J

MARCH 1990 VOLUME 15, NUMBER,7'

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear."
NOISE INDUCED
HEARING LOSS
IN MUSICIANS
NEW DIRECTOR FOR
NATIONAL INSTITUTE
ON DEAFNESS AND
OTHER COMMUNICA
TION DISORDERS
BETTER HEARING &
SPEECH MONTH
TINNITUS IN THE 14TH
CENTURY
RESEARCH GRANT
ANNOUNCEMENTS
VESTIBULAR DISOR-
DERS
LETTERS FROM
READERS & NOTICES
SELF-HELP GROUP
NEWS
REGISTRATION FOR
JUNE CONFERENCE
TRIBUTES-SPONSORS
PROFESSIONAL
ASSOCIATES
BOOK ORDER FORM &
DUES
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lence. Because we are dedicated
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and those you serve, we believe
ALL your patients should benefit
from this newest generation of
unequaled sophistication, no
matter what they presently wear.
Starkey products, including
tinnitus maskers, are available
from your local hearing
health care professional listed
in the Yellow Pages under
"hearing aids".
Editorial and advertising offices:
American Tinnitus Association,
P.O. Box 5 Portland, OR 97207
(503) 248-9985
Executive Director & Editor: Gloria
E. Reich, Ph.D.
National Chairman: Robert M.
Johnson, Ph.D.
Editorial Advisor:Trudy Drucker,
Ph.D.
Advertising sales: AT A-AD, P. 0.
Box 5, Portland, OR 97207 (800-
634-8978)
Tinnitus Today is published
quarterly in March, September and
December. It is mailed to members
of American Tinnirus Association
and a selected list of tinnitus suf-
ferers and professionals who treat
tinnitus. Circulation is rotated to
175,000 annually.
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reject or edit any manuscript
received for publication and to
reject any advertising deemed un-
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Today does not constitute endorse-
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the advertiser's offer. The opinions
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nitus Today are not necessarily
those of the Publisher editors, staff,
or advertisers.American Tinnitus
Association is a non-profit human
health and welfare agency under 26
USC 501 (c)(3)
Copyright 1990 by American Tin-
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ISSN: 0897-6368
TINNITUS
TODAY
The Journal of the American Tinnitus Association
Volume 15 Number 2 March 1990
CONTENTS
4 NOISE-INDUCED HEARING LOSS IN MUSICIANS
6
8
9
10
12
13
14
15
17
18
19
NEW DIRECTOR FOR DEAFNESS INSTITUTE
BETTER HEARING AND SPEECH MONTH
GRANT PROCEDURES, HYPERACUSIS STUDY
PROFESSIONAL SEMINARS, YOUR DUES DATE
TINNITUS IN THE 14TH CENTURY, GRANTS
THE VOICE, LETTERS, BIBLIOGRAPHY, NOTICE
VESTIBULAR DISORDERS
LETTERS, SPONSORS, SELF-:HELP GROUPS
REGISTRATION FORM FOR TINNITUS II
TRIBUTES, PROFESSIONAL ASSOCIATES
BOOKS, DUES
Cover illustration and the illustration on page 5 are by Portland artist
Joanne Radmilovich. The photo on page 8 was taken by Robert lannazzi,
on page 6 the photo was supplied by NJDCD, and on page 13 by Paula
Bartone.
3
THE PROBLEM OF NOISE-INDUCED
HEARING LOSS IN MUSICIANS
by Phillip K. Steffan
There exists a great irony in the lives of many
modern musicians. This irony lies in that many
musicians, through abuse and overstimulation, have
incurred in themselves a noise-induced hearing loss,
the symptoms of which are tinnitus (head noises),
hyperacusis (extreme sensitivity to sound), and
dysacusis (distortion of sound or notes). These
symptoms occur either singularly or in varying com-
binations. To understand how and why these
symptoms occur, a little physiological background
is necessary.
The human ear is an incredible feat of
biological engineering. Able to detect virtually the
slightest vibrations (as little as a few moving
molecules of air) and interpret these vibrations as
sound, these same organs can also hear and interpret
sounds literally millions of times greater in terms of
sound pressure.
Problems arise when sounds become so loud
or intense that the ear cannot physically handle the
sound pressure it is being exposed to. At some point
(different ears have varying degrees of tolerance)
damage to the intricate nerve system of the ear
occurs.
Most human ears can withstand brief periods
of high intensity sound. By high intensity I mean 110
decibels or greater. But even the toughest ears will
soon weary and fatigue after too much exposure to
this type of sound.
At some point (which varies from individual
to individual) the microscopic hair cells which line
the cochlea or inner ear become damaged. When this
occurs the frequencies for which the damaged cells
were responsible are lost. In the case of most
musicians with noise-induced hearing loss (noise
referring to loud music in this case, perhaps a
debatable point to some) the frequencies from about
4
2000 to 8000Hz are the most affected. Thus the term
"high-frequency hearing loss".
This hearing loss is common among
musicians who play frequently in either nightclubs
or concert halls. Most susceptible are those
musicians whose instruments utilize the afore-men-
tioned frequencies at high volume. Electric
guitarists are one of the more susceptible groups.
The combinations of very high notes and electronic
amplification is the double-edged sword that
provides the guitarist a valuable tool of expression
but also a self-damage inflicting weapon.
Drummers also can damage their own ears
with the sound of drums and cymbals. A solidly
struck snare drum produces a wide range of frequen-
cies and cymbals are an especially high frequency
instrument. Of course, with the advent of high-
volume monitor systems &!musicians on a stage can
be subject to high intensity sound of one form or
another, be it vocals, miked instruments, or both.
The warning signs of high-frequency hear-
ing loss often occur ~ substantial damage has
already occurred. The only way to detect any loss
without symptoms is by audiometric examination.
That is why I advocate this examination on a regular
bhsis for all frequently performing musicians. If the
damage has occurred then preventive means can be
taken to eliminate any further damage. A pure-tone
test and a speech discrimination test will provide the
necessary information.
Noise-induced hearing loss refers to a ~
sorineural hearing loss. This means that nerve
damage has occurred. This damage is considered by
modern medicine to be irreversible (although certain
holistic and spiritual healing methods claim to offer
some hope). Conductive hearing loss refers to the
outer and middle ear and is not usually associated
with hearing loss due to noise exposure. Some con-
ductive hearing loss can be remedied by surgical
means.
Continued on page 5.
Most of us are familiar with at least one of
the major symptoms of excessive noise exposure.
After firing a gun or hearing an explosion of some
son, most people will experience a "ringing" sensa-
tion that generally subsides shortly. This is though
to be a fatiguing of hair cells. If this "ringing" is
experienced by a musician after at hig.h
volume, it can be interpreted as a stgn that his
hearing is being endangered. This ringing is called
"tinnitus". Tinnitus refers to head noises of all types,
including ringing, buzzing, roaring, chirping or
many other types of noises.
At frrst the tinnitus usually will subside after
a brief period of rest or especially sleep. But once
sufficient damage has occurred the tinnitus becomes
constant and chronic. It never ceases.
When temporary tinnitus is experienced by
the musician it is essential that hearing protection be
utilized. This will help prevent further damage if
used properly. Foam earplugs or custom made 'ear
defenders' are probably the best insurance against
hearing loss while still allowing the musician to hear
what he is playing. These plugs can offer up to 35
decibels of sound reduction across the entire fre-
quency spectrum. Other types of hearing protection
such as ear-molded rubber plugs and earmuffs are
available as well but might be considered too cum-
bersome or cosmetically distracting to be feasible.
Tinnitus is often the first symptom of hear-
ing loss and, as you might imagine, can
maddening. Absolute quiet is gone forever. Tmrutus
is the first thing you hear in the morning and the last
thing you hear at night. Some people are so bothered
that they need psychological counseling and/or
masking devices to substitute for the noise. The
intensity of tinnitus varies from person to person,
and become subjectively louder if more damage
occurs. These sounds can be constant or intermit-
tent; in either case they are extremely unpleasant.
Tinnitus is not necessarily the worst
symptom of high-frequency hearing loss. In my own
case, hyperacusis and dysacusis have been more
5
debilitating than tinnitus, although at times the tin-
nitus can be the most distressing.
My loss was caused by nightly exposure to
the music I played in nightclubs. I played guitar in
a pop band. Most people think of super-loud, heavy-
metal rock bands when they think of ear-damaging
music, but the music I played was often very mel-
low, some of it of moderate volume, and only part
of it was very loud. The main factor involved was
the regularity of my playing (almost every night),
and my own personal susceptibility to hearing loss.
I suffered a sensorineural "notch" in both ears be-
tween 2 and 8 Hz.
At frrst my ears would ring after I fmished
playing at night, but would be quiet in the
Having never read anything about the subject I had
no reason to assume it wouldn't always be this way.
But one morning I awoke and they were still ringing
and have never stopped since. Unfortunately, the
story doesn't end there. Although I began using
foam earplugs at this point and prevented further
damage for several years, I relaxed my guard a little
after having quit playing for about a year. I had
begun playing again and had been caught situa-
tion without my earplugs. I had moved to a different
town and had no luck in finding new plugs even after
calling a hearing specialist So I went ahead and
played a few nights without them. I soon regretted
that decision. I awoke one morning to find my
tinnitus greatly increased. I had an increased sen-
sitivity to moderate and loud noises, especially
high-pitched ones, and I noticed an audible distor-
tion of sound, especially music and women's
voices. It was as if my ears were like speakers
whose fabric had torn.
These symptoms are supposedly per-
manent. This has drastically altered my career as
well as my life in general. I can no longer attend
events with high ambient noise levels without dis-
comfort. Crowded rooms become intolerable.
Music played at anything other than low volume is
painful, as well as distorted. The constant noise in
my head makes relaxation difficult.
Some of the world's prominent musicians
have also experienced this dilemma. Probably the
most notable is the Who's Peter Townshend. In
interviews he has discussed the same problems I
mentioned. His band played at extremely high
volume n.ight after night on concert tour.
Townshend also admitted to listening to music on
headphones at a very high volume. He now rehear-
ses in a specially designed soundproof booth to
avoid further hearing damage.
The point I'm trying to make is this:
PREVENTION and EDUCATION are the best
tools for fighting hearing loss. If a musician current-
ly plays in a band that operates at high volume, he
should consider either lowering volume, wearing
hearing protection religiously, or actually quitting
that group and joining one that plays at a tolerable
sound level. He should also consider the ears of his
audience. They are probably even less aware of
possible hearing damage from the music.
I found out the hard way. There is no known
cure for sensorineural hearing loss, although people
like myself always hope for some sort of medical
breakthrough to improve our condition. I hope the
lesson I've learned and talked about can prevent
other musicians from damaging their most prized
possession; their gift of hearing.
6
JAMES B. SNOW JR. , M.D.
NEW DIRECTOR TO LEAD
NATIONAL INSTITUTE ON
DEAFNESS AND OTHER
COMMUNICATION DISORDERS
HHS Secretary Louis W. Sullivan, M. D.,
has announced the selection of James B. Snow Jr.,
M.D., as the director of the National Institute of
Deafness and Other Communication Disorders
within the National Institutes of Health.
The NIDCD was established in October of
1988 by Congress to increase emphasis on research
and research training with respect to hearing and
other communication processes including diseases
affecting balance, voice, speech, language, taste,
and smell. As director, Dr. Snow will be responsible
for the development, implementation, and evalua-
tion of institute programs to conduct and support
biomedical research, research training and public
health information in these areas. Current initiatives
of the Institute include the development of a strong
science base through investigator-initiated re-
search, training the next generation of scientists and
physician investigators, the development of multi-
purpose centers, a major consensus conference on
noise and hearing loss, the establishment of a Na-
tional Information Clearinghouse on deafness and
communication disorders, and a major education
and prevention campaign on communication disor-
ders."The U.S. Public Health Service is fortunate to
have such an outstanding physician as the first direc-
torofthenewestofNIH's 13 institutes," said James
0. Mason, M.D., llliS assistant secretary for health
and acting surgeon general.
Dr. Snow received his M.D. cum laude from
Harvard Medical School in 1956. He conducted his
internship in surgery at Johns Hopkins Hospital in
Baltimore and his residency and research training in
otolaryngology at the Massachusetts Eye and Ear
Infirmary in Boston. In 1960, he served as a captain
in the U.S. Army Medical Corps. After two years,
he returned to his home state of Oklahoma and began
work at the University of Oklahoma Medical Center
in 1962. Ten years later, Dr. Snow moved to
Philadelphia to become professor and chairman of
the department of otorhinolaryngology and human
communication at the University of Pennsylvania
School of Medicine. Dr. Snow is also the medical
director of both the Smell and Taste Center and the
Speech and Hearing Center of the Hospital of the
University of Pennsylvania. He holds general
hospital appointments with the Children's Hospital
of Philadelphia, the Graduate Hospital, the Pennsyl-
vania Hospital, and the Presbyterian-University of
Pennsylvania Medical Center.
During the past 20 years, Dr. Snow has
specialized in the hearing and speech sciences and
cal Sciences in China in 1985, was an honorary
fellow with Japan's Broncho-Esophagological
Society, and holds an honorary Master of Arts de-
gree from the University of Pennsylvania. He has
helped establish the world wide status of training
accreditation and specialist certification in the field
of otorhinolaryngology. Dr. Snow serves on the
editorial board of Chemical Senses and is historian-
editor of the American Laryngological Association.
Dr. Snow is a member of or holds official
positions in numerous professional societies includ-
ing the American Association for the Advancement
of Science, the American Academy of Otolaryngol-
ogy-Head and Neck Surgery, the American Board
of Otolaryngology, and the American Academy of
Facial Plastic and Reconstructive Surgery, the
American College of Surgeons, the American Medi-
cal Association, the American Neurotology Society,
and the Association for Research in Otolaryngology.
Dr. Snow has resided in Philadelphia with
his wife and has two sons and one daughter.
As director of NIDCD, Dr. Snow will
replace Jay Moskowitz, Ph.D., who has been acting
director for the new institute since his appointment
shortly after former President Reagan signed the
establishing legislation in October of 1988. Dr.
Moskowitz continues as associate director for
science policy and legislation for the National In-
stitutes of Health.
the chemosenses (taste and smell). He has published ..------------------......
over 175 articles, books, and abstracts about his
specialty areas and research findings which include
studies on radiation therapy and cancer of the head
and neck, blood flow in the cochlea, infections of
the ear and nose, effects of noise on hearing, surgical
therapy for voice problems, effects of aging on
hearing and the chemosenses, sudden deafness, and
diagnoses of communication disorders.
American Tinnitus Association
is a participant in the
Combined Federal Campaign
#0514 in the CFC Brochure
Dr. Snow was a 1970 recipient of the
Regents' Award for Superior Teaching at the Thank You For Helping
University of Oklahoma, held a consulting profes- To Fight Tinnitus
sorship at the Shanghai Second University ofMedi- .._ _________________ _,
7
MAY IS BETTER HEARING AND SPEECH MONTH
"L.A. Law" star Richard Dysart and 5-year-old Kimberly Bloss of Colorado Springs, CO, are the poster
people for Better Hearing and Speech Month. They will represent more than 24 million Americans with
communication disorders in this year's public information campaign.
Attention ATA self help groups and volunteers; you can help bring the better hearing message to your
community by asking your local stations to play ATA's public service announcements during the month of
May and by distributing literature from AT A and the Council for Better Hearing & Speech Month at various
public meetings and locations. Please call or write for further information. A TA national office (503) 248-9985,
or Council offices 1-800 EAR WELL.
TINNITUS II EASTERN REGIONAL CONFERENCE
Chairman Ed Gautier reports that plans for the Tinnitus II Eastern Regional Conference are moving on
target. Eight health professionals, mostly M. D.'s have accepted invitations to make presentations at the meeting.
Other health care experts will be leading seminars, workshops, or panel discussions. Dr. Entique Mendez, Jr.,
Major General, U.S. Army Retired, presently Principal Deputy Assistant Sectrtary of Defense for Health
Affairs, will be the Conference's luncheon speaker. Dr. Mendez has been nominated by President Bush to the
position of Assistant Secretary of Defense for Health Affairs and is currently awaiting confirmation by the U.
S. Senate. Be sure to save June 9, 1990 to attend this most important meeting. Registration information is
available from this office or by contacting the planning committee at (301) 248-7694. The conference is for
people who have tinnitus, their families and friends, and for those who treat tinnitus. Workshops, displays,
and lectures about tinnitus will be conducted throughout the day long event Remember: June 9, 1990, at the
Quality Hotel Capitol Hill, 415 New Jersey Ave NW, Washington, D.C. Pre-registration deadline to take
advantage of the lower price of $15.00 is March 31, 1990. Registration after March 31 is $25.00 per person.
(see registration form in this issue)
8
TINNITUS RESEARCH GRANT
APPLICATION PROCEDURES
Proposals for scientific studies about tinnitus
are presently being considered by the American
Tinnitus Association. Studies must be directly con-
cerned with tinnitus and most favorable attention
will be given to clinical studies and/or projects with
budgets under $10,000. Please note that ATA does
not provide funds for overhead, principal inves-
tigators salary, or other indirect costs.
AT A does not require a formal proposal
statement but expects from applicants a concise
written proposal containing essential elements as
follows:
Introduction and statement of the problem.
Discussion of relevant literature.
Specific testable goals and objectives.
Procedures
Design of the study.
Sampling and measurement data.
Plan for analysis and evaluation.
Time schedule.
Personnel and facilities
Who will do the study?
What are their qualifications?
What institution will administer the funds?
Budget
Studies with budgets of $10,000 or less are
most likely to be considered. If the proposed study
will require a larger budget or take longer than one
year please explain the circumstances for further
consideration.
Use of the study
End product envisioned
Scientific advisory board members of AT A
are asked to read and comment on proposals sub-
mitted. Board members will not be asked to read
and comment on proposals from their own institu-
tion. Final acceptance or rejection of a proposal
rests with the AT A board of directors.
9
Conditions concerning ATA research funds
are that the money be spent in accordance with the
budget submitted with the grant proposal. Any
changes in budget, personnel, or objectives of the
project require prior approval of AT A. A financial
report as well as the final report on the project is to
be submitted to ATA at the end of the grant period,
(normally one year). Unless authorized by ATA
unexpended funds must be returned to A TA with the
expenditures report at the end of the grant period.
Grants can be made only to non-profit tax-
exempt institutions, public or private, to support
research directed at those institutions by inves-
tigators who are on their staffs or are otherwise
formally attached to them.
Publications resulting from work supported
in whole or in part by the American Tinnitus As-
sociation should contain a credit line to that effect.
A copy of the publication should be submitted to
AT A.
Investigators are expected to make the
results of any publishable research promptly avail-
able to the scientific public and if the fmal report of
the project is not readily understandable by the lay
public, to provide a short summary of the work in
laymen's terms for publication in the ATA journal
Tinnitus Today.
HYPERACUSUS PILOT STUDY
If you suffer from hyperacusis and would
like to participate in a pilot survey to try to find out
more about the problem, please contact the national
office . Confdential surveys are being collected and
will be analyzed at the Oregon Hearing Research
Center.
WE
SUPPORT
UNDERSTANDING AND TREATING
TINNITUS
A SERIES OF SEMINARS
AT A is presenting a series of professional
seminars to provide useful information about tin-
nitus to those having professional and clinical inter-
est in its cause and treatment. These seminars
present a basic core of knowledge permitting the
hearing health professional to construct or recom-
mend an effective patient management program
which best meets the needs of those served. These
seminars are being held at various locations. The
first was held in San Francisco in March. The next
scheduled seminar will be in Chicago, illinois in
October 1990. Continuing education credit from
ASHA, NHAS, and state examining boards is avail-
able. Each seminar lasts a day and a half. Tuition is
$150.00 which includes an extensive syllabus.
Please write or call for further information. ATA, P.
0. Box 5, Portland, OR 97207. (503) 248-9985.
YOUR DUES MAY BE DUE- HERE'S
HOW TO CHECK YOUR
ANNIVERSARY DATE
At the suggestion of one of our members,
the mailing label has been redesigned to show the
date of your last contribution to ATA. A quick look
at the label on the back cover and you '11 be able to
tell whether it is time to send in your dues and keep
your membership active. The numbers above your
name represent the date of your last contribution.
You can decipher the numbers as follows: YYM
MDD, Y=year, M=month, & D=day.
890601 would mean that your last donation was
recorded on June 1, 1989. If no numbers appear, this
issue is complimentary.
You may use the form on page 19 to join or
to renew your membership and assure receiving
each issue of Tinnitus Today.
Mail your check today!
"COPING WITH TINNITUS""
e STRESS MANAGEMENT & TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT fROM THE
STRESS Of TINNITUS WITHOUT COMPLEX
INSTRUMENTATION & VALUABLE OffiCE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids, tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered can be performed daily in the
\ patient's home environment It has been demonstrated that the relaxation response can release muscle
\"' c::.. tension, lower blood pressure and slow heart and breath rates.
1:. A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
;:::7 .,. .. p.. has successfully treated for many years chronic pain, tension headaches, insomnia and many other

50
conditions. . ..
.. 1.. The program consists of one cassette tape of Metronome Relaxation and two add1ti<!nal
tapes of unique masking sounds which have substaf!tial benefit the
p;SSCXJATfD ""'' th nood of odd!Oonol reH< Th"' '="''""' bo ""d to mdu ''"P'"9 ., =thmg
backdrop for activity and can be played on a simple portable cassette player.
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10
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These satisfied customers
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What is tinnitus? It's a subjective
experience of hearing a sound, ring,
or a noise when no such external
physical sound is present. Some call
it head noises, "ringing", or other
similar things. The Oregon Health
Science University.
TINNITUS IN THE FOURTEENTH
CENTURY
by Trudy Drucker, PhD.
The interesting note from Mary F. Carvalho
in Tinnitus Today 14:3 (September) 1989 about a
reference to tinnitus in a book by Teresa of Avila
(1515-1582) encouraged me to track down another
clear reference to tinnitus in medieval times.
Margery Kempe of Lynne, England, was a
Fourteenth Century autobiographer and self-styled
mystic. She could not read or write, but was able to
persuade two clerics to record, in the third person,
her conversion to Christianity and her experiences
of direct communication with God. In 1934, the
scholar Hope Emily Allen discovered Margery's
diary, and it is an astonishing document. Margery
was certainly mentally ill, and religion provided the
armature for symptoms. I described these in 1972
(New York J.Med. 72:3).
Margery had a dismaying habit of staging
crying fits in public, usually when she was ap-
proaching a religious shrine (she travelled widely)
or was hearing a sermon. She had epileptiform
seizures, lapses of consciousness, visual hallucina-
tions that resembled classical migraine attacks, and
auditory hallucinations that she interpreted as direct
messages from Jesus but which can now be clearly
recognized as tinnitus.
"This creature had various tokens in hear
hearing. One was a kind of sound as if it were a pair
of bellows blowing in her ear. She- being dismayed
at this - was warned in her soul to have no fear, for
it was the sound of the Holy Ghost. And then our
Lord turned that sound into the voice of a dove, and
afterwards he turned it into the voice of a little bird
that is called a redbreast, that often sang very merrily
in her right ear. And then she would always have
great grace after she heard such a token. She had
been used to such tokens for about twenty-five years
at the time of writing this book."
Margery's "conversion" began after the birth
of her first child. She exacted a pledge of chastity
from her husband, and embarked on a lifetime of
imitating the mystical experiences of, for example,
the Thirteenth Century Benedictine nun St.
Gertrude, whose Revelations she surely heard of,
and the celebrated Julian of Norwich. The latter two
women are venerated by the Catholic Church, but
modern Catholic scholars now view Margery as a
victim of religious hysteria. She skillfully incor-
porated her various physical problems into a well-
structured pattern of hallucination, and the pleasure
and "secondary gain" she achieved from her tinnitus
must have made those bird-chirps tolerable and even
welcome.
RESEARCH GRANT
ANNOUNCEMENT
An AT A research grant has been made to Dr.
Gary Jacobsen at the Henry Ford Hospital in Detroit,
Michigan for a study titled "N euro-magnetic record-
ings of auditory evoked cortical fields (AECF) in
tinnitus and non-tinnitus groups." Successful com-
pletion of this study should provide information for
the objective measurement of tinnitus.
12
Research funding for a study of "Supression
of tinnitus through electrical stimulation", has been
granted to Dr. Jack A. Vernon at the Oregon Hearing
Research Center. In this study they hope to identify
a safe and effective waveform for tinnitus supres-
sion. If such can be demonstrated, then development
of a wearable commercial unit can be undertaken.
Research funding has been made to Dr.
Donna Wayner at the Albany Medical Center, Al-
bany, New York; and fellowship funding to Dr.
Richard Hallam of the Royal National Nose, Throat
and Ear Hospital, London, England, to conduct a
clinical study entitled "Cognitive Therapy for Tin-
nitus". From this study Dr. Wayner hopes to
develop a study guide for professionals interested in
the use of cognitive therapy for tinnitus.
THE VOICE SETS SAIL IN CORPUS
CHRISTl
The Voice, a national magazine about hear-
ing loss, has expanded circulation and enhanced its
format to better serve its readers. "In today's infor-
mation age, without knowledge and access to the
constantly emerging technology available, a large
number of people with hearing loss will be left in
isolation," says Paula Bartone, editor. "We offer an
opportunity for deaf and hard of hearing people to
learn about the many options open to them."
Included in the broad range of areas covered
by The Voice are historical biographies about such
hearing impaired geniuses as Thomas Edison,
Beethoven, and Francisco de Goya. The latest in
entertainment, education, captioning, research, and
tips on coping assist readers in living successfully
with hearing loss.
Based in Corpus Christi, Texas, the
magazine is published by Voice International Pub-
lications, Inc. a privately owned Texas corporation.
Subscription rate is $14. annually. For more infor-
mation: The Voice, P. 0. Box 2663, Corpus Christi,
TX 78403-2663.
LETIERS FROM OUR READERS
Dear sirs:
Just a note to say
that somewhere inside
some indeterminable part
of me resides a phantom Cicada
who, unceasingly, sizzles away
its fraction of eternity.
Suffice it to say, were it not for
that shrill, disconcerting succession
of sibilants - the static blizzard
of esses and zees which constitutes
the sounds of some psycho-diabolical
wizard's machinery -
I could, perhaps, consider the sorcery.
Sincerely!
BIBLIOGRAPHY SERVICE
ATA's Tinnitus Bibliography service may
be used in two major ways: 1) Purchase of the
complete bibliography (a list of approximately 1800
writings relating to tinnitus, including author, where
published and date of publication) at a price of $25
to ATA members, or $50 to non-members. 2)
Specific topic list. You may request a subject search
list (if you want only one or two specific topics) at
a charge of $5.00 per topic.
Hard copies of articles may be selected and
ordered from these lists. Our charge for copying the
articles is $0.10 per page, plus postage and handling.
NOTICE
The American Tinnitus Association does not
endorse products. From time to time you may see
advertisements promising a relief or cure for tin-
nitus. We suggest you contact your personal
physician who can help you decide whether or not a
product may be beneficial in your particular case.
13
VESTIBULAR DISORDERS: WHAT
THEY ARE, WHAT CAUSES THEM
'
AND HOW TO GET HELP
by Charlotte L. Shupert, Ph.D.
Everyone knows that ears are for hearing,
but most people are not aware that the inner ear has
a second important function. The inner ear is a
complex structure of fluid-filled tubes and chambers
located within the skull. One of these structures, the
cochlea, is responsible for hearing. The other parts,
called the vestibular system or the labyrinth, are
responsible for balance in walking and standing and
the control of some kinds of eye movements.
The vestibular system contains delicate
structures that detect the direction of gravity and
signal the speed and direction of head movements.
Signals from the vestibular system make it possible
for animals and humans to balance their bodies over
their feet and to see clearly while moving about.
When the vestibular system or the nerves that con-
nect it to the brain are damaged by disease orinjury,
the result can be devastating.
The most common complaints associated
with the disorders of the vestibular system are diz-
ziness and imbalance. These symptoms can be as
mild as a momentary sense of disorientation or as
severe as a violent spinning sensation that makes
even sitting upright in bed impossible. The in-
cidence of vestibular disorders has not been ac-
curately measured yet, but statistics indicate that
vestibular disorders occur frequently. In 1985, over
5 million Americans sought medical help for dizzi-
ness, and about 10% (500,000) of these patients
were disabled by their symptoms. In 85% of patients
with dizziness, the symptoms are caused by a ves-
tibular disorder.
Vestibular disorders have a variety of
causes. Bacterial or viral infections of the inner ear
and damage resulting from head blows are the two
most common causes. Less often, allergies or dis-
14
eases of the immune system are at fault. Some
vestibular disorders appear to run in families.
Tumors on the nerve leading from the inner ear
(called acoustic neuromas) may also cause ves-
tibular symptoms. Finally, the cause of some disor-
ders is unknown.
Vestibular disorders are usually diagnosed
by an ear specialist, after the patient's regular doctor
has ruled out other causes for the symptoms. The
specialist will take a careful history of the problem,
and may order special tests. Once the diagnosis is
made, treatments specific to the disorder will be
prescribed. Drugs help in some cases; special diets
or exercise regime help in others. If symptoms are
severe and do not respond to conservative treatment,
surgery may be required.
Despite the fact that medical help is often
available, dealing with dizziness and imbalance
presents a formidable challenge for patients and
their families. Dizziness can result from many
causes, so getting a diagnosis is sometimes a lengthy
and expensive process. Also, dizziness is a common
complaint, like headache or low back pain, and the
patient's symptoms are often not taken seriously.
For many disorders, the recovery process is slow,
and not all patients respond to treatment.
Fortunately, there is help. The Vestibular
Disorders Association was formed in 1983 in order
to help patients and their families cope. The Associa-
tion sponsors support groups for patients and their
families. The Association also distributes a quarterly
newsletter to members and produces books,
pamphlets and videotapes containing useful infor-
mation about vestibular disorders. For more infor-
mation write to the Vestibular Disorders
Association, 1015 N. W. 22nd Ave, D-230,
Portland, OR 97210-3079, or call (503) 229-7705.
(Charlotte L. Shupert is a research scientist and a member of
the VEDA board of directors.)
LETTERS FROM OUR READERS
Dear Dr. Reich,
Yes, I have tinnitus and it is becoming more
intense in one ear. A few years ago I got one hearing
aid, which was all I could afford, although
audio grams showed that both ears had almost a total
loss above 2 Hz.
Because I work with frequency generators, I
knew that I had "islands of hearing" in both ears at
higher frequencies. Audiologists could not measure
these islands because they were between the set
frequencies of their instruments. Although my
speech discrimination was poor, I could use the
phone with either ear and tinnitus was similar in
both. Then I got an aid for my left ear.
Now, after about two years with an aid, I
cannot measure an "island" in my left ear nor can I
use a telephone with that ear. Guess which ear has
the most intense tinnitus? I can determine that there
is an "island of hearing" in my right ear between
7,100 and 7,900 Hz but the audiologists have no way
to quantify it. My recent loss of high frequency
hearing and increase tinnitus are apparent to me but
can't be documented.
Is it not strange that so many fundamental
questions remain unanswered in the field of auditory
science? What is tinnitus? How can we normally
hear the low intensity sounds that we do? What is:
Deafness? Summation effect? Two-tone suppres-
sion? Why does a fundamental assumption concern-
ing the inner hair cells of the cochlea, that was made
over 50 years ago, remain essentially untested? Is it
possible that tinnitus is a good-sign? Can certain
types of tinnitus be an indicator that the basic hear-
ing mechanism is functioning? G.O., Ph.D.
(editors note: AT A will be happy to forward any comments to
Dr. 0.)
15
ATA SPONSOR
MEMBERS
DECEMBER 1989
TO MARCH 1990
JosephAiam
David M. Alexander
Jesse L. Alexander
Ralph Arnold
Kristin Bayless
Arnold Bellowe
Antoinette Buhr
Raymond Buse
Louis Carro
William K. Carson
Leigh E. Christensen
Barry Christensen
Stephen Cornell
Patrick Costigan
John W. Crlsanti
Rick Dilslzlan
Randall C. Ducote
Frederick Elkind
Robert Farland
John W. Finger
Patricia S. Fink
Jean Fockele
ArthurGelb
Andrew R. Gillin
D. Petgrave Gray
John Hafer
William Haskin
Charles & Kathleen Hauser
Dan Robert Hocks
Fred Isabella
John H. Jessen, Sr.
Delbert Johnson
Dr. Khairy A. Kawl
Mr.& Mrs. Eugene Kerley
Charles W. Kiker, Jr.
Charles Kostel
Robert M. Kyvik
Bob Lalemant
Herman LaVine
Duane Logsdon
Vince Mangus
Thomas B. Martin
Donald Me Clay
John Meehan
Phyllis E. Meier
Carle Middlekauff
Martin Monas
T. A. Ornelas
James Ortaslc
Allan Pacela
John & Sara Patterson
Henry B. Peacock, Jr.
Harvey A. Pines
Allen Polhemus
Kenneth A. Preston
Ronald Rohleder
Nancy M. Rosen
Gayle Sanders
Rick Sarkisian
Wanda Shannon
Mrs. A. B. Shields
K. Thomas Shipley, Jr.
G. E. Shultz
Charles H. Smith, Jr.
Luther J. Smith II
Michael Smith
Patricia Smith
Larry Spoden
E. Boyd Stagmer
Richard SWenson
Morton Tabak
Leon & Carol Tager
Arthur Teague
Will iam R. Tower, Jr.
Donald Ubell
Jaranan Vanichanan, M.D.
Arthur Verharen
Jack A. Vernon, Ph.D.
Duane D. Walters
Robert Weimer
C. E. Xenopoulos
Lawrence Yont
SELF-HELP NEWS FROM ATA
TINNITUS SUPPORT GROUPS
From time to time we collect enough infor-
mation from the self-help groups to produce this
column to provide a report of their activities. It is a
good opportunity to share ideas and get inspiration
about future projects.
We currently have on hand a limited number
of copies of a pamphlet entitled "A Layman's Guide
to Tinnitus and How to Live with It," by Robert
Slater, a group coordinator for the British Tinnitus
Association. We are making these available to group
coordinators (limit one per group) on a first come,
first serve basis.
ATA will continue to send you as many
copies as you may need of our free brochures,
(describing the organization and its purpose with the
detachable card to mail for further information).
However, we have a new flyer designed to facilitate
the ordering of our other brochures. We hope to
accomplish two things: I) To help pay for the print-
ing costs, and 2) To encourage subscriptions to our
journal "Tinnitus Today." We appreciate your as-
sistance in implementing this new policy.
TAMPA BAY AREA
The flrst phase of research testing of David
Findlay's relaxation tape was concluded. The result
of the testing was that some of the participants were
helped to achieve deeper relaxation.
This group has also kept itself busy assisting
on arrangements for the "Tinnitus II Eastern
Regional Conference," to be held in Washington,
DC June 9, 1990.
SOUTHERN VIRGINIA
Before taking a winter break, members
shared results they have had with drug therapy.
Personal testimony about what has helped or hurt
people cope with tinnitus has been a popular group
activity.
BERGEN COUNTY
Members heard speakers James E.Gelman
and Richard Zimmerman, both attorneys, at their
February meeting, on the topic "Your Legal Rights:
Noise, Hearing and Tinnitus."
Coordinator, Trudy Drucker's article, in
which she explores the frustration of being subjected
to constant noise from the environment, and ap-
plauds the Supreme Court's decision to allow NYC
to limit the volume of rock concerts in Central Park's
open bandshell, appeared in the NY Times Dec. 10,
1990.
WASHINGTON METRO AREA
This group is developing an audio tape
library. Members can check out, or make copies of,
tapes of speakers, environmental sounds, and stress-
reduction messages.
The December meeting brought Bill Fuller
to the group as a speaker on Trigger-Point
Myotherapy, (muscle treatment to ease spasms and
tension). In January, members deepened their
knowledge of the workings of the ear by hearing
Dr.Bloom speak.
Members of this group are active on the
Tinnitus II planning committee.
DELAWARE VALLEY
This Elwyn Institute based group is also
participating in the planning of the "Tinnitus II
Conference."
BIRMINGHAM
Faye Churchill, coordinator/audiologist,
says her group meets with the local SHHH group for
some activities.
FT LAUDERDALE
Coordinator, Glenna Ehret, and Larry
Brown brought questions from the group to the
Cedars Medical Center Tinnitus Meeting on
February 2, in Miami Beach. Although time did not
permit discussion of all that were presented, respon-
ses were provided to many. The group may also
address questions to the other hearing professionals
who participated in the meeting.
NEW GROUPS
New groups are forming in the following
areas: Mesquite,TX; Fargo, ND; Bloomfield Hills,
MI; Columbia, SC; Port Richey, FL; and Pittsburgh,
P A. If you would like more information or to be-
come involved in starting a group, please contact our
national office.
16
TINNITUS II EASTERN REGIONAL CONFERENCE
TINNITUS II EASTERN REGIONAL CONFERENCE, a one day seminar providing edox:ation and increased advoacy for people with ring1ng in the ears and head noises, is being
sored by a consonum of self-help groups 1n me Eastern Seaboard states, affiliated with the Amencan T1nnitus Assoeiaton. The Fort Washtngton Tinnitus Croup in Maryland serves as
host The Conlerff!C\' will be held at me Quahty Hotel Captol Hill, 415 New Jersey Ave. NW, Washington, D.C. 20001 on June 9, 1990.
The Conlerfflet' will generate community and public suppon while providing a forum lor tinnws sufferers, offerng informatiOn on me latest development. advances and research in
th1s area. as well as suggested merapes for the alleviauon of ttnn1tus.
Concurrently With morn1ng and afternoon speakers will be Exhib11:S and Worl<shops. There will be a luncheon with an address by a well known personality.
Pie- cu1 Ofl cloned liM
REGISTRATION FORM
!Complete a separate reg1stration fonn for each anendee. If add1110nal fonns are requ1red, photocopy.)
TINNITUS II EASTERN REGIONAL CONFERENCE
SATURDAY, JUNE 9. 1990
QUALITY HOTEL CAPITOL Hill
Washington, D.C. 20001
1-800.22851 51
Pre-registration Deadhne:
March 31, 1990
S 15.00 per person now mru
March 31, 1990.
S25.00 per person after
March 31, 1990
I plan to attend the TINNITUS II conference and understand I mUSl repon to me registration desk upon amval.
LUNCHEON:
Early Regstrani:S:
After March 31 :
S10.00
S15.00
DO NOT SEND CASH I SEND PAYMENT ALONG WITH COMPLETED REGISTRATION FORM TO: TINNITUS II EASTERN REGIONAL CONFERENCE, P.O. BOX 441228, FORT
WASHINGTON, MARYLAND 20744
NAME (PLEASE TYPE OR PRINT PLAINL Yl
ADDRESS
NAME & LOCATION OF SUPPORT OR SELF HELP GROUP
(..-)PLEASE CHECK APPROPRIATE BLOCKS
DATA MEMBER
0 I do not have T1nn1tus but I
am a fam1ly member or f"end.
OO!he<
0 Ttnnitus Sufferer
WORKSHOPS, SEMINARS & PANELS !Please IndiCate your preferences in numerical order).
1. COPING STRATEGIES:
0 Mental Health Aspeas of Ttnnttus
0 Exerctse & Nutrtton
0 AlcohoVOrugs & Tinnttus
II. REHABILITATIVE PROCEDURES:
0 Drug Therapy
0 Cochlear Implants
0 Dental Treatments
111. OTINNITUS RESEARCH
IV. 0 MASKERS & HEARING AIDS
0 Support Faciltues
0 Psycho-soctal Impact of Ttnnnus
0 Noise & 13 Consequences
0 Electrical S11mulation
0 Autosuggestionlboleedback
V. OOTHER: _________________ _
I WOULD APPRECIATE YOU SENDING ME LITERATURE ON THE FOLLOWING:
0 local TransportatiOn and Parkng (local buses/transit lone require exact change).
0 Travel lnfonruotoon.
Hott1 ,_,...,""''mull bot <NM dorftjly by altona the QUALITY HOTEl CAPITOl HIU ...,.
DONATIONS
0 I can not 'nffld me conference, but I would be onterested in having my name l1sted on your progr;am as a Donor.
ADVERTISING
I would be onterested n advertosong on your program
0 Full Page (8x10l S100.00
SPONSORSHIP
0 Half Page (8xS) $60.00
I STATE
0 T1nn1tus ServiC\' Provider
0 Stress Management
0 Family Suppon Systems
0 Medical Treatments
0 Cognitive Therapy
0 Busoness Card S25.00
I ZIP CODE
We would apprecoate sponsors for our conferffiC\' luncheon, or our Friday night cocktail reC\'I)toon (618). For a $50.00 minomum you and your organtution will be listed in our program
and pubhcly at our luncheon.
TOTAL ENCLOSED:
Registration
luncheon
Donation
Advenisin'
Sponsorship
0 S ----per person - ---people
0 S per person people
(SSO.OO Minimum)
17
TOTAL
$. ______ _
TRIBUTES
The A TA tribute fund is designated 100% for research. Thank you to all those people listed
below for sharing memorable occasions in this helpful way. Contributions are tax deductible and
are promptly acknowledged with an appropriate card. The gift amount is never disclosed.
IN MEMORY OF CONTRIBUTOR IN HONOR OF CONTRIBUTOR
Michele Aliperti
J.A.l. Baigrie
Lowell Bank
D. Boese
Mabelle C. Boomker
Graham & James Bullock
Nancy Currey
Marion E. Frego
Your Dear Mother Freud
Paul Griffiths
Your Dear Husband Hirsch
Your Mother Hosbach
Aorenoe S. Hostetler
Neal B. Kaplan
Paull Keller
Your Father Kendis
Your Dear Sister Kohn
Casimir Kowaleski
Craig Lassen
Sister Ueberman
Mother & Father Upschitz
Thomas Marshall
Audrey E. Meredith
Thomas Orr
Robert Palmer
William C. Pannill
Veronica Perusina
H. G. Peters
Shirley Plazzo's relative
Anne Richardson
August Richebacher
Donald Robert
Donald Robert
Dorothy V. Rohleder
Samuel Rosenbach
Your Dear Father Rosenthal
Your Dear Father Rosenthal
leonard Sabatino
Colleen Schlater
Jeff Schroeder
Michael Smith
R. Blair Smith
Robert B. Torp
Edgar Tunsch
Your Mother Warshauer
Philip Wilder
Kenneth Wilson
Harvey Wilson
IN MEMORY OF Patrick Bayless
CONTRIBUTORS
Amy L Senger; Floyd & lois Johnson
Junella Bernard; Tropical Fisheries
Kristin Bayless; Capitol City Hatchery
Eagle Pet Supply; M. Julie Berkeley
Northtown Merchants Association
Douglasltlancy Herrboldt; Laura Johnson
Jonathan.Ueanna Hartman; Donald Oakes
Anthony Alipertl
Frances Janiga
WM Efrom Abramson
Joe Alam & Trudy Drucker
Honore Martin
Joan T rnovsky
Mike Carol & Rob Ayers
Clarence Robillard
Jean & Joe Wolfson
Richard Adams
Jean & Joe Wolfson
Barbara & Bernard Zimmerman
Shirleyann Hostetler
Woody Kaplan
Richard Keller
Jean & Joe Wolfson
Jean & Joe Wolfson
Ted Kowaleski
WM Edmund lassen
Marc Ruff
Dianne Egherman
Donald M. Bowman
Mrs. B. H. Johnson
Mr & Mrs John Schlater
Elizabeth H. Palmer
F. H. Pannill
Anne Marie Story
Leona M. Rodwell
A Friend
Marion Anderson
Dennis Richebacher
MIM Kenneth Knowles
Women of the Moose
Ronald L Rohleder
Dorothy Jacobson
louise, Suellen & Jeffrey
Jean & Joe Wolfson
Bergen Tinnitus Group
WM John Schlater
John & Faye Schlater
MIM len Mayer
Agnes B. Smith
Mrs. Robert B. Torp
Augusta Tunsch
Barbara & Bernard Zimmerman
Donalee Julian
Joan Wilson
Usa Wilson
Wade & Annetter Bjergo
La Verne E. Johnson
Warren & Janice Johnson
Stanley & Gail Gunderson
Gertrude M. Finberg
Eddie & Donald Pelkey
Donald & Doris Hansen
David & Sally Johnson
18
Special Project
Dr. House & Dr. Derebery
Vicki & Tom Akers
Vicki & Tom Akers
Jo Alexander
Bill Allin
Mother Atkins Speedy Recovery
larry Auerbach
Morris Blkumenfeld Speedy Recovery
Mrs. Joseph Brodsky Good Health
Norman Brokaw
Mary Cassel Birthday
Mother Cassis' Speedy Recovery
Aldo Coelho, M. D.
J. P. Doyle, Recovery
Trudy Drucker, Birthday
Trudy Drucker, Birthday
Trudy Drucker, Birthday
Trudy Drucker, Birthday
Trudy Drucker, Birthday
Trudy Drucker, Birthday
Trudy Drucker, Birthday
John Emmett, M.D.
John Emmett, M. D.
John Emmett, M. D.
Wendy Ferrell, M.D.
Gladys Fleischman
Jack Gilford
Jack R. Harary. Happy Hanukkah
Jack R. Harary, Birthday
Jack R. Harary, Birthday
Jack R. Harary, Happy Chanukah
Ilene Hollis
Steve Sohmer, Mancuso FBI
William N. Mazzadra, Birthday
Andrew Mitchell
Hannah Jill Moss, Birth
Mary's Good Health, Nassour
Ralph Revere
Phyllis Rubin, New Job
St. Vincent Health Center
Eugene Sayfie, Good Health
Dr. Abraham Shulman
Antonietta Sioia
Sandy Schlater
Or. Rose Smart
Martin Starr, Good Luck
Thomas G. Thaek
Robert P. Umland
Jack Vernon, Ph.D.
Ersun Yergin, An Honest Man
ATA PROFESSIONAL ASSOCIATES
Professional Associates support ATA at
the sponsor level or above. Usted below
are those people responding from
December 1989to March 1990.
Sue Carter, M. A.; Joseph Danto, Ph.D.;
"Room 126" Reg.Mtr.Veh.,Rhode Is.
Anonymous
Jack & Dorothy Akers
Rick & Jan Swain
Mr. & Mrs. Eugene Kerley
leo M. Schlocl<er
Jean & Joe Wolfson
Jean & Joe Wolfson
Jean & Joe Wolfson
Jean & Joe Wolfson
Jean & Joe Wolfson
Joseph Alam & Trudy Drucker
Jean & Joe Wolfson
Jean & Joe Wolfson
J. Alam & T. Drucker
Jules H. Drucker
Peggy & Jim Doyle
Mabel L Hopper
Adele B. Alam
Joseph Alam
Mary E. Tully
James & Rosalie Traver
Joe E. Hawkins
Dr. & Mrs. Luther J. Smith II
Luther J. Smith Ill, M.D.
Jean & Joe Wolfson
June Dunnavant
Jean & Joe Wolfson
Robert M. Harary
Michael Harary
Daniel Harary
Dan & Kim & Jordan Harary
Eric B. Yeoman Ill
Jean & Joe Wolfson
Margo Scott
Stuart M. Mitchell
J. Alam & T. Drucker
Jean & Joe Wolfson
Ann Revere
Jean & Joe Wolfson
Erie Audiology & Hrg Aid Ctr
Jean & Joe Wolfson
Frederick Elkind
Piera Luzzini Iori
John & Faye Schlater
Jean & Joe Wolfson
Jean & Joe Wolfson
Tammy Thaek
M/M Elmer R. Umland
Sonya Z. Kaplan
Jean & Joe Wolfson
Robert R. Harmon
Valerie P. Kriney, MAJCCCA
Dorothy Muto-Coleman, M.A.
Stuart Wilks, M.A.
Sharon K. Woods, B.C.
Richard D. Zujko, M.D.
reputation
Two names you know you can trust.
ACTIVAIR. Q DURHEI
Sound Leadership 1M
AMERICAN TINNITUS ASSOCIATION
P.O. BOX 5, PORTLAND, OR 97207
ADDRESS CORRECTION REQUESTED
NON-PROFIT ORG.
U.S. POSTAGE
PAl D
American Tinnitus
Association