March 1993 Volume 18, Number 1

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear."
In This Issue:
Anatomy of the Ear
Research Repmt
Self-Help News
Regular Features
TM
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Edotorial and advcni,ing oflices:

P.o. Box
5
Pon- The Journal of the American Tinnitus Association
Do rector&. Editor:
GIQri3 E. Reoch. Ph.D.
F.ditoroal Adli\or:
Trud} Drucker, Ph.D.
Advenl\ing -ale.: AT A-AD. P. 0. Box 5. Pon-
land. OR 97207
Tinnotu\ Tt><IO.\' " quanerly in March,
September nnd December. It is mailed to
of American Tinnitus Aswciation and u
'elected li>t oftinnitu> and professionals
who treat tinnitu,. Circulntion is oo 200.00()
annually.
The Publi\her rc\Crvcs the right to reject or edit
any received for publication and tore-
ject any deemed unsuitable for Timrilll.f
Ttl<fm. Acceptance of ad1ertising by Tinmws To
day 11(>1 con\lotute endorsement of the ather
ti\Cr, it. product\ or \Cf\;ces. nor doe> TimriiUJ
Tcl<fay make any claim' or guarant= as to the ac-
curncy or alidoty of the ad,ertiser"s offer. 1lle
oponron' e\pn."'\Cd by contributors to Tinnitu.\ 711-
cla\' are not nece,..arily tho\C of the Pubhsher. cdr
tuf\. \laff. <>r ad1eni\Crs. American Tinnitus
A\sodntion i' n non-profit human heahh and wcl-
fure agency undtr 26 USC 50J (c)(3)
Volume 18 Number 1 March 1993
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
5
Anatomy of the Ear
by Ronald G. Amedee and Tynes E. Mixon
Book Review: "Noise & Your Health"
by Trudy Drucker
Cupyright 1993 by American Tinni tus A>socia
6 tion No pan of thh publication may be rcpro- Research Report: "Furosemide Open Trial for Treatment ol
Tinnitus
\ton:d tn u retrieval system. or transmilled
rn any h1m1. or by any means. without the prior
"rillcn pcm>i"ion of the Publisher.
ISS!\ OS97-6:l68
Sdentitic \d\ Boord
Ronald G. Amedee, MD, Ne\\ Orlean>. LA
Roben 1-. Brummell, PhD. Ponland. OR
Jacl D. Clemi,, \10, Chicago. IL
John R Emmell. MD. Memphis. TN
Barbara Gold>tCIO, Ph.D .. New York. NY
Richard I,. Goode. MD, Stanford, CA
Chris B Fo,tcr. MD, San Diego. CA
Johr1 W. I louse, MD. Los Angeles, CA
W F. S Hopmcicr, St. Louis, MO
Rohcn M fohn,on, PhO. Ponland, OR
Gnlc \\ . !'vi iller, l\ID. Cincinnati. OH
J. Gaol Neely. l\ID, St Louis, MO
Jerry 1\onhcm. PhD, Denver. CO
Roben E. Sandhn. PhD, San Diego. CA
Abraham Shulman. \ID. Brooklyn. :-;y
\1an,lield Smrth, MD. San Jose. CA
Harold G. Tabb. MD, New Orleans. LA
Alfred We''' MD. Boston, MA
Honorary Board
Senator Mark 0. I lao field
Mr. Tony Randall
Boar'd of Directors
Edmund Gro,sberg. Chicago, IL
Dan Roben Hocks. Ponland, OR
Roben M John,on. PhD, Portland, OR
Pholip 0. Monon, Portland, OR
Aaron I. O'herow, St. Louis. MO
Glona E. Retch, PhD, Ponland. OR
Thoma.' Wi"t:>aum. CPA. Ponland. OR
10
15
by Robert A. Dobie
From the Editor
by Gloria E. Reich
Coming Events, Calendar
16 Self Help: News from the Groups
by Laurie Bauer Rosborough
Regular Features
12
14
17-18
19
Questions & Answers
Media Watch: Tinnitus in the News
Tributes, Sponsor Members, Professional Associates
Books Available, Donation Fonn
Cover painting, "All From One", by Margaret Wei!, Portlcmd Artist, whose work is
exhibited in various Oregon galleries. She may be contacted directly about her work
at (503) 297-6196.
Anatomy of the ear
by Ronald G. Amedee, M. D., F.A. C.S., & Tynes
E. Mi.xon, M.D. Department of Otolaryngology-
Head & Neck Surgery, Tulane University School
of Medicine, New Orleans, Louisiana.
The human ear begins to take shape in the 6
week old embryo and development is completed
approximately 20 weeks after conception. The ex-
ternal ear (which is sometimes called the auricle or
pinna) continues to grow slowly after birth and
continues through old age. Ironically, as the exter-
nal ear continues to grow with time, the inner ear
has nerve cells and special sensory cells which
slowly lose function leading to a decrease in hear-
ing and sense of balance.
The ear is the first sensory organ of the body
to begin functioning. The brain of a fetus begins to
sense signals from the ear while still in the mother's
womb. It is these signals, and signals which con-
tinue after birth, which help direct development of
the parts of the brain responsible for speech and
language development. If the brain is deprived of
this input due to repeated infections or birth defects,
speech and language development in children may
be hindered.
The ear is divided into two parts: peripheral
and central. The peripheral ear is composed of the
external, middle, and inner ear. The central ear is
composed of the nerves and processing center
4 Tinnitus Today/March 1993
within the brain which translates the signals of the
peripheral ear into messages which are understood.
Peripheral Ear
!)External Ear: Sound reaches our ears as
waves of energy traveling through air. The first part
of the hearing system to come into contact with
sound is the external ear. It helps to concentrate
sound, locate the direction, and establish the dis-
tance of a sound. The ear, because of its prominent
position, is often injured in trauma or bums to the
head and it is also a frequent site of skin cancer.
The ear canal is a skin lined tube which trans-
mits sound. The outer 1/3 is lined with cartilage and
contains hair follicles and glands which produce
wax. The inner 2/3 of the ear canal is composed of
bone and does not have hair follicles or glands. The
ear canal is a frequent site of an infection which is
often called swimmer's ear because of the tendency
for swimmers to be affected by this problem. An-
other common cause of this infection is trauma to
the ear canal by foreign objects such as cotton
swabs. Wax in the ear canal serves as a protective
barrier. When the ear canal is scratched with a
cotton swab or some other foreign body, bacteria
are able to invade and cause infection. Proper ear
hygiene includes never placing foreign objects in
the ear.
2)Middle Ear: The ear
drum marks the outer boundary
of the middle ear. Sound which
impacts on the ear drum is trans-
mitted through three small bones
contained within the middle ear.
The sound is intensified by the
action of the ear drum and the
small bones. Disease of these
structures can result in de-
creased conduction of sound.
The middle ear is a cavity which
is also subject to infection, a
condition referred to as otitis
media (middle ear infection).
Children get otitis media much
more frequently than adults.
This is because the eustachian
tube which ventilates the middle ear is smaller and
the direction less favorable for drainage in children.
Adults also have problems with their eustachian
mbes. This can cause a "popping" or fullness in the
sometimes associated with pain. People occa-
siOnally have problems equalizing pressure in the
ear while diving, flying or even when riding
m elevators. Normally the eustachian tube opens to
allow equalization during yawning and
swallowmg. Colds and nasal congestion make it
more difficult to open the eustachian tube. Medica-
tions can be prescribed to aid in eustachian tube
opening.
3)Inner Ear: Sound that is transmitted throuah
the middle ear bones enters the inner ear. Here the
energy is transformed into electrical signals. The
inner ear is a complex sensory organ which func-
tions as the hearing center. The inner ear is also
closely related to the balance organ which is re-
sponsible for maintaining proper equilibrium.
Problems which affect the inner ear often cause
decreased hearing and/or imbalance. The cells and
of the inner ear undergo slow degeneration
With age and may eventually have a decrease in
their function.
Hearing and balance are two special sensory
functions provided by the ear. They are the end
result of a very complex chain of events. A wide
variety of pathologic processes from the external
ear to the brain can affect the ability to hear and
maintain balance.
REFERENCES
. JE: Granfs Atlas of Anatomy. 8th ed,
Balt1more, W1lbams and Wilkins, 1986.
2.Becker W, Naumann HN, Pfalty CR: Ear Nose
and Throat Disease. New York, Thieme Medical Publish-
ers, 1989.
3.English G: Otolaryngology. Philadelphia, J.B. Lip-
pincott Co., 1992.
4.Gates G: Ther_apy in Otolaryngology Head
and Neck Surgery. Philadelphia, B.C. Decker, Inc., 1990.
5.Lee KJ: Essential Otolaryngoloo-y. New York
MEPC, 199l. "' '
6.Paparella Metal: Otolaryngology. 3rd ed Phila-
delphia, W.B. Saunders Co., I 991. '
Book Review
Billy Ray Boyd. Noise & Your Health. San
Francisco: Taterhill Press, 1993.
Reviewed by Trudy Drucker
The dangers of loud noise are well known to
medical professionals and, alas, to its victims. Now
the problem is to get this information to the noise-
makers, so they will turn down the torment, and to
those who willingly expose themselves to rock
concetts and other mega-decibel events, so that
they will think twice about seeking out a strong,
clear possibility of serious and permanent damacre.
T_his is the audience to which Mr. Boyd addres;es
and! can wish for his book's widest pos-
stble cuculatwn among those who need it badly.
Mr. Boyd is a glib writer, persuasive and
pleasantly informal . He is not afraid to use a good
word like "lousy" on appropriate occa-
stons. The book is enlivened by apt quotations
sprinkled through the text. The few minor typos
and errors of grammar and spelling can be cor-
rected in a second edition, which is already being
planned.
The author evidently has no credentials or
previous publications in the hearing sciences, but
is no reason to seriously question his accuracy
or his thoroughness. Two of his conclusions will
seem somewhat far-fetched: that vegetarians suffer
less from traumatic noise exposure than do meat-
eaters, and that the stress of noise exposure might
weaken the immune system to the point of making
the subject more susceptible to AIDS. These state-
ments, for which Mr. Boyd makes logical argu-
ments, could have used some strono- in-text
0
documentation from traditional medical authorities.
I strongly agree with the author's call for legal
and community action against those who assault
captive audiences with painful, dangerous sound.
Government has a role to play, and there are good
laws on the books to protect workers and others
through agencies such as OSHA and EPA. During
the Reagan-Bush administrations these were essen-
tially ignored and the work of the agencies charged
our protection was weakened to the point of
Impotence. Better times might lie ahead. An appen-
Cominued on Page 10.
Tinnitus Today/March 1993 5
Research Study Report: Furosemide (Lasix)
by Robert A. Dobie, M.D., Department of
Otolaryngology-Head and Neck Surgery, The
University of Texas Health Science Center, San
Antonio, Texas.
Introduction
Oral Furosemide has recently been reported
(Guth et al, 1991) to be effective in reducing tinni-
tus sensation. This study was undertaken to further
explore the possible efficacy of furosemide, in part
to determine whether this institution would wish to
participate in a large double-blind randomized
clinical trial of this drug.
Materials and Methods
Twenty-six subjects complaining of continu-
ous tinnitus present for more than six months were
interviewed for this study after screening for treat-
able otologic disorders. Twenty subjects enrolled
and began therapy after completing a battery of
baseline tests as listed below:
Intake Questionnaire
Internally-Referenced Loudness and Disability Analog
Scales
Tinnitus Tnterference Scale
Sheehan Disability Scales
Iowa Tinnitus Handicap Questionnaire- Abbreviated
Extemally-Referenced Loudness and Disability Analog Scales
Beck Depression Inventory
Pure-tone air and bone conduction audiometry
Speech discrimination audiometry at 90dBHL
Tinnitus evaluation, including tinnitus match, loudness
match to l kHz pure-tone signal, and tests of minimum
masking level and residual inhibition
Fluid Balance Profile laboratory studies (including elec-
trolytes, C02, and BUN)
Pregnancy test (for females of child-bearing age)
Blood pressure measurement
Patients began at a Furosemide dosage of 40
mg. b.i.d. (80 mg.) for two weeks. Dosage was
increased to 40 mg.t.i.d. (120 mg.) for the third and
fourth weeks, then to 40 mg. q.i.d (160 mg.) for the
fifth and sixth weeks, if there had been no adverse
side effects and no previously noted improvement
in tinnitus. Patients stayed on their maintenance
dose (120 or 160 mgs. per day) for a six-week
6 Tinnitus Today/March 1993
period, followed by final testing including the fol -
lowing:
Internally-Referenced Loudness and DisabiJjty Analog
Scales
Tinnitus Interference Scale
Sheehan Disability Scales
Iowa Tinnitus Handicap Questionnaire - Abbreviated
Extemally-Referenced Loudness and Disability Analog Scales
Beck Depression Inventory
Pure-tone air and bone conduction audiometry
Speech disctimination audiometry at 90dBHL
Tinnitus evaluation, including tinnitus match, loudness
match to 1 kHz pure-tone signal, and tests of minimum
masking level and residual inhibition
At two week intervals during the dose adjust-
ment period, patients completed the following brief
questionnaires:
lntemally-Referenced Loudness and Disability Analog
Scales
Tinnitus Interference Scale
Sheehan Disability Scales
Extemally-Referenced Loudness and Disability Analog Scales
Results
The twenty enrolled patients had an average
age of 49.7 years ( 12.8 years std dev). They were
equally divided between men and women; eighteen
were Caucasian and two were Hispanic. The mean
duration of tinnitus was 11.3 years, but the median
duration was only 5 years. Six patients had tinnitus
of more than 10 years duration. Some patients were
on drugs which could have been relevant to their
tinnitus, but were not stopped during this study for
medical reasons. These included 2 patients taking
Nortiiptyline, 2 patients taking Xanax, and 3 who
were taking non-steroidal anti-inflammatory drugs
both before and during the study.
The average baseline pure-tone audiometric
results are shown in Table 1 and indicate high-fre-
quency sensorineural hearing loss. Five patients
had normal hearing in both ears. No conductive
hearing losses were present. Two patients had
Meniere's Disease, but without active audiometric
fluctuations within the past several months. No
patients with fluctuating or progressive sensorineu-
ral hearing loss were included. Final pure-tone
Research Report: (continued)
Report: Furosemide Open Trial ror Treatment or Tinnitus
Robert A. Dobie. M.D.
TABLE!
Freguen!:I (Hz)
125 250 500 1000
200)
:roJ 4000 0000 0000
Right
Mean 13.75 13.0 12.5 15.0 11.75 21.0 24.25 37.25 41.75
Std.Dev 12.66 14.09 16.9 16.38 14.62 19.57 19.49 181!8 21.42
Left.
Mean 15.25 13.75 13.75 14.5 13.25 26.0 33.0 45.0 48.5
Std.Dev 13.91 16.45 15.21 14.13 16.88 21.0 24.99 20.48 30.14
thresholds are not shown, but were not statistically
significantly different at any frequency in either ear
for the group, and no individual patient showed
pure-tone threshold shifts exceeding 10 dB at any
frequency.
Eight patients dropped out of the study after 4
weeks. Interestingly, 7 of the 8 had tinnitus of
duration greater than or equal to 6 years. Of the 12
patients who continued to the end of the s t u ~ y , 9
had durations less than 4 years. Twelve pat1ents
completed the maintenance dose period. Of these
12, I 0 took 160 mg. of furosemide per day during
the maintenance period while 2 took 120 mg. per
day because of side effects experienced during the
dose adjustment period.
At the end of the study, 4 patients answered
yes to a global satisfaction question: "Has the drug
helped you in any way?" However, 2 of these
mentioned benefits unrelated to tinnitus (perceived
improvement of hearing in 1 and reduction of
edema for another). Two of twelve patients an-
swered yes to a second global question, "Is your
tinnitus improved?"
Because the a priori hypothesis was that
Furosemide might affect tinnitus sensation, analy-
sis focused primarily on measures of tinnitus loud-
ness, rather than secondary measures of annoyance,
disability, etc. Figures 1 and 2 show self-report
ratings for both internally-referenced and exter-
nalLy-referenced analog scales, for the drop-out
group of 8 and for the completion group of 12.
Figures 3 and 4 reproduce the internally-referenced
and externally-referenced scales respectively.
Figure 1 showed a tendency toward decreased
internally-referenced tinnitus loudness in the drop-
out group, with no apparent change in the exter-
nally-referenced ratings. Figure 2 shows a more
substantial decrease in internal loudness ratings for
the group of 12 who completed the 12-week course.
Comparison of baseline to final ratings showed a
statistically significant decrease in internally-refer-
encedloudness (paired, t-testt= 3.095, p =0.0102).
rn
Figure 1
Laslx Study Drop-Out Group
Internal vs External Loudness
(N = 8)
4 6 8 10 12
Time (Weeks)
Curiously, the externally-referenced loudness
showed a statistically significant increase (paired
t-test, t = 3.079, p = 0.0105).
Tinnitus intensity matches, in dB sensation
level (SL), were performed both at the tinnitus
match frequency and at l kHz. The results were
similar for both. Some subjects showed increases,
others decreases, and some showed no change. Of
the 12 subjects who completed the study, only 11
returned for the final matching, so Figure 5 shows
before and after compruisons for only 11 subjects.
The filled circles at the left margin indicate the 1
kHz match levels for the 9 subjects who did not
7
Figure 2
Laslx Study Completion Group
Internal vs External Loudness
(N = 12)
4 6 8 10 12
Time (Weeks)
Tinnitus Today/March 1993 7
Research Report: (continued)
Figure 3
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TttE.UNI'YASfTY Of TDAS HbLTK SCie:HCI! C9fTU SAH ANTOHfO
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have a final match level measurement. The
dashed lines in Figure 5 indicate the 3 subjects
who had tinnitus duration equal to or greater
than 7 years; 2 of the 3 had increased tinnitus
match intensity levels. The remaining 8 sub-
jects all had durations less than or equal to 4
years; 5 showed decreased 1 kHz match lev-
els, l was unchanged, and 2 showed increases.
Six subjects expressed some interest in
continuing on furosemide at the end of the
study, either by prescription from their per-
sonal physicians, or through the principal in-
vestigator. These six are indicated by the
asterisks on Figure 5. Telephone follow-up at
least I month after completion of the study
indicated that none of the six subjects had
Figure 4
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8 Tinnitus Today/March 1993

= I
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I
.=,.
continued taking furosemide. Three sub-
jects had their diuretics switched by their
physicians to hydrochlorothiazide. They
reported no subjective change in their
tinnitus. Two elected not to continue the
use of diuretics of any type. We were
unable to contact the last subject.
Discussion
As in any open trial, placebo effects
can be prominent, and can affect "objec-
tive" measurements such as intensity
match levels, as well as questionnaire
and rating scale results. Thus, any prom-
ising results from this study must be
viewed as only preliminary and in need
of verification by placebo controlled
studies.
FI!Jfre 5
60
Laslx Study - 1 k z Match Worse Ear
50
40
*
"'
"'
.: 30
;;;
a:
20
10
*
0
0
Time (Weeks)
12
No patient with a tinnitus duration
exceeding 4 years claimed any benefit from
the treatment or demonstrated any reduc-
tion in tinnitus match intensity levels.
These "long-duration" patients were more
likely to drop out of the study, as well. If
furosemide is to receive further study as a
palliative for tinnitus, it may be wise to
limit those studies to subjects with rela-
tively short duration of tinnitus.
Tinnitus loudness scales based on in-
ternal and external reference points (Fig-
ures 3 and 4) gave conflicting and
surprising results. Subjects who completed
the study tended to feel that the tinnitus
Research Report: (continued)
loudness had decreased compared to their recollec-
tion of the loudest it had ever been. However, when
asked to compare the tinnitus loudness to the loud-
ness of common environmental sounds, they noted
a slight increase. Perhaps the internally-referenced
scale is more susceptible to placebo effect or one
or both of these findings could have been spurious,
despite their relatively high significance levels
(each was close to the 0.0 l confidence level). Tin-
nitus match intensity levels at l kHz showed a
tendency towards improvement, if one first ex-
cluded subjects with tinnitus duration greater than
4 years.
Guth et al. (1991) pre-screened their oral
furosemide subjects by a test involving intravenous
furosemide; (only those who improved with the
intravenous chug were placed on the oral drug). 1t
is possible that such screening would have removed
those subjects who either dropped out of this study,
failed to improve, or became worse.
We conclude that oral furosemide may have
promise as a palliative for reducing tinnitus sensa-
tion although results are not likely to be dramatic.
(No patient reported cessation of tinnitus). Deter-
mining a genuine benefit will require a placebo-
controlled randomized clinical trial of sufficient
size that it would need to be conducted at multiple
centers. To improve statistical power, an intrave-
nous drug trial is probably reasonable, as is exclu-
sion of subjects with tinnitus of long duration. A
single subject or multiple cross-over design should
be considered to permit detection and documenta-
tion of even a small proportion of subjects who may
be genuine responders.
"COPING WITH TINNITUS"
e STRESS MANAGEMENT & TREATMENT
e TINNITUS MANAGEMENT IS OfTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STRESS OF TINNITUS WITHOUT COMPLEX
INSTRUMENTATION & VALUABLE OFFICE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids. tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered and can be performed daily in the
patient's home environment. It has been demonstrated that the relaxation response can release muscle
tension, lower blood pressure and slow heart and breath rates.
A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
has successfully treated for many years chronic pain, tension headaches. insomnia and many other
conditions.
The program consists of one cassette tape of Metronome Conditioned Relaxation and two additional
tapes of unique masking sounds which have demonstrated substantial benefit whenever the
feels the need of additional relief. These recordings can be used to induce sleeping or as a soothtng
backdrop for activity and can be played on a simple portable cassette player.
ALL ORDeRS MUST ACCOMPANI!ID BY
011!'.CK. VISA. OR INSTmrrtONAL P.O.
6796 ST., UPPER DARBY. PA 19082
Phone (215) 352-0600
Tinnitus Today/March 1993 9
Book Review, continued
clix provides excellent suggestions for what lay
people can do to protect themselves and live in a
quieter world. A list of agencies that can provide
aid and information is included.
I find fault with the bibliography, which lists
some minor articles but omits, for example, Shul-
man's definitive book on tinnitus. Because he sup-
ports animal rights and disapproves of the use of
animals in medical experimentation, Mr. Boyd's
bibliography is skewed against good works for
which animal experimentation can be assumed. Mr.
Boyd has written previously about vegetarianism,
and his favorable bias toward it does show a bit.
His other book is about circumcision, but, thank-
fully, this subject is not discussed.
Readers will probably finish this book with a
life-long terror of exposure to loud noise, and this
is devoutly to be desired. I wish the book had been
available thirteen years ago, when it might have
kept me from a wedding reception that made my
ears bleed and permanently, seriously worsened
my tinnitus. Loud noise hurts! That is the message
of this good little book, and I hope it will be widely
heard.
ISBN: 0-9616792-6-3. Distributed by C. Ol-
son & Co., PO Box 51 00-E, Santa Cruz, CA 95063-
5100. ( 408) 458-3365.
Classified
SPECIAL PILLOW CAN RELIEVE EAR
NOISES AND AID SLEEP
Your sleeping habit may be robbing you of a proper
night's sleep. The Ear Relaxer can change your life. Austin
Skaggs, the inventor of the Ear Relaxer Pillow, reports that it
has helped him and many other people who have tried it. It is
comfortable for those who wear their hearing aids or maskers
to bed. Testimonials are available on request from Mr. Skaggs.
Toorder,send$17.95 (postpaid),outside U.S. send$20.95
(U.S. funds), for postage paid shipment to:
EAR RELAXER
POBOX90
VICTOR WV 25938
Replacement pillow slips are available for $5.00
10 Tinnitus Today/March l993
From the Editor
by Gloria E. Reich, Ph.D., Executive Director,
American Tinnitus Association
The American Tinnitus Association bas re-
ceived numerous letters regarding the possible use
of the new auditory training technique developed
by Guy Berard in France for treating tinnitus pa-
tients with hyperacusis. This technique was in-
itially designed to assjst people with autism who
may have a hypersensitivity to loud sounds. To
date, AT A does not have a formal policy regarding
this form of treatment for hyperacusic patients. We
have received correspondence from A TA members
who have participated in this program and feel that
it is inappropriate for treating hyperacusis. The
American Speech Hearing Association is presently
reviewing this treatment procedure to determine
whether it is efficacious for that population. We
would encourage any members who have partici-
pated in this program to share their results and
comments with us.
The AT A has also received requests for infor-
mation regarding the Ginkgo-Laser treatment es-
poused by Dr. Klaus Peter Meyer in Germany. We
have attempted to obtain professional feedback
regarding this procedure from colleagues in Ger-
many and England and have not received answers.
Until more definitive information is obtained, the
AT A cannot support its use as a viable treatment
for tinnitus patients. Mate1ials received from Dr.
Meyer's clinic are presently being translated from
German into English.
The January, 1993 issue of Consumer Reports
carried an article warning people about the addic-
tiveness and other possible problems relating to the
drug Xanax. There are several important things to
remember concerning the use ofXanax for tinnitus
relief. 1) The dosages are much smaller than those
commonly used for anxiety relief, 2) The drug is
administered for a shorter period of time in order
to avoid drug dependence, and 3) Scientific studies
have been published regarding the use of this drug
for treating tinnitus. You may request information
from the ATA bibliography about Xanax or your
physician is welcome to call the Oregon Hearing
Research Center, for fmther information about the
use of Xanax for tinnitus relief. (503) 494-8032.
From the Editor (continued)
It is the policy of the American Tinnitus As-
sociation to explore any possible new treatment of
tinnitus and obtain experimental data regarding its
effectiveness before suggesting its use to the mem-
bership. We do not want to deny patients of any
clinical treatment which may provide them some
relief from their tinnitus. However, in the absence
of experimental evidence that the procedure is
clinically relevant, we cannot advocate its use. If
future investigations produce positive results for
any of these procedures, we will immediately share
it with our readers.
Putting the record straight.
The December issue reported decreased atten-
dance at the International Hearing Society meeting.
While our display drew fewer people the meeting
itself was the largest ever. We apologise for the
confusion. Also in the December issue we carried
an article by Syd Hunt in which he stated his
opinion that the British Tinnitus Association has
long been convinced that anxiety is the only cause
of tinnitus.Early in January we received a letter
from Jo Hazelby, Chairman of the British Tinnitus
Association setting f01th BT A's views as follows:
"We are well aware that as yet, there are only
theories, with proof being very difficult to obtain.
What is known, however, is that stress and anxiety
do increase or amplify the tinnitus sounds, making
them difficult to ignore. Wh<:.t BTA does say, is that
there can be an enjoyable life after tinnitus. It is not
an easy task to achieve but it can be done, and we
are here to provide support and encouragement as
each individual finds their own answers to their
problem."
How do you say TINNITUS?
Have you ever had the misfortune to have
spoken the word tinnitus and then been sharply
reprimanded for having said it the "wrong" way?
You're not alone! The controversy about how to
pronounce tinnitus, either tin-ni-tus or ti-night-us,
has been raging for years. It is not a reflection of
your intellectual ability, language skills, or social
position to use one or the other of these pronoun-
ciations. Furthermore, it is not either correct or
considerate to attempt to intimidate someone else
for their pronounciation. Let the record show that
Dorland's 27th edition Medical Dictionary prefers
the following: ti-ni' -tus. According to their "Indi-
cation of Pronunciation," the accent Breve over the
'i' in 'ti' indicates a short vowel. An unmarked
vowel ending a syllable is long thus, the 'ni' would
be pronounced as if it were spelled 'nigh.' The last
syllable, 'tus' follows the rule for an unmarked
vowel in a syllable ending with a consonant, and is
short. The accent comes on the second syllable
which gives us the word sounding like ti-night' -us.
The alternate pronounciation as given in a 20 year-
old "Webster's" dictionary is as follows: 'tin-et-es,
which accordingly is pronounced with the accent
on the first syllable ti' -ni-tus. There you have it!
Make your own choice. We are the American Ti-
night' -us Association.
Hocks A ward for 1992
The 1992 Hocks Memorial Award for excel-
lence in the field of tinnitus is presented to a person
who has demonstrated outstanding work either in
tinnitus research, clinical endeavors, or service to
the American Tinnitus Association. The award was
established in memory of Robert Hocks, ATA's
first national chairman. This year's recipient quali-
fied in all three categories and was the unanimous
choice of the ATA board.
The award was presented, in December, to Dr. Robert M.
Johnson, Ph.D., Director of the Tinnitus Clinic at the Ore-
gon Hearing Research Center, by Gloria E. Reich, Ph.D.,
Executive Director of the American Tinnitus Association.
Tinnitus Today/March 1993 11
Questions & Answers
by Jack Vernon, Director, Oregon Hearing Re-
search Center
Some questions, due to limited column space and
the length of the answer required, have been an-
swered directly rather than through this column.
If my answers have provoked unresolved ques-
tions, please feel free to submit those additional
questions. We have learned about tinnitus primar-
ily from tinnitus patients. Thus, you may have
experiences or comments that inspire questions
appropriate for this column. If so, send them in.
Q uestion: I developed tinnitus two years ago
which is a ringing mainly in the left ear. Currently
I am on Prozac, Inderal, and Atavan. Would any of
these drugs have an effect either good or bad on my
tinnitus? Mr. B. from Maryland.
A nswer: There are those who claim that anxiety
and/or depression can cause tinnitus and thus they
treat the anxiety or the depression. I happen to think
that the reverse i.s more likely the case. That is, that
tinnitus can produce depression or anxiety and that
if we can relieve the tinnitus the anxiety or depres-
sion will no longer be a problem. The Inderal is for
hypertension, the Prozac is for depression and the
Atavan is a tranquilizer. I do not think any of these
will adversely affect your tinnitus, however, as
always I recommend these matters be discussed
with your prescribing physician. The real question,
it seems to me, is what are you doing for your
tinnitus? Have you tried either masking or Xanax?
If not, and you are interested, may I suggest that
you contact me to see if we can work out a relief
procedure for you.
Q uestion: I have been told that I probably have
otosclerosis in the left ear where I also have a small
perforation in the ear drum. I was prescribed Flori-
cal, an over the counter drug, to stabilize this con-
dition. How does Flori cal work? Will the
perforation heal? Should I consider surgery? Mr.
R. from New York.
A nswer: I am not familiar with Florical but it
seems unJikely that any medication could arrest or
reverse the otosclerosis process. You have now had
12 Tinnitus Today/March 1993
the ear drum perforation for three years, thus it
seems unlikely it will heal with the present treat-
ment. Sometimes a perforation in the ear drum has
no effect upon hearing, it all depends on how large
it is and where it is located. It might be possible to
temporarily patch the perforation with moistened
paper to see if your hearing test results are im-
proved. If the diagnosis of otosclerosis is substan-
tiated by a second opinion then an operation may
very well regain some or most of the hearing in that
ear. Hearing losses can be both conductive and
sensorineural and the operation for otosclerosis
could only regain the conductive part of the loss.
Q uestion: I avoid loud noises but I do enjoy some
items which seem to exacerbate my tinnitus such
as caffeine drinks, pork, and occasional use of
marijuana. Will continued use of these items per-
manently increase my tinnitus? Mr. L. from Texas.
A nswer: As a general rule I recommend avoiding
anything which makes tinnitus worse even tempo-
rarily. In your case it is interesting that you find that
pork exacerbates tinnitus, I have not heard that
before. Continued exposure to loud noises will
most likely lead to a permanent elevation of the
tinnitus but I doubt pork will. We have seen about
a dozen tinnitus cases where marijauna was in-
volved. In two of these cessation of marijuana
eliminated the tinnitus and in most of the others the
tinnitus was reduced. Thus I tend to advise against
marijuana just as I advise against loud sounds and
that includes loud music.
Q uestion: About this thing of people hearing the
horizontal oscillator in TV sets. It oscillates at
16,000 Hz and I can hear it despite the fact that at
8,000 Hz my hearing is down 80 dB. Mr. G. from
Maryland.
Answer: Several people have written that they
can hear the horizontal oscillator in TV sets and I
have no doubt about such statements. As you know
when we humans were brand new and had no
damage to our hearing we could hear up to about
20,000 Hz. That your hearing is down 80 dB (by
the way, that is about 10,000 times below normal)
at 8,000 Hz does not mean that your hearing is also
Questions & Answers (continued)
down at even higher frequencies. In your case it is
clear that your ability to hear some very high fre-
quencies is still intact ("islands of hearing' , per-
haps). It would be interesting to have your hearing
measured at all frequencies you can hear. The
trouble is that many audiometers only test up to
8,000 Hz. You did not mention yom tinnitus but
others have indicated the high frequency tone from
the TV set can trigger their tinnitus and is thus
something they avoid. As you suggest, proximity
to the TV set may be the answer.
Q uestion: I suffer with headaches and pulsatile
tinnitus for which I have taken amitriptyline and
Deseryl. I have noticed the tinnitus was less while
taking these medications. Now I have learned to
live with it but I wonder if there is a cure for all this
and are the headaches and the tinnitus related?
A nswer: I do not know if the headaches and the
tinnitus are related. I do think you should see a
neurologist about the headaches. The pulsatile tin-
nitus is not the usual breed of subjective tinnitus,
indeed it is an objective tinnitus. It is my guess that
most likely there is some partial obstruction in the
blood supply near the ear so that a real sound is
produced and it is that sound which you hear. To
locate the possible obstruction involves major pro-
cedures and if you have learned to live with it
perhaps you should leave well enough alone. In my
own case, I have a new rutificial heart valve which
I can hear at night (it is a "pulsatile tinnjtus"), the
rest of the time I can only hear it in very quiet
circumstances. I have found, to my great surprise,
that I can mask this pulsatile sound by using a
relatively low-pitched masker. I use the Marsona
1200-A set on "waterfall" with the tone control set
to full bass. I have been sleeping with the Marsona
sound for over a year now. The only way to find
out whether or not such a thing will work for you
is to try it.
Q uestion: I have had tinnitus all my life, in fact
until I was an adult I thought it was normal. I have
several questions: 1) I can change my tinnitus by
turning my neck to the extreme left or right. 2) I can
warble my tinnitus by shaking my head violently.
3) I can increase the intensity of my tinnitus by
biting down as hard as possible. Are these common
manifestations? Mrs. B. from Kansas.
A nswer: Two of the events which alter your
tinnitus possibly point to the same thing ... TMJ
syndrome, that is, a problem with the temporo-
mandibular joint (the jaw joint). Problems with the
jaw can cause tinnitus and correction of the prob-
lem can, in some cases, relieve the tinnitus. I would
recommend you see a dentist about the possibility
of TMJ problems. I don't know what to say about
the result of violent head shaking except to say
don't do it.
Q uestion: I have been diagnosed as having tinni-
tus, sensorineural hearing loss, and allergic rhinitis.
I have been taking 50 mg of sodium fluoride daily
for three years for cochlear otospongiosis. Will this
treatment harden my cochlea and therefore allevi-
ate my tinnitus? Please do not list my name or city.
A nswer: The best treatment for sensorineural
hearing loss is the use of properly fitted hearing aids
which might also help the tinnitus. It is difficult to
establish the presence of cochlear otospongiosis
and even more difficult to determine whether or not
sodium fluoride is of value. I tend to doubt it. You
have taken sodium fluoride for three years now
with no effect upon your tinnitus or hearing so I
would conclude it is not helping you.
Q uestion: I have a high-pitched hissing sound in
my right ear and I think I heru a similar sound in
the left ear. Is there any way to confmn this? Mr.
P. from Mary land.
A nswer: If you can selectively mask the right ear,
say under earphones, you will be able to determine
whether the tinnitus is also in the left ear. Better
still, if you can put the right ear into residual
inhibition, left ear tinnitus, if present, would be
obvious. These tests can most easily be done for
you by an audiologist.
Tinni1us Today/March 1993 13
Media Watch: Tinnitus in the news
by Cliff Collins, Oregon freelance writer. Please
send clips, including source and date, to Media
Watch, PO Box 5, Portland OR 97207.
It's bad news for the man, but oood news for
C>
tmmtus education that British rock guitarist Jeff
Beck allegedly has joined the growino list of rock
musicians with ear damage. Last year
0
MTV News
reported that a too-loud rehearsal with Guns ' n'
Roses forced Beck to cancel a ouest appearance
with ha_rd-rock group. The apparently
Beck s tmmtus was so aggravated by the practice
session that he was forced to cancel.
Michael Carrucoli of New Cumberland Penn-
. '
sylvama, who sent tl1is tip, adds that MTV an-
nouncer Kurt Loder "went on to explain to listeners
exactly what tinnitus is." Beck is the biggest rock
name with tinnitus since Pete Townshend dis-
cussed his tinnitus, recruitment and hearing loss a
few years ago, though it is not clear whether Beck
actually talked about his tinnitus or word simply
leaked out. If he did go public a la Townshend his
doing so would be of immense value in
C>
people about the danger of loud music.
The roar of the crowd: Unfortunately for
America's ears, none of us need be rock musicians
or fans to get in trouble earwise. Sports fans, always
exposed to loud noise at games, now are subject to
even worse damage because of the proliferation of
covered sports domes. The Minneapolis Metro-
dome, scene of a recent World Series, recorded
decibel readings of 125 each time the Twins hit the
b.all! That's J 0 times the occupational limit set by
the government, according to the physician who
took the readings.
" . New York magazine's Nov. 2 cover story,
Notse! How to Save Your Sanity in the Loudest
City in the World," is an extremely sad commen-
tary of civilization run amok. After reading this you
wonder how anyone could stand to Live in such a
place, though aiJ other metropolitan areas have
similar noise problems and those problems are
multiplying.
One of the worst additions in recent years to
the cornucopia of cacophony in cities and suburbs
is the abominable leaf (and apparently snow, dust
14 Tinnitus Today/March 1993
and whatever else) blower. The syndicated column
"Gadget Guru" says there is now a vacuum-type
blower that draws leaves into a shoulder bao and
C>
mulches them. It doesn't mention the noise in-
volved, and the photo with the piece is typical of
advertising for blowers and other power tools: It
shows a man equipped with goggles to protect the
eyes (good idea) but nothing to protect the ears (as
usual ).
Hearing noise: Si nger-actress Barbra
Streisand continues to talk freely of her tinnitus.
most recently in Vanity Fair. She's had ringing in
her head since the age of 7. How she endures a
musical career 40-plus years later, especially with-
out worsening her condition, defies understandinu.
T.innitus featured in November's Johns Ho;-
kins Med1cal Letter. Health After 50, in which the
newsletter gave a good account of the problem and
solutions. Elsewhere, columnist Lawrence E.
Lamb, M.D., notes that the hearing-impaired ear
perceives internal noise (tinnitus) more easily be-
cause it isn't picking up as much external noise; he
fails to take this notion the next logical step and add
that hearing aids can be helpful to tinnitus for that
very reason.
A TA members with hyperacusis can relate to
the character the "bubble man" in the TV series
"Northern Exposure." Anthony Edwards plays a
lawyer who has multiple chemical sensitivity and
must negotiate his environment wearing a NASA
spacesuit. Also on that front, People magazine (Jan.
18) ran a piece on famed Italian movie-maker
Federico Fellini that included this: "Federico is not
an easy man to be with. He doesn't want to hear
people talking loudly, he can't stand television ...
or even the sound of a fork and knife on a plate."
Hyperacusis, or merely nerves?
Finally, the comic strip "For Better or Worse"
had its schoolgirl character moping in bed that
she's missing the dance, "the social event of the
year." But the dance frame shows "BOOM, THUD,
BOOM, THUD," with the attendees askinu each
other, "Huh? What? Say Again? Can't you."
Funny, if it weren't so true.
Coming Events
There are two tinnitus meetings scheduled for
1993. Both of these meetings are primarily directed
to the professional with an interest in tinnitus but
the information may be of interest to some laymen
as well. If you have an interest in either of the
meetings please contact the organizer to determine
whether space is available.
JUNE 4-5, 1993 MANAGEMENT OF THE
TINNITUS PATIENT
The University oflowa, Iowa City, Iowa
Guest of Honor: Professor Ross Coles, Dep-
uty Director, Medical Research Council, Institute
of Hearing Research, Nottingham, United King-
dom
Guest Faculty: Rene Dauman, M.D., Hopi tal
Pellegrin, Bordeaux, France
University of Iowa Faculty: Paul Abbas,
Ph.D., Bruce Gantz, M.D., Brian McCabe, M.D.,
Donald Schum, Ph.D., Robert Schum, Ph.D.,
Richard Smith, M.D., Richard Tyler, Ph.D.
For information on registration and accom-
modation, contact the Office of Continuing Medi-
cal Education, The University of Iowa College of
Medicine, 130 Medicine Administration Building,
Iowa City, IA 52242-1101 USA (phone 319-335-
8598; fax 319-335-4058). For information on Call-
for-papers, contact Regina Tisor, (phone
319-356-2471; fax 319-353-6739). Continuing
education units have been applied for from ASHA
and HAIC.
OCTOBER 15-16, 1993 Henry Ford Hospital-
CURRENT CONCEPTS IN TIIEEV ALUATION
AND MANAGEMENT OF PATIENTS WfiH
TINNITUS
Meeting location: Grand Manor at Fairlane,
19000 Hubbard Drive, Dearborn, Michigan 48126
For information contact: Gary Jacobson,
Ph.D., Henry Ford Hospital, Division of Audiol-
ogy, 2799 West Grand Blvd., Detroit, MI 48202-
2689. (phone 313-876-3280; fax 313-876-7263)
Invited faculty: Michael Benninger, M.D.,
Kenneth Bouchard, Ph.D., Robert Brummett,
Ph.D., Robert Dobie, M.D., Gary P. Jacobson,
Ph.D., Pawel Jastreboff, Ph.D., RobertM. Johnson,
Ph.D., Paul R. Kileny, Ph.D., Michael LaRouere,
M.D., William H. Martin, Ph.D., Aage R. Moller,
Ph.D., Edwin Monsell, M.D., Ph.D., Craig W.
Newman, Ph.D., Richard Tyler, Ph.D., Glmia E.
Reich, Ph.D., Jack A. Vernon, Ph.D., Donna S.
Wayner, Ph.D.
Continuing education units have been applied
for from ASHA, IHS, and AMA.
Research Session
Immediately following the Dearborn meeting,
ATA will sponsor a half-day meeting "Research
Initiatives in Tinnitus" . Participation in this session
will be by invitation and limited to 25 people. The
purpose of the research meeting is to develop pri-
orities for research in tinnitus for the next 5 to 10
years. Dr. James Snow, Jr. , Director of the National
Institute on Deafness and Other Communicative
Disorders, has been invited to chair this meeting.
1993 Meeting Calendar
April 15-18, American Academy of Audiol-
ogy, Phoenix, Arizona
September l -5, International Hearing Society,
San Diego, California
October 3-7, American Academy of Otolaryn-
gology Head and Neck Surgery, Minneapolis, Min-
nesota
October 4, American Tinnitus Association,
Annual Advisory Board Meeting, Minneapolis,
Minnesota.
November 19-22, American Speech-Lan-
guage Hearing Association, Anaheim, California.
Future Events:
July 12-15, 1995,
International Tinnitus
Seminar and Interna-
tional Tinnitus Support
Association Meeting,
Portland, Oregon. For
further information con-
tact AT A.
(phone 503-248-9985;
fax 503-248-0024)
Tinnitus Today/March 1993 15
Self-Help News and a Fond Farewell
by Laurie Bauer Rosborough
Good-bye from Laurie
The Pen-Pal Support Network, the recent
Computer Support Network and the formation of
new groups are just a few of the things that I'm so
glad to have been a part of. Most of you know I
recently married, and because I will be moving with
my husband when he begins his family practice
residency this summer, I must say a fond farewell
to all of you. We're not sure yet where we'll be, but
no matter where I go, I'll take with me many
memories of my work with all of you.
I have enjoyed getting to know you and pro-
viding AT A's help when possible, and I appreciate
all that you have done in return. Many of you have
inspired me with your ideas and dedication, and I
encourage you to continue your important work.
There have been days when our work at A TA
seemed especially frustrating, when I longed for
tinnitus to get the recognition it deserves, or when
I wished, along with everyone else, that we had the
magic answer to offer, or at least more of an expla-
nation. On these days I was particularly glad to hear
from you, with an update on your group, a question
or suggestion, a story to report, or a request for
more brochures. Your perseverance and willingness
to help others brightened my days, thank you.
I thank you, also, for the help you gave me
when I started. My replacement (for whom we are
searching) will need some time to settle in and learn
about you, and I know you'll give her (hin1?) a
warm welcome. Keep in touch with the office - we
need you, and we appreciate you!
I have enjoyed working with all of you, and
wish you the best.
Pen Pal Support Network Update
by Lorraine Cramer-Mooney, Coordinator
1992 was a whirlwind year for the Tinni-
tus/Meniere's Pen-Pal Support Network as we
ended the year with over 170 participants. The list
began as 5 names and addresses swimming on a
sheet of white paper and now fills eight pages that
include information on each member such as age,
marital status, details on their affliction, interests
16 Tinnitus Today/March 1993
and occupations. The more detailed list allows
members to do their own matching, and eliminates
time and expense for everyone. This was made
possible by Bruce Cherkas, who gave me a word
processor for my birthday so that I could keep up
with the needs of the growing network. I am sure
the network will join me in thanking him for his
overwhelming generosity.
The word processor has made it possible for
me to continuously update the membership list,
correlate responses to a recent survey, and stay on
top of cotTespondence. In the near future, I would
like to compose periodic newsletters that feature
input from members.
If you aren't already a pen-pal support net-
work member, why not become one now and reap
these growing benefits?!
Below is a tabulation of responses to the pen-
pal group questionnaire, along with the information
already on pen-pal membership files. I hope you
find it enlightening.
Respondents: Male 36, Female 68
Age: Mean age , 44, range J 9 to 80
Affliction: Tinnitus only 86, Hyperacusis 6, Meniere's 18
Reported Cause: Accident/injury 3, Allergies 6, 111-
ness/infection 14, Noise 12, Medication/side effects 10
Where located: Left ear 7, Right ear 2, Both 12
Insomniacs: 15
Users of corrective devices: Hearing-aids 14, Maskers
7
Alcohol abusers: 3
Chapter News
No Walls of Stone: An Anthology of Literature
by Deaf and Hard of Hearing Writers has been
published by Gallaudet University Press. Three
poems and a short prose piece by Trudy Dmcker,
facilitator of the Bergen County Tinnitus Self-Help
Group, have been published in this anthology. Cop-
ies can be obtained from the publishers at 800
Florida A venue NE, Washington DC 20002.
Annual Report Available
Copies of the 1992 Annual Report are now available from
the AT A office. These can be used to provide information
when you are soUciting support for ATA programs from in-
dividuals and businesses in your community.
Self-Help News
Bob Luthmann promotes our agency (#0514) through the
CFC with Ann Geissler, director of Public Relations at 1he
IRS.
Become involved! Pictured here is a New
York City AT A member, Bob Luthmann, at the
Internal Revenue Service's agency fair, where em-
ployee's gather information about the various
agencies in the Combined Federal Campaign to
whom they can contribute through payroll deduc-
tion. Bob is there talking with the employees about
tinnitus and A TA, and distributing our brochures.
This is just one of many ways to help in our "fight
against tinnitus."
American Tinnitus Association
is a participant in the
Combined Federal Campaign
#0514 in the CFC Brochure
Thank You For Helping
To Fight Tinnitus
Professional Associates, continued.
Meredith K L Pang MD
Robert H Payne MS
Benjamin Pereira DDS
Max Ronis MD
Elaine E Sauer
Lucy Shih MD
Thomas E Sonne MD
Robert M Southard
John C Vaughan MD
Joseph P Velek MD
DonnaS Wayner PhD
Brent A Welch II MD
Elliott N Wineburg MD
Howard D Zipper MD
More Tributes
The AT A tribute fund is designated 100% for re-
search. Thank you to all those people listed be-
low for sharing memorable occasions in this
helpful way. Contributions are tax deductible
and are promptly acknowledged with an appro-
priate card. The gift amount is never disclosed.
IN MEMORY OF
Bob Ahrens
Egon & Jeffrey Kot
Louise Anderson
Elizabeth Anderson
Mrs Hilda (Holly) Boone
Thelma P Batchelder
Mrs Elise Caplan's Father
Jacques & Claire Simon
Etalo Del Fiorentino
Steve & Valerie Marchand
The Norvelle Family
Bill Femister
Eary W Smith
Eleanor Fold
Constance Farrell
Mr Hirshberg
Claire & Jacques Simon
Michael W Hurdelbrink
Patricia S Hurdelbrink
John G Jaser
Jasper J Jaser
Rose Kateman's Brother &
Sister
Sally Rice
Richard Allen Mankley
David F Williams
Charles H Marion
Atlantic Underwriting Group
James & Eileen Coyle
Mertain & Janice Gardner
Joseph A Hatch
Jersey Wahoos Swim Club
Dr & Mrs Theodore Lempert
The Rohrbach Family
The Thompson Family
M/M Milton Zimmerman
Max Novack
Claire & Jacques Simon
Douglas R Olsen
John & Faye Schlater
Robert A Palmer
Elizabeth H Palmer
Sophie Perkovich
Ethel Barnhart
Robert & Carly Wood
Edythe D Wood
Jack Reich
Florence Reich
Alan & Selma Rothenberg
Susan R Ericson
Mike Shapiro
AI & Carol Ostberg
Mark Solomons
Herbert A Levin
Thelma Spiegel
AI & Mae Feluren
William Staiger
Leslie Kane
Ralph W Stitt
Bill Haskin
Marion Earle Vernon
Marjorie M Vernon
Bertram Weissman
Sam & Sylvia Eisenberg
Paul Zakin
Lennox & Gloria Wigney
Harvey Wilson
Lisa K Wilson
Charlotte Wiseman
M/M Efrom Abramson
Simon Wiseman
M/M Efrom Abramson
IN HONOR OF
John G Alam-Recovery
Joseph Atam/Trudy Drucker
AT A Staff Support
Virginia Fitzgerald
Pearl Berger - Birthday
Ronald Berger
Ronald F Burnham - Birthday
Martha Burnham
Walter & Harriet Blum
Helene & Mac Herbst
Wilfred & Lisl Lederer
Herbert & Fritzi Owens
William Consalo Jr
Umberto & Kathleen Bifulco
Trudy Drucker - Birthday
AdeleAiam
Joseph G Alam
American Tinnitus Assoc Staff
Mora Emin
Charles Preston
Rosalie & Jim Traver
Mary Tully
John R Emmett MD
Luther J Smith Ill
Luther J Smith II MD
Birth of Theodore Gelman
Joseph Alam/Trudy Drucker
Paul Haas
Douglas H Morgan DDS
Jack R Harary- Birthday
Michael & Cindy Harary
Robert Harary Family
Pearl Hoffman - Birthday
Bea & Joe Weintraub
Wolf Levy
Martin Monas
TinnitusToday/March 1993 17
Tributes, Sponsors, Professional Associates
Dr Max Novich - Birthday
Joseph Alam!Trudy Drucker
Gloria E Reich- Birthday
Marianne & Philip Feldman
Nancy & Dick Kosterlitz
Eva & Gerald Lowen
Robert & Margaret Weil
Laurie & Rob Rosborough
Joseph Alam!Trudy Drucker
Richard Ruderman
M/M S Eisenberg
Eleanor Schroeder-Recovery
Joseph Alam!Trudy Drucker
Dr Abraham Shulman and Bar-
bara Goldstein PhD
Frederick Elkind
Owen Tully- Birthday
Joseph Alam!Trudy Drucker
Dr Jack Vernon
Louise Consalo
SPONSOR MEMBERS
OCTOBER 1992 .JANUARY 1993
Charles L Adams
Joseph G Alam
EarlE Anderson
Atlantic Underwriting Group
John J Banavige
Helene S Benson
Ronald Berger
Sam Berkman
M/M L C Biedenharn Jr
Robert Boerner
Mario Bonello
Raymond L Buse Jr
Gerrie Cabrey
William R Cagney PhD
Charles J Callaghan Jr
Barry Christensen
AndreJ Codispoti MD
Robert W Cole
Delight E Colombatto
Jack Cooley
Richard W Cooper
Anthony G A Correa
Patrick M Costigan
W SCowling II
Jean C Crawford
Gregory Crouch
G Kirby Dawson
Jeffery J DeRassette
AJ Diani
John Doering
Donald B Douglas MD
Trudy Drucker
Randall & Elise Ducote
H Renwick Dunlap
Katherine A Elberfeld
Frederick Elkind
Cecil WEIIis
Douglas C Erikson
Philip F Farha
Julius D Feigelson
Jerry Fetter
John W Finger
18 Tinnitus Today/March 1993
Bernard Fishman
Eunice Fitzell
David E Flatow
Joy Fogarty
Shirley P Fogelberg
Elio J Fornatto MD
Raymond & Francine Foster
Florence M Frank
Norman Frankel PhD
Robin Fuller
Arthur Gelb
Ken P Gelinas
Beverly & lan Getreu
Veva J Gibbard
Nathan L Gibson
Andrew R Gillin
James S Gold
Emanuel Goldman
Andrew Good
C Rod Granberry Jr
Ronald K Granger
Christopher Gray
Dr William C Gray
Claude H Grizzard
Ed Grossberg
Donald B Haake
John R Hafer
William R Hale
Raymond & Camille Hankamer
Harmonious Housing Inc
Alan & Wendy Hart
William J Haskin
Ted Hofmeister
Max Horn
M/M William H Hurt
Robert C lncerti
JasperJaser
Frank H Jellinek Sr
Johnnie W Johnson
Ruth M Johnston
Jack A Jossem
Bernard Kaminsky
Harold S Karpe
Milton Katzman via Congrega-
tion Adas Israel
Harry & Marion Keiper
Emily S Kerley
Ok-Ja Kim
Sidney C Kleinman
Charles & Christine Kostel
Marvin Kowit
R J Kramer MD
Patricia R Kroeger
Floyd E Kuehnis Jr
Clide V Sonny Landreth Ill
Sharon Ann Lemke
PauiLenchuk
Marvin H Levendorf
Herbert A Levin
Romulus Linney
Robert & Ursula Long
Marian B Lovell
W Don Lovell
Ernest V Marsh
A F Martin
Dr Giorgio Mattei
Peter C Mayer PhD
David L McClintock
Jim McElroy
Ed Leigh McMillan II
Thomas F McNulty
John E Meehan
Mary B Meikle PhD
Robert Mermuys
Ernest E Mhoon Jr MD
Carle A Middlekauff
Alexander Miller
Steve Moksnes
Martin Monas
NYC Transit- Charity Committee
Jerry L Northern PhD
Benjamin Ossman
Herbert & Fritzi Owens
Dr Allan F Pacela
John & Sara Patterson
Henry B Peacock/Peacock Fdn
Robert L Pope
D Stewart Precythe
Kenneth A Preston
Anthony M Raia MD
Florence Reich
Gloria E Reich PhD
Harry L Ricketts
William D Riley
Nancy M Rosen
Margaret A Ross
Jack Salerno
William B Salsgiver
Stephen Savegh
Richard Schweiker
Evelyn J Schwertl
Peter & Anne Seamans
Don & Janet Seaquist
David K Sengstack Fdn
Wanda M Shannon
Mrs Ambrose B Shields
Allen C Sickel
Errol W Smith
Patricia & Richard Smith
Robert Smith
Luther J Smith II MD
Luther J Smith Ill
Larry Spoden
Steve Staller
Dr Beatrice States
Douglas H Steves
Susan K Stevens MD
Howard C Stidham
Mrs Ruth M Swan
Richard F Swenson
Harold G Tabb MD
Fred D Thompson
Jim Thompson
Shauna Thompson & Family
William R Tower Jr
Edward L Vadnais Jr
Arlene Van Norden
Arthur & Margaret Verharen
Jack A Vernon PhD
Elbert S Walker
Duane D Walters
Michael Webber
Harold E Wells
Derwin Williams
Keith Winters
Gena Lou Woywood
Pamela Zabell
Cicely L Zeppa
RESEARCH FUND NOVEM-
BER 1992 JANUARY 1993
Marilyn L Torgrimson
Dennis D Heindl
PROFESSIONAL ASSOCIATES
NOVEMBER 1992 .JANUARY 1993
Sean R Althaus MD
George Atkins DMD
F Owen Black MD
Lisa Blackman MA
Warren Brandes DO
Gail B Brenner MAICCC-A
Jack D Clemis MD
Joel G Cohen MD
Richard E Conley
Joseph Danto PhD
C Philip Daspit MD
Shahn A Divorne
Marco Elisabetsky MD
John R Emmett MD
Kathy Foltner MAICCC-A
Chris B Foster MD
Gregory J Frazer PhD
John A Fushman MD
Edward W Gallagher MD
Donald W Goin MD
Robert A Goldenberg MD
Elliott Goldofsky MD
Kenneth Greenspan MD
Bernard Harmon PhD
Soraya Hoover MD
W F S Hopmeier
John W House MD
Gary P Jacobson PhD
Jim Kaloris
Richard S Kaufman DDS
Mitchell P King
Artine Kokshanian MD
Egon & Jeffrey Kot
Barbara Kruger PhD
Les Leale
Howard W Lowery MD
Deborah M Manchester PhD
E Gail Marcopulos MA
Peter & Connie Mercola
Ron Meyer Sr
Steven J Millen MD
Maurice H Miller PhD
William H Moretz Jr MD
Douglas H Morgan DDS
Terrence P Murphy MD
Scott M Nelson MD
Thomas J Norwood MSPAICCCA
Richard J Osborn MA
continued on page 17
4. Describes
Hyperacusls,
the problem of
super-sensitive
ears and how
those who have
it are affected.
Urges protection
from noise.
!JrtfriiLIIldt tlr

RICHARD HALlAM
LIVING WITH TINNITUS
1. Information
is given in the
form of
questions and
answers about
tinnitus.
Covers causes,
treatments,
and effects.
Dealing with the ringing
in your ears through better
understanding and changing
belief s.
5. Supportive
and useful
information
for families
and friends
of people who
have tinnitus.
LEARNING
TO UVE WITH IT
LESLIE SHEPPARD
iVld
AUDREY HAWKRIOGE

TINNITUS LEARNING TO
LIVE WITH IT
Suggestions and advice
from authors who overcame
much of their misery.
2. Presents
coping tips
for reducing
stress. Lists
ways for self-
control of
tinnitus, and
how to seek
help.
1Jii
liM
3. Describes
how noise can
cause tinnitus
and how to
avoid it.
Presents levels
of permissibl e
noise exposure.

TilE SELF-HELP
PROGRAM
John Thddey, DD.S.

TMJ THE SELF-HELP PROGRAM
How to recognize a TMJ
problem, relieve pain and restore
health. When to seek profes-
sional help.
SEE INSIDE BACK COVER FOR FULL PUBLICATION LIST AND ORDERING INFORMATION.