket calculator - that
amplifies, filters, and digitizes the sound into
coded signals. The signals are sent via the same
cord to a disk-shaped transmitting coil held in
place magnetically on the side of the head by a
receiver/stimulator that has been surgically
10 Tinnjtus 1bday/ June 1995
Transmitting Coil
Directional Microphone
Cable (cord) to Speech
Processor
imbedded just below the skin and behind the
ear. Attached to the internal receiver/stimulator
is an array of electrodes that passes through the
middle ear (leaving the ear drum intact), and is
threaded through the round window and into
the cochlea. The remaining nerve fibers deep in
the cochlea are stimulated to send information
to the brain that is interpreted as sound.
Surgical implantation of the cochlear device
destroys hair cells and all residual hearing a
patient might have in the implanted ear. Its use,
consequently, has been carefully limited to the
deaf or near-deaf.
In 1976, a cochlear implant patient first
reported its positive effect on her tinnitus, and
Electrical Stimulation Therapy (continued)
research took a new turn. By 1984, John House
had studied 64 deaf tinnitus patients who had
received the House Single Channel cochlear
implant and evaluated their tinnitus improve-
ment. Thirty-four of the 64 had experienced a
decrease in the number of tinnitus sounds
heard, diminished loudness and frequency of
currents, and frequencies and reported the
results in their 1993 extracochlear (outside of
the cochlea) implant research. When electrodes
were implanted onto the extracochlear tissue of
the deaf ears of three patients with previously
intractable tinnitus, relief was obtained and
sustained for more than three years. The lowest
occurance, and a
change in pitch. For
some, the tinnitus
remained suppressed
for periods of time
with the device
turned off. Some
experienced a sup-
pression of tinnitus
in the non-implanted
ear as welL Those
whose previous use
of hearing aids had
helped their tinnitus
were often the ones
who experienced
successful tinnitus
suppression with
implants. After one
year, patients subjec-
tively evaluated their
own status: All who
..---------------'--="'------==--.. possible frequency
of stimulation (20
'JYmpanic Membrane
(Ear Drum)
Promontory
Round Window
Hz) from the
implant gave the
~ ~ i i l l l i j best suppression, but
' at no time was
Implant Electrode
Array
tinnitus suppression
achieved without
evoking a sensation
of hearing other
sound. Researchers
speculate that lower
frequencies could
elicit better results.
Work is currently in
progress in Sweden
and England on
implants specifically
designed for tinnitus
Nu-c-le_u_s -22- Ch_a_n_n-el_C_o_c_ hl_ea_r_I_m_p_la_n_t - el- ec_tr_od _e_a_rr _a_y_fi-ed- th-ro-u-gh- ro-u-nd _. suppression.
window into cochlea. Because cochlear
had had relief initially, still experienced relief.
Al1 who had not been helped initially, remained
unhelped. For five of the 64 original implantees,
the tinnitus worsened.
The implantation effect of the new Nucleus
22 Channel cochlear implant was evaluated in
1991 by Ward, Tonkin, Berlin, David, Rigby,
Nuss, Palmer, and Follent. Of 149 implantees
with tinnitus, 98 had post-operative reduction of
their tinnitus, six reported tinnitus increase, and
two reported tinnitus onset after the surgery.
In 1993, Dauman, 'JYler, and Aran closely
studied two tinnitus patients who had received
multi-channeled cochlear implants. The
researchers learned that stimulating selected
electrodes with varying pulses of current affect-
ed the different sounds of tinnitus (e.g., elec-
trode 4 with a pulse rate of 250 Hz was best for
cricket noise, electrode 20 was best for ocean
noises, etc.).
Hazell, Jastreboff, Meerton, and Conway
applied complex variations ofband widths,
implant users often
note a reduction in stress as they rejoin the
hearing world, a question is still unanswered: Is
the reduced stress level the causative factor in
tinnitus reduction? Other questions remain: Is
post-implantation tinnitus suppression a result
of masking by newly heard ambient sounds or is
the electrical stimulation causing true suppres-
sion? Are the long-term effects of AC stimula-
tion known? Considering the invasive nature of
the therapy and its formidable expense (about
$35,000), can the tinnitus patients who would
most likely benefit from it be pre-selected? Can
this technology cross the deafbarrier to benefit
the mi11ions of tinnitus sufferers who hear? Can
the transient tinnitus suppression produced by
other types of ES- internal and external -be
sustained for weeks or months without causing
tissue damage and hearing loss? The answers
today are unknown. But history, in its persis-
tence, reminds us that answers are always
around the corner.
Tinnitus Thday/ June 1995 11
Electrical Stimulation Therapy <continued)
Resources
.House Ear Clinic, 2100 W 3rd St., l st floor,
Los Angeles, CA 90057, (21 3) 483-5706
Cochlear Corporation, (Nucleus 22-Channel Implant),
61 Inverness Dr. E., #200, Englewood, CO 80112. Cochlear
Implant Information Hotline (800) 458-4999, V /TDD
(303) 790-9010
Advanced Bionics (Clarion Implant), 12740 San Fernando
Rd., Sylmar, CA 91342, (800) 678-2575, TT (800) 678-3575
References
Aran, J-M., and J-P. Erre. 1987. Effects of Electrical Currents
Applied to the Cochlea. Proceedings III Intl. Tinnitus Sem.
400-409.
Aran, J-M., andY. Cazals. 1981. Electrical Suppression of
Tinnitus. Ciba. Found. Sym. 85:217-231.
Aran, J-M. 1981. Electrical Stimulation ofthe Auditory
System and Tinnitus Control. f. Laryngol. Otol. (Supp).
4:153-161.
Balkany, T., and H. Bantli. 1987. Workshop:Direct Electrical
Stimulation of the Inner Ear for the Relief of Tinnitus.
Am. J. Otol. 8:207-212.
Berliner, K.., and F. Cunningham. 1987. Tinnitus
Suppression in Cochlear Implantation. Tinnitus 118-130.
Chouard, C.H., B. Meyer, and D. Maridat. 1981.
Transcutaneous Electrotherapy for Severe Tinnitus. Acta.
Otol. (Stockh). 91:415-422.
Cohen, N., and M. Gordon. 1994. Cochlear Implants: Basics,
History, and Future Possibilities. S.H.H.H.J. Jan/Feb 8-10.
Dauman, R., R. '!yler, and J-M. Aran. 1993. Intracochlear
Electrical Tinnitus Reduction. Acta. Otolaryngol. (Stockh).
113:291-295.
Feldmann, H. 1987. Electrical Stimulation in Suppressing of
Tinnitus - Historical Remarks. Proceedings III Intl. Tinnitus
Sem. 394-399.
Feldmann, H. 1984. Suppression of Tinnitus by Electrical
Stimulation: A Contribution to the History of Medicine.
f. Laryngol. Otol. (Supp). 9:123-124.
Gersdor.ff, M., and T. Robillard. 1987. Our Clinical
Experience of Electrical Stimulation in Treatment of
Tinnitus. Proceedings III Intl. Tinnitus Sem. 459-460.
Hazell, J., L. Meerton, and R. Ryan. 1989. Electrical
Tinnitus Suppression. Hear. J. 42(11):26-33.
Hazell, J., P. Jastreboff, L. Meerton, and M. Conway. 1993.
Electrical Tinnitus Suppression: Frequency Dependence of
Effects. Audiology 32:68-77.
House, J . 1984. Effects of Electrical Stimulation on
Tinnitus. f. Laryngol. Otol. (Supp). 9: 139-140.
Kitahara, M. 1988. Combined Treatment for Tinnitus.
Tinnitus Pathophysiology and Mngmt. Ch 9:107-117.
Kitajima, K., M. Kitahara, and K. Uchida. 1987.
Transcutaneous Suppression of Tinnitus with High
Frequency Carrier Waves. Proceedings III Intl. Tinnitus Sem.
435-438.
12 Tinnitus 1bday/June 1995
Kuk, F., R. 'fYier, N. Rustad, L. Harker, and N. 'lYe-Murray.
1989. Alternating Current at the Eardrum for Tinnitus
Reduction. J. Speech Hear. Res. 32:393-400.
Okusa, M., 1'. Shiraishi, A. Thmaki, T. Kubo, and
T. Matsunaga. l 991. Attempts to Suppress Tinnitus by
Electrical Promontory Stimulation. Proceedings Fourth Intl.
Tinnitus Sem. 409-411.
Portmann, M., Y. Cazals, M. Negrevergne, and J .M. Aran.
1979. Temporary Tinnitus Suppression in Man Through
Electrical Stimulation of the Cochlea. Acta. Otoltlryngol.
(Stockh). 87:294-299.
Shulman, A. 1989. Electrical Stimulation for Tinnitus
Treatment/Control. Hear. Instr. 40(6):18-19.
Thedinger, B., E. Karlsen, and S. Schack. 1987. 'Treatment
of Tinnitus with Electrical Stimulation: An Evaluation of
the Audimax Theraband. Laryngoscope 97(1):33-37.
Vernon, J. 1985. A Review of Attempts to Use Electrical
Stimulation to Produce Suppression of Tinnitus. ATA
Newsletter 10(1 ): 1-3.
Vernon, J. 1987. Use of Electricity to Suppress Tinnitus.
Seminars in Hearing 8(1 ):29-48.
Ward, N., J. Thnkin, C. Berlin, S. David Jr., P. Rigby,
D. Nuss, A. Palmer, and S. Follent. 1991. The Effect of
Promontory and External Ear Canal Electrical Stimulation
of Tinnitus. Proceedings Fourth Intl. Tinnitus Sem. 413-415.
International Hearing Aid
Conference III
An international conference on hearing aids
titled "New Directions for Clinical Practice" will
be held at the University oflowa, June 15-18,
1995. The guest of honor is Dr. Brian C.J. Moore
from Cambridge University, England. Dr. Moore,
an expert on auditory perception with a strong
background in applied research, will present
new information on the perceptual conse-
quences of cochlear hearing loss and the practi-
cal and theoretical application this has on
hearing aid design and use.
Presentations will include current perspec-
tives on fitting modern non-linear hearing aids
and information on the new wave of subjective
scales that are emerging from the FDA mandate.
Pragmatic issues related to the new programma-
ble hearing aids will also be addressed. For
further information, contact Regina Tisor
(319) 356-2471 or FAX (319) 353-6739.
Ginkgo Biloba and
Animal Research for Tinnitus
by Pawel J. Jastrebofj; Ph.D., Sc.D.,
Professor and Director, University of Maryland
Tinnitus & Hyperacusis Center
The search for a drug that can effectively
suppress tinnitus, without creating significant
negative side effects, continues. Among the
many substances that have been tried, an
extract from a Chinese tree, ginkgo biloba, has
attracted some attention. It is possible to pur-
chase various ginkgo extracts on the market
with widely different compositions.
The best controlled extract is produced in
France and Germany under governmental con-
trol and can be purchased only as a prescription
drug in those countries. It is called EGb 761 and
is sold in the United States under the label
Ginkgold. There are a number of reports
describing the effect of this drug on tinnitus
patients, with results varying from no effect
whatsoever, to mild improvement in general
well-being, to "taking the edge off tinnit us" and
even partial attenuation of tinnitus.
Ed. note: A few ATA members have called or writ-
ten to say that Ginkgo had worsened their tinnitus.
EGb 761 attracted our attention for the fol-
lowing reasons. The drug has no reported nega-
tive side effects so it can be used safely. If we
were looking for a drug capable of strongly sup-
pressing or eliminating tinnitus, EGB 761 would
not be of particular interest.
However, the drug can potentially offer sub-
stantial benefit when combined with our treat-
ment approach, aimed at inducing and
facilitating tinnitus habituation, that is, reaching
the state where the patient is not aware of the
presence of tinnitus the majority of the time.
This is achieved by retraining the auditory path-
ways in the brain with the help oflow level,
broad-band noise, generated by behind-the-ear
devices. The approach is based on a neurophysi-
ological model of tinnitus. According to the
model, even a partial suppression oftinnitus
while undergoing treatment with broad-band
noise generators should speed up the treatment
process and further improve our results.
Although we are observing a significant
improvement in over 80% of our patients, the
process takes 12 to 18 months and requires us to
spend a large amount of time with each patient.
Finding a drug that can even partially attenuate
tinnitus should shorten the patient's treatment
and allow us to treat more patients. The results
from previous experimental work on animals
performed with EGb 761 at NIH were encourag-
ing and showed that EGb 761 suppresses the
metabolic activity within the auditory pathways.
Since there is a general agreement that tinnitus
is associated with enhancement of the metabolic
activity, there is a chance that ginkgo, by
decreasing this activity, might attenuate tinni-
tus. Other reports have shown that EGb 761
enhances calcium homeostasis. Since we have
postulated that disturbances in calcium home-
ostasis might be involved in the emergence of
tinnitus, EGb 761, by enhancing calcium home-
ostasis, might perhaps attenuate tinnitus.
Our animal model of tinnitus, in which we
temporarily induce tinnitus in rats using salicy-
late, allows us to evaluate not only the presence
or absence of tinnitus in rats, but to measure its
loudness as well. As such, the model is well-suit-
ed for finding out whether a drug has the capa-
bility of attenuating salicylate-induced tinnitus
in animals. We performed experiments on
eleven groups of rats, each group consisting of
six animals treated with different doses of EGb
761, as well as control groups with saline, or
saline and ginkgo only. The results showed a
dose-dependent attenuation of salicylate-
induced tinnitus by EGb 761. Notably, EGb 761
alone was without any effect on animal behav-
ior, indicating that our results were not contami-
nated by nonspecific effects of the drug.
Although the mechanisms of tinnitus sup-
pression by EGb 761 are unknown
1
these results
are encouraging to such an extent that we are
considering performing a clinical double-blind
study with this drug on our patients.
Tinnitus Thday/ June 1995 13
Temporal Bone Organ Donations
The NIDCD's Thmporal Bone Registry, estab-
lished in 1992 to advance research on hearing
and balance disorders, encourages people with
tinnitus and other ear disease to become tempo-
ral bone donors.
They write: The temporal bone is the part of
the skull that contains the structures of hearing and
balance - the middle and inner ear (including the
cochlea, ossicles, ear drum, semicircular canals,
and parts of the cranial and vestibular nerves).
Because of its inaccessible location inside the tem-
poral bone, the inner ear can only be studied after
death when the temporal bones are removed and
processed for microscopic study.
Knowledge gained from the study of temporal
bones about how certain disorders, like tinnitus,
affect the ear will ultimately improve the evaluation
and treatment of hearing and balance disorders for
"COPING WITH TINNITUS"
e STIU:SS MANAGEME.NT &. TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETIE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STIU:SS OF TINNITUS WITHOUT COMPLEX
INSTRUMENTATION&.. VALUABLE OffiCE TIME
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
9
9 5 recordings can be used to induce
$ 5 er

sleeping or as a soothing back-


!10 drop for activity and can be played
"l on a portable cassette player.
AU ORDERS MUST BE ACCOMPANIED
reNTE BY CHECK, VISA, MASTERCARD,
OR INSTITUTIONAL P.O.
6796 MARKET ST., UPPER DARBY, PA 19082
Phone (215) 352- 0600
14 Tinnitus 'Tbday/,June 1995
others in the future. No one is too old or too young
to be a donor. Removal of the temporal bone will
not affect the donor's appearance and therefore will
not affect funeral or burial arrangements. Thmpora1
bones are collected at no cost to the donor's family
or estate and will not delay the donation of other
organs that the donor wished to donate.
That Others May Hear (a short informational
brochure) and The Gift of Hearing (a 16-page
comprehensive brochure) explain in depth the
process of temporal bone collection and the
Registry's research goals. These materials are
available free of charge. Call (800) 822-1327 or
write to:
NIDCD National Thmporal Bone Registry
Massachusetts Eye and Ear Infirmary
243 Charles St, 8th Floor CC
Boston, MA 02114-3096
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 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 SW 1st Ave., #417, Portland, OR 97201.
What happens to the aids that you turn in?
In some cases they can be repaired and given to
needy people or used in charitable missions to
underdeveloped countries. Even if they can't be
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!
Road to Recovery
by Stefan P. Kruszewski, M.D.,
Medical Director - Psychiatry,
Pottsville Hospital & Warne Clinic,
420 S. Jackson Street, Pottsville, PA 17901
(71 7) 621-5000
The American Tinnitus Association included
an article about my tinnitus odyssey over one
year ago. After its publication, I received a
plethora of letters and calls from across the
United States and around the world. I've since
had the opportunity to speak on behalf of fellow
sufferers at meetings in and out of
Pennsylvania. Via these meetings, lectures,
letters, and calls, many salient features emerged
that I am compelled now to share:
Everyone had been frustrated finding help
or even someone to take them seriously.
People were willing to try and/ or do almost
anything to help themselves.
Everyone had a story to tell.
This new information has given me impetus
to do more with the tinnitus support group in
nearby Lancaster, Pennsylvania, and with Judy
Brivchik, the group facilitator. She and I will be
working on a research survey this year.
About tinnitus itself, I learned:
No two tinnitus experiences were exactly
alike.
Pain, unilateral or bilateral, is often an
accompaniment.
The noises can disappear, occasionally for
years. Sometimes, unfortunately, they
return.
History of head trauma often precedes the
onset of tinnitus.
High frequency hearing loss is common.
Others have suffered middle and sometimes
low frequency hearing loss.
My own personal tinnitus treatment has
helped to relieve tinnitus in about 50% of
my patients. For the others, nothing that I
recommended helped.
Maskers, hearing aids and audiological
surgeries have been useful for some, useless
for others.
One Year Later
Oriental herbs have been helpful for some,
a waste for others.
Anti-depressants are helpful (especially
fluoxetine, nortriptyline and paroxetine), but
not uniformly so.
In response to those who've asked what I do
to decrease my noises, here again is my regi-
men - remembering that what works for me
may not necessarily be helpful to others.
Prozac 20mg once per week.
Klonopin 0.5 mg every morning
Vitamin E 800 IU every day
Vitamin C 4000 mg every day
Selenium 100 mg every day
Beta-carotene 50,000 IU every day
Niacin 800 mg each day in divided doses
with meals - (the short acting form of
niacin only).
The medication may be part of the answer
for me, but I don't know. Perhaps more effective
are the life-style changes I've made.
In my weekly regime I regularly include:
Aerobic exercise.
Resistance training/ weight lifting.
Leisure time: gardening, walking, movies,
friends.
Laughing.
Praying/ meditating.
A voiding naps.
Eating light meals.
Minimizing stress.
I feel lucky that now, six years later, my
tinnitus has resolved significantly. There are
still reminders (about 5% of the day) when my
tinnitus is extremely loud and annoying. But for
at least 80% of my waking hours, I have no
tinnitus whatsoever.
I am willing to share my news further; one
needs only to write to me.
Tinnitus 'Ibday/ June 1995 15
Questions & Answers
by Jack A. Vernon Ph.D., Director;
Oregon Hearing Research Laboratory,
3515 SW Veterans Hospital Rd., Portland, OR 97201
[Q]
From Mr. J. from Florida, "You have
often made mention of residual inhibi-
tion. What is it, and is it the purpose of
masking?"
Residual Inhibition is the temporary
suppression of the tinnitus after the
masking has either been turned off or
removed. It comes in several forms. It can be a
reduction of the tinnitus (partial residual inhibi-
tion) or a total absence of the tinnitus (complete
residual inhibition) or a combination ofboth. In
general, it is of short duration. The standard test
for residual inhibition at the Tinnitus Clinic in
Portland is to mask the tinnitus with the mini-
mum masking level plus lOdB for 60 seconds
and then note the kind and duration of residual
inhibition that results. In the Tinnitus Data
Registry, a sampling of 1,412 tinnitus patients
offered the fo11owing results:
+ No Residual Inhibition - 240 (1 7%)
+ Partial Residual Inhibition - 484 (34%)
+ Complete Residual Inhibition- 9 (4%)
+ Both Complete and Partial- 639 (45%)
These data reveal that 83% of the patients
tested displayed some form of residual
inhibition, and the average duration of it was
64 seconds. Don't let the result - 60 seconds of
masking producing an average of 64 seconds of
residual inhibition - confuse you. That does not
mean that one hour of masking will produce
slightly over one hour of residual inhibition.
Indeed, one hour of masking may still only
produce about one minute of residual inhibition.
As of now, we do not lmow how to extend the
duration of residual inhibition.
[Q]
Ms. B. In California writes: "I have had
tinnitus for nine years as a result of
remodeling my house using loud tools.
I've tried folic acid, acupuncture and ginkgo to
no avail. I do get significant relief from 1
1
/z
Manhattans in the evening. During the day I
have trouble understanding speech due to the
tinnitus. Do you have any c1ues?"
16 Tinnitus 1bday/ June 1995
The fact that you have trouble under
standing speech most likely is not due to
your tinnitus, although tinnitus can be a
serious distraction. Most likely, the difficulty
you have understanding speech is due to a high
frequency hearing loss, produced by the same
noise that produced your tinnitus. By the way,
did you know that a hammer blow is llSdB? I
would suggest that you have your hearing tested
and, if there is a high frequency hearing loss,
see a hearing aid dispenser about hearing aids.
If you have any hearing loss greater than 20 dB,
it would be worthwhile to try hearing aids.
Many heallh care professionals advise patients
with bilateral hearing loss to only obtain one
hearing aid suggesting that the patient get used
to one aid and then later, if necessary, get the
second aid. Bad advice! For maximized hearing,
we need two ears. Remember, hearing aids are
dispensed with a 30-day, money-back-guarantee
so you have very little to lose if this plan does
not work.
[Q]
Many of you have written in to
essentially say, "You have, from time to
time, suggested that tinnitus will eventu-
ally have a cure. Could you possibly suggest the
nature of that future cure?" What follows is pure
speculation and nothing more.
The ultimate cure for tinnitus, as I see
it, depends upon advances in the
technology of brain scanning, technolo-
gy that is already developing at a rapid pace. We
often read that tinnitus is located in the inner
ear for some patients (peripheral tinnitus) or in
the brain for other patients (central tinnitus). If
one is exposed to loud sound from which tinni-
tus results, the assumption follows that the
inner ear (periphery) is the locus of the tinnitus.
If one suffers a blow to the head from which
tinnitus results, the assumption is that the locus
of the tinnitus is central or in the brain. The fact
is that the perception of any tinnitus, regardless
of its origin, is in the cortex (top layer) of the
brain. It is this area that must be located and
identified by brain scanning techniques in order
to indicate the minute area that must be
removed in order to cure tinnitus. I speculate
Q & A (continued)
that the ultimate cure for tinnitus will be highly
specific and highly restricted brain surgery.
Most likely the surgery will be conducted not
with the scalpel but with stereotactic laser
beams.
Today, Magnetic Source Imaging (MSI) can
detect and map the brain activity responsible for
epilepsy that is critical for directing surgical
interventions that cure some forms of epilepsy.
MSI, while in its infancy, does provide the capa-
bility for non-invasive mapping of cortical brain
activity.
The cortical area of the brain devoted to
the hearing system does not lie conveniently on
the brain's upper surface. Rather it is buried in
the side walls of a cave-like fold extending back
into the temporal area of the brain. It is well-
protected and difficult to access. Nevertheless,
with proper control, it could be approached.
If removal of the brain area responsible for
epilepsy can cure epilepsy, doesn't it follow
that removal of the brain area responsible for
tinnitus can cure tinnitus?
We need to be able to detect the electro-
chemical brain activity responsible for the
perception of tinnitus. As of now, such brain
activity cannot be detected. Moreover, there will
be the problem of distinguishing tinnitus brain
activity from spontaneous brain activity which
means that we may have to turn the tinnitus off
and on in order to locate it. For many patients,
residual inhibition could do just that.
Let's assume that we are unable to detect the
brain activity responsible for the perception of
tinnitus. I think it would be possible to substi-
tute an "artificial tinnitus" - by selecting a band
of noise that the patient identifies as identical to
the tinnitus they hear - in order to locate the
involved brain tissue.
I see the day when the tinnitus investigator
will scan the brain of the tinnitus patient under
very special conditions afforded by MSI (or
subsequent generations of MSI) and indicate to
the neurosurgeon the specific area or areas to be
removed. It is but one of many hopes for the
future.
When considering the central nervous
system, Hallowell Davis and Richard Silverman
said in their book, Hearing & Deafness,
"Remember that everything is more complicated
than you think."
Your Letters to
Barbra Streisand
We received more than 300 of your personal
letters and cards for Ms. Streisand in expression
of thanks for her generous $25,000 gift to us last
year. Your notes were put into a scrapbook
(unopened if that was the request) and shipped
to the Streisand Foundation in Southern
California. In March of this year, Rachel
Donaldson of the Streisand Foundation called to
let us know that she recently hand-delivered the
scrapbook to Barbra. For all who requested a
signed photo, Rachel suggests patience!
Tinnitus 'Ibday/ June 1995 17
Talking It Out
by Barbara Tabachnick,
Client Services Manager
"I feel better just having
talked with you."
I hear this over the
phone every day despite
the fact that I'm neither
a trained counselor nor
a tinnitus sufferer. It is
heartening, certainly,
and confirms what most
of us know: People need
each other. Usually in
these exchanges, I get as much as I give.
Sometimes I get more.
Our self-help network, composed of support
groups, pen pals, and telephone contacts, is a
lifeline to those deeply in distress. While run-
ning a group is a great gift to any community, it
is without question beyond the scope of many
people. But support takes various forms, the
simplest of which may simply be talking with
others on the phone.
As we look over our nationwide support net-
work list, we're struck by the gaping regional
holes we see. Entire states (Vermont, Rhode
Island, New Hampshire, Delaware, North
Carolina, Alabama, Mississippi, Wisconsin,
South Dakota, North Dakota, Montana,
Arkansas, Wyoming, Idaho, and Alaska) are
without a single ATA support contact. In other
locales, one or two people constitute an entire
statewide network. The recipe for an effective
telephone support person requires only a few
ingredients: 1) compassion, 2) knowledge of the
struggles faced by those with tinnitus, and
3) time. Consider your circumstances. Yours
could well be the next new voice in our network
of support.
Talk to us, too, if you are in the public
relations field or have local media contacts. We
plan to release our new television PSA's soon
and are considering a "media tour" - taped
satellite-delivered interviews with tinnitus-
afflicted celebrities (still a draw and still hard to
get) and tinnHus experts for network news
stations nationwide. We continue our push to
make the prevalence and definition of tinnitus
commonly known- a push to make tinnitus
18 Tinnitus 'lbday/ June 1995
very visible. Please let us know if and how we
can use your valuable connections and talents.
While we work to line up celebrities and
tempt the major networks to air the plight of
the millions with tinnitus, your voice is essential
to corroborate our plea. Again, we want you to
talk - to your neighbors and doctors, to teachers
and librarians, to children and seniors and any-
one you can about tinnitus. Tell them how it
sounds to you, what is known about it, what
caused it, how noise affects it, how it has affect-
ed your life and the lives of your family mem-
bers. We know that, for many, this is a tall order.
Lester Lemke, an ATA support group leader
and good friend, knows why some people keep
their tinnitus hidden. "What would people have
thought if I'd told them I heard noises?'' For the
first 42 years of his tinnitus, only his wife knew
that he'd had it. And even she didn' t know its
extent. Being relieved of the secret has helped
him. "Become bold," he advises.
Our success as a champion to those suffering
with tinnitus hinges on the creation of a wave of
human chatter that will not stop until the noises
themselves stop. ATA continues tirelessly to
"se11" the dire problem of tinnitus to the public.
But it is the sufferers' collective voice, anxious
for answers, that is heard above all the others.
Thlk to everyone. You, who bear the heaviest
burden, carry the most weight.
M y message for people with
disabilities -or any person
who has been told he can't do
something - is simple.
Ignore it. The answers are
inside your own heart.
Curtis Pride, Outfielder
(deaf baseball player)
Montreal Expos, 1994
Health Meetings Across the U.S.
by Pat Daggett,
Assistant Director
Peacock Terrace
(complete with pea-
Our increased cocks!), and did a
participation in brisk business dis-
national meetings seminating materi-
is in response to a als to more than
growing interest in 700 audiologists. We
tinnitus and were encouraged
improved options that there were
for treating this three separate con-
distressing tinuing education
condition. In sessions on tinnitus
February, Dr. Reich at this meeting:
and I attended the
1
"Neuro-physiologi-
annual meeting of cal approach to tin-
the Association for nitus and
Research In hyperacusis," with
Otolaryngology in Pawel Jastreboff, Ph.D. (left) a.nd Sen. Tbm Harkin Dr. Pawel Jastreboff
Florida. Announcements about the Fifth and Susan Gold; "Current concepts in the evalu-
International Tinnitus Seminar were included in ation and management of tinnitus," with Drs.
registration packets Jaynee Calder, Gary Jacobson, and Craig
for the 1,250 Newman; and
attendees. "Severe intractible
Information about tinnitus: Multi-dis-
.ATA's research cipline evaluation
grant proposal and treatment,"
guidelines was also with Drs. Maurice
available at our Miller, Barbara
display. Goldstein, and
During this Abraham Shulman.
event, we were The Tri-State
invited to a recep- Hearing
tion for Senator Convention, attract-
Thm Harkin, for- ing dispensers from
mer chairman and Washington,
current member of Oregon, and Idaho,
the Senate held its annual
Appropriations
Health & Human
Mary Meikle, Ph.D. (left) a.rul Sen. Tbm Harkin
meeting in
February. Although
a much smaller
Services
Subcommittee. The Senator feels a special con-
cern for issues of hearing disorders because of
his own family's experience. Both he and
Senator Hatfield, ATA honorary board member,
have been instrumental in advancing hearing
research efforts by the federal government.
Dallas was the site for the annual American
Academy of Audiology convention, held March
30 - April 2, which attracted over 4,000 regis-
trants. The ATA booth was located in The
gathering, 200 hearing aid dealers were recep-
tive to learning more about ATA and its services.
We continue to be amazed at how many people
still don't know about our association! We feel
strongly that attendance at meetings of this kind
is an important part of our educational effort.
The people we reach are the ones who are
involved in dispensing hearing health services
and identifYing better treatments for tinnitus.
Tinnitus 1bday/ June 1995 19
Is Our Help Wanted?
We are ready to help you establish a tinnitus
support group. Your part: locate a meeting place,
pick the first date (giving us six weeks notice),
and send us a list of your local zip codes. Our
part: create and mail the first meeting
announcement to 200-300 lay people and
professionals in your area, and send you
informational materials to hand out at your
meetings. These efforts usually pull together a
core group of 10-20 very interested people.
Whether as a telephone contact, pen pal, or
support group leader, involving yourself in our
Tinnitus Support Network is a remarkable
contribution. Full details for group-starting as
well as telephone- and letter-helping are avail-
able in our Self-Help Information Packet.
Write for it.
TINNITUS
NEW HOPE FOR A CURE
by Paul VanValkenburgh
AN ORIGINAL NEW BOOK
Explaining the mechanisms of tinnitus and
potential therapies, by an internationally known
research engineer I writer.
Introducing entirely new ideas on how tinnitus
works and how to stop it. Revolutionary theories
provide a unified explanation for each and all of the
peculiarities of tinnitus.
Written for both sufferers and professionals, with
extensive new biomedical research refetences for
neuroscientific support. Surprising revelations in:
+ spectrum edges + tonotopic maps
+internal filtering +filter overload
+ auditory resonance+ sensation adaptation
+ cochlear capillaries+ normal reaction ringing
This is a limited first printing for the 1995 seminars.
128 pages, paperback, $15.00 postpaid (in U.S.)
TINNITUS
Box 3611
Seal Beach, CA 907 40
20 Tinnitus 'Tbday/ June 1995
A grateful welcome to our
new Tinnitus Support
Network volunteers:
Telephone & Letter contacts
Irene Duffield
4923 Rollingfield Dr
San Antonio TX 78228-1058
(210) 684-5609
Judith Dunne MA/CCCA
Elmhurst Hospital Ctr
7901 Broadway HC-69
Elmhurst NY 11373
(718) 334-3395 (w)
(718) 358-828 (h)
New Telephone Contact
Max Thnnenbaum
(708) 966-81 71
OurNewPSXs
... are finally in the works. Thny Randall and
Jerry Stiller have graciously agreed to do a
series of public service announcements for ATA.
Scripts have recently been presented to them,
and the filming will be done in New York this
spring. When we get the "raw" film, the post-
production phase of editing, copying, and
distribution will begin. When the finished
product is available, you will an be the first to
know! Our thanks to the many of you who have
helped support this project.
Tributes, Sponsors, Special
Donors, Professional Associates
Silence special donors who have demonstrated their commitment in the fight
agamst tmmtus by makmg a contribution or research donation of $500 or more. Sponsors and
Professional Associates contribute at the $100-$499 level. ATA's tribute fund is designated 100% for
research. We send our thanks to all of those listed below for sharing memorable occasions in this
hopeful way. Contributions are tax deductible and are promptly acknowledged with an appropriate
card. The gift amount is never disclosed. GIFTS FROM 1-16-95 to 4-5-95.
Champions of
Robert Hitchens Thelma P. Batchelder
Professional
Silence
Renee & Arnold Hock Deborah & Charles Bern
Associates
Beverly Hodges Robert A. Bowler
Thomas W. Buchholtz, M.D.
Max Horn Charles T. Brown
Nancy J. Ahrens. BC-HIS
Sukey Garcetti
Robert C.Incerti Barbara Young Camp
Audio-Dent Inc.
Ronald K. Granger
Dr. Khairy A. Kawi
Paul R. Kileny, Ph.D. Robert B. Dellbrugge
Knox Brooks
Eleanor Kleiner
Walkemar Kissel, Jr. Rick Dilsizian
Sidney N. Busis, M.D.
John Malcolm
Robert Lewicki Eva A.Dimitrov, M.D.
Stanley J. Cannon, M.D.
Ed Leigh McMillan
William C. Licht Sukey Garcetti
Joel G. Cohen, M.D.
John E. Meehan
John W. Linley Stehen Gazzera, Jr.
Linwood W. Custalow, M.D.
The Jacob & Sophie Rice
Doug Marshall Dr. Arthur Gelb
John R. Emmett, M.D.
Family Foundation, Inc
John E. Meehan Richard L. Goode, M.D.
Bruce A. Feldman, M.D.
Arthur H. Schoenstadt
Frank M. Melvin, M.D. Ronald K. Granger
Elliot Goldofsky, M.D.
Family Foundation
Andrew Metrick Marvin Green
Lawrence R. Grohman, M.D.
Agnes Varis
Earl R. Moore William E. Gromen
John W. House, M.D.
Stanley E.Moore John Haleston
RichardS. Kaufman, D.D.S.
Sponsor Members
Dennis W. Organ Gloria Hunter
Egon Kot, BCHIS-FNAO
H. E. Adams
Felicia A. Passero Dr. Khairy A. Kawi
Valerie P. Kriney, MA/CCCA
Joseph G. Alam
Jay L. Pomrenze Wayne M.Kern
Barbara Kruger, Ph.D.
Earl E. Anderson
James K. Quire Sidney C. Kleinman
Stefan P. Kruszewski, M . .D.
Gerald W. Apel
David Rapaport Eleanor Kleiner
Peter A. Mercola, MSEE
James D. Arden
Bernard Richards Marvin Kowit
William H. Moretz, Jr., M.D.
Kathy Bai
J . Thomas Roland, Jr., M.D. Floyd E. & Karen
Douglas H. Morgan, D.D.S.
Charles T Bintz
Thnit Ganz Sanchez Kuehnis, Jr.
John T. Murray, M.D.
Walter T. Bolick, III
Claude M. Sanguy, A.D. Sonny Landreth
C. Randall Nelms, Jr., M.D.
Lauran Bromley
Arthur H. Schoenstadt Henry G. Largey
Scott M. Nelson, M.D.
Thomas W. Buchholtz
Family Foundation Richard A. Layton
Meredith K. L. Pang, M.D.
Anthony G. A. Correa
Evelyn J. Schwertl Donald Lemmons
Kurt T. Pfaff, MAICCCA
Daphne Suzanne Crocker-
Fred Sellers Dan J. Logan
John Risey, MCD
White, Ph.D.
Edwin McMahon Singer Vince Majerus
Richard L. Ruggles, M.D.
Ronald H. Dailey
Raymond M. Smith, ill John Malcolm
Frank A. Skinner
Jose Echenique Diaz, M.D.
Maxwell Solomon Vince A. Mangus
Helena Solodar, M.S.
Richard Elder
Richard V. Sowa Christopher Marken
Robert M. Southard
Richard Emmerson
Barbara A. Vanderploeg Andreas Matthiesen
Hung-Chia Thng, M.D.
Evergreen Speech &
Ph.D. Ed Leigh McMillan
John C. Vaughan, M.D.
Hearing Clinic
Susan T. Wargo Emil Natelli
Elliot Wineburg, M.D.
Floyd Fielitz
Sheldon Weinig Michael F. Otero
Francine & Ray Foster
Delmer D. Weisz Anthony M. Raia, M.D.
Elliott S. Frankfort
Keith C. Winters Anthony Rooney
D. Jeanne Frantz
Lynn Rosemurgy
William K. Friedman
Research Donors Martin F. Schmidt
Beverly & Ian Getreu
Joseph G. Alam Gerald W. Scott
Veva J. Gibbard Lt.Col.Henry D. Baker, Jerome D. Shine
Alton Hadley
Jr.,Ret.
Joseph Souto
John R. Hafer
Edwin N. Barnes Richard VSowa
Dan Hardisty
David M. Bartlett Agnes Varis
Tinnitus Thday/ June 1995 21
Tributes, Sponsors, Special Donors
In Memory Of
Hazell J. Hall
Jeremy C. Clark
Inte11igence Program
Support Group
Charles E. Allen
Joan F. Surrette
Michael F. Munson
S.R Willard
Thresa C. Bigler
Cheryl J. Roby
The Yengel Family
Gretchen F. LaRosa
Marie P. Everhart
Harry Mondschein
Mrs. Harry Mondschein
Arthur Fein
Smith, Gambrell & Russell-
Attorneys at Law
John E. Greve
Joanne E. Greve
Patrick Cedola
Manila E. Meier
Rev. Richard K. &
Marcia R. Smith
Kenneth W. &
Helen V. Kleinfehn
Bertha Miller
George & Shirley A. Ritten
Elizabeth M. Arms
Mary Jane 'frenerry
Roger S. Vessels
Roy Grytness
Arlo & Phyllis Nash
LeRoy Waldum
Arlo & Phyllis Nash
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
indude 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,
so 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).
22 Tinnitus 1bday/June 1995
In Honor Of
Bergen County Tinnitus
Self-Help Group
Dr. & Mrs. Ray G. Wilkinson
Birthday - Mora C. Emin
Joseph G. Alam & Thudy
Drucker
Barbara Thbachnick
Gladys Gottlieb
Dr. Jack Vernon
Milton A. Lang
Matching Gifts
You might be able to double
or triple the size of your gift
to the American Tinnitus
Association by taking advan-
tage of your employer's
Matching Gift Program.
Many companies have
matched contributions to
ATA. We urge you to ask if
your employer will match
your gift, or to call ATA for
the names of companies
that match contributions.
Hearing Aid
Donations
649 pre-owned Hearing Aids
and Maskers have been
received and recycled.
Thank you. We'll be glad to
receive more!
Please do not submit previously published
articles unless permission has been obtained
in writing for their use in Tinnitus Tbday.
(Please attach a copy of the written release to
the artide submitted.)
All letters accompanying manuscripts sub-
mitted 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
convey(s) all copyright ownership to Tinnitus
Tbday in the event that such work is pub-
lished 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 aU submittals or inquiries
to: Editor, Tinnitus Today, P. 0. Box 5,
Portland, OR 97207-0005. Thank you for your
consideration.
1!1 1!1
~ ~
~
Communications Awareness Day
~
~ ~
~ ~
Recognizing
~ ~
The National Institute on Deafness and
~
Other Communications Di sorders (NIDCD)
~
~
Progress of Research in Human Communication
~
~
Hearing - Tinnitus - Balance
~
~
Voice- Speech- Language
~ Thste - Smell
~ ~
~
The day's activites will include a morning exhibit designed to educate members
~
~
of Congress and the public about the various communications disorders (free),
~ a luncheon with presentations from the scientific community (tickets required),
~ ~
and an evening gala with celebrities and entertainment (tickets required) .
~
Details in September issue of Tinnitus 'Ibday.
~
~
Wednesday, October 18, 1995
~
~ ~
Washington, D.C.
~ ~
~
Save the Date
~
~ ~
~ ~
L.::; &::;
1!1 1!1
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Non-Profit Org.
Forward and Address Correction
U.S. Postage
PAID
American
Tinnitus
Association
l
l
\
Last International Tinnitus Seminar in
the U.S. in this Century! Don't miss it!
This is where you'll hear and meet virtually all of the world's scientists who are
working in the field of tinnitus. Speakers from the U.S., Canada, England,
Europe, Israel, Japan, Russia, Austral ia, and more, will provide a global
perspective for tinnitus understanding. Representatives from the National
Institute of Deafness and Communication Disorders (NIDCD), the organization
that funds major hearing research, will also be attending.
Time will be available during social events to visit with researchers and others
who are spearheading the attack on tinnitus.
Social Events during the Fifth International Tinnitus Seminar
TUESDAY -Hospitality Suite open 5:00 to 7:00p.m. for early registrants.
WEDNESDAY - Opening of Exhibits 5:00 to 7:00p.m.
THURSDAY -Dinner cruise aboard the ship Spirit of Portland. While eating,
drinking, and cruising along the beautiful WiUamette River, you'll have views
of lovely riverfront neighborhoods, luxury condominiums, houseboats, sailing
clubs, parks, industrial sites, commercial shipping and drydocks and, of course,
Portland's many beautiful bridges. The ship is comfortable and the ride is
smooth.
FRIDAY -For spouses and accompanying persons, there will be a special all
day bus tour up the spectacular Columbia River Gorge to Timberline Lodge at
Mount Hood, where lunch will be served. You'll see waterfalls, a major hydro-
electric dam and locks, the apple and pear orchards of Hood River, and the
alpine environment atop Mt. Hood. Historic Timberline Lodge, lovingly
restored to its original state, is rustic and alone worth the trip.
Hospitality Suite at the Marriott will be open from 5:30 to 8:00p.m.
SATURDAY- The Gala Awards Banquet, at Montgomery Park Atrium, 7:00
p.m., promises to be both interesting and entertaining. AT A's honorary
directors, Senator Mark 0. Hatfield and actor Mr. Tony Randall have been
invited to attend. There will be music. special awards and recognitions, and a
superb dinner of Oregon foods and wines for your enjoyment.
Dont Miss the Boat
FIFTH INTERNAiliiONAL
tf-INNITUS SEMINAR
Portland, Oregon
July 12-15, 1995
Last call for registration!
Use coupon attached, or
for more information
Call (503)248-9985, Fax (503)248-0024,
or e-mail gloria@ata.org
Tuesday, July 11, 1995
3:30- 7:00p.m.
REGISTRATION
Registration will also be open during the
meetings Wednesday to Saturday.
5:00-7:00 p.m. HOSPITALITY SUITE
OPEN (Badges required)
Wednesday, July 12, 1995
8:00- 9:30a.m. OPENING SESSION with
welcoming remarks from co-chairmen Jack
Vernon, Ph.D. and Gloria Reich, Ph.D.
REPORT FROM NTDCD,
Director, James Snow, M.D.
GUEST OF HONOR ADDRESS,
Ross Coles, M.D.
9:30 - 9:45 a.m. COFFEE BREAK-
POSTERS
9:45 - 12:00 0000
EPIDEMIOLOGY & DEMOGRAPHICS
SECTIONHEAD: Mary B. Meikle, Ph.D.
SPEAKERS: Axelsson, Davis, Gabriels,
Meikle, Nodar, Vernon
12:00 - 1:00 p.m. LUNCH
1:00-3:15 p.m. ASSESSMENT MEASURES
SECTJONHEAD: Gary Jacobson, Ph.D.
SPEAKERS: Coles, Goldstein, Henry,
Jastreboff, Johnson, Matsuhira, Mitchell,
Newman, Traserra
3:15- 3:30p.m. COFFEE BREAK
3:30-5:30 p.m. lNSTRUMENTATLON
SECTIONHEAD: Richard Tyler, Ph.D.
SPEAKERS: Davis, Feenstra, Gold, Goldstein,
Matsushima, Nunley, Roland, Steenerson,
Tyler, Vesson
5:00 7:00p.m. EXHIBITS OPEN
FREE EVENING
Thursday, July 13, 1995
8:00 - 9:45a.m. AETIOLOGY
SECTIONHEAD: Jonathan Hazell, F.R.C.S.
SPEAKERS: Ba.skill, Coles, Davis, Hazell,
Jastreboff
9:45 -10:15 a.m. COFFEE BREAK-
EXHIBITS - POSTERS
10:15 - 12:00 noon MECHANISMS
SECTIONHEAD: Aage Moller, Ph.D.
SPEAKERS: Cacace, Eggerrnont, Gerken,
Kaltenbach, Lenarz, Salvi
12:00 - 1:30 p.m. LUNCH and TONNDORF
LECTURE
SPECIAL SPEAKER: Aram Gloring, M.D.
1:30 - 3:30p.m. ANIMAL
MODEUOBJECTIVE MEASURES
SECTIONHEAD: Pawel Jastreboff, Ph.D.
SPEAKERS: Attias, Brix, Claussen, Jacobson,
Jastreboff, Martin, Rosenhall
3:30 - 3:45 p.m. COFFEE BREAK
3:45 - 5:00p.m. TMJ
SECTIONHEAD: Douglas Morgan, DDS
SPEAKERS: Goode, Morgan, Rubenstein,
Taddey
7:00p.m. WILLAMETTE RIVER CRUISES
& DINNER aboard the "Spiri t of Portland"
(Tickets required)
Friday, July 14, 1995
7:30a.m.
DAY TRIP TO COLUMBIA RIVER
GORGE & MT. HOOD Bus
leaves from front of the Marriott Hotel. Lunch
is included. (Tickets required)
8:00 - 10:00 a.m. DRUGS
SECTIONHEAD: Robert Brummett, Ph.D.
SPEAKERS: Baskill, Bayar, Coles, Dauman,
Davies, Dobie, Domenech. Hieber, Kileny,
Kit ahara
10:00 -10:30 a.m. COFFEE BREAK-
EXHIBITS - POSTERS
10:30-12:15 P.M. LEGAL AND NOISE
ISSUES
SECTIONHEAD: Ross Coles, M.D.
SPEAKERS: Axelsson, Coles, Gabriels, Griest,
Vernon
12:15-1:15 p.m. LUNCH
1:15- 4:30p.m. MEDICAUCUNICAL
SECTIONHEADS:
Abraham Shulman, M.D.
Jennifer Derebery, M.D.
SPEAKERS: Derebery, Berliner- Allergy
Gold, Gray, Jastreboff- Habituation
Almeling, Goldstein, Kraft, Seidman, Shulman,
Sheldrake, Windle-Taylor
5:30 - 8:00 p.m. HOSPITALITY SUITE
OPEN (Badges required)
FREE EVENING
(Schedule is subject to change without notice)
Saturday, July 15, 1995
8:00 - 10:00 a.m.
PSYCHOLOGICAUREHAB !LIT ATION
SECTIONHEAD: Soly Erlandsson, Ph.D.
SPEAKERS: Erlandsson, Goebel, Gartner,
Hallberg, HazeU, Jacobs, McKenna, Wayoer
10:00- 10:15 a.m. COFFEE BREAK-
POSTERS
10:15 -12:00 noon
ALTERNATIVE TREATMENTS
SECTlONHEAD: Robert Sweetow, Ph.D.
SPEAKERS: Axelsson, Davies, Gu, von
Wedel, Witt
12:00 - 1:00 p.m. LUNCH
1:00-3:15 p.m. SELF-HELP WORKSHOP
SECTIONHEADS:
Joan Saunders, M.A.
Barbara Tabachnick
SPEAKERS: Birk.ett, Dees, Druck.er, Eayrs, J.
Saunders, P. Saunders, Tabachnick
3:15 - 3:30p.m. COFFEE BREAK
3:30- 5:30p.m. SUrviMARY PANEL
DISCUSSION/PUBLIC FORUM
MODERATOR: Jack Vernon
SPEAKERS: AU sectionheads, platform
participants, poster participants and audience.
(open to all)
7:00p.m.
GALA OREGON BANQUET- A WARDS
AND ENTERTAINMENT
SPECIAL INVITED GUESTS: AT A Honorary
Board Members: Oregon's Senator Mark 0 .
Hatfield, and actor Mr. Tony Randall
At Montgomery Park Atrium, Bus transportation
leaves from front ofManiott Hotel. (Tzckets required.
one ticket included with each full registralion)