June 1999 Volume 24, Number 2

Tinnitus day
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinni tus for
the benefit of present and future generations"
Since 1971
Education -Advocacy - Research - Support
In This Issue:
Gaze-evoked Tinnitus
'Iteatment of Tinnitus
and TMJ Dysfunction
Perfusion of the Inner
Ear Via Round
Window Membrane
The Tinnitus Research
Consortium
Tinnitus Prevention
in Young People
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Tinnitus
Editorial and Advertising offices: American Tinnitus Association, P.O. Box 5, Porriand, OR 97207 S03/248998S, 800/6348978 http:f jwww.oto.org
Executive Director & Editor:
Gloria E. Reich, Ph.D.
Associate Editor: Barbara Thbachnick
Timuttts 7bday is published quarterly in
March. June, September, and December. It is
mailed to American Tinnitus Association
donors and a selected list of tinnitus suffer-
ers and professionals who treat tinnitus.
Circulation is rotated to 80,000 annually.
The Publisher reserves the righr to reject or
edit any manuscript received for publication
and 10 reject any advertisi ng deemed unsuit-
able for nnmtts 7bday. Acceptance of adver-
tising by Tinnitus 70day does nor constitute
endorsement of the advertiser, its products
or services. nor does Tinnitus Thday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The
opinions expressed by comributors to
Tinnitts 7bday are not necessarily those of
the Publisher, editors, staff, or advertisers.
American Tinnitus Association is a non-
profit human health and welfare agency
under 26 USC 501 (c)(3).
Copyright 1999 by 1\merican Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
without the prior wrirten permission of the
Publisher. ISSN: 0897-6368
Executive Director
Gloria E. Reich, Ph. D., Portland, OR
Board of Directors
James 0. Chinnis, Jr., Ph. D., Manassas, VA
Claude H. Grizzard, Sr., Atlanta, GA
w. F. S. Hopmeicr, St. Louis, MO
Gary P. Jacobson, Ph.D., Detroit, Ml
Sidney Kleinman, Chicago, JL
Paul Meade, Tigard, OR, Chairman
Philip 0. Monon, Portland, OR
Stephen Nagler, M.D., F.A.C.S. , Atlanta, GA
Dan Puljes, New York, NY
Aaron I. Osherow, Clayton, MO
Susan Seidel, M.A., CCC-A, Thwson, MD
Tim Sotos, Lenexa, KS
Jack A. Vernon, Ph.D., Portland, OR
Mcga11 Vidis, Chicago, JL
Honorary Directors
The Honorable Mark 0. Hatfield,
U.S. Senate, Retired
Tony Randall, New York, NY
William Shatner, Los Angeles, CA
Scientific Advisors
RDnald G. Amedee, M.D., New Orleans, J..A
RDbert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, l L
Robert A. Dobie, M.D., San Antonio, TX
John R. Emmett, M.D. , Memphis, TN
Chris B. foster, M.D. , La Jolla, CA
Barbara Goldstein, Ph.D., New York, NY
John W. House, M.D., Los Angeles, CA
Gary P. Jacobson, Ph.D., Detroit, Ml
Pawel J. Jastreboff, Ph.D. , Atlanta, GA
William H. Manin, Ph.D., Portland, OR
Gale W. Miller, M.D., Cincinnati, OH
J. Gail Neely, M.D., St. Louis, MO
Robert E. Sandlin, Ph.D., El Cajon, CA
Alexander J . Schleuning, 11, M. D.,
Portland, OR
Abraham Shulman, M. D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Robert Sweetow, Ph. D., San Francisco, CA
Legal Counsel
Henry C. Breithaupt
Sroel Rives Boley Jones & Grey.
Portland. OR
The Journal of the American Tinnitus Association
Volume 24 Number 2, June 1999
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.
Table of Contents
9 Perfusion of the Inner Ear Via Round Window Membrane
by John R. Emmett, M.D., FA.C.S.
11 Gaze-evoked Tinnitus
by Richard Salvi, Ph.D., and Alan Lockwood, M.D.
13 Tinnitus Prevention in Young People: A Survey of
Students in Hamburg
by Michael Freitag (translated by Mimi Macht)
14 Thmporal Bone Organ Donations
15 The Tinnitus Research Consortium
by James B. Snow, Jr., M.D., FA.C.S.
16 Announcements
17 Successf ul Treatment of Tinnitus in Patient s with
TMJ Dysfunction
by Ira M. Klemons, D.D.S., Ph.D.
18 Community Health Charities -Public Donations
for Tinnitus
19 TinnitusSupport@Groups
by Barbara Tabachnick
20 My Friend T
by David Barber
26 1999 Calendar
Regular Features
4 From the Editor
by Gloria E. Reich, Ph.D.
5 Letters to the Editor
21 Questions and Answers
by Jack A. Vernon, Ph.D.
24 Special Donors and Tributes
Cover: sunflowel's' (watercolor), by Gail Wells-Hess, wells56@ibm.net ol' 800/ 776-4245.
Represented by the Seattle Art Museum Rental Sales Gallery, Seattle, Washington.
Posters, cards and original painting available.
American Tinnius Association Tinnitus Today/June 1999 3
FROM THE EDITOR
by Gloria E. Reich, Ph.D.,
Executive Director
On September 5, 1999, the
International Tinnitus Support
Association will hold a meet-
ing at Fitzwilliam College,
Cambridge, UK. The meeting
will run from 1-5 p.m. and
will feature presentations
from several international
group representatives as well as my chairman's
report and a general discussion. Part of the order
of business will be to elect a new chairman who
will serve until 2002 when the group meets again
during the 7th International Tinnitus Seminar in
Perth, Australia. There is no special registration
required to attend the ITSA meeting and anyone
with an interest in furthering tinnitus support
or self-help, especially in countries that don't
presently have such an association, is cordially
invited to attend.
I wish to thank all of you who have given so
generously of your time and money during the
years that ATA has grown to be the pre-eminent
organization for tinnitus in the world. Most of
the tinnitus organizations in countries worldwide
have patterned themselves on the ATA example.
These organizations have brought hope to mil-
lions of people through their caring and sharing
of knowledge. Much has been learned about tin-
nitus during these two decades and it is very
appropriate at this point to acknowledge the fine
research projects that we, and others, have fund-
ed during the last 20 years. Finally,
there seems to be a glimmer of
~ light at the end of the tunnel
and I'm hopeful that the next
~ decade will truly bring relief for
many from the incessant sounds of
tinnitus. Your help is still needed,
however. ATA research is funded
primarily from your
"restricted to
research" dona-
tions over and
above your annual
membership
contribution.
4 Tinnitus 7bday/ June 1999 American Tinnitus Association
Research that ATA has seeded has brought
new ideas to the hearing research field. Those
new ideas have generated more effective treat-
ments for tinnitus and sdentific inquiries that
were not even thought of in the 1970s. We've
seen patients helped through better diagnosis
because there is now a large data base that pro-
vides information for the primary physician as
wen as for the hearing specialist. This data base,
called the Tinnitus Data Registry, began at the
Oregon Hearing Research Center and is now to
be utilized and supplemented on a nationwide
basis through the Veterans Administration
Hospitals. Masl<ing, a technique developed by
Dr. Jack Vernon and colleagues, has provided a
basis for helping patients for more than 20
years. It also was the forerunner of the very suc-
cessful procedure known as Tinnitus Retraining
Therapy. Sounds are employed in both of these
treatments: masking provides instant relief to
those who find the sound an acceptable substi-
tute for their inner noise; TRT employs a similar
sound, but more quietly so that over time the
brain learns to ignore both it and one's own
internal sound. ATA has supported the Tinnitus
Data Registry, Dr. Vernon's early work about
masking, and Dr. Pawel Jastreboffs later studies
about TRT.
ATA has also supported studies about various
psychological interventions. It has been
observed that often a combination of therapies
will achieve much more relief than a single
procedure. Some of these involve stress relief
through behavior modification training, cogni-
tive therapy, biofeedback, acupuncture, relax-
ation therapy or a myriad of other mental and
physical exercises. Another approach has been
the use of drugs to alleviate tinnitus. People who
have been deprived of sleep by their tinnitus are
often grateful and relieved to have their physi-
cians find a drug that can help them rest quiet-
ly. In rare cases, surgery for the treatment of
some other related problem provides help for
the tinnitus as well.
More recently, ATA and other funding
organizations have supported basic research
designed to identify the actual causes and mech-
anisms of tinnitus. The most encouraging of
these studies have involved the use of sophisti-
cated imaging techniques that can show sites of
activity in the brain when tinnitus is either pre-
Letters to the Editor
From time to time, we include letters from our
members 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 or endorsement by ATA.
,
have noticed improvements in tinnitus
symptoms since I began adding vitamin
supplements to my daily diet. They also
seem to reduce my sensitivity to loud sounds
and the sensation of "fullness'' in my ears.
After about a week of taking a 600 mg of
magnesium, I noticed a difference in the tonal
quality of my tinnitus which I have had for 37
years. The ringing is more tolerable and subdued
now, less "metallic" in quality. I still have periods
of increase especially when I lie down, and peri-
ods of near absence right after my morning
shower, but overall improvement has occurred.
Ed Edwards, PO. Box 971, Warsaw, MO 65355
FROM THE EDITOR (continued)
sent or absent. Where tinnitus used to be the
exclusive property of the hearing profession, it
has now become an area of interest for psycholo-
gists, neurologists, dentists, and others who have
found interesting areas of overlapping activity.
Dipping into these areas so briefly, I want to
remind you that Tinnitus 'Ibday regularly pro-
vides articles with in-depth coverage about treat-
ment for tinnitus. You may also utilize ATA's
bibliography service to inform yourself of the
many ways tinnitus can be helped.
Do you want to help tinnitus research direct-
ly? All you need do is complete the survey in the
middle of this issue. The information that is
collected will help direct the course of research
projects that are now being planned. This is your
chance to make a difference. II
A
s most of your readers know, Dr. Vernon
donates every Wednesday of the year to
receiving telephone calls from those of us
around the world who have tinnitus. Over the
years he has helped and given hope to thou-
sands of people. After one recent conversation
with Dr. Vernon, I offered to pay him for the
consultation, but he refused saying this was one
way he gives something back to humanity.
Thus, I urge all others who are being helped by
Dr. Vernon and those who have been helped in
the past to make a donation to the ATA in his
honor. It would be one way of expressing appre-
ciation to him for his unselfish work.
Enclosed is my check. Perhaps we can estab-
lish a Jack Vernon Honor Fund which can be
used to further tinnitus research. I am sure that
that is something Dr. Vernon would endorse.
Paul Guyton, 100 South Georgia Ave.,
Mobile, AL 36604, 334/438-1992
Editor's note: ATA's 'Ihbute Fund was established
for just such a purpose. Contributions that are
made to honor special individuals can be designat-
ed specifically for tinnitus research. And yes, Jack
approves of this very much!
(continued)
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American Tinnitus Association Tinnitus Tbday/ June 1999 5
Letters to the Editor (continued)
T
he December issue of Tinnitus Today,
which included Dr. Nagler's article on
Ginkgo biloba, was of particular interest to
me. I began using Ginkgold in 1992, and found
it to be most helpful in suppressing the mild
tinnitus in my left ear. In 1996, I started to
develop the nosebleeds mentioned in Nagler's
article. I have not found ENT specialists to be
helpful or knowledgeable about tinnitus, so I
didn't consult with my physician when the
nosebleeds began. On a hunch, I stopped using
Ginkgold in February of 1997. It was probably
several months before the nosebleeds ceased
entirely.
A year later, my tinnitus was noticeably
worse. In addition, I began to have sudden,
slight episodes of imbalance. Frightened
by the progression of my symptoms, I tried
Phospholoba, another ginkgo product. But the
nosebleeds resumed immediately, so I gave
that up after a six-week trial.
In October of 1998, I visited a chiropractor
for a mild recurring neck injury. The chiroprac-
tor prescribed Osteomax, a calcium supplement
(500 mg calcium, 200 mg magnesium, 200 IU
vitamin D, 100 mg L Lysine- one tablet daily).
While I am pleased to report that my neck
is now fine, I am even happier to say that
Osteomax seems to be having a mitigating effect
on my tinnitus. The relief became noticeable
within two weeks ofbeginning the supplement.
It is not as effective as Ginkgold was but there is
enough of a change in my condition to warrant
its continued use. Sometimes I hear no tinnitus
at all; other times I hear it in both ears. While
two months is admittedly too short a period
from which to draw blanket conclusions, I hope
this information will be of help to some ofyour
readers. The address for the manufacturer of
Osteomax is: Nutraceutics Corporation,
Deerfield Beach, Florida 33441.
Valerie Foley, New York, NY
6 Tinnitus Tbday/ June 1999 American Tinnitus Association
,
had tried many prescriptions for my tinnitus
but they did no good. Then a friend recom-
mended that I try the herb Ginkgo biloba.
I started to use Sundown Vitamins' ginkgo,
standardized extract 6% terpene lactones,
120 mg. As long as I take at least two per day,
it stops the ringing in my ears. What a relie1
Wayne Livingston, 292 East Garden Ave.,
Salt Lake City, UT 84115
I
'm a musician, so the reasons for my mild
case of tinnitus might seem obvious.
However, the truth is that I don't attend loud
concerts or play loud music. So how did I get
tinnitus?
During a rather desperate point in my life
three years ago, I chose to take a telemarketing
job. I had reservations about wearing head-
phones all day, but I thought I could bear it
until I found a better job. The headsets we had
to wear were made so that we not only heard
the person on the other end of the line, but we
also heard our own amplified voices through the
headphones. Th make matters worse, if we had a
caller whose voice was especially faint, we had
to turn up the volume to hear the customer
which made our voices louder too! I tolerated
this until my ears were physically sore. Eventu-
ally I spoke with management and demanded
that something be done. I was fortunate that
they let me train for another position.
Sleeping is now often difficult because I
hear a hiss I can't turn off. During the day,
my ears get tired easily. I have to pace myself
and take frequent breaks to keep from getting
headaches.
I have contacted the headset manufacturer
(Plantronics) but they do not believe that some-
thing they make - and that was approved by
OSHA - could be harmful. I hope to continue
spreading the word to the audio equipment
manufacturers so they can make their products
safer. And I hope that people will learn that
our hearing so often depends on the choices
we make.
Jeremy J. dePrisco, 717/ 657-0611,
jdeprisco@paonline. com
Letters to the Editor (continued)
I
am an ATA member, and appreciated your
excellent article, "Sound Sensitivity," in the
September 1998 issue. A resource you didn't
mention was the hyperacusis listserv, a means
for on-line communicating with people who are
interested in the topic.
To subscribe, send an e-mail message to
majordomo@utdallas.edu
Write: subscribe hyperacusis yourname
It should take your e-mail address. It is run
by the University of 'Texas at Dallas where
there is a tinnitus/ hyperacusis clinic at the
Callier Center for Communication Disorders
(214/ 905-3027).
I am a teacher in another area, but was
treated at the clinic with excellent results.
Susan Chizeck, Ph.D., Director of Internships,
U of 'Iexas at Dallas, MS GR 2. 6, Richardson,
TX 75080-0688, 9721883-2354, fax 972/ 883-2440
I
feel for Dr. Vernon's four patients who suf-
fered hearing loss and tinnitus as a result of
air bag deployments in otherwise minor traf-
fic accidents. I have tinnitus as a result of noise
exposure from a single rock concert. My biggest
fear now is being exposed to another loud noise.
And the biggest risk, I feel, is from an air bag
deployment. It is enough of a fear that I have
decided to not purchase a new vehicle.
Dr. Vernon's letter to NHTSA [see the Dec.
1998 Tinnitus Tbday] in which he called for
on-off air bag switches is well intended. But I
feel that a slightly different solution is needed.
First of all, the air bag is activated by sensors
designed to activate when a certain speed is
exceeded. The problem is that NHTSA has set
the acceleration level at which the air bag must
deploy too low, a level at which the car's occu-
pants are not at risk to severe injury. That is
why an air bag can deploy in a 12 mph collision
in a parking lot. I believe that NHTSA needs to
significantly raise the impact speed threshold
for air bag deployment.
It is arguable as to whether or not air bags
cause more harm than they prevent. Given this,
I feel that individuals should not be forced to
use them.
Stephen P Maxin, 503 Penny Lane, Cockeysville,
MD 21030-2757
I
don't mean to beat a dead horse but it really
irks me when people, especially trained
professionals in the hearing field, pronounce
tinnitus with a soft vowel sound on the second
"I" instead of the long "I" (as in eye).
I think it is important to consider the fact
that both Dorland's Medical Dictionary and
Taber's Cyclopedic Medical Dictionary list the long
"I" pronunciation as the first, or most prominent
one. (In fact, my 1981 edition of Thber's only
lists the long vowel form). Which pronunciation
best describes the condition of ringing in the
ears: a soft word (tin-it-us), or a sharp one (tin-
night-us) that hits the mark?
Those of us with this persistent and nagging
problem would agree that it's not a matter to be
diminished by description. Please - especially
you professionals - call it like it is!
Brian R. Lux, PO. Box 363, Pollock Pines, CA
95726-0363, 530/ 642-0628
W
ill you please correct the pronunciation
of this medical condition which is not an
infection or inflammation of anything, as
the suffix "itis" indicates? You must teach every-
one to say tin' i-tus, not tin-night'-us, as on the
new poster. This really bugs me!
Marion J. Nims, 4629 194th St. S ~ #311,
Lynnwood, WA 98036
Editor's Note: When ATA was founded in 19 71,
the founders considered the pronunciation of the
word. The director at that time opted for Dorland's
Medical Dictionary's preferred pronunciation -
tin-night' -us. Both pronunciations (tin-night'-us
and tin'-i-tus) are used and acceptable.
American Tinnitus Association Tinnitus 7bday/ J une 1999 7
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8 Tinnitus 'Jbday/ June 1999 American Tinnitus Association
Perfusion of the Inner Ear Via
Round Window Membrane
by John R. Emmett, M.D., F.A.C.S.
In previous issues of Tinnitus
Tbday a number of different
treatment modalities for trou-
blesome ear noises have been
reviewed. These modalities
include tinnitus masking,
habituation training, and the
treatment of tinnitus with
various oral medications and
electrostimulation. This article
is not about a specific treat-
ment (i.e., a drug), but rather it is intended to
make the reader aware of a drug delivery system
to the inner ear that has become the subject of
increasing interest in research involving disor-
ders of the ear, hearing, and balance.
Any medkation, whether taken orally or
intravenously, reaches its site of action via the
bloodstream. Occasionally a particular medica-
tion will have a certain predilection for a certain
target organ, but generally speaking the medica-
tion becomes evenly distributed throughout the
body. For example, if a person is receiving an
antibiotic for an ear infection, the level of the
antibiotic in the patient's little finger is about the
same level as found in the ear itself. Because of
the real or potential side effects of many medica-
tions, the dosage level has to be kept relatively
low. The same problem is encountered in radia-
tion therapy for certain malignant tumors. The
dosage of the radiation has to be adjusted to
prevent potential damage and subsequent side
effects to structures and organs immediately
adjacent to the tumor. In recent years, radio-
active materials, commonly called seeds, have
been directly placed into the tumor mass, there-
by achieving a much higher level of radiation to
the tumor mass while sparing the surrounding
tissues of potential harmful effects of higher
levels of radiation.
In the last several years, there has been
increasing interest in a similar treatment modali-
ty to the inner ear. The ear is commonly divided
into three anatomically different spaces. The
outer ear is made up ofthe pinna (earlobe)
and the external auditory canal (ear canal). The
middle ear consists of the tympanic membrane
(eardrum) and three ossicles (hearing bones).
The inner ear consists of the cochlea (snail-
shaped portion of the inner ear containing the
hearing nerve) and the three semicircular (bal-
ance) canals. The small thimble-sized space
underneath the eardrum, called the middle ear,
is separated from the inner ear, which is com-
pletely encased in bone, by a small membrane
called the round window membrane.
The round window membrane lies at the
end of a sma11 cave-like opening in the middle
ear called the round window niche. The round
window membrane is semi-permeable, which
allows some fluids placed into the middle ear
space to perfuse or, as our used to
say, "seep," into the inner ear much hke coffee
passing through a coffee filter. This fact allows
for the introduction of drugs into the middle ear
space that subsequently seep into the inner ear.
This results in a higher therapeutic level of the
medication in the inner ear fluids than could be
achieved by giving the same medication orally
or intravenously. This has led to a number of
ongoing studies using a variety of medications
(some of which could have toxic side effects to
other organ systems when administered orally
or intravenously) for the treatment of a variety
of ear, hearing, and balance disorders.
The procedure itself can be performed with
the use of a topical anesthetic agent or under a
general anesthetic. Critical to the success of a
perfusion procedure is visualization of the round
window niche and removal of any tissue that
may be blocking the niche, which would pre-
vent medica6on from coming into direct contact
with the round window membrane. (The niche
is covered by an outer layer of tissue in approxi-
mately one-fourth of individuals.) This can .be
achieved by a standard middle ear exploratiOn
done through the ear canal whereby the con-
tents of the middle ear can be inspected after
folding back the eardrum. If the round windo.w
niche is blocked, the tissue is removed exposmg
the round window membrane, and the eardrum
returned to its normal anatomical position. A
small incision is made through the eardrum,
and the middle ear space is filled with medica-
tion. An alternate method, which can be done
(continued )
American Tinnius Association Tinnitus 7bday/ June 1999 9
Perfusion of the Inner Ear (continued)
under a topical anesthetic while the patient is
awake, is done by making an incision through
the eardrum directly over the round window
thereby allowing visualization of the round win-
dow niche and membrane. Once it is established
of the drug have been found in the lower and
upper turns of the hearing portion of the inner
ear (cochlea) as well as in the balance portion
(vestibule) after being left against the round
window membrane for three hours
1

that the round win-
dow niche is not
blocked, the medica-
tion is injected into
the middle ear space
through the incision
in the eardrum.
In 1987 and 1991,
Sakata, Iota, and their
colleagues
2

3
reported
treating 61 Meniere's
patients with perfu-
sion through the
round window with
The incision in the
eardrum typically
heals in five to seven
days. Most medicines
are suspended in
another solution,
such as Hyaluron,
which results in a vis-
cous, or syrup-like,
liquid that is intro-
duced into the middle
ear space. This helps
maintain the medica-
tion in the middle ear
space, adjacent to the round window membrane.
If the medication was not suspended in such a
material, it could drain down the eustachian
tube and into the back of the throat. The patient
is then instructed to lie down with the operated
ear up for three hours. Depending upon the
medication used and the ear disease being treat-
ed, the perfusion is usually done on a daily basis
for several days.
2 mg of dexametha-
sone. They received
good results regarding
control of vertigo and
improvement of hear-
ing. Parnes et al,
4
have shown that anti-
inflammatory steroids
do not readily enter
the inner ear fluids
after oral or intra-
venous administra-
tion, even in larger-
___________ _. than-therapeutic
In the past, the inner ear condition most
commonly treated by perfusion of the inner ear
via the round window membrane is Meniere's
disease. Meniere's disease is due to an abnormal
inner ear fluid build-up, the cause of which is
not fully understood. This condition results in
the symptoms of fullness in the ear, tinnitus,
fluctuant hearing loss, and vertigo. Drugs that
have been used in the past in the treatment of
Meniere's disease using this treatment modality
include gentamicin, streptomycin, and more
recently dexamethasone or a dexamethasone/
streptomycin combination.
There is good experimental evidence that
dexamethasone readily passes through the
round window membrane. Large quantities
10 Tinnitus 7bday/ J une 1999 American Tinnitus Association
doses, but do get into the inner ear fluids and
remain longer after round window perfusion.
Shea, Jr., and Ge
5
reported their results of
dexamethasone perfusion of the inner ear plus
intravenous dexamethasone for Meniere's dis-
ease in their first 21 patients with a one-year
follow-up. Their study showed improvement of
hearing in 67.9%, reduction of fullness in 89.3%,
a reduction oflow-tone tinnitus in 82.1 %, and
relief from dizzy spells in 96.4%. The hearing
was made only slightly worse in one patient
(3.6%). In 1997 Shea, Jr.
6
reported extremely
encouraging results with the perfusion of dexam-
ethasone and streptomycin for the treatment of
Meniere's disease.
It has been established that the round win-
dow membrane is semi-permeable and allows
passage of certain medications into the inner ear.
This is a finding that has opened up a whole new
area of research with regard to inner ear disor-
ders. Hopefully in the foreseeable future,
Tinnitus Tbday will be able to report to you the
results of research that uses inner ear perfusion
for the troublesome symptom of tinnitus. m
Gaze-evoked Tinnitus
by Richard Salvi, Ph.D., and Alan Lockwood, M.D.
Patients who have undergone surgery to
remove a tumor from their auditory I
vestibular nerve sometimes develop an
unusual form of tinnitus - gaze-evoked
tinnitus. This type of tinnitus significantly
increases in loudness and/ or pitch when
the patients move their eyes to look to
the side.
When we were trying to locate individuals
with gaze-evoked tinnitus to participate in our
brain imaging studies, we thought we would
be lucky to find five individuals with it. (It was
thought to be a rare phenomenon since only a
few case sh1dies have been reported in the scien-
tific literature.) However, we have identified over
100 individuals in the United States who have
gaze-evoked tinnitus. We were surprised by the
large number of acoustic neuroma patients who
have this kind of tinnitus.
With our colleague, Robert Burkard, Ph.D.,
we are now analyzing the data from these
tinnitus patients by comparing their PET brain
images as they shift their eyes from looking
straight ahead (when the tinnitus is low) to
looking to the side (when the tinnitus is loud).
So far, the results of our study have produced
striking results. Specific regions of the brain
are definitely activated, or tur ned on, by gaze-
evoked tinnitus.
Despite the fact that the patients lose hearing
in the ear from which the tumors are removed,
the subjects in our study report hearing the tin-
nitus in their deaf ears. There is an inescapable
conclusion that must be drawn from this obser-
vation: the neural signal causing gaze-evoked
tinnitus must be generated in the portion of the
brain devoted to hearing and not in the deaf-
ened inner ear. The brain likely "rewires" itself
after the tumor is removed. We hypothesize that
the aberrant, irregular neural connections that
are formed lead to gaze-evoked tinnitus.
Our research team has recently published
a comprehensive PET study in which we've
mapped the neural responses to pure tone
sounds in normal subjects. We anticipate that
the data from this investigation will serve as an
important benchmark for comparing the normal
human auditory system to the auditory system
of patients with tinnitus and/ or hearing loss.
The long-term goal of our study is to apply PET
imaging technology to more standard forms of
tinnitus. Ill
Dr. Salvi is a researcher at the University of
Buffalo's Center for Hearing and Deafness.
Dr. Lockwood is a professor of neurology and a
researcher at the University of Buffalo's Center
for Positron Emission 7bmography. In 1998,
Drs. Lockwood and Salvi received a $1.5 million
grant from the National Institutes of Health for
this five-year study.
Richard Salvi, Ph.D., Hearing Research Lab,
215 Parker Hall, University of Buffalo, Buffalo, NY
Phone: 716/829-2001, fax: 716/829-2980
E-mail: salvi@acsu.buffalo.edu
Web site: http:! lwings.buffalo.edu/faculty/
research/ chd/
Perfusion of the Inner Ear (continued)
References
1. Nomura, Y., Otological significance of the round window. Advances in Otorhinolaryngol 33: 67-72, 1994.
2. Sakata, E. , N. ltoh, A. ltoh et al., Comparative studies of the therapeutic effect of inner ear anesthesia and
middle ear infusion of a steroid solution for Meniere's disease. Pract Otol (Kyoto) 80: 57-65, 1987.
3. Itoh, A. , E. Sakata, Treatment of vestibular disorders. Acta Otolaryngol Supple (Stockh) 481: 617-623, 1991.
4. Parnes, L.S., A.H. Sun, D.J . Freeman, Corticosteroid pharmacokinetics in the inner ear: A comparison of
different drugs and routes of administration. Presentation to the Middl e Section of The American
Laryngological, Rhinological and Otological Society. Dearborn, Michigan, January 21 , 1996.
5. Shea, J.J., X. Ge, Dexamethasone perfusion of the labyrinth plus intravenous dexamethasone for Meniere's
disease. Otolaryng Clin of North Am 29: 353-358, 1996.
6. Shea, J.J., The role of dexamethasone or streptomycin perfusion in the treatment of Meniere's disease.
Otolaryng Clin of North Am 30: 1051-1058, 1997.
American Tinnius Association Tinnitus 'TOday/June 1999 11
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12 Tinnitus 'TOday/June 1999 American Tinnitus Association
Tinnitus Prevention in Young People:
A Survey of Students in Hamburg
by Michael Freitag (translated by Mimi Macht)
Reprinted with permission from the Deutsch
Tinnitus-Liga e. V's Tinnitus-Forum, August 1998
In order to initiate and promote various
measures of tinnitus prevention, 1 spent seven
months among teenagers and young adults
researching the possibilities. The core of my
research was a written survey administered to
584 male and female students aged 15 to 21.
I personally conducted this survey in January
and February of 1998 at a variety of high schools
and trade schools. The results of my research
follow.
I was guided by two principles: to check
on the necessity of tinnitus prevention geared
specifically to young people, and to gain some
insight into which particular measures of pre-
vention should be addressed in the future.
I chose schools for this survey so that a
variety of young people could be included.
Previously, only certain young people had been
consulted in a study of this nature, namely sol-
diers or university students. The young people
in my survey had a choice, either to participate
or to decline; the parents of minor children also
were given the opportunity to refuse if they
did not want their children to take part in the
survey. The young people demonstrated an
extraordinary interest in the subject manner,
as witnessed by the return rate of the question-
naire (97%). In addition, there were lively dis-
cussions after the questionnaires were turned
in, in which I answered their questions and
informed the participants about the causes and
possible prevention of tinnitus.
The results of my research seem to confirm
earlier estimates and concerns regarding the
underlying causes of tinnitus:
1. Eighty-eight percent of the young people
who replied had experienced noise in their ears,
while 4% admitted to chronic noise, and 39%
reported frequent episodes (more than three)
of noise. The survey clearly confirms the
assumption held by many experts that noise
associated with young people's leisure activities
is a causative factor in the origin of tinnitus.
2. Only a few of the young people with chronic
tinnitus reported that they were impaired by the
noise in their ears.
3. One cannot assume the need for preventive
measures simply by the fact that certain young
people are affected. Therefore, individual ques-
tions in the survey sought answers: did some of
the participants take preventive action, and did
they have enough information to initiate suc-
cessful measures to prevent chronic tinnitus?
It turned out that only 8% of the young people
made an attempt at protecting themselves
from damage to their hearing, and that at least
60% of the young people, even those who had
experienced acute tinnitus, had sought out no
further information about causes and possible
treatments.
In my opinion, the large number of insuffi-
ciently informed young people, the extremely
small number ofyoung people who do protect
themselves against loud music or noise, and the
generally large incidence of tinnitus confirm the
necessity for comprehensive preventive mea-
sures geared specifically towards young people.
After analyzing the data, and following my
discussions with the young people, it became
clear that information and education are, indeed,
important aspects of preventive work. However,
these are not sufficient to counteract the devel-
opment of chronic tinnitus caused by excessive
noise.
Although 98% of the young people reported
that undiminished hearing was highly important
or at least significant to them, and at least 27%
of the respondents were aware of the causes
of tinnitus, only three of the young people
acknowledged protecting themselves against
harmful noise. It is my opinion that this situa-
tion cannot simply be attributed to youthful lack
of concern. As long as individually fitted and
reusable plugs cost about $200 and are therefore
a luxury item, only very few young people will
use them to protect themselves successfully
against harmful noise in discos and at concerts.
Since I myself acquired chronic tinnitus at the
age of 17 at a concert, I sympathize with these
students, and I understand that they are not will-
ing to use protective devices which interfere
with the quality of the music. They feel particu-
larly negative about using these expensive pro-
tective devices at musical events, which are
already quite expensive.
(continued)
American Tinnius Association Tinnirus TOday/ June 1999 13
Tinnitus Prevention in Young People (continued)
In my opinion, the goal should be a legal
limit of noise levels in discos, in WalkmanT ..
devices, etc. Furthermore, there should be a
reduction in the cost of protective plugs. The
health insurance companies, that generally don't
cover noise prevention devices used for recre-
ation, as well as the manufacturers of these
devices, could lead an initiative toward that end.
Since 71% of the surveyed young people who
had experienced noise in their ears attributed
this noise particularly to loud music, it is appar-
ent that we should concentrate on the noise
levels that occur during recreational activities.
We have very little information, and not
much experience, with preventive measures
directed primarily at young people. Th provide
a basis for suggesting various methods of edu-
cation in the field of tinnitus prevention, the
young people were asked to rate specific preven-
tive measures. The assumption was that a pro-
posal would only be meaningful and efficient
if it was acceptable to the young people.
The following eight methods aimed at pre-
vention were offered to the students. They rated
them in their order of preference, and in some
cases, their non-preference.
The NIDCD's 'Temporal Bone Registry, estab-
lished in 1992 to advance research on hearing
and balance disorders, encourages people with
tinnitus and other ear disease to become tempo-
ral bone donors.
They write: The temporal bone is the part of
the skull that contains the structures of hearing and
balance - the middle and inner ear (including the
cochlea, ossicles, eardrum, semicircular canals, and
parts of the cranial and vestibular nerves). Because
of its inaccessible location inside the temporal bone,
the inner ear can only be studied after death when
the temporal bones are removed and processed for
microscopic study.
Knowledge gained from the study of temporal
bones about how certain disorders, Iike tinnitus,
affect the ear will ultimately improve the evaluation
and treatment of hearing and balance disorders for
others in the future. No one is too old or too young
14 Tinnirus 1bdayl June 1999 American Tinnitus Association
Liked
1. an informational event at school
2. a detailed brochure about tinnitus
3. an Internet page
4. a short informational film, shown in movie
theaters along with the commercials
5. a small informational card (credit card-sized)
with instructions on what to do when a ring-
ing in the ear suddenly occurs, and where to
get help if it doesn't go away
Disliked
1. a radio program about tinnitus
2. a flyer
3. telephone advice specifically aimed at young
people
The surprising evaluation of these preven-
tive measures, and the diverse comments and
creative suggestions which I was fortunate
enough to gather through my interaction with
the young people, led to one of the most signifi-
cant conclusions of this entire survey: in order
to carry on tinnitus prevention in young people,
it is both necessary and sensible to include them
in the initiation and the development of the pre-
ventive measures. Cl
to be a donor. Removal of the temporal bone Win
not affect the donor's appearance and therefore will
not affect funeral or burial arrangements. 'Temporal
bones are collected at no cost to the donor's family
or estate and will not delay the donation of other
organs that the donor wished to donate.
That Others May Hear (a short informational
brochure) and The Gift of Hearing (a 16-page
comprehensive brochure) explain in depth the
process of temporal bone collection and the
Registry's research goals. These materials are
available free of charge.
Voice: 800/822-1327, TrY: 888/561-3277
e-mail: tbregistry@meei.harvard.edu
Web site: www. tbregistry. org
NIDCD National Temporal Bone Registry
Massachusetts Eye and Ear Infirmary
243 Charles St., Boston, MA 02114-3096
THE TINNITUS RESEARCH CONSORTIUM
by James B. Snow, Jr., M.D., F.A.C.S.
The Tinnitus Research Consortium was formed
in the fall of 1998, and is supported by a philan-
thropist who wants to accelerate progress in basic
and clinical tinnitus research. The Consortium con-
sists of 12 accomplished basic and clinical scien-
tists some of whom have worked on the problem
of t i ~ n i t u s before. Those who have not previously
worked in tinnitus research are expected to apply a
fresh perspective. Involving them is a way to bring
additional cutting edge scientists to the problem.
Those who have worked in tinnitus research lend
experience and will help prevent the tendency to
reinvent the wheel.
The first meeting of the Consortium was held
in November of 1998. The group unanimously
agreed that the state of the science is sufficiently
developed to make substantial research progress
in tinnitus at this time. This opinion was based on
discoveries and developments relevant to tinnitus
that have occurred in the last 20 years but that
have not been fully applied to tinnitus research.
They include: 1) otoacoustic emissions, 2) the
motility of the outer hair cells and its role in fre-
quency selectivity and amplification, 3) the bio-
physics of the conversion of sound energy to
neural impulses, 4) the location of a multitude of
disease genes and the cloning of many of them
responsible for hearing impairment as well as
development and maintenance of the auditory sys-
tem, 5) the identification of molecular substrates
of the auditory system, 6) the regeneration of the
sensory cells in the auditory and vestibular sys-
tems of birds and mammals, 7) the plasticity of the
auditory system, 8) the organization of the central
nervous system, 9) the ability to image central ner-
vous system changes associated with tinnitus using
positron emission tomography (PET) and function-
al magnetic resonance imaging (fMRI), and 10) the
chemical degeneration ofbrain cells caused by free
radicals, glutamate cytotoxicity, ionic fluxes, etc.
The group selected biophysics, molecular
pathogenesis (origination and development of a
disease), biochemical pathophysiology (functional
changes that accompany a disease), diagnosis,
physical suppression, and pharmacotherapy of
tinnitus as the areas upon which to focus their
research efforts.
The group came to the conclusion that it
must begin at the beginning by performing in-
depth reviews of the literature in several critical
areas. There is a need for a taxonomy - or
classification guide - of tinnitus, diagnostic
guidelines, a standardized patient questionnaire,
and an annotated bibliography. Reviews of the lit-
erature on electrical stimulation of the auditory
system and the effects of salicylates on the central
nervous system will be performed. Also, a manu-
script of the review of clinical trials will be pro-
duced and perhaps published.
The Consortium wiU meet twice each year to
brainstorm on new research strategies in tinnitus.
The group agreed to delineate what is currently
known about tinnitus and recommend approaches
and strategies in tinnitus research. If members of
the consortium could and would carry out the
"The ... Consortium seeks to benefit the
countless millions of tinnitus sufferers
throughout the world by ... attracting new
cutting-edge scientists to the problem .... H
actual research proposed, that would be ideal. If
not, they would be asked to identify scientists who
could carry out the research. Written requests for
applications will be developed and issued to the
scientific community to accomplish the research.
The requests for applications will be published
electronically through the web sites of relevant sci-
entific societies. The applications will be modeled
after those used by the National Institutes of
Health. Peer review would be performed by two
or three members of the Consortium or by experts
selected on the basis of the expertise needed for
the topic of the proposed project. If members of
the Consortium or their close colleagues are appli-
cants, the review would be performed largely by
individuals who are not Consortium members.
Three years of support for each grant is anticipat-
ed at up to $100,000 per year. Progress reports
would be required every six months, and each
year's support would be contingent on satisfactory
progress. (Overhead costs will not be provided for
projects supported through the Consortium.)
Prompt publication of the results of the research
in peer-reviewed journals will be encouraged.
It is anticipated that two requests for applica-
tions for clinical trials will be issued in the late
spring of 1999.
The Tinnitus Research Consortium seeks to
benefit the countless millions of tinnitus sufferers
(continued)
Ame1ican Tinnius Association Tinnitus Tbdayl June 1999 15
Announcements
lnterMed
1
99 - International Trade Show and
Conference
Date: June 21-23, 1999, Thronto, Canada
North America's International Medical and Healthcare
exhibition with delegates from 46 countries.
Guest Speaker: Mr. Brian Wilson, United Kingdom's
Minister of State for 'Itade and Industry
Contact: Mark J. Palmer, 514/ 731-1015,
fax 514/731-1645, e-mail: mpalmer@mpe.ca
Cognitive Behavior Modification For Tinnitus:
A Workshop for Patients and Friends
Date: June 25-26, 1999, The University of Iowa,
lowa City, Iowa
Speakers include: Peter Wilson, Ph.D., Psychologist,
Flinders University of S. Australia, Adelaide, Australia;
Jane Henry, Ph.D., Psychologist, University of New
South Wales, Sydney, Australia; RichardS. Tyler,
Ph.D., Audiologist, University of Iowa
Enrollment is limited and by pre-registration only
Cost: $395 per person
Contact: Cheryl Schlote, conference secretary,
319/ 384-9757, e-mail: cheryl-schlote@uiowa.edu
20th Anniversary meeting of the British Tinnitus
Association -
11
Tinnitus Research Today"
Date: September 4-5, 1999
Fitzwilliam College, Cambridge, UK
Guest of Honor: Gloria E. Reich, Ph.D.
Speakers include: Dr. Ross Coles, Dr. Carol Hackney,
Dr. Ewart Davies, David Baguley, and Richard Hallam.
Contact: BTA, Freepost NEA 3263, Sheffield,
England, S1 lAY
3rd International Tinnitus Support Association
meeting
Date: September 5, 1999
Fitzwilliam College, Cambridge, UK
1-5 p.m., open to the public
Contact: Gloria E. Reich, Ph.D., e-mail: gloria@ata.org
6th International Tinnitus Seminar
Date: September 5-9, 1999
Cambridge, UK (See back cover of this issue for
details)
Seventh Annual Conference on the Management
of the Tinnitus Patient
Date: September 30-0ctober 1, 1999
The University of Iowa, Iowa City, Iowa
For professionals and tinnitus patients.
Guest of Honor: Jack Vernon, Ph.D.
Speakers include: Michael Block, Ph.D.; Gloria Reich,
Ph.D.; Meredith Eldridge, M.A.; Soly Erlandsson,
Ph.D. psychiatrist; Anne Mette-Mohr, clinical psych-
ologist; Paul Abbas, Ph.D.; Bruce Gantz, M.D.; Brian
McCabe, M.D.; Rich Tyler, Ph.D.; David Young, M.A.;
and Richard Smith, M.D.
Contact: Rich JYler 319/ 356-2471, fax: 319/ 353-6739,
rich-tyler@uiowa.edu, http: / / www.medicine. uiowa.
edu/ otolaryngology /news/ news.html.
THE TINNITUS RESEARCH CONSORTIUM (continued)
throughout the world by clarifying the state of the
knowledge in tinnitus research, attracting new cut-
ting-edge scientists to the problem of tinnitus and
devising promising tinnitus research approaches
and strategies. Although I am largely retired, it is
again a pleasure and a privilege to be involved in
research with such a distinguished group of scien-
tists, dedicated to accelerating progress in tinnitus.
The members of the Tinnitus Research
Consortium are:
William E. Brownell, Ph.D., Department of
Otolaryngology and Communicative Sciences, Baylor
College of Medicine; Peter Dallos, Ph.D., Auditory
Research Laboratory, Northwestern University; Robe1i A.
Dobie, M.D., Department of Otolaryngology, University
of Texas Health Sciences Center, San Antonio; Bruce J.
Gantz, M.D., Department of Otolaryngology/Head and
Neck Surgery, University of Iowa Hospitals and Clinics;
16 Tinnitus Thday! June 1999 American Tinnitus Association
A. James Hudspeth, M.D., Ph.D., Howard Hughes
Medical Institute, The Rockefeller University;
Pawel J. Jastreboff, Ph.D., Sc.D., Emory Tinnitus and
Hyperacusis Center, Emory University; M. Charles
Liberman, Ph.D., Eaton-Peabody Laboratory,
Massachusetts Eye and Ear Infirmary; Brenda L.
Lonsbury-Martin, Ph.D., University of Miami Ear
Institute, Department of Otolaryngology; Alfred L.
Nuttall, Ph.D., Oregon Hearing Research Center, Oregon
Health Sciences University; Allen F. Ryan, Ph.D.,
Division of Otolaryngology/ Head and Neck Surgery,
University of California, San Diego; Leonard P. Rybak,
M.D., Ph.D., Division of Otolaryngology, Department
of Surgery, Southern Illinois University School of
Medicine; and Phillip A. Wackym, M.D., Department of
Otolaryngology and Communication Sciences, Medical
College ofWisconsin. ri2
Dr. Snow is the former Director of the National
Institute on Deafness and Other Communication Disorders,
National Institutes of Health.
Successful Treatment of Tinnitus
in Patients with TMJ Dysfunction
by Ira M. Klemons, D.D.S., Ph.D.
The condition commonly
referred to as "TMD" - tem-
poromandibular joint disorder
-is a complex dysfunction of
muscles, ligaments, andjoints
in the head, face, and neck.
(The temporomandibular
joint, or "TMJ," is the joint in
front of the ear which allows
us to speak, chew, swal1ow,
kiss, smile, and exhibit normal
facial expressions.) TMD is typically caused by
injuries that result from falls, automobile acci-
dents, trauma at birth, etc. It is very common for
the onset of symptoms to be delayed for months
or years. The delay of onset occurs, in part,
because these tissues progressively degenerate.
Close to half of the patients who have TMJ
dysfunction have tinnitus as one of their symp-
toms, and in these patients, success rates in
eliminating these sounds approach 90%. Recent
research has found that TMD therapy improves
tinnitus in 46-96% of patients who have TMD and
coexisting tinnitus. A survey of patients taken two
years after TMD therapy suggests that improve-
ment is sustained over time.
The diagnosis of TMD requires evaluation
by a dentist or physician with advanced training
and experience in treating head and facial pain.
Diagnosis begins by taking a detailed history of
the patient's (sometimes extensive) list of com-
plaints. Symptoms can include headaches; pain
in the face, eye, neck, or ear; blurred vision that
comes and goes; hearing loss that comes and
ATTENTION
ATA MEMBERS
Please include your "zip+ 4" zip codes when
you write to us. Those four extra numbers
save us a considerable amount of money on
postage. And since they speed up mail deliv-
ery, they will help get Tinnitus Tbday to you
faster. Thank you!
goes; frequent sore throats; dizziness; ringing in
the ears; pressure or blocked sensation in the
ears; difficulty swallowing; burning tongue; and
tingling or numb sensations of the arms and
hands. A physical examination of the muscles of
the head, face, neck, and shoulders is done using
manual palpation to rule out "trigger points" and
muscle spasms that can transfer pain to other
areas. Range of motion tests, x-rays, sonograms,
and painless EMG's can also help in reaching an
accurate diagnosis.
Treatment commonly employs painless pro-
cedures which help stimulate muscles and joints
to function normally, decrease spasm, remove
toxic waste products, and increase blood flow and
nutrition to the affected areas. Therapies such as
low current electric stimulation to reduce muscle
spasm and stimulate healing, ultrasound for deep
tissue heating, hydrocollator for moist heat, and
cryotherapy (cold therapy) are used with a vari-
ety of removable orthopedic appliances aimed to
correct the posWon of the condyle, or "ball," of
the lower jaw within its socket. In addition, joint
mobilization procedures, physical manipulation,
and other procedures might be employed. Eighty-
four percent of our last 1200 TMD patients who
also had tinnitus reported that their ear sounds
were "gone" or "almost gone" after treatment.
Treatment time and costs vary according to
the extent of dysfunction, the simultaneous pres-
ence of related problems such as neck injury or
thyroid disorders, patient compliance, and the
patient's age. Unfortunately, for reasons not yet
explained, we have found a decreased success
rate for elimination of tinnitus in patients over
60 years of age.
Many patients are given only home care
instructions at a single visit, while others require
an average of 4-6 months of care. Still others
require much lengthier treatment and, in a small
number of cases, even surgery. Approximately
1% of our patients require TMJ surgery and
approximately 3% require radiofrequency ther-
moneurolysis - a surgical procedure that uses
high frequency electrical energy to modify or
eliminate pain impulses from injured structures.
This technique in particular offers enormous
promise for eliminating pain and tinnitus where
other conservative procedures have failed to
bring relief.
(continued)
American TiJmius Association Tinnitus 7bday! June 1999 17
Con1n1unity Health Charities -
Public Donations for Tinnitus
As a member of the National Voluntary
Health Agencies (NVHA), the American
Tinnitus Association participated in the
Combined Federal Campaign (CFC).
During the last 10 years, federal and
state employees have given an average
of $84, 000 to ATA each year. We are
very proud and thankful for their
support. (ATA's designation # is 0514.)
During the past year, the NVHA has merged
with the Combined Health Appeal in order to
expand the donor base to include the private
sector. The new federation will be known as the
"Community Health Charities."
Revenue from the CFC hit its peak in 1991
and then dropped off (because of down-sizing in
the federal government) - until this year.
Donations are again on the rise.
TMJ Dysfunction (continued)
Wright and Bifano cite a study in which the
relationship between tinnitus and TMD therapy
resulted in the following: of 267 TMD patients
who were evaluated, 101 reported co-existing
tinnitus. Ninety-three of those agreed to partici-
pate in the study. Of the 93 subjects who were
treated for TMD, 52 said that their tinnitus had
resolved, 28 reported experiencing significant
improvement, and 13 reported minimal or no
improvement. No one reported experiencing a
worsening of the condition. It's been noted that
patients who have tinnitus without any other
symptoms are relatively unlikely to experience
improvement with treatment of this type.
Over the last few decades, we have come a
long way in diagnosing and treating TMJ disor-
ders and the accompanying symptoms such as
tinnitus. No doubt future research will provide
greater knowledge regarding the relationship
between tinnitus and temporomandibular joint
dysfunction and consequently even higher
success rates than are available at the present
time. II
18 Tinnitus Tbday/ June 1999 American Tinnitus Association
Many thanks to all of you who have donated
to our association through the CFC. Our thanks,
also, to the following volunteers who have repre-
sented us at local meetings and health fairs:
Charles Abegg, Tracy Armstrong, Jack Berman,
Jim Boardman, Gail Brenner, Judy Brivchick,
Dhyan Cassie, Pete Clements, Rob Crichton,
Charles Gilbert, Buzz Grossberg, Lynn Haddon,
Thrry Hamilton, Kathy Harvey, Bill Haskin,
Sharon Hepfner, Ben Jacobs, Carrol Jude, Jim
Keyes, Marylou Leubbe, Malvina Levy, Stanley
Lewis, Don Lovell, Bob Luthmann, Doug
Melton, Jack Mundy, Charles Ohlinger,
Harvey Pines, Mari Quigley, Shirley and Mort
Rosenhaft, Bob Sandlin, Susan Seidel, Megan
Vidis, and Milly Walker. Bl
,\,
-;y,Community
Health Charities
WORKING FOR A HEALTHY AMERICA
Dr. Ira Klemons' practice is devoted to head and
facial pain and temporomandibular joint dysfunc-
tions. He is President of the American Board of
Head, Neck, and Facial Pain; and Director of The
Center for Head and Facial Pain in South Amboy,
New Jersey. Additional information can be obtained
at www. headaches. com
Names of members of the American Academy of
Head, Neck, and Facial Pain can be obtained by
writing to the Academy at 520 West Pipeline Rd.,
Hurst, TX 76053.
References
l. Wright, F., and S. Bifano: Tinnitus improve-
ment through TMD therapy, JADA, vol. 128,
pp. 1424-9, Oct. 1997.
2. Gelb, H., M. Gelb, and M. Wagner: The rela-
tionship of tinnitus to craniocervical mandibu-
lar disorders, Journal of Craniomandibular
Practice, vol. 15, no. 2, pp. 136-142, April1997.
Tinni tusS u pport@Grou ps
by Barbara Tabachnick,
Client Services Manager
How the definition of "self-help
group" has changed! What was
once only a gathering at a local
church or library one night
a month now encompasses a
24-hour-a-day, international,
computer accessible network
of support.
The Internet's Worldwide Web has brought
thousands of people in touch with thousands of tin-
nitus informational Web sites. It has also brought
thousands of people in touch with each other.
These are people whose tinnitus or other circum-
stances have kept them from traveling to self-help
groups, or who live where there is no organized
group to attend. The number of support doors that
have been opened because of Internet chat rooms
and newsgroups is phenomenal.
It bears mentioning that discussions on the
Web are not monitored or edited by any tinnitus
authority for accuracy or attitude. One wonders:
do they need to be? (I could easily argue both sides
of the question!) The bigger question is this: with
10,336 tinnitus-related Internet Web sites to date,
who would have time to do it?
Tinnitus information on the Internet is a
collection of the volunteered thoughts and investi-
gations of people who have tinnitus, who have rela-
tives troubled by tinnitus, or who treat tinnitus.
Active participation is optional: one can contribute
information to it or simply read it. In this regard, it
displays a close resemblance to the old-fashioned
support group, the kind where you enter freely,
take what information you want from it, and leave
the rest.
Jim McGlynn, a tinnitus Internet newsgroup
participant recently attended the Los Angeles
Tinnitus Support Group's 15th anniversary seminar
where Dr. Stephen Nagler spoke. Afterwards, Jim
went back to his Internet support group and shared
these thoughts:
"Stories on the Internet lose a lot in the trans-
lation. Many of the things Dr. Nagler said at the
conference are things he has published on his
Web site. The stories were not new to me. But
with inflection, direct interaction, and eye contact,
they all seemed different.
"The Internet is a wonderful place. Our ques-
tions are answered by people around the world.
There are things we can write here that help an
uncounted number of people. It has its advantages
and it has its limitations. I think that it's important
to check out a real live support group or tinnitus
lecture if you can, to shake the hand of someone
else whose ears are also ringing. I'm lucky. I got to
sit with people like me at that seminar, people
who also have tinnitus. I'm very lucky."
What meets your support need? A reassuring
telephone call? An empathetic hug? A 4 a.m.
on-line chat? E-mail? Real mail? W1ite or call us
for details on how to connect with others. We'll
be in touch. al
ATA, P.O. Box 5, Portland, OR 97207-0005
voice: 800/634-8978 fax: 503/248-0024
e-mail: tinnitus@ata.org Web site: www.ata.org
Welcome to ATA's New Support Givers
Telephone/Mail Contacts
Kathleen Munley
387 Main St.
Archbald, PA 18403
717/876-2747
munleyg@microserve.net
Alex Ravetti
2314 S.E. 27th 'Thrr.
Cape Coral, FL 33904
941/772-8956
B. Martin Brinitzer
18278 Hummingbird Dr.
Penn Valley, CA 95946
530/432-3507
Beryl Clark
445 Seaside Ave.
Box 164
Honolulu, HI 96815
808/923-8716
Support Group Leaders
Elayne Myers
40 Pennyroyal Rd.
Malta, NY 12020
518/899-4885
David M. Smith
6501 Byron Ave.
Springfield, VA 22510
703/866-3025
Marie Richter, M.S., CCC-A
Hear America, Inc.
12352 Olive St. Blvd.
St. Louis, MO 63141
314/514-7800
American Tinnius Association Tinnitus 7bday! June 1999 19
My friend T taUght me how much my family
loves me.
My friend T taught me how wondrous each
new day is.
My friend T taught me that I had too much
stress in my life.
My friend T taught me the value of good sleep.
My friend T taught me to eat healthy foods
and take my vitamins.
My friend T taught me how wonderful my
Motown collection is.
My friend T taught me to take nothing in life
for granted.
My friend T taught me that it is okay to reach
out for help.
My friend T taught me that I was abusing my
body with loud sounds.
My friend T taught me who my real friends are.
My m end T taught me that I need to love me.
My friend T taught me to appreciate joy.
My friend T taught me to control and confront
my fears.
My friend T taught me that I could change
vocations and become MORE successful.
My friend T taught me to be a flexible thinker.
My friend T taught me to be strong.
My friend T taught me not to let the little
things in life bother me.
My friend T taught me to enjoy the sounds
of nat ure.
My friend T taught me the power of positive
thinking.
My friend T is one of the best friends I have
ever had ... he just has a really annoying voice
and he talks too loud!
20 Tinnitus 7bday/ June 1999 American Tinnitus Association
A Special Book Offer
New Low Price on Proceedings
The Proceedings of the Fifth
International Tinnitus Seminar
is a treasury of 1 31 tinnitus
research papers on topics
including: causes and
measurement of tinnitus,
drug therapies, clinical
treatments, tinnitus retraining
therapy, psychological approaches and
implications, legal and noise issues, self-help
strategies, and alternative remedies.
The Proceedings is now available at the
special low price of $10, plus shipping &
handling. To add to this great offer, a limited
number of books are signed by editors Gloria
E. Reich, Ph.D., and Jack A. Vernon, Ph.D.
Please use the form on the inside back
cover of this issue to place your order.
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QUESTIONS AND ANSWERS
Jock Vernon's Personal Responses to Questions from our Readers
by Jack A. Vernon, Ph.D., Professor Emeritus,
Oregon Health Sciences University
Q
Mr. S. from Pennsylvania writes to ask
about the work of Col. Richard D. Kopke
and the Army Medical Corps. An article
in the local newspaper indicated that they were
working on a way to save inner ear hair cells
from toxic or damaging agents. Their procedure
involves placing a miniature catheter deep into
the ear in order to inject medicine to the exact
place it is needed. The approach uses anlioxidant
drugs to counteract toxic compounds generated
by injury. Dr. Kopke and his team of researchers
have demonstrated success with this technique
on animals and to date have tried it on three
people with apparent success in all three.
A
I think Dr. Kopke's work is very interesting
and very important. Loud noise and drugs
such as the aminoglycosides damage the ear
by causing the production of harmful substances
known as free radicals. That production can be
reduced or prevented by the presence of antioxi-
dants. It is this antioxidant which Dr. Kopke is
injecting into the inner ear. I firmly believe that
the delivery of the drug to the exact position where
it is needed vvill offer significant advances for
noise-induced and drug-induced damage to the ear.
[See "Perfusion of the T1mer Ear Via Round Window
Membrane," page 9.] It is also very possible that
any action that prevents or corrects ototoxicity or
ear damage will also prevent or correct tinnitus.
Q
Ms. S. from Pennsylvania states that she has
followed the Xanax dose schedule and has
experienced only slight relief from it. What,
she asks, should she do next?
A
Some patients who have gotten only minor
relief from 0.5 mg three times a day have
found significant tinnitus reliefby increasing
the dose to 0.5 mg four times a day. I suggest that
you consult your prescribing physician about this
possibility. Do not do this without his/her
permission.
Q
Ms. G. in North Carolina writes to describe
an unusual hearing effect. After she is
exposed to the sound of a hair dryer and the
dryer is turned off, she continues to hear the sound
of that motor. She has been unable to find any
information about this effect although her doctor
told her it was "inner ear tinnitus." She also notes
that she has sensorineural hearing loss.
A
I am not sure there is an answer for your
question. I would guess that most likely
the retention of the motor noise is occurring
somewhere in the area of the brain devoted to
hearing. You are not the first person to report
the occurrence of sound retention. Several other
patients have remarked upon the retention of
music after listening to music. Here is my ques-
tion for you: does the retention of sound cause
you any inconvenience? One wonders if correcting
the sensorineural hearing loss with hearing aids
would correct the sound retention phenomenon.
Also, reducing the level of the motor noise with
earplugs might reduce either the intensity or the
duration of the sound retention. At least it is
something for you to try.
Q
Dr. S., a dentist in South Africa, writes that
he has had tinnitus for many years and
wonders if his exposure to the high-speed
drill caused his problem. His ENT physician thinks
he might have otosclerosis which might have
caused his tinnitus and his sensorineural hearing
loss. He wishes to investigate the possible connec-
tion between hearing Joss and tinnitus and the use
of the dental drill. He asks if there is any literature
on this topic.
A
The literature with which I am familiar is
only that of Dr. G., a dentist and a patient
of mine, who surveyed a11 the dentists in
Oregon, Washington, Idaho, and Northern
California. He found that all who had purchased
the high-speed drill, which became available in
1955, had high frequency hearing loss and tinni-
tus. 1b prevent your tinnitus from becoming
worse, we recommend that you wear ear protec-
tion any time you are using the high-speed drill.
Q
Mr. K. from Pennsylvania states that he has
tinnitus. But because he has normal hear-
ing, the Social Security Administration's
disability division will not acknowledge the pres-
ence of tinnitus. They claim that tinnitus is caused
by and must be accompanied by hearing loss.
A
Oregon Hearing Research Center's Tinnitus
Clinic has treated over 6,000 patients with
significant tinnitus. Ten percent of these
patients have normal hearing as determined by
actual audiometric testing. I hope this helps your
case presentation.
(continued)
American Tinnius Association Tinnitus Today/ June 1999 21
Questions and Answers (continued)
Q
Ms. C. in California asks ifthere are any
new products on the market for the control
of tinnitus. She has tried Xanax and it did
not work for her. In addition she is almost com-
pletely deaf so that masking is not a possibility.
A
Ms. C., you might want to investigate the
pos.sib.ility of a cochlear implant which in the
maJonty of cases not only provides hearing
but tinnitus relief as well. The House Clinic in Los
Angeles indicates that 90% of their implant patients
obtain tinnitus relief. I have also learned that
American Pharmed Labs, Inc. in Englewood Cliffs,
N.J. (www.apl-pain.com) is considering production
of a transdermal or "through-the-skin" product,
called "Paintrol TV," for tinnitus and vertigo. Their
medical director told us that they are trying to
develop a way to deliver a topical anesthetic drug
(they wouldn't tell us which one) to relieve tinni-
tus. They say they are at least a year away from
seeing results.
Q
Mr. Z. in California states that his tinnitus is
the sound of dripping water which he only
hears at night. He found that putting a
swimmer's earplug in the affected ear stopped the
problem. He asks if it is the pressure of the earplug
m the ear canal that stopped the tinnitus.
A
A guaranteed way to make tinnitus louder is
to earplugs, thus your opposite experi-
ence IS most unusual. It may be that you are
experiencing what is termed "objective tinnitus."
That is, the tinnitus you hear is not a phantom
sound experience but rather a real sound being gen-
erated inside the ear. In some cases of objective tin-
nitus, others can hear the sound coming from the
patient's ear. I suggest that you locate an audiologist
who has an Etymotic Insert Earphone. This device
contains a small, sensitive measuring microphone
with which to listen to the ear (such systems are
used for special tests to evaluate "otoacoustic emis-
sions" in the ear) and possibly determine if you
have some mechanical problem in your middle
ear, such as a perilymphatic leak. If so, it should
be possible to provide a patch to repair that leak.
Q
Ms. L. in Illinois presents a very interesting
and puzzling condition. She states that due
to her hyperacusis (a super-sensitivity to
everyday sounds), she can only tolerate TV by mut-
ing it, then listening to the audio with a small radio
capable of receiving the TV channels. She is curi-
ous about the fact that the small radio can present
the audio at an acceptable level while the TV
cannot.
22 Tinnitus 7bday/ June 1999 American Tinnitus Association
A
Hyperacusis is inversely related to the pitch
of the sound. That means that the higher
the pitch, the less tolerance the person with
hyperacusis has for it. Most likely the small radio
does not reproduce the high pitches as well as the
TV speakers do. Please remember that hyperacusis
can be relieved by not overprotecting your ears
and by listening to low-level "pink noise" to rein-
state your normal loudness tolerance. It is not an
easy procedure but it can be beneficial if you stick
with it. I would further suggest that you not use
any ear protection for sounds that are 65 dB or less
for a period of one month. (You can get a sound
level meter at Radio Shack for about $35 to mea-
sure the sounds in your home and elsewhere.)
Then for the next month, do not use ear protection
for sounds that are at 70 dB or less and so on until
you are at the level of normal loudness tolerance.
Q
Mr. H. in West noticed that
he cannot hear h1s tmmtus when he is
standing near his refrigerator when the
motor is running. The refrigerator motor is very
low-pitched. Indeed, he thinks he can only feel
it and not hear it. He asks whether or not sounds
that are either too low-pitched or too high-pitched
to be heard might produce a "silent masker."
A
Many years ago I had a similar idea. 1 rea-
soned that if ultrasonic sound (which the
human ear cannot hear) could mask tinni-
tus, we would have the ideal condition. I tested
a number of tinnitus patients first to determine
which high-frequency region they could not detect,
and then to see if that frequency region could
mask their tinnitus. It turned out that if they could
not hear the sound, their tinnitus could not be
masked. Recently there has been a new twist on
this approach.
Hearing Innovations, Inc., in Thcson, Arizona
(http://hearinginovations.com), has developed the
HiSonic device - a high-frequency bone conduc-
tion hearing instrument for people who are pro-
foundly hearing-impaired. A modified version of
the HiSonic was studied at the Oregon Hearing
Research Center's Tinnitus Clinic to see if it could
be used as a super-high-frequency tinnitus masker.
This modified device generates frequencies up to
36,000 Hz which is way beyond what we should be
able to hear. Of the 20 tinnitus patients tested, 90%
experienced some degree of masking, and 85% of
them had residual inhibition - a cessation of the
tinnitus after the masker is removed - of slightly
longer duration (although just minutes longer in
Questions and Answers (continued)
most cases) than that induced by conventional
maskers. We don't know exactly what the HiSonic
is stimulating since most of the profoundly deaf
people who can hear with it probably have few if
any cochlear hair cells.
Q
Mr. H. from North Dakota writes to say that
he is aware that the sound of front air bags
inflating is too loud for the human ear.
What, he asks, is the level of the sound produced
when side air bags are added? And shouldn't we
have the optjon of h1ming them off?
A
The addition of side air bags to two front
air bags can cause the noise inside a car to
reach 178 dB. However short the exposure,
that is too loud for the human ear! Keep in mind
that a 140 dB sound is right at the human thresh-
old for pain. There have been concerted efforts to
get air bag "on-off switches" installed or to get the
air bags disconnected altogether. So far, most of
these efforts have failed. (I have heard that air
bag manufacturers have a very powerful lobby in
Washington, D.C.) I think the idea of a switch is
very reasonable so that air bags could be turned
off or on at the drivers' discretion - off when
driving in town where accidents might not be
life-threatening, and on when driving on freeways.
I have reports from two patients who sustained
h earing loss and tinnitus from very minor, very
low-speed accidents in which air bags inflated.
Remember that regardless of where you drive, use
of the seat belt is mandatory.
Notice: Many of you have left messages requesting
that I phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9.30 a.m. - noon and 1:30 - 4:30p.m.
PDT (5031494-2187). Or mail your questions to:
Dr. Vernon c/o Tinnitus Thday, American Tinnitus
Association, PO. Box 5, Portland, OR 97207-0005.
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American Tinnius Association Tinnitus Thday/ June 1999 23
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 mak-
ing a contribution or research donation of $500 or
more. Sponsors and Professional Sponsors have con-
tributed at the $100-$499level. Research Donors
have made research-restricted contributions in
any amount up to $499.
Contributions to ATA's 'Ih.bute Fund will be
used to fund tinnitus research and other ATA pro-
grams. If you would like your contribution restrict-
ed for research, please indicate it with your gift.
Thbute contributions are promptly acknowledged
with an appropriate card to the honoree or family
of the honoree. The gift amount is never disclosed.
Our heartfelt thanks to all of these special
donors.
All contributions to the American Tinnitus Association are tax-deductible.
GIFTS FROM 1-16-99 to 4-15-99.
Champions of
W.E. Couling Romulus z. Linney Patricia A. and Richard Ronald L. Steenerson, Deborah J. Frye, M.A.
Silence
Kay F. Crouse John w. Mars Smith M.D. Jeanne B. Gaylord
(Contributions of $500
Elizabeth J . Curtis Tim Matheson Raymond M. Smith, Ill Steven Stegman Stephen P. Gazzera
John G. Davis Dr. Curtis L. Mathis, Jr. Lewis E. Stengel, ,Jr. John C. Vaughan, M.D. Barry S. Goldberg
and above)
Walter Z. Davis, ,Jr. Mike and Bonnie Leonard Stowe J. Dan Weathers, M.D. Susan E. Griest, MPH
Roy Barna
Joaquin Delpino McCann Michael M. Sullivan Edmund .J. Grossberg.
Robert w . .Booth
Gilles C. Desbiens Eugene McFaddin Richard W. Sullivan
Corporations with
CLU
Carol A. Brown
Lewis G. Desch Colin L. McMaster Ruth M. Swan Matching Gifts Richard R. Harlow
Charles T. Brown
Anita E. Dever Juerg Meng Max and Jean American Express John T. Hennig
Thomas w. Buchholtz,
Jerome C. Dougherty 'Thrrill E. Menzel Thnnenbaum Argonaut Group
Virginia R. Holt
M.D.
Hugh W. Emerson, J r. F. N. Merralls Irwin Thntleff
Bank America
W.F. Samuel Hopmeier,
Mary Kay H. Davis
Francis R. Fant, Jr. Andrew Metrick Daniel K. Thrkington
Foundation
BCHfS
Frank H. Dunn
Kathryn. Alexander Miller David Hollis Thylor Bestfoods North Darrell and Bette
Jean and Lou Fockele
Fitzsimmons Eugene A. Miller Scott 11.1 mer America Johnson
Helen Pappas
Janet E. F1orentin Robert E. Monaghan Brian VanPutten BP America, lnc. Gregg L. Johnson
Louise Parmley
Mary A. .Floyd Earl R. Moore Robert J. Veltkamp Citicorp Foundation Neal and Joyce
Stephen G. Sayegh
Martin E. Fossler Jeff Morse William P. Voerg Computer Assoc. Johnson
Stephen M. Schwarcz,
Duane Foster Andrew J. Murphy A. Gary Voyten Inti., Inc.
Scott L. Johnson
D.D.S.
Isaac Frishman Cameron R. Murray Eliot Wagner J.P. Morgan & Co., Inc. Beth Kempton
Phyllis W. 1\viss
Michael J. Fucilli Margaret Nau Linda A. Wainhouse Johnson & Johnson
Dr. and Mrs. Paul Kline
Daniel H. Walker
Veva J . Gibbard Glenna L. Neilsen Bernard J. Weber
Mobil
Peter Kobelansky
Stephane W. Wratten
Nathan L. Gibson Dr Vernon&lisabeth Edward R. Weiss Pfizer Inc.
Warren L. And Virginia
Delbert W. Yocam
Charles W. Gilbert Neppe Dehner D. Weisz Phil ip Morris
M. Lagers
Sponsors
James S. Gold Frank P. Nicoletti AlE. Witten
Sarah Lee Foundation
Rose Marie and Loran
(Individual Contributions Donna Graham
Thomas R. Ogren Brian and Karen Sun Microsystems Lathrop
from $100. $499) Paul Green
R. J. Palornbit Woolsey 1\"ansamerica
Howard Levirne
Gerald w. Ape! John P. Griesbach
Randy L. Parks Walter K. Wornick Foundation
Barbara Lighthizer
Robert A. Bailenson Jane A.
Robert E. Parr Mr. and Mrs. David J. Safeco Insurance Jill Lilly
John J. Banavige Donald D. Gu1t0
Thomas J. Patrician Wright Union Pacific Mike and Georgina
James R. Barney
Faye M. Harrison Kenneth W. Pearce Paul W. Zerbst Resources PAC
Linghor
M. Lloyd Baum
Diana G. Haver Adelio Percic Brad Zennan US West Frank L. Long
Peter B. Baylinson
James R. Heard Peter Phair Marilyn K. Zion Washington Mutual Vince Loporchio
Howard G. Bernett
Glen Heidbecht Kim Pollock
Professional Special Friends
Robert E. Lyons
Dan G. Best
Mark Herritz Richard E. Popovits, Jr. Vince Majerus
Judy C. Bezek
Paul G. Hill Margaret L. Possert Sponsors Fund
Mary A. Marshall
Gordon J . Birgbauer, Jr.
Gulielma T. Hooper Daniel Pritchett (Professional In Memory of Dr.
Lynn and Sharon
R. John Bishopp
Daniel E. Horgan Jessie N. Quinn Contributions from Robert M. Johnson
Martin
Bob Boggus
Andrew Hrivnak, 1IJ Martha Ramos $100-$499) Charles w. Abegg, Sr.
William Hal Martin,
Michael L. Bowen
Anita Jane Hull Catherine S. Reitz Robert Battista, M.D. Richard and Susan
Ph.D.
Sharon E. Bowyer
Karen Hunt Carl F. Rench Gail B. Brenner, M.A. , Ahlquist
Raymond and Rebecca
Robert J. Bradley
Robert C. Jncerti Patrick R. Richards
CCC-A Alan and Carol Baker
Mathsen
Dorothy M. Brahm
Philip H. Ingber Herbert Roach Joseph Danto, Ph.D. Miriam G. Bloomfield
John P. And Jenny A.
Alan L. Brock
James Irving Philip L. Robi nson Barbara Goldstein, Laird C. Brodie
Merkel
Robert L. Brown, Jr.
Elizabeth A. Ivankovic Anna S. Roemer Ph.D. B. Evelyn Brown
Keith R. and Susan L.
Helen S. Burkey
Wayne G. Jakobs Linda Ronaldson David W. Holmes, Richard E. Burnham
Morgan
Richard A. Burns
Eric Janie Beth and Scott Ross Ph.D. Kristen Carlisle
Julie Morin
J. Christopher Carson
Hartmut G. H. Jaspert Jon M. Rundle Pat Johnston Carol J. Carpenter
Gary Morton
Charles A. Carver
Kurt Jensen M. Vem Rupp Jeffrey S. Keyser, M.D. Jack D. Clemis, M.D.
Stew and Kay Morton
Merle C. Chambers
Nils P. Jensen John and Jrma Russell Gregory D. King, M.S., Donald J . Cook
Stephen M. Nagler,
Kerry N. Chatham,
Oscar S. Johnson, III Frederick J . Ryan CCC-A Rose Cottrell
M.D., F.A.C.S.
DVM
Kenneth W. Jones Russell A. Sabanek Guy E. McFarland, Richard . And Eileen
Dallas and Louise
ShuN. Chau
Louis 1. Jones Stewart Sandman M.D. E. Cronn
Nelson
Gail Chesler
Pawzi Kawash James B. Sasser Aage R. M0ller, Ph.D. Ralph J. D'Ambrosio,
Bruce and Karolyn
C. J. Childers
Alexandra B. Keith Marie Saxe John D. Mowry, M.D.
Jr.
Newgard
Clary Childers
0. Ray Kirkpatrick Evelyn J . Schwenl
Scott M. Nelson, M.D. Jackie DeGagnc
Mr. and Mrs. Francis D.
Ralph G. Ciaramello
Norma Kratz Robert R. Sfi re D.W. Newton, D.D.S. M. Bernice Dinner
Nold
Garrett H. Clark
Jerry Lastelick Mark Shaffstall William Lee Parker, Virginia M. DuBlanc
Jerry L. Northern,
John F. Coggin
Shirley C. Lavenberg Robert J . Shapiro Ph.D. Sylvia Eisenberg
Ph.D.
Gardner C. Cole
Stewart M. Ledbetter Fr. Thomas F. Sheehan, Tra D. Rothfeld, M.D. John R. Emmett, M.D.
Alfred Nuttall , Ph. D.
Stanton Cole
Barbara S. Lentz OFM Jeffrey R. Schlesinger Alfreda R. Fedrizzi
Elizabeth K. O'Halloran
Robert L. Coley
Laura Leprino Glenda Sheppard Abraham Shulman, Jean and Lou Fockele
Kathy Peck
Diana C. Connolly
Hazel Lessley 'Thrry Blair Sidwell MD. Herbert Frank
Leslie Petcher
Joseph A. Cordes
Roben Link Rube Simon
Jnge Frederiksen
Nicholas J. Pialoglous
24 Tinnitus 7bday/June 1999 American 'Tinnitus Association
SPECIAL DONORS AND TRIBUTES (continued)
Lynn 1<. Pratt Daria Laird
In Honor Of
Jane E. Darlington Andrew J. Leginze Elsie R. Simas
Edward Porsov Gloria Mante
Dl'. Alan Loclwood
Almudena De Llaguno Raymond J. Lemoine Robert C. Sittig
Penny Roberts Rap10r William Marlette
Stephen M. Nagler,
Marilyn C. Dee John E. Lewison Thelma M. Sjostrom
Fredric D. And Barbara Susan McCloud
M.D., F.A.C.S.
Aldo Delco! Jorene M. Lightfoot Betty J. Slater
Y. Reed Nirmal Mittal
Dr. Billy Martin
Vivia M. Dennis Donald J. Lisio Clyde and Darleen
Gloria E. Reich, Ph.D. Ruby Morek
Stephen M. Nagler,
Rita M. Desotell Richard P. Loach Smi[h
Tianying Ren Hiep Nguyen
M.D., F.A.C.S.
O'Neil N. Destefano Palmer R. Long David R. Smith
Paul Richter, M.D. James O'keefe
Philip 0. Morton
Jules H. Drucker John M. Maiorano Kenneth J. Smithee
James A. Rocthlin Lisa Pierce
Lake Grove
Dorothy M. Earl V. James Marino Paul C. Sorensen
Herman J. Schechter Jim Politi
Presbyterian Church
Linda D. Elliott Carol A. Markey Larry A. Stafford, SFC
Alexander J. Jeff On
Or. Richard Salvi
Harvey A. Erikson Alexander Markowski Henry G. Stanley
Schleuning, M.D. Brenda Proctor
Stephen M. Nagler,
Michele Ezratty Gilbert D. McCann Lewis E. Stengel, Jr.
Susan J. Seidel, M.A., Karen Rockey
M.D., FA.C.S.
Edgar M. Feathers Richard E. McCollum David B. Stewart
CCC A Steve Russell
Jack A. Vernon,
Edward A. Feldkamp Kenneth J. McGinnis Ruth N. Stewart
Madge Sempert Kim Scullen
Ph.D.
Robert J. Fendrich Roberta J. McKenna Ingrid H. Stroud
Robert E. Shields Monica Seh
Patrick Guyton
August E. Firgau Mary Beth McMahon John A. Sullivan
Florence A. Smith Evelyn Sinkler Bernard Fishman Edward J. Megerian W. Pat Sullivan
Peter F. Smith James Smith Research Donors Johnston K. Fite Carolyn V. Merritt Ruth M. Swan
Stellajoe E. Staebler Eleanor Stone Helen D. Adams Larry C. Focht Rhoda S. Mesker Irwin 'Thntleff
Elizabeth Stevenson Wanda Thoclle Ken Adler Linda and Nelson Fox Gary Mi[Chell Abraham 'Thubman
Elizabeth S. Thylor
JaneS. C.'trnaltan
Joseph w. Adside, Robert M. f'uller, Jr. Janet Mitchell Willard C. Thorn
Harvey and Elizabeth
Jamee Wolf
Ph.D. William M. Gabriel, Sr. Barbara W Moose Barbara and Richard
Thompson
Dr. Trudy Drucker
Marian H. Agee Grace E. Gaereminck Rebecca Morrison 1l"attner
Brian and Jennifer Thlk
Adele Alam
Lloyd T. Amaral Nick Georgeoff Jeff Morse Barbara 'Il'oy
James and Ann Ulum
Jules H. Drucker
Rae Azose Gigi Giannoni Edward Muserlian Florence 'Thukui
Jack A. Vernon, Ph.D.
Mora Emin
Natalie E. Babson Thomas C. Glassie John and Louise Myers Bettie M. 1hcker
Joan and David Vick C1therine M. Bailey James J. Gleeson Donald . Nace J\llarilyn Turville
Kenneth and Ruth Vick
Bob !-locks
Joan U. Ball Frances M. Goldbourne Ian L. Natkin Christine E. Ulanowski
Fred H. Wilken
(1n memory of
Renee R. Ballou Bob Goodman Dean B. Nelson Jack Wallner
Donald and Jody
brother's birthday)
E. Louise Barg Theresa Gray Douglas Nord Delmer D. Weisz
Witten
Joanne Jeremiah
Irma A. Barrett Seymour Greenblatt Keith and Stacy Oliver
John and Sherri Wright NelJie Jackson Janet E. Baumgartner Jack I. Groom Michael F. Otero
Christine Yoshinaga Katherine S. Wootton Jay C. Bear Gerald L. Gulseth JohnS. Ott
ltano
Norman Jesfjeld
Prof. Erol Belgin, Ph.D. francis S. Hall Leonard J. Pacifico
Diane and Lester Zoller
Arlo and Phyllis Nash
Paul R. Bennett John E. Hall David Palmer
TRIBUTES
Kermit Johnson
L.E. Bentkowski Richard E. Haney Joan Parker
Bernie Bercuson Margaret A. Harrod Thomas J. Patrician
In Memory Of
Arlo and Phyllis Nash
Helga R. Bergthold Harold J. Henderson Jeffrey Pauker
Lillian Pauline
Howard G. Bernett Victor Hierl Roi N. Peers
Jane Burkard
Markowitz
Jeanne B. Betcher Judith S. High Mr. and Mrs. Donald R.
Bernard Kinter
John Biviano
Lena Bernstein
Mark A. Bleich Linda Hoeger Perry
Edna and Nathan
Kim D. Blume George Homa, Jr. Lucille M. Petersen
Fabrice Bonnaire
Douglas Brennan
Chansky
Diana Boatwright Shirley J. Hostetter Craig S. Phinney
Linda and Nelson Fox
Jay M. Borick Ann M. Hotta Rita Hundt Pincsak
Gopa Chakrabarti
Ethel Gordon
Gene Borok Herbert R. Hughes Richard E. Popovi[S, Jr.
Thomas Cordes
Marion C. Lappin
Dr. Lowell L. Bouchard William H. Hunnicutt Col. Richard L. Prave
Thomas Davis
Herbert Mann
Eleanor P. Boyle Patricia A. Ilardi R. Steven Pulvennan,
Lamine Diallo
Doris Edwards
Amy Fish Siegel
Loran J. Brader James Irving DO.
Mark Edwards
Franz Miles Dennis D. Braun Susan M. James Thomas J. Rabideau
Edv.,in Espejo
Arlo and Phyllis Nash Barbara F. Brown Donald J. Janov Laura L. Ragonese
Leola Farmer
Helen Pagel
Julian Bulla Joanne Jeremiah Rose M. Rainona
Mary Ellen F'eid
Arlo and Phyllis Nash
John J. Burke David T. Kaczmarek Jack M. Rauch
William Foster Rose (lllother of
Michael W. Burnham George K. Kanemoto Robert Ravoni
Angela Green Millicent Weiser)
Edward P Canto Larry W. Karkela James M. Reel
Stuart B. Carlson Henry B. Keese Thomas M. Robertson
Terry Hairston Jerome Kurtz
Ralph Carn1en R. L. Keheley Alden R. Rodgers
Pooran Hamidi
David Schwartz
David Hannaford
John A Champlin Harry G. and Marion Albert and Eileen
Eldridge Harding
Claire and Jacques
La'\l'Tence Chance Keiper Roemer
Simon
Carol Jean Chatterton Frank L. Kellogg, Jr. Richard Rohrmann
Joyce Hicks
Joyce Sinatra Patsy Cilurzo William J. Kerschner J. Lewis Romett, M.D.
Sharron Hicks
Thomas Hicks
Claire and Jacques Luella Clausen Shirley M. Kimel Mary Rothman
Jacqueline Holder
Simon Ralph Consiglio Gerald F. Kiplinger Albert Rouse
An Huynh
Phil White
Maryanne Cornelius Kenneth P. Kleinpeter Bunny J. Safron
Gregory Issac
Don and Dolly Mozel
Harry H. Cotterill, Jr. David R. Kosutic Dustin Schaller
Scott Johnson Edna Wootton
W. E. Couling Sue Kozlowski Emily A. Serko
Diane Katz Mr. and Mrs. Axel
Dennis M. Cox Lance Kroetz Margaret B. Shattles
Paul Krasley Anderson
Carolyn Jean Marie E. Kruse Norma T. Sheld
Olga Armstrong
Cummings Joseph A. Kuhn Glenda Sheppard
M. Ann Hutton
Dennis M. Daly Mildred A. Kunkel William P. Sherman
William J. Wolfe
Eileen M. Dambis Jeannette Lawrence Dorothy L. Shipe
American Tinnius Association Tinnitus 'TI>day/ June 1999 25
You m_ight have noticed ... an error in our 1999 calendar (in the
December 1998 issue of Tinnitus Thday). Please accept our apologies - and our new corrected calendar.
American Tinnitus Association
Working throughout the year t o s i le n ce ti nnit us
1999
January February March April
SM TW T SSM T W TFSSMTW TFS SMTW S
l 2 l 23 456 1 23 456 23
3456 89 8 9 10 11 12 13 8 9 10 11 12 13 4 5 6 8 9 10
10 11 12 13 14 15 16 14 15 16 17 18 19 20 14 15 16 17 18 19 20 11 12 13 14 15 16 17
17 18 19 20 21 22 23 21 22 23 24 25 26 27 21 22 23 24 25 26 27 18 19 20 21 22 23 24
24 25 26 27 28 29 30 28 28 29 30 31 25 26 27 28 29 30
31

SM TW SSM TW SSM TW T F SSM TW T S
12 345 1231234 56
2 3 4 5 6 7 8 6 7 8 9 10 11 12 4 5 6 7 8 9 10 8 9 10 11 12 13
9 10 11 12 13 14 15 13 14 IS 16 17 18 19 11 12 13 14 15 16 17 15 16 17 18 19 20
16 17 18 19 20 21 22 20 21 22 23 24 25 26 18 19 20 21 22 23 24 22 23 24 25 26 27
23 24 25 26 27 28 29 27 28 29 30 25 26 27 28 29 30 31 29 30 31
30 31
September October November December
S M T W T F S S M T W T SSM TW T S SMTW TF
1 2 3 4 2 123 456 1 23
5 6 7 8 9 10 11 3 4 6 7 8 9 7 8 9 10 11 12 13 5 6 7 8 9 10
12 13 14 15 16 17 18 10 11 12 13 14 15 16 14 15 16 17 18 19 20 12 13 14 15 16 17
19 20 21 22 23 24 25 17 18 19 20 21 22 23 21 22 23 24 25 26 27 19 20 21 22 23 24
26 27 28 29 30 25 26 27 28 29 30 28 29 30 26 27 28 29 30 31
REMINDERS:
e Make my annual
ATAon __________
e Watch for .... h
Box 5, Portland, OR 97207-0005
5031248-9985 800/ 634-8978 Fax. 503/248-0024
e-mail: tinnitus@ata.org Website: www.ata.org
6th International
Tinnitus Seminar
Cambridge UK
September 5-9, 1999
Hosted by the British Society of Audiology
Plenary Sessions: Mechanism and Models
(tinnitus and hyperacusis); 'Treatments: TRT;
Medical, Surgical; Role of the Psychologist;
New Advances in Research and Methods
of Detection.
Scientific Program: Tonndorf Lecture, Award
Lecture, Technical Exhibition, Free paper
sessions.
Social: Gala dinner in St. John's College with
choir, extensive
11
accompanying persons"
program. Combine with a holiday!
Deadlines: April 1st submission of abstracts,
June 16th late registration.
Registration Fee: 350; College accommodation:
33 per day (first come, first served) .
Scholarships available.
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Address Service Requested
Further information and registration:
Website: www.tinnitus.org
Ann Allen, BSA secretary, 80 Brighton Rd.,
Reading, Berks RG6 lPS, United Kingdom
Tel: 44 + (0) 118 voice 9660622 fax 9351915.
bsa@b-s-a. demon. co. uk
Chairman and academic program: Jonathan Hazell,
FRCS, 32 Devonshire Place, London
WlN lPE, UK, j .hazell@ucl.ac.uk
3rd International Tinnitus Support
Association Meeting
Cambridge, UK, September 5, 1999
For information, contact:
Gloria E. Reich, Ph.D., gloria@ata.org