tinnitus today september 1997 vol 22, no 3

7/23/2019 Tinnitus Today September 1997 Vol 22, No 3

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September 1997 Volume 22, Number 3

Tinnitus TodayTHE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION

"To promote relief, prevention, and the eventual cure of tinnitus for

the benefit of present and future generations"

Since 1971Research- Referrals- Resources

In This Issue:Tinnitus and

Homeopathy

Back to School -

Children and Tinnitus

Fad Diets, Quick Fixes,and Tinnitus

New PET Research



'11/1111

/ l j , j ; / ~ ( 1 !



Tinnitus T o d ~ y Editorial an d Advertising offices: American

Tinnitus Association, P.O. Box 5. Portland,

OR 97207, 503/ 248-9985, 800/ 634-8978,hu pJ I w1"w.telepon.com/ NilW

Execuuve Director & Editor·

Gloria E. Reich, Ph.D.

Associate Editor: Barbara Thbachnick

Ton111rus 7bday is published quarterly in

March, June. September, an d December: It ismailed to members of the American TinnitusA ~ s o c i a t i o n an d a selected list ot tinnitus sur.

fcrcn> an d professionals wh o treat tinnitus.

Cn·wlation is rotated to 75,000 annually.

Th e Publisher reserves the right to r c j ~ c t or

edit an y manuscript received for publication

,111d to reject an y advert1s1ng deemed unsuit·

~ b l e for nnmtus 7bday . Accept.mcc of adver·

tt<ing by Tmnuu.s 7bday does not constitute

endorsement of the advertiser, 1ts products

or ! l e r v i t e ~ . no r does Tlnntt!AS 7bday make

an y cla1ms or guarantees to the accuracy

or validity of the advertiser's offer. Th e

opinions expressed by contributors toTmmrus 7bday are not necessarily those ofthe Publisher, editors, staff, or advertisers

American Tinnitus Associauon is a non·

profit human health and welfJre agency

under 26 USC 501 (c)(3)

Copynght 1997 by American Tinnitus

A<'<Ociation . No pa n of th1s publication may

be reproduced, stOred in a retrie1•al system,

or transmmed in anv form, or bv anv means.

wnhout the prior w;itten permission of the

Pubhsher ISSN: 0897·6368

ScientificAdvisoryCommitteeRonald G. Amedee, M.D., New Orleans. LA

Robert E. Brummett. Ph.D., Portland, OR

Jack D. Clemis. M.D. , Ch1r.ago, IL

The Journal of the American Tinnitus Association

Volume 22 Number 3, September 1997

Tinnitus, ringing in the ears or head noises, is experienced by as many

as 50 million Americans. Medical help is often sought by those whohave it in a severe, stressful, or life-disrupting form.

Table of Contents7 Fad Diets, Quick Fixes, and Tinnitus

by Robert Sweetow, Ph.D.

8 Books at a Glance

by Barbara Thbachnick

9 New PET Research Study of Auditory System

10 Tinnitus and Homeopa thy- My View

by Stephen M. Nagler, M.D.

12 Back to School

by Barbara Thbachnick

14 New ATA Support Network Volunteers

15 ATA's New Board Members16 Announcements



Letters to the Editor

From time to time, we include letters from ourmembers about their experiences with "non

traditional• treatments. We do so in the hope that

the information offered might be helpful. Please

read these anecdotal reports carefully, consult with

your physician or medical advisor, and decide for

yourself if a given treatment might be right for you.

As always, the opinions expressed are strictly those

of the letter writers and do not reflect an opinion orendorsement by ATA.

A a thirty-year tinnitus sufferer, I apprecited Barbara Thbachnick's article on

earing protection aboard airplanes

(June 1997 Tinnitus Tbday). Since I am a professor, I need to fly frequently to attend academic

conferences and always dread i t for fear that

the noise might worsen my already bad ringing.For years I have used foam earplugs of the typeshe recommends. These help some, but they failto cut out the loud low drone of the engines.However, there is a solution: noise cancellationheadphones. I have tri ed several brands and findthat, although all work well, the "Noise-BusterExtremes" work best and are fairly cheap. They

can be purchased from Heartland Americafor $69. (800-229-2901 ). Believe me, once you

try them, you'll never fly (or drive) without

them again!Dr. William Fu.sfield, Pittsburgh, PA

[Editor's Note: According to a United Airlines

spokesperson, major U.S. airlines require passen

gers to turn off all electronic devices during takeoff

and landing, regardless ofa device's electrical output. Noise Cancelation Technologies (NCT), manu

facturer ofNoise-Buster Extremes, claims that this

device should not interfere with critical airplane

controls. However, they cannot state it unequivocal

ly. NCT concedes that it might be hard to convince

flight attendants to allow you to wear any electrical

device during takeof fand landing.]

A!chnique for abating the annoyance of

mnitus, which I have had for most of

y life (I am 67 now) was taught to me

about 20 years ago during a human potentialseminar I attended. The technique was supposed to temporarily sharpen hearing, but Ifound it helpful for my tinnitus. Here it is: The

lower part of the palms of each hand are placed



Letters to the Editor (continued)

over both ears in such a way that virtually no

noise can get through. Fingers are pointing tothe back. The index finger is then used to

thump on the bone at the base of the skull. I t

will sound like a not-unpleasant pounding on awall. I thump with the finger from each hand

simultaneously about 50 times.

Even i f he tinnitus sound doesn't diminish,

there is a considerable immediate sense of relief

that lasts for awhile. The technique doesn't

work as well for me as it did 20 years ago, but

there were many occasions when I thought this

was one of the more valuable coping things Ihave learned.

Otherwise, losing some of my hearing and

the tinnitus have no t prevented me from enjoy

ing an active, productive life about which I feel

most grateful.Murray Cohen, Delphos, OH

I ot a good laugh from J a ~ e d M c L a ~ g h ~ i n ' s letter in the March 1997 1ssue of Tinmtus

Tbday. I'm too old to take up the bag pipes,

but he's right - it's a great "masker."

Marlea Rice Warren, St. Louis Park, MN

ving recently completed my experimental tinnitus therapy, coordinated by

E even years ago I was diagnosed with tinnitus (the intermittent, one-note whistle

variety). I was told there was no known

cure. 'IWo years later, while under chiropractic

care for a slightly herniated disk, I was advised

to take lOOmg. of manganese sulfate and 300mg.

of B-complex daily. This helped my back but

surprisingly cured my tinnitus completely with

in a month. The tinnitus would return only if Istopped taking the manganese. I gradually low

ered the amount as the tinnitus episodes abated.

Thday, I have been tinnitus-free for nine

years and only rarely take manganese. This

"anecdotal cure" also worked for my husband'stinnitus. Dr. Lendon Smith suggests, in his book

Feed Yourself Right (Dell Publishing Co., 1983),

that manganese "five to lOmg. a day for a monthor two" might help nervous tissue.

Barbara Carlson, Ottawa, Ontario, Canada.

Thank you for your very well-written

article, "Air Bag Ruling? - Still Up in the

Air" in the June 1997 issue of Tinnitus

Tbday. I have written to NHTSA several times to

ask that our government require automobile

manufacturers to do the research and development necessary for the production of an air bag



Fad Diets, Quick Fixes, and Tinnitus

by Robert Sweetow, Ph.D.

There are two conditions affecting millions

of Americans that most of us will go to great

lengths to avoid. One, as all the readers of this

publication are aware, is tinnitus. The other is

obesity. Obesity and some of the medical prob

lems that result from it (like hyperlipidemia)

have been associated with tinnitus. Thus, many

tinnitus patients have tried a variety of diets inwell-intentioned efforts to control their weight

and "get healthy." Recently, one of my tinnitus

patients, who has made a wonderful adaptation

to the symptom, phoned me in a minor panic

because his tinnitus had suddenly increased

"tenfold." One week later, the tinnitus returned

to its baseline. The apparent culprit was the diet

medication he started just before a t rip overseas.Once he stopped taking the pills, the tinnitus

decreased within three days. He asked me to

look into a possible relationship between the

diet and tinnitus.

Ironically, two days after I began my investi

gation, this diet hit the front pages. My patient

was one of over 18 million people who have

taken the very popular Fen-Phen diet medications since 1990. On July 8th of this year, it was

The point of all this is that tinnitus patients

should proceed with fad diets (and, for that mat

ter, any unproven "cures" for tinnitus) with

extreme caution. There is no long-lasting, quick

weight loss scheme. If you lose weight fast, and

then return to your previous eating habits, the

pounds will inevitably return. Long-term exer

cise and reduction in calorie intake is generally

essential. In other words, a behavioral and psy

chological modification must be made. Tinnitus

"cures" will likely meet with similarly short-lived

fates unless you also alter previous behavioral

patterns, including exposure to noise, exposure

to silence (equally as aversive), and make a psy

chological adjustment to your symptom, recog

nizing that regardless of where the tinnitus

originates from, it is the brain that ultimately

perceives it. Thus, you and your health profes

sional must work together toward developing a

strategy to alter your reaction to your tinnitus so

that you might facilitate eventual habituation.

AIRBAGS.. .

Still Waiting



Books at aGlance

by Barbara Thbachnick, Client Services Manaverb

Clinical Otology, by Gordon B. Hughes and

Myles L. Pensak, 1997.

Thieme Medical Publishers, Inc., The MaplePress Distribution Center, I-83 Industrial ParkPOB 15100, York, PA 17405. Hardbound I480 pages, $139.

This large, glossy, colorfully illustrated book

is a collection of material by clinicians for clinicians. Two chapters focus on tinnitus. The chapter on non-pulsatile tinnitus by Richard H.Nodar and Thny L. Sahey is a short primer on

case history-taking, evaluating tinnitus mecha-• I

msms of tinnitus, and consulting with patients.The authors advise clinicians to approach tinnitus patients with compassion, to acknowledge

how distressing the condition can be, and i f apatient appears to be at "the very edge of control" to gently ask if he or she would like a referral for counseling. The authors admit that thischapter only scratches the surface of a complexand distressing auditory experience.

Aristides Sismanis delineates the multiple

causes of pulsatile tinnitus in a very technical

and thorough chapter replete with diagrams an d

photographs. The various forms (vascular and

authors . Tinnitus is no t specifically mentioned,?ut t r a u m ~ t i c brain injury is. This type of injuryIS the leadmg cause of death and disability in

the United States for individuals age 40 and

younger. Head trauma has been cited as a com

mon cause of tinnitus.

Hearing Loss, by Peter S. Roland, Bradley F

Marple, and William L. Meyerhoff, 1997.Thieme Medical Publishers, Inc., The Maple

Press Distribution Center, I-83 Industrial ParkPOB 15100, York, PA 17405. Hardbound,

316 pages, $69.This book gives strong focus to the ear's

physiology and what can go wrong with it.Multiple contributors discuss disorders of the

outer ear, tympanic membrane, mastoid, middleear, and inner ear. Vestibular disorders an d rehabilitation are also discussed at length. Tinnitus

is mentioned twice - one paragraph defining itand its relationship with hearing loss, and

another explaining the benefits of hearing aids,maskers, an d tinnitus instruments (hearing aidand masker in one unit). Audiologic tests, like

auditory brainstem response (ABR), electrocochleography (ECoG), an d otoacoustic emissions (OAEs) are clearly explained. This highly



New PET Research Study of

Auditory SystemThe University at Buffalo recently received a

$107,000 grant from the James H. Cummings

Foundation of Buffalo to fund a pioneering

research project that will look at how the brain

transforms the sounds we hear into information.

This three-year study will combine images ofbrain activity using Positron EmissionTomography (PET) scans with images of structures in the brain acquired through MagneticResonance Imaging (MRI) to create a unique

image that links neural activities to specificbrain sites. Through the combined images,researchers hope to gain new insights into how

sounds relayed by the auditory system areunderstood.

Directed by Alan Lockwood, M.D., professorof neurology, the multi-disciplinary project willinvolve the departments of nuclear medicine,neurology, communicative disorders and sciences, linguistics, psychiatry and rehabilitationmedicine, and the Faculty of Social Sciences.

Also participating is the Department of VeteransAffairs through the VA Western New York

between sound and the emotion centers in thebrain, we may also be able to better understand

hearing loss and disorders such as tinnitus or

'ringing' in the ears, which is associated with

adverse psychological symptoms such as depres

sion, anxiety and insomnia." This study willcompare the auditory function of "normal hearing" subjects with that of subjects affected by

various hearing disorders. Lockwood and

Richard Salvi, Ph.D. recently received an ATA

grant to study the neural basis of subjective tinnitus using Positron Emission Tomography.

Unlike other imaging technologies, PET

scans produce images of the body's functionsrather than its structure. Magnetic ResonanceImaging provides a detailed three-dimensionalimage of anatomical structures.

Using newly installed MRI equipment and

powerful computers in the VA Medical Center,the researchers will combine the MRI and PETimages to map the functions observed in the

PET scans onto precise locations in the bodyindicated by the MRI images. Part of the funds



Tinnitus and Homeopathy

MyViewby Stephen M. Nagler; M.D., FA.C.S.

The question regarding the appropriateness

of homeopathic approaches to tinnitus management frequently arises. I thought I might try to

shed some practical light on it from a Western

medicine perspective.First of all, it is important no t to confuse

homeopathic medicine with holistic medicine -

an easy mistake to make because the words start

and end with the same phonetic sounds.

Holistic medicine is based upon the theory that

an organism is not merely equal to the sum of

its parts, but must be perceived or studied as a

whole. This particular philosophy has a lot ofappeal to me for many reasons, not the least of

which is demonstrated by the general observa

tion (and my professional experience) that if apatient has a good relationship with his/her surgeon and has a good self-concept, that patient

tends to recover more quickly from a givenoperation than one who does no t.

Homeopathy is something entirely different.I t is based upon the "law" of similia (likes are

who use "extracts" to build up resistance to,

for instance, various pollens. There are two

differences:1. The pollens from which the extracts are made

elicit no symptoms in healthy individuals -

only in individuals with allergies to the pollensin the first place.2. The dilutions used by homeopaths are purer

than distilled water. Distilled water theoreticallyhas less than 1 part in 109 in impurities- or one

part per billion. Homeopaths frequently usedilutions as pure as 1 part in 10 100

- or one part

per billion billion billion billion billion billion

billion billion billion billion. That dilution mathematically has been judged roughly analogous to

placing a crushed grain of rice in a pool of pure

water the radius of which is the distance fromthe sun to Pluto - then drinking a glass of the

solution to get the effect of the rice. (With this

in mind, whether or not homeopathic remedieshelp you, i t seems highly unlikely that they can

hurt you.)The problems that many of us who practice



Tinnitus and Homeopathy (continued)

Since I question the basis of the theory and

since simple double-blind experiments have not

been done to any statistical satisfaction, I find it

difficult to recommend homeopathy as a treatment for tinnitus. Still, some tinnitus sufferers

report that homeopathy occasionally seems to

help them. This observation is termed "anecdo

tal evidence" - a phrase that unfortunately car

ries a lighthearted connotation. But there is

nothing remotely lighthearted about a treatment

that might in certain circumstances be benefi

cial in alleviating the discomfort oftinnitus. In

my experience: No tinnitus sufferer who found

even a small amount of relief ever cared one iota

whether or not the treatment which resulted in that

relief was based on "science. n (Nagler's Law.)

So,how does a reasonable person reconcilethe above apparently conflicting positions - no

scientific basis or solid evidence vs. anecdotalreports of successful treatment? And what posi

tion should a responsible health care profession

al take when faced with this question?

Doctors who state that they depend strictly

on the results of double-blind randomized

prospective studies when they make recommen-dations to patients are either naive or forgetful.Most of us have tricks that "seem to work well

indicated, and in general developing a meaning

ful relationship with the afflicted. This sounds

like what M.D!s used to do years ago beforesome began to sacrifice time at the "bedside" for

quantity of patients treated. Whether this grad

ual change in posture in modern American

medicine is a result of the onslaught of managed

care, or economic reality, or advancing science,

or just plain greed (I suspect a combination of

each), many of our patients have ultimately had

to pay the price. To the homeopath's credit, no

significant compromise has been made withrespect to the time spent with each patient.

Herein might lie the answer to the homeopath's

occasional anecdotal success.

The philosophy of homeopathy cannot readi

ly be measured by traditional double-blind randomized prospective methodology, which may

in part explain the reluctance of the homeopath

ic community to subject their treatment proto

cols to this type of rigorous testing. It does not,

however, explain the reluctance of the homeopathic community to report even retrospectively

specific success rates backed by good data.

If a tinnitus patient told me that he hadexperienced success with homeopathy foranother ailment and wanted to include a home



Back to School

by Barbara Tabachnick, Client Services Manager

I walk into the second grade classroom laden

with a large and mysterious cardboard box.

Despite their curiosity, the seated children there

ask no questions and I give no clues. I put the

box down, take ou t a video and put it in the

VCR. I do not press the "play" button just yet.

With the teacher's permission, I erase some

space on the blackboard then wait to be intro

duced. "I have an important question for you,"I begin. "How many of you have ears?"

I can tell by the giggles and the 25 hands

that shoot up in the ai r that this is not going

to be a tough crowd. I continue, "Oh good. I

came to the

right room . Ihave another

question: How

many ofyou

like your ears?"All hands shoot

up again. I

smile and take

a long, hard

look at the

young faces - and at the trust written all over

them. These eight-year-olds are ready to learn

hearing aids but won't. And some children have

tinnitus - intermittent, pulsatile, and sometimes constant to the point that they cannot

sleep at night. Alarmingly, their parents don'talways know. Also alarming is the data I unwit

tingly gather: an average of two children per

classroom confide in me that they have tinnitus.

Children With Tinnitus

The actual number of children with tinnitusis not known, and for a number of very goodreasons: Children have a difficult time convinc

ing adults of their condition. Children are often

afraid to tell adults that they hear noises.

Children who are born with tinnitus have no

frame of reference and do not know that it is

un usual. When children are given hearing tests,

they typically give positive answers to pleasethe testers. (This makes it hard for testers to

identify what children really hear.) Children alsolikely under-report the condHion because their

busy and distracted lifestyles help them get past

the problems associated with tinnitus.

Dr. Richard Nodar conducted a study in

1972 to approximate the prevalence of tinnitus

- - - - - - - - - - in children.Ofthe 2000



Back to School <continued)

In another study, Graham found that only two

out of 78 hearing-impaired school-age children

with tinnitus reported their tinnitus to be con

stant. "This suggests," he writes, "that where the

electrical'-' ' activity asso-

ciated with

tinnitus has

been present

since birth, it

generally

needs to be

intermittent

to be per

ceived."

Researchers speculate that children's intermit

tent tinnitus might become constant when they

reach adulthood.When it comes to avoiding environmental

noise, like the kind in school gyms or movie

theaters, children have relatively little power -

and they know it. I encourage them to exercise

that power anyway, however slight it might be .

"Ask for your world to be quieter. Ask for the

noise to be turned down. Grown-ups are out

there asking too," I assure them. "We can'tchange everything, but we can change some

message across and short enough to ge t it across

before we lose our audience's attention. We ask

questions, draw on the board, watch a video, do

an earplug demonstration, play a game. Every

week from September through June, we present

the program to a different school. And by

request, we send Hearing Conservation kits tovolunteers across the U.S.

Teaching is a slow process. I t is also won

drously rewarding. Thousands of children arenow putting earplugs in their ears properly (or

close to it) who had not done so before. Childrentell us that now they understand why their ears

ring after they go to basketball games. One

seven-year-old who complained about his broth

er's loud stereo before the presentation said to

me excitedly afterwards, "I know what I'll do. 1'11tell him to TURN IT DOWN! But I'll have toshout it, 'cause if I don't, he won't hear me."

How critical is it that we disseminate this

information? Completely. Children and their

parents, grandparents, and teachers are still in

the dark about the unforgiving consequences of

excessive noise: permanent hearing damage,

tinnitus, learning disabilities, other health ills,and the concomitant damage to the emotionalwell-being of everyone concerned.



Back to School (continued)

ResourcesBoodman, Sandra G., Researchers say airplane noise curbs

reading skill, The Washington Post.

Gabriels, Pam, Children with tinrtitus, Proceedings

of he Fifth International Tinn itus Seminar, editors,

Gloria Reich and Jack Vernon, 1995.

Graham, J.M., Tinnitus in hearing-impaired children,

Tinnitus, 1987; 131-143.

Graham, John, Paediatric Tinnitus, Journal of Laryngology

an d Otology, Supplement 4, 1981; 117-120.

Graham, John, and Jane Butler, Tinnitus in children,

Joumal of Laryngology and Otology, Supplement 9, 1984;236-241.

Mills, R.P., and D.M. Albert, C.E. Drain, Tinnitus in child

hood, Clinical Otolaryngology, 1986, l l ; 431-434.

Nodar, Richard H., Tinnitus aurium in school age children:

a survey, Journal of Auditory Research, 1972; 12, 133-135.

Nodar, Richard H., and Mary H. W. LeZak, Pediatric titmitus

(a thesis revisited), Journal ofLaryngology and Otology,

Supplement 9, 1984; 234 -235.

Stouffer, J.L., and R.S. 1Jier, J.C. Booth, B. Buckrell,Tinnitus in normal-hearing an d hearing-impaired children,

Proceedings o f he Fourth International Tinn itus Seminar, edi

tors, Jean-Marie Aran and Rene Dauman, 1991.

How can you get the free

Elementary School

NewATA Support

NetworkVolunteers

Support groups commonly reassemble in thefall after their summer hiatus. This fall, several

new groups are beginning too. Welcome back,

and welcome all!

The Tinnitus Support Network is designed

to offer one-on-one contact between those

who have found treatments and coping ski11s

that work and those who are still looking for

answers. Thousands of people use this resourceevery year.

Are you ready to help others? Please let

us know. We will gladly send you a packet of

materials to help you become a telephone

contact or support group leader.

New Support Group Leaders

Sharon Weinhaus

425 E. 58th St. #40B

New York, NY 10022

212/758-0791

Larry Maurer

9680 Glenstone Dr.

Kirtland, OH 44094

216/256-8023

Edna Young

1808-C N.W O'Brien Rd.

Lee's Summit,

MO 64081

816/246-4644

(near Kansas City)

Mitzi Cahn

1439 Bonita Ave.

Berkeley, CA 94709510/527-9075



ATA's New Board MembersStephen Nagler, M.D.,

F.A.C.S.

Dr. Nagler writes:

"After my graduation in

1975 from Northwestern

University Medical School,I completed an internship

and residency in GeneralSurgery and surgical subspe

cialties. I am a Diplomate ofStephen M. Nagler, M.D. the American Board of

Surgery and a Fellow of the American College of

Surgeons. As a surgeon, I am intimately familiar

with the physical impact of disease as well as its

emotional consequences upon patients and their

loved ones."Prior to becoming Director of the new

Southeastern Comprehensive Tinnitus clinic, Ispent two years studying the anatomy, physiolo

gy, and pathology of the auditory system as they

relate to the etiology of tinnitus and the efficacyof various treatment modalities. I have lectured

on numerous tinnitus-related topics - includingthe multi-modality approach to tinnitus patient

management, the role of pharmacologic agentsin tinnitus therapy, and the place of hypnosis in

tinnitus treatment.

Sidney Kleinman

Sid writes:"I believe that each day is a'gift,' sometimes wonderful

and marvelous, and some

times no t so great. But it isa gift to be enjoyed and

experienced. Furthermore,one cannot just take from

the World and Life in aSidney Kleinman

narcissistic manner. One

must give back and try to assi st others.

"As a result, throughout my professionalcareer, I have always made a commitment toothers as - among other roles - a volunteer

working with emotionally disturbed teenagers; avolunteer attorney representing rent strike build

ings in Chicago's inner city; a co-founder of achamber symphony; an active member of theAdvisory Board of the DePaul University School

of Music; and now as a member of the Board of

the American Tinnitus Association."It is my hope that I will be able to assist ATA

in its role as the advocate for th e silent tinnitussufferers of this country - in advancing continue d research to find the mechanisms of tinnitus

and the means to ameliorate its symptoms -



Announcements

ATA To Receive $5000 FromBarry Manilow

As the result of a court settlement, BarryManilow - the man who "writes the songs" -has also written a check to ATA. Philip Espinosa,an Arizona Court of Appeals judge and ATA

member, brought suit against the famous performer after a 1993 concert left him with severe

tinnitus. "I expected soft amplified music,"Espinosa stated, but the music was too loud and

he now has a constant "screeching" in his ears.

While neither Manilow nor his production

company admits any fault, Espinosa believes the

suit will be helpful in raising consciousnessabout the serious problem of high volume levelsat entertainment events. "Unfortunately in our

society, large industries like the music business

do not listen to you unless you file a lawsuit,"he said. "It (the money) is not a large amount

in terms of a permanent injury, but it's a very

significant amount for the American Tinnitus

Association."

MedWatchThe U.S. Food and Drug Administration

(FDA) has a way for the public to confidentiallyreport problems with any medication (prescrip

a recognized pioneer in tinnitus research. In thisvideo of that lecture, Dr. Vernon discusses theorigins of tinnitus treatment and the contemporary applications of masking, hearing aid use,and other treatments for tinnitus remediation.His formidable knowledge, practical experience,and gracious manner highlight the hour.

Cost.· $20 (shipping included), Running time: 59minutes, 20 seconds

Send check to: OHSU, Office of Community

Relations, Attn: Thrry Erb, 3181 Sam Jackson

Park Rd., L101, Portland, OR 97201-3098

The Third Course on Tinnitus

Retraining Therapy for Management of

Tinnitus & HyperacusisSeptember 28-30 1997Organizers: Pawel J. Jastreboff, Ph.D., Sc.D., and

Margaret M. Jastreboff, Ph.D.Tinnitus & Hyperacusis Center, University of

Maryland, Baltimore, MD 21201 USA

This course will cover the following topics:+ An outline of common methods for treating

tinnitus and hyperacusis

+ Theory and clinical implications of ourapproach



Back Issues of Tinnitus TodayYour interest in Tinnitus Tbday back issues

has been tremendous. Thank you!The following is a list of the featured topics

in each issue. Almost every issue contains ·Dr. Jack Vernon's Q & A column, information

about self-helping, research updates, and (fromSeptember 1994 to the present) Letters to the

Editor.

The cost per issue:$2.50 (member price); $5.00 (non-member price)See the table below for shipping cost.For orders outside the U.S., please add $5to the total shipping cost.

Supplies are still ample for most issues

listed. A few, however, are available only as

photocopies. Every effort will be made to send

the originals.

J une 1997 Barometric Changes and the Ear;Elderly People and Tinnitus; Air Bag update

March 1997 NIDCD-funded Tinnitus Research,Treatments for Subjective Tinnitus; Similaritiesbetween Tinnitus and Chronic Pain; Air Bagupdate

Dec. 1996 Air Bag Safety- Air Bag Risk;

Interview with researcher Jos Eggermont, Ph .D.Sept. 1996 Ototoxic medications; Silent Dental

September 1993 How Tinnitus is Generated;

HypnosisJune 1993 1Jpes of Hearing LossMarch 1993 Anatomy of the Ear; Researchreport (PHOTOCOPIES ONLY)

December 1992 TMJ

September 1992 Industrial Liability CaseJune 1992 ATA history; Monitoring YourTinnitus

March 1992 Interaction of Earmold Acoustics,Real Ear Resonances, and Tinnitus MaskerResponsesDecember 1991 Fourth International Tinnitus

Seminar; Personal Injury lawsuitsSeptember 1991 Tinnitus in the Nursing

Home; Research report; Cochlear Implants

June 1991 VA Info; Hyperacusis; Researchhighlights (PHOTOCOPIES ONLY)

March 1991 Noise and Tinnitus; There is Hope;Tbny RandallDecember 1990 Tinnitus Measurement; Drug

Therapies

September 1990 Older Americans and

Tinnitus; Research Report; ADAJune 1990 Cognitive Therapy; AmplificationMar ch 1990 Noise-induced Hearing Loss in

Musicians; Vestibular Disorders; Tinnitus in the

14th CenturyDecember 1989 Tinnitus Patient Management;



ATXs Passport to Progressby Cora Lee (Corky) Stewart,

Program Development Director

While i t is often fun to impulsively take off

on a quick trip to an undetermined destination

a real journey requires careful planning. YouI

need to know where you are going, how you

will get there and, perhaps most importantly,

why you are going there. For the past year, the

ATA Board of Directors and staff members havebeen planning what could be classified "a major

journey" for ATA. As such, it's bound to be the

trip of the century, so hop on board for ATA's

Big Adventure.

What I'm referring to is, of course, ATA's

Strategic Plan, which sounds like a rather boring

business document bu t is really an exciting

itinerary that defines ATA's direction, approach,and focus for the next five years. On July 1 (the

start of this fiscal year), the Plan became our

roadmap.

This is not to imply that ATA has been drift

ing aimlessly; far from it - as a non-profit

organization, i t is in an enviable position. With

a diverse membership, it is financially stable,

recognized internationally as a credible sourcefor tinnitus information, and is the leading advo

formed an incredibly intense inspection of

everything ATA has done and wants to do· what

similar organizations are doing; and what needs

aren't being met in the tinnitus arena at large.They agreed, disagreed, discussed, and even

cussed. But the result is a clearly defined Planfor ATA, complete with measurable objectives,

workable projects, and reachable time lines.

The good news is that there was consensuson the major points and considerable validation

of much of ATA's past activities. The bad news is

that we had to accept the fact that our resources

are limited and we can't continue to be allthings to all people. This clarity of focus is

reflected in the new ATA mission statement:

Th promote relief, prevention and the eventualcure of tinnitus for the benefit of present and

future generations.

Naturally, finding a cure for tinnitus was

(and is) the number one priori ty for everyone,so investing i n - and advocating for - research

will continue to be the most important compo

nent for ATA. And until the cure is found, there

is clearly a continuing need for an organization

that provides programs tohelp people

avoid getting tinnitus and that supports those who have

it. Thus we've ended up with the EARS Plan



AMERICAN TINNITUS ASSOCIATIONStrategic Plan- July 1997 through June 2000

Mission:

PROGRAM S:

7b promote relief, prevention, and the eventual cure of tinnitus for the benefit ofpresent and future generations

Education Goal: To further awareness and understanding of tinnitus through education

Thrgets: Hearing health professionals, primary care physicians, general public'Ibols: Tinnitus Today and ATA brochures, professional workshops, workplaceand classroom seminars, exhibits at conventions, targeted mailings, media

placementsMeasurements: Currently there are no statistics pertaining to actualawareness of tinnitus, so the first step will be to conduct a survey to establishbenchmarks. (Education efforts work: In 1986, patients were told to "learn to

live with it" ahout 83% of the time. By 1996, the figure was down to 74%.Similarly, in 1986 only 33.7% felt their physicians were helpful, but that

improved to 58.2% by 1996. In 1986, only 31% of the people surveyed had tried

any form of tinnitus treatment. By 1996 that number had jumped to 60%.)

Advocacy Goal: To advocate for tinnitus in the development and implementation of

public and private policies'Ibols: Participation in federal meetings and policy making for the NationalInstitute on Deafness and other Communication Disorders (NIDCD) or similaragencies; direct contact with health insurance providers and with manufacturers

of noisy products.Measurements: While 83.7% of the respondents to ATA's 1986 survey receivedpartial or complete insurance coverage for their tinnitus treatments, claimprocessing is often complicated and sometimes litigious. ATA will work to

establish a liaison/advisory role with major insurers to improve this situation.Many manufacturers of noisy products provide cautionary information, but few



Questions and Answers

by Jack A. Vernon, Ph.D.

[Q]Mr. S. from Hawaii writes to report an

unusual aspect about his pulsatiletinnitus. He indicates that his pulsatile

tinnitus can be 99% eliminated by extendedneck flexion, that is, placing the chin firmly on

the chest. What, he asks, is the possible mean-

ing of this effect?

It may mean that the pulsatile tinnitus

is coming from a partial occlusion in the

carotid artery and that the neck flexioncauses that blockage to be somehow relieved.Mr. S., may I ask you i f any physician has

listened to your neck region to see if he or she

can hear your pulsatile tinnitus? You describe it

as a high-pitched whine, thus the listener would

need to have good high frequency hearing inorder to detect your pulsatile tinnitus. If your

pulsatile tinnitus is an objective tinnitus

(detectable by others), then a surgical exploration of the neck region using temporary liga

tion (a tying-off) of the possibly offending artery

may lead to a cure for you. Note that this is amajor procedure! I do know of one case where a

surgeon did essentially that. With a stethoscope,the surgeon explored the opened neck area and

There is a significant difference between

pink noise and white noise. White noisecontains all frequencies from 20Hz

through 20,000Hz. Pink noise contains frequencies from 200Hz through 6000Hz. The purpose

of the listening exercise is to establish normalloudness tolerance for everyday ordinarysounds. Remember hyperacusis is no t the lowered threshold for sound detection but rather it

is a collapse of loudness tolerance. The usualsounds to which we are exposed are composed

of frequencies from around 200Hz to around

4000Hz. Also recall that hyperacusis is inverselyrelated to the pitch of the sound: The higher thepitch, the less the loudness tolerance. Sometime back, a patient in our hyperacusis treatment program questioned our use of white

noise for desensitizing hyperacusis ears on thegrounds that the high frequency portion of the

white noise would delay the recovery process.Instead the patient suggested that we use pinknoise which contains those frequencies foundin normal environmental sounds and does notcontain the high frequencies. Our patient'sreasoning seemed reasonable to us and we have

been using pink noise ever since. I t is criticallyimportant for hyperacusis patients to not over



Questions and Answers (continued)

[Q]Ms. G. from Ohio writes that one health

care professional said she did not needhearing aids, another said that she does,

and a third said that she needs both tinnitus

maskers and hearing aids. Naturally she isconfused.

Regarding hearing aids, the way todetermine whether or not you need

them is to try them. You can do this with

a 30-day money-back guarantee. In some cases,a hearing aid is all that is necessary for relief

of tinnitus. Mostly it will depend upon the kind

of hearing loss you have and the pitch of your

tinnitus. If the tinnitus is low-pitched and if the

hearing loss extends into the low frequencies

then perhaps hearing aids are all you need .If, on the other hand, you have a high-pitchedtinnitus and a high-pitched hearing loss then

the combination of hearing aids and tinnitusmaskers (called tinnitus instruments) are what

you should try. Many physicians believe that

the high frequency loss does not interfere with

normal hearing. And they are correct - so longas the patient is in a quiet place and speaking

one-on-one. Unfortunately we are more commonly in the presence of background noise.

relief from the use of vinpocetine. Hopefully

someone here in the U.S. will conduct a pair ofstudies of this drug. First, an open study shouldbe done where everyone gets the drug. If that

turns out to produce positive effects in high

enough numbers, then a double-blind placebocontrolled study should be done. If you don'twant to wait for the results from such studies,you can write to Interlab, BCM Box 5890,

London WCIN 3XX, England and request an

order form. Vinpocetine (or Cavinton) is an

over-the-counter drug in England and SouthAmerica but you still might need a physician'sprescription to order it. Vinpocetine sells for$26 per 100. If you order and use vinpocetinewe will be most interested in your results.

[Q]Mr. B. from California, who noticedcomments in Tinnitus 1bday suggestinga relationship between pain and tinnitus,

offers direct evidence of such a relationship.Mr. B is cursed with otalgia (ear pain) and tinnitus which started eight years ago. The cause of

his otalgia has not been discovered but the paincan be relieved by narcotics. Severe chronic pain

haskept Mr. B.

on Demerolwhich

has beeneffective not only for the pain but has also



Questions and Answers (continued)

[Q]Mr. B. from Michigan was told that his

hearing was so impaired that maskingwould not help him. He further states

that even with hearing aids, he can hear peoplespeaking but cannot understand what they are

saying.

Regarding masking, never judge in

advance. Always conduct a trial. Mostlikely the best chance for success for

you, Mr. B., is with tinnitus instruments. Ifyou

try the tinnitus instrument remember that it isessential to adjust the hearing aid portion first.Only after that do you add in the maskingsound.

Speech comprehension is a common complaint,especially among elderly patients with hearing

losses. The act of understanding speech involvesnot only hearing the speech sounds but also processing those sounds in the brain. The processing actually requires a certain amount of time to

achieve. Apparently as we age, that processing

Learn Lip Reading

with this Fun,Self-Help,

of speech sounds (like many other things) simply slows down. And it doesn't have to slowdown much for speech to become an incomprehensible mess. Dr. David Lilly of OHSU conducted a study where the time interval between

utterances was increased by 250 milliseconds.The delayed timing as compared to the normal

timing of speech improved speech comprehension significantly for the elderly hearing

impaired. Unfortunately, as yet there is no

wearable electronic device available that can

effect the slower presentation. I t will be helpfulto you, however, i f you suggest that those speaking to you do so not louder but more slowly.

Notice: Many ofyo u have left messages requestingthat I phone you . I simply cannot afford to meet

those requests. Please feel free to call me on any

Wednesday, 9:30a.m.- noon and 1:30-4:30 p.m.

(503/494-2187). Please send your questions to:

Dr. Jack Vernon c/o ATA, Tinnitus 7bdayPO Box 5, Portland, OR 97207-0005.



Tinnitus Transformation

from Sufferer to Survivor

by Thomas J. DA.iuto

I had never heard the word

tinnitus uttered until the

day of my injury. And after

15 years as a police officer, Iwish I could say I was

injured in some heroic way.But my injury was the result

of a weight-lifting accident

in the police fitness room.

The medical diagnosis was"perilymph fistula," but basically I pushed toohard on the bench press and exploded my inner

ear. I clearly remember that other than the sen

sation of a pop and a clogged feeling, the firstsymptom was a ringing sound which I thought

was a phone in the gym!

When I got up from the weight bench, I wasnauseous and off-balance. I stumbled back tomy office to call my doctor but there was no dialtone when I picked up the phone. Now sick and

mad that the phones were broken, I asked my

secretary to check her phone. I t worked. As Itried her phone I discovered that I was deaf in

now know feeds directly from and supports thetinnitus. It is depression.

Until my audiologist told me about the .ATA,

I had been on a two-year downward spiral, with

what appeared to be no help in sight. I can

clearly remember receiving my first issue of

Tinnitus Tbday and how I read it from cover tocover as if it were food for a starving individual.1 also can remember sitting there alone and crying, realizing that I was not crazy or unique in

my pain. Tinnitus Tbday has become my "lifepreserver." And it seems to always be thrown

my way just when I most need it.I began and continue to receive counseling

and drug treatment for depression. Stil1, when

the depression starts to clear and I feel activeand alive, the tinnitus reminds me that living in

this noisy, busy world extracts a hefty price. I t is

a vicious circle in that when I do feel well and

in need of stimuli, it is the stimuli that willdrive me back to seclusion which starts the

cycle over. Although I know my major tinnitus

triggers, there is no way to eliminate them

entirely without eliminating my quality of life.This is where tinnitus and depression appear to



Tinnitus Transformation (continued)

bring tinnitus out of the closet and in turn and if

possible, help prevent someone else from suffer

ing from this affliction, maybe even help find a

cure. Since tinnitus is not a fatal illness, it is

hard for many to take it seriously. I am con

vinced that it's up to us - people with tinnitus

- to push for acceptance, understanding and,

ultimately treatment. This has been a huge fac

tor in my transformation from tinnitus suffererto tinnitus survivor.

I am also blessed in having a wonderful and

understanding family- my wife, Lindy, and my

son, Tony - who perceive my discomfort level

when we're ou t socially and are completely sup

portive i f I need to leave when the noise

becomes unbearable. Both Lindy and Tony arewell-educated about tinnitus, and volunteer

their time and efforts at our monthly support

group meetings and by taking support phone

calls when I'm not able to. This is another major

positive factor in living with this disease.

Now with the help of excellent therapists

and rehabilitation counselors, I am back in

Guidelines for Writers

school full-time (and pulling straight A's) work

ing towards a paralegal degree. I know I cannot

work in a traditional work environment due to

the severity of my tinnitus but I can utilize new

computer technology to work from home. I've

learned through vocational counseling and mar

ket surveys that there are many local employers

who will accommodate my needs. I look forward

to making the transition from a police criminal

investigator to a criminal and litigation

researcher. The tools will change - from hand

cuffs and a gun to a computer mouse and theInternet- but the skills remain the same.

So I try to enjoy the good days, and know

that even on the deepest, darkest days, just over

the next cresting wave is a lifeboat. Inside are

fellow survivors (not sufferers) smiling, as one

tosses the next copy of Tinnitus Tbday my way.

While I yearn for the day my "life preserver"

carries the headline TINNITUS CURED, the

warmth, compassion, and understanding of

these survivors rescue me and 1 know that

I am not alone.



SPECIAL DONORS and TRIBUTES

ATA's Champions of Silence are a remarkable

group of donors who have demonstrated their commitment in the fight against tinnitus by making acontribution or research donation of $500 or more.Sponsor Members and Professional Associates

have contributed at the $100-$499 level. ResearchDonors have made research-restricted contributionsin any amount up to $499.

acknowledged with an appropriate card to the

honoree or family of the honoree. The gift amount isnever disclosed.

Our heartfelt thanks to all of these specialdonors!

All contributions to the American TinnitusAssociation are tax-deductible.

GIFTS FROM 4-16-97 to 7-15-97.A T ~ s Tribute fund is designated 100% forresearch. 'Ihbute contributions are promptly

Champions of

Silence(Contributions of$500 and above)Julia R. AmaralAllen R. BernsteinRobert w. BoothRichard Burnat

Rob M. Crichton

Glen R. CuccinelloCornelius R. DuffieJosephine K. Gump

David W. Hopkins,Fonnit PrintManagement

W. F. Samuel

Hopmeier, BC-HISHarry G. an d Marion

KeiperJohn Malcolm

Bruce MartinJohn E. Meehan

Raymond L. Buse, Jr.Raymond L. BuseMemorialFoundation, Inc.

John F. CaddvBarbara Young CampStan ColeMichael L. ConnollyRichard R. Cortright

CliffordS.

CraigGeorge Crandall, Jr.Carole DesnoesIrene DuffieldA. T. EvansRobert Fasic and Roy

GrieshaberBernard FishmanDavid E. FlatowMary A. FloydFrancine and Ray

FosterElliot S. FrankfortRobin R. Fuller

Marvin KowitE. Joseph KubatAllan S. KushenHenry G. LargeyFred R. LawsonEvelyn Schrader LeeRuth T. LelszGary W. LightnerGary L. Lombardi

Peter ManasseAugusto MarcianteEllen Anne MarksPeter A. MarrinanAndy MatthiesenMr. and Mrs. M.

Richard MayGudrun Wallgren

MerrillJohn M. MeyerAlexander Miller

Judith MmerMatt MinningerPhilip 0. Morton

Forrest ShookDavid J. Simm

Raymond C. SimonJoel Smith

Connie StantonRichard H. StecklerVeronica

SteffensmeierDouglas H. Steves

William an d Cora Lee(Corky) StewartElsebeth S. StrykerRichard W. SullivanAntril C. Suydam

Robert L. SzaboFred D. Thompson

James C. TottenJack WallnerDavid J . WalshJ . Michael Wiggins

MaryB.

WilliamsonShirley L. WiremanStephane W. Wratten

Carlos Herraiz, M.D.David T. Malicke, D.O.

Sol Marghzar. M.S.,CCC-A

Ernest E. Mhoon, Jr.,M.D.

Stephen E. Mock,Ph.D.

Kenneth E. Mooney,

M.D.Philip A. Rosenfeld,M.D.

'Thnit Ganz Sanchez,M.D.

Martin SmithDr. Blair R. Swanson

Corporationswith

Matching GiftsAmerican Express

Chase ManhattanCPC InternationalHoechst Celanese



SPECIAL DONORS and TRIBUTES (continued )

TRIBUTES

In Memory OfFlorence Angello

Mary G. KalilMrs. Louise Barrows

Mark Jurich

'f rudy Drucker,Ph.D .

Barbara M. Handy

Mary R. KokesHazel V. Fingal

John H. And Faye L.SchleterBernhard GarfinkleShirlie Kesselman

Lydia KonitzerJames KonitzerIrene Lomax

Kolbrenner &Alexander, L.L.C.

Jerry PragerSybil BarzilayEd ThnnienJoella and Lester

SatterthwaiteMary J. McGorray'Thd Van Sloote nArlo and Phyllis Nash

In Honor OfJack Harary

(for Father's Day)Bob and Debbie

Harary and Family

Ronald W. BocksrukerJoyce C. BodigDarlene K. BohincMildred S. BonwitRichard C. BorellaChristina BourdaaTheodore T. BoutisBessie M. BowensSr. Antoinette BoykinTrene E. Brennan

Kathleen M. BrockElaine F. BrodeyBarbara F. BrownGay BrowneHarry A. Bruhn

J. Ben BuckPaul Bunts

Michael W. Burnham

Abigail H. BurrDaniel M. CahillMiriam W. CampbellMichelle CanzioDaniel J . Carlin

Joh n CarloStuart A. ChalfantSusan P. ChizeckLorime r T.

Christensen

Jean CinaderC. Dennis Clardy

Thomas R. Coffey, I IArthur P. Coletta, CVS-

LifeArthur B. CollierE.

Landon CollinsMary J. CollinsEileen T. Corcoran

Elaine Gannon

David J. GaudieriMark S. GellerOtto GenoniJu dith M. GillErwi11 C. GotschPeggy B. Gouldman

Seymour GreensteinNorman GrolmanJack A. GubancJohn F. HallgrenJohn R. Hammond

Laura E. HardyCharles T. Hawn

Mrs. F. W. HeesBetty J . Reisch

Geraldine Herrs. Dale HessE. Alan Hildstrom

Paul G. HillCirel HillmanLouise M. HirasawaSara Jean Hoffmann

LorettaL.

HughesDorothy Ikemeyer

David P. Ja nkofskyBarry V. JohnsonHoward W. Johnson

Christopher A. KaelinRebecca B. KaisermanR. L. KeheleyFrank L. Kellogg, Jr.Fred F. KentopWayne M. Kern

MichaelW.

KerschenDavid Kiecker

John E. Kinney

Byron R. MannLillian P. MarkowitzJohn MasciaJulianne MattimoreJohnathon R.

McCartneyMarvin MeskerShirley A. MillerWard T. MilnerGladys V. MooreWalter N. MorganFranco MormandoHarry H. MorrittE. Susan MortonDavid E. MotternElayne MyersMae Nachmanlan L. Natkin

Vivian NewillJerome H. Newman

Regine R. NexsenRobert NicholsDonald G. O'Brien, Sr.

WilliamD.

OdbertCurtis S. OlsonRobert OroszBenjamin OssmanKarl E. Owen

John PalazzoEdward PalinJan ie L. Palmer

Carl J . PaluckiThmmy Kells Parker

Kanti S. Patel

Sharon PayneRobert PecciniH. w. Pedersen

Richard S. SchonwaldWilliam SchwartzArlan R. SchwoyerJim Shawn

Norma T. SheldMark W. SholofskySylvia K. ShugrueKatherine L. SimmonsSherwood L. SimmonsRaymond C. SimonMark A. SniegowskiMildred F. SohnJean

SpenceElizabeth H. SpencerMaureen T. SprohgeJames J. SteponikDouglas H. StevesJim StokesJames E. StorerLyle E. StrahanSteven Strong, M.D.Elsebeth S. StrykerRaymond L. Sullivan

Ronald Swid1erHelen K. ThylorKaren M. Thomson

Eugene F. TI:uaxLen UflandWayne VaughnMaxine VincentLee K. VorisekMichael VucelichMildred WadJerMark K. Wallack, M.D.

Marc WeinsteinRichard L. WeisErik Wennermark



Noise, either of short or long duration was jump in 1996 to 60%. People also reported getting



associated with the onset of tinnitus for 36.8% of

the respondents. Another 36% did not know wheretheir tinnitus came from. 12% reported it from ear

infections. Various other causes were reported in

small numbers.

Nearly 70% of people responding reporthaving a hearing loss. Strikingly 75% of thesepeople do not wear hearing aids. The majority

considers tinnitus a greater problem than hearing

loss.

Almost everyone, 97%, has health

insurance. Only 16% report no coverage for tinnitus,83.7% received either partial or complete payment

Tinnitus has a significant effec t on the lives

of those completing this survey. It interfered with

work for 56.8%, with social interaction for 69.3%,and with general enjoyment of life for 85.7%.

Additionally, 70.8% of the respondents reportedbeing depressed. In spite of these numbers onlyabout 12% have had to quit work because of

tinnitus.

Ninety people reported their tinnitus led to

litigation, bu t most have taken no steps to achievea settlement. Ten have begun litigation. Twenty-sixreported receiving a favorable settlement and 33

reported receiving an unfavorable settlement.

It appears that some headway is being

made in educating both professionals and thegeneral public. Patients in 1986 were told to "learnto live with it" about 83% of the time. That haddecreased to about 7 4% by 1996. Physicians will be

pleased to note that respondents now consider

them 58.2% helpful with tinnitus - a dramaticincrease from 33.7% ten years ago. However,91.7% of the respondents did not think they hadbeen offered effective relief!

In 1986 only 31% of the people had triedany form of tinnitus treatment, that number

increased a little in 1992, to 34%, but took a big

relief from what they'd tried. Masking in its variousforms, including retraining therapy and bedside

masking accounted for most of the successes.Drugs for tinnitus accounted for considerable relief,but not as much as in 1992.

More than 10% of he respondents reportedattending ATA self-help group meetings with themajority rating them good to excellent.

HOW CAN I FIND HELP FOR MY TINNITUS?

The American Tinnitus Association, a non-profitorganization, supported solely by private donations,is dedicated to helping tinnitus patients andsupporting tinnitus research. Activities include the

production and distribution of public awarenessmaterials, educational programs for the professionaland lay communities, establishment and guidancefor self-help groups and their leaders, and thepromotion of community hearing protectionprograms.

For further information and membership benefits:

AMERICAN TINNITUS ASSOCIATION

Post Office Box 5

Portland, OR 97207-0005

Tel: (503) 248-9985 Fax:(503) 248-0024http://www.teleport.com/-ata

e-mail: [email protected]

A non-profitvoluntary human health and welfare agency under

26USC 501 (c)(3) @ATA 0997

RESULTS OF THE

1996 TINNITUS

PATIENT SURVEY

FROM THE

AMERICAN

TINNITUS

ASSOCIATION

I GENERAL INFORMATION 7. Employment status: I TINNITUS DESCRIPTION



1.Age: Mean 59.76, Range 19-91

2. Sex: 62.3% male, 37.4% female

3. Marital Status:MarriedNot married

4. Ethnicity:WhiteNon-white

5. Education level:

72.1%27.9%

96.3%3.7%

Grade schoolHigh/vocnl school

1.0%22.8%

6. Where residence located by geographiccensus area:

NortheastMidwestSouthWest

27%20%25%

28%

Full time 36.9%Part time 7.8%Retired 42.8%UnempiJDisabled 4.7%Not empl.outside home 7.8%

Major Lifetime Occupation

8. Major occupation throughout life:Sales/officeTeacher/student/creativeHomemaker/farmerAdmin/managerScientist/medical

Mechanic/const.lfactoryFire/Police/Military

9. Annual family income:Under $25,000$25,000 to $49,999Over $50,000

10. General Health Level:Excellent 34.6 %Good 52.6%Fair 11.0%

Poor 1.8% .

13.0%33.8%53.2%

23.8%18.9%15.6%15.1%14.9%

6.7%4.9%

11 . How long have you been aware of your

tinnitus?:Up to 1 yr

1 up to 2 yr

up to 5 yr

5 up to 10 yr

10 up to 20 yr

20+ years

5.9%8.7%19.4%22 .7%23.8%19.4%

12. Did the tinnitus come on gradually or

suddenly?:GraduallySuddenlyUnsure

34.2%51.0%14.8%

13. Where does your tinni tus seem to belocated?:

Lef t ear 15.7%Right ear 11.0%Both ears 54.6%

In head 7.7%In head & ears 10.0%

14.1s your tinnitus constant or ntermittent?:Hear it part time 16.6%Constantly there 83.4%

15. What does your tinnitus usually soundlike?:

RingingHissing

Transformer noiseBuzzingClear ToneSizzlingPulsatingWhistleHigh TensionOcean RoarHum

29.3%22.2%

8.7%5.3%5.3%4.1%3.1%3.1%2.3%2.3%1.7%

16. Tinni tus loudness rating on a scale 1 to 10,where 10 is the loudest.:

Mode 5; Mean 5.95; Median 4.92



17. Onset association:Not known 36.0%

Noise exposure/long time 18.5%Noise exposure/brief 18.3%Ear Infection 12.0%Drugs 5.6%

Illness 5.1%

Head Injury 3.1 o/o

Whiplash 1.4%

18. Do you also have a hearing loss?:No 21.8%

Yes 69.9%

Unsure 9.7%

19. Do you currently wear a hearing-aid?:No 74.9%

Left ear 8.1%

Right ear 6.3%

Both ears10.7'1/o

20. Which is more of a problem?:Tinnitus 59.4%

Hearing loss 14.6%Equal bother 22.8%

Unsure 3.1%

• TINNITUS AND HEALTH CARE

21. Do you have health insurance?:

No 2.9%Yes 97.0%

22. Were the costs of your tinnitus visits

covered by insurance?:No 16.0%Partial 54.4%

Yes 29.3%

23. How many tinnitus visits to any health careprofessionals have you made in the last 12

months?:Mean 1.11

24. How many visits since tinni tus onset?:Mean4.3

25. Were health care professionals helpful andsympathetic?:

AgreeDisagree

58.2%41.5%

26. The treatment offered reduced or

eliminated tinnitus:AgreeDisagree

8.0%91 .7%

27. The treatment offered was ineffective:Agree 58.5%

Disagree 41 .0%

28. Only treatment offered was "Learn to Jive

with it":

Agree

Disagree

74.1%

25.3%

29. Have you tried any form of treatment for

your tinnitus?:No 39.5%Yes 60.0%

Listanyproviding relief:

Bedside maskersAuditory HabituationMaskersDrug TherapyHearing-aids

BiofeedbackAcupunctureOther

65.0%

50.0%

47.3%

42.8%

37.4%

31.8%19.1%38.1%

30. Visited a health professional on ATAreferral list?:

NoYes

81.5%

18.2%

31. Rate care received from that referral: (248people reporting)

Excellent29.4%

Fair17.6%

Good 37.3% Poor 12.9%

IV TINNTUS AND THEQUAliTY OF UFE

32 . How much effort to ignore tinnitus?:Easily ignored 16.8%Ignored with effort 41.5%

Considerable effort to ignore 26.9%

Can never ignore 14.9%

33. Feel irritable due to tinnitus?:NeverSometimesOftenAlways

16.5%57.3%

21.4%

4.9%

34. Sleep problems due to tinnitus?:NeverSometimesOftenAlways

31.0%

48.4%

11.6%9.0%

35. Ever feel depressed due to tinnitus?:Never 28.24'/o

Sometimes 51.8%

Often 14.9%Always 5.1%

36. How much does tinni tus interfere withwork?:

NoneSlight amountModerate

Great

37. Ever quit work due to tinnitus?:NoYes TemporarilyYes Permanently

43.1%

31.3%

16.7%

8.8%

88 .0%6.8%

5.3%

38 . How much does tinnitus interfere withsocial activity?:

NoneSlight amount

ModerateGreat

30 .8%30.24'/o

22.S0.4

16.6%

39. How much does tinni tus interfere with Bibliography service 44. Rate the self-help group you attended



enjoyment of ife?:NoneSlight amountModerateGreat

14.2%

42.5%

27.0%

16.2%

V RATING OF ATA'S SERVICES

40. Rank ATA services according to their

importance to you:

> Publication of "Tinnitus Today"Very important 73.0%

Somewhat important 24.3%

Not at all important 2.0%

Financial support of tinnitus researchVery important 80.7%


Not at all important 4.2%Publication of tinnitus brochuresVery important 54.5%



Sale of books about tinnitusVery important 29.3%


Not at all important 21 .0%

Professional referral networkVery important 45.7%


Not at all important 14.1%Establishment & support of local selfhelp groups

Very important 29.5%



Public awareness & preventionprograms


Somewhat impor tant 28.3%




Not at all important 32 .6%

Workshops/seminars fo r professionalsVery important 61 .3%



Forums/regional meetings fo r peoplewith tinnitus




Lobbying & advocacy about tinni tuswith Federal government

Very importantSomewhat importantNot at all important

68.2%

23.1%

8.1%

41. Rate quality of Tinnitus Today in meeting

informationa l needs about tinn itus and ATAactivitiesExcellentGoodFairPoor

50.1%

41.7%

8.0%

0.2%

42. Rate tinni tus books and brochurespurchased from ATA in terms of meeting your

needsExcellent

GoodFairPoor

27.7%

54.4%15.7%

1.1%

43. Have you participated in an ATA tinnitu sself-help group

No 72.0%

Yes 10.5%

None in my area 17.4%

Excellent 16.0%

Good 46.2%

Fair 26.1%

Poor 4.2%

VI TlNNmJS LEGAL ISSUES

45. Tinnitus caused by circumstance leadingto litigation?:

NoYes

92.4%

7.6%

If yes, have you taken: (number of people who

checked this response)No steps to settle 173

Plan to take steps 21

Have begun litigation 10

Reached favorable settle 26

Reached unfavorable settle 33

VI TlNNRUS SURVEYS:Comparing 1986, 1992, and 1996:

ATA conducted a readership survey in 1986and again in 1992 and 1996. The 1986 survey was

mailed to 130,000 names, 13,000 surveys werecompleted and returned. Every 5th survey wascoded and a total of 2514 entered for statisticalanalysis. In 1992, 39,000 were mailed and 7,500

returned. Again, every 5th survey, total 1429, wascoded for analysis. The 1996 survey was sent to15,000 names, 3,736 were returned and every 3rdone, a total of 1 232, was coded and analyzed.

Examination of the ATA databasecorroborated our assumption that the surveys hadbeen completed by substantially different groups.

The demographic information provided in

each of the three surveys was strikingly similar.

tinnitus today september 1997 vol 22, no 3

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