VOLUME 5, NO.

2, APRIL 1980
THE AMERICAN TINNITUS ASSOCIATION
Thank You-STYX!
Sometimes h e ~ p comes from
where we least expect it.
A few weeks ago ATA was noti-
fied that we were the recip-
ients of $1000. donated by
the ST:tX, a weU known band
who had been given the Golden
Reel Award by Ampex. ATA
extends its congratulations to
the STYX on this important
award and thanks them for
their generosity in supporting
our efforts for tinnitus relief.
Members of STYX are,Z tor:
C'huck Panozzo
Dennis De Young
Tommy Shaw
James Young
John Panozzo
* * * *
Following is an excerpt from
a letter from the Personal
Manager of STYX, Derek Sutton
The band member s of STYX have been performing extensively throughout
the United States, Canada & Europe for several years. Last year, one of
the band members developed an ear problem which sparked an interest in
the research conducted by AT A.
We believe that AT A has made remarkable progress in the research into
tinnitus and the methods of alleviating ear disorders . It is because of this
belief that -<R.e donated the funds we received from the Golden Reel Award.
The Gold Reel Award is given by Ampex, a leading manufacturer of
recordin tape, to artists who record top-selling albums on their product.
ou continued success in your research!
YOUR EAR PROTECTORS
by Robert W. Hocks, Chairman
American Tinnitus Association
The medical histories of patients with
tinnitus indicate that exposure to excessive
noise is a significant factor in at least half
the cases. Therefore, tinnitus patients must
wear good ear protection if they are likely to
have any exposure to dangerous levels of noise,
even for a short period. Ideally, no one should
subject himself to noise over 85 decibels but
this isn't always possible. Some persons must
work in a noisy environment and others won't
sacrifice their noisy recreations. Therefore,
reliable ear protection is an absolute must
whenever exposure to noise is likely to occur.
Effective ear protection must provide com-
fort, retention, and attenuation. If the device
isn't comfortable, it can't be worn cont i nuously
for long periods. If the device can't be re-
tained, then obviously it can't be effective. A
device that does not provide maximal attenuation
of sound is of little value.
Ear-protection devices come in three types.
Preformed or foam devices are inexpensive and
easily obtainable in drug stores, hardware
stores, and some sporting-goods stores. These
devices won't be helpful unl ess they are com-
fortable and easily retained in the ear . Because
of their low cost, it is possible to try various
devices to find the one that offers the hi ghest
degree of comfort, retention, and attenuation.
Earmuffs, the second type, are more expen-
sive; these can be obtained in the hardware,
sporting-goods, or safety sections of some major
stores. These are better than preformed plugs
for retention and attenuation provided there is
no excessive hair near the ears and provided
glasses with thick ear bars are not used. To
assure maximum attenuation of sound, there must
be good tension or pressure of the muff against
the head.
The third type of protectors, the custom-
molded ear defenders, cost slightly more than
earmuffs. These defenders are made of a soft
material and, because they are individually made
for each patient, provide the maximum in comfort,
retention, and attenuation . Your otologist can
fit you or recommend that this be done by an
audiologist or hearing-aid dispenser.
It must be remembered that even the best ear
protection is not effective beyond 115 or 120
decibels . The skull attenuates about 30 dB of
external sound, but when the external sound
reaches 120 dB (the average volume of a rock
concert}, then the middle and inner ear is being
subjected to the excessive and dangerous levels
of 90 dB and above.
REMINDER
Have you sent in your annual contribution?
Remember, ATA is funded by YOU. We need
money to continue to send out the News l etter
and to answer all your letters. We want to
be able to spend do l lars for research. Only
with your help can we conquer tinnitus.
Ea:t' Proteotors continued
Hearing loss from noise is insidious; it
occurs so gradually that the victim is not aware
of the day-to-day loss. The damage is irrevers-
ible. A single instantaneous exposure to exces-
sive noise has been known to cause permanent
hearing loss or tinnitus or both in some persons.
If proper ear protection had been used, millions
of hard-of-hearing persons would not have this
affliction and probably the number of tinnitus
patients would be half of what it is today.
The t i nnitus patient might experience some
apparent increase in his ear noise when hearing
protectors are used, because the ambient noise
is reduced and no longer maski ng the tinnitus.
But this is a temporary discomfort that might
prevent much future trouble.
Good ear protection is the best investment
you can make, but no device will work if it isn't
worn. Tinnitus sufferers who are exposed to
noise should have regular hearing check- ups to
ensure t hat their ear protection is effective.
MASKING
The. following is an exeerpt from a tetter from
C. Conrad Carter, M.D. which should be of
interest to persons working in the tinnitus
program.
" The practice CollJllittee of the American Academy
of Neurology on 25 January 1980 elected to
recommend that 'Tinnitus Masking' be accepted as
a legitimate and effective method of treating
tinnitus."
"It was also recollJllended that an effective ENT
evaluation be made prior to the referral for
tinnitus masking and that ongoing care and eval-
uation be provided by a physician . I believe
that the committee looked upon the tinnitus
masker much liKe one would look upon the use of
hearing aids and eyeglasses. There are certain
serious remedial diseases that may be associated
with progressive impairment of hearing, as well
as progressive impai rment of vision, and such may
be the case with tinnitus. If the symptom is not
a part of a condi tion which needs medical or
surgical remedy, then certainly the next step is
to try to relieve the symptoms with appropriate
procedures."
And, on the same subject from tinnitus patient
Mr. Joseph A. Grieser, Jr who acquired his inner
ear 'jet symphony' during service in the Air
Force.
" I saw the article in Parade magazine about the
ATA . . .. . . wrote to you and got a list of people to
see.
I went to the Christie Cl inic in Champaign, Il
and was shocked when they not only knew what I
was talking about, (tinnitus) but could actually
test and evaluate the tinnitus. Guess what? I
didn't get the ' l earn to live with i t ' routine -
I got a masker! When I put it in, I just lean
back and smile - how do you spell rel ief?
M - A - S - K - E - R
Thank you, Mr. Grieser and thanks to aU of you
who responded to the questionnaire in the last
Newsl-etter. The resul-ts are now being tabul-ated
and wilt be reported in a later issue.
ON LIDOCAINE
by Robel't E. 81'W7FT1ett, PhD
Dl' . 81'W7FT1ett , an eal'ly membel' of ATA, is well
known fol' his studies about the effects of
drugs on the auditol'y system.
The ATA has received many inquiries over the
past several months about the possibility of using
lidocaine and tocainide for the treatment of
tinnitus. The people making these inquiries became
aware of these two drugs because they have received
a great deal of publicity recently in the lay press
where they are reported to be miracle drugs for the
treatment of tinnitus. So that our readers do not
get any false hopes concerning the usefulness of
these drugs, the following comments are appropriate.
First, lidocaine is a very useful and widely
used local anesthetic. It is also commonly used to
treat irregul arities of the heartbeat. For both of
these purposes, the drug must be given by injection,
because it is not effective when given by mouth.
Tocainide is a drug that has very simi l ar properties
to lidocaine, but has the advantage that when used
for the treatment of irregularities of the heart, it
can be taken by mouth.
The association of these drugs with tinnitus
has been entirely by accident. It has been found
that a few patients who were given lidocaine for
other purposes reported that their tinnitus stopped
or was markedly reduced in severity for a few min-
utes following the drug administration. There has
never been any controlled studies performed to
verify these chance observat i ons. At the present
time, such a study is being conducted at the Depart-
ment of Otolaryngology at the University of Oregon
Health Sciences Center. Unfortunately, even if
lidocaine should prove to be effective in relieving
the symptoms of tinnitus it would not be a useful
drug for the general treatment of tinnitus for two
reasons. First, the effect, if it occurs, is only
temporary--lasting only a few minutes. Second, it
must be given in rather large doses intravenously.
It is too dangerous to administer such a drug by
this route on a continuous basis outside a hospital
because the patient could not be continuous ly
monitored.
Because of the similarity of the effects of
1 i doc a i ne to those of toea i ni de; it is fe-lt t h a ~ t - if
lidocaine can be proven to be effective for the
temporary relief of tinnitus, tocainide might also
be effective and tocainide has the advantage that it
can be taken by mouth. This would mean that patients
might be able to have their tinnitus controlled for
long periods of time by a drug that they could take
at home.
I wish to stress that even the first assumption
that lidocai ne is effective for the treatment of
tinnitus is, at the present time, unproven. If it
does prove to be effective, there are no guarantees
that tocainide will be equally effective when taken
by ~ u t h . Therefore, we are still a long way from
hav1ng an effective drug regime for tinnitus.
Tocainide is still an investigational drug for
the treatment of heart beat irregularities and is
not available for qeneral use. At the oresent time.
it is undergoing testing in a few humans to see if
it is effective for this use and if it is suffic-
iently safe for this use. All drugs are not with-
out danger and neither lidocaine nor tocainide are
exceptions.
Lidocaine continued
I wi sh to again emphasize that, at the present
time, neither drug has been proven to be effective
agent for tinnitus treatment . They are being
tested and if they should prove effective and
appropriately safe, they would only become avail-
able sometime in the future. Even in the event
that they were to be found both effective, it is
al so doubtful if they would be useful for the
treatment of all types of tinnitus .
Jack Vernon pPesenting case histories of
tinnitus patients at a r ecent workshop.
TINNITUS WORKSHOPS
by GZoria E. Reich, Executive Dil'ectol'
American Tinnitus Association
The t i nnitus workshop program continues to
provi de training in tinnitus evaluation and
management to physicians, audiologists and
hearing-aid di spensers who work with tinnitus
patients.
To date 16 workshops have been held in
various citi es around the country. Five more
are scheduled for 1980 as follows:
May 15,16
June 19,20
Sept. 19,20
October 16,17
November 20,21
Pittsburgh, PA
St. Louis, MO
San Francisco, CA
Toronto, Ontario
Phoenix, AZ
There are over 1100 persons who have come
to these workshops. Each month ATA sends their
names as referrals to t he over 1000 inquiries
that we receive.
The workshop program has proven to be an
excellent forum for the exchange of the latest
information about tinnitus.
Instructors for the program are:
Jack A. Vernon, PhD
Robert M. Johnson, PhD
Robert E. Sandlin, PhD
These men along with Robert Hocks and
Gloria Reich have travelled over a half million
miles to spread the word about tinnitus relief.
For more information you may write to:
ATA, PO Box 5, Portland, OR 97207
Bob Johnson
explains t he use
of the tinnitus
synthesi zer at a
workshop session.
LET'S LOBBY FOR OUR LAB!
by Trudy Drucker, PhD
[)r> . Drucker, ATA member and frequent contribut or
to the Newsletter act ion.
Jack A. Vernon and his dedicated col -
l eagues have been doing everyt hing they can to
hel p those of us who have tinnitus. Masking has
brought relief for so many of us, and we all
hope f or even more help in the future.
The Kresge Hearing Research Laboratory has
also hel ped profess i onals in the field to under-
stand ti nnitus better and help patients all over
t he country -- in fact, the world.
our desperately needed Lab is in danger .
Federal grants have been refused, end, although
new efforts are being made daily , there is a
cri ti cal money shortage now.
Won't you help? Just a letter from YOU
could make a real difference. Please write to
your congressman; your library or newspaper will
gi ve you t he name and address if you telephone.
Write t he strongest l et t er you can, asking for
support f or t he Kresge Hearing Research Labora-
t ory of Portl and, Oregon. Please write TODAY.
Sound Off ! -- and maybe we can get your sound
off.
TELL ME, DOCTOR . ..
Jack Vernon continues to give answers to
some of the most frequentZy asked questions
about t innit us. If you have a tinnit us
questi on that you wouZd Zike to see answered
in this coZumn pZease address your Zetter to
"Newslet ter - Mailbag Ques tions "
Q. Is tinnitus usually in both ears?
A. No, it can be in one ear only and often is.
When it appears i n both ears it may be weaker
on one side than the other .
Q. Can tinnitus be localized in the head? .
A. Yes, often patients report that the t1nn1tus
is 'filling the head' or in the center of the
head, or at the back of the head .
Q. I've been told that a hearing aid will amplify
my head noises?
A. That is not true. Only in very rare cases
does the hear ing aid exacerbate the tinnitus. In
over 900 tinnitus patients I ' ve seen only two
where hearing aids had that negative effect. In
contrast I have seen many for whom the hearing
aid rel ieves the tinnitus.
Q. How can a hearing aid relieve tinnitus?
A. If the pitch of the tinnitus is not too high,
say below 3000 or 4000 Hz, then the hearing aid
simply masks the t i nnitus by amplifying the
environmental sounds in the pitch region of the
tinnitus. So the hearing aid is simply another
form of masking.
ANNUAL CONTRIBUTION AMERICAN TINNITUS ASSOCIATION
Regular Member $ 10 or more
Sustai ni ng Member $ 25 or more
Professional Member $100 or more
Benefactor $500 or more
YOUR GIFT IS TAX DEDUCTIBLE
Do you know someone who has tinnitus and would like to receive our newsl etter?
Name _________________________________________________ __
Address ---------------------------------=----=-:-------
State, Zip
Published by the
MRICAN TINNITUS ASSOCIATI()l
A private non- profit corporat ion
under the Zaws of Oregon
Robert w. Hocks ... Nati onal Chairman
Gl oria E. Rei ch .. Execut ive Direct or
MEDICAL BOARD
B08 R. ALfORD, H. 0.
Hou-ston, Texas
Ph. D.
San Olago, C.al i rorrda
ROGER SOLES, H. O. I<AMLD G. TA8B, M.D.
San FrancJsto, Cal ifor.nia New Orleans . loui siana
1<0\IMO P. HOUSE. II. D.
los Angeles , Clifornia
ROBERT II. JOI!NSON, Ph.O.
Pot tl and . Orc90r'l
MERLE LAWRENCE , Ph.O.
Atln Arbor, Hlchig:m
JERRY NORTHERII. Ph. D.
Oenvcr, Colorado
GUNNAR 0. PROUD, >I.D.
City. 1\.lnsas
GEORGE F. REED, H. D.
Syracuse, New York
ADVI SORV BOARD
!i0NORA8LE DL CLAIISOH
Uni States
t+ouse of
OAVIO D. DeWEESE . M.D.
Portland. Or"egon
HONORI\8LE I<ARK HATF IElD
Unl ted States Senate
ROBERT II, HOCKS
Pon l:tnd, Or"egon
CHARLES UN ICE . M. D.
Downey, Ca l i (ornia
The American Tinnitus Association
Post Office Box 5
Portland. Oregon 97207
(503) 2489985