MARCH 1992 Volume 17, Number 1

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear."
IN THIS ISSUE:
The Interaction of Earmold Acoustics, Real Ear Resonances, and Tinnitus Masker Responses
Update on Federal Programs I Know What You Are Hearing
Bang! Went the Sounds in My Night Self-Help Group News
Feel the ocean's spray ... go barefoot
by a swift mountain stream ... or take
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mnt
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Scientific Advisory Board
Alfred Weiss, MD, Boston, MA
Abraham Shulman, MD, Brooklyn, NY
John R. Emmett, MD, Memphis, TN
Gale W. Miller, MD, Cincinnati, OH
Jack D. Qemis, MD, Chicago, IL
W. F. S. Hopmeier, St. Louis, MO
Harold G. Tabb, MD, New Orleans, LA
J. Gail Neely, MD, Oklahoma City, OK
Jerry Northern, PhD, Denver, CO
John W. House, MD, Los Angeles, CA
Robert E. Sandlin, PhD, San Diego, CA
Chris B. Foster, MD, San Diego, CA
Richard L. Goode, MD, Stanford, CA
Mansfield Smith, MD, San Jose, CA
Robert M. Johnson, PhD, Portland, OR
Honorary Board
Senator Mark 0. Hatfield
Mr. Tony Randall
The Journal of the American Tinnitus Association
Volume 17 Number 1 March 1992
Contents
4
13
15
16
17
The Interaction of Earmold Acoustics, Real Ear
Resonances, and Tinnitus Masker Responses
by R .W. Sweetow, P. Cato, M. Levy
Update on Federal Programs
Information from NIDCD and COR
I Know What You Are Hearing
by Elaine Sauer
Bang! Went the Sounds in My Night
by Philip M. Coston
Self-Help Group News
by Laurie H. Bauer
Regular Features
9 Questions & Answers
14 Media Watch: Tinnitus in the News
18 Tributes, Sponsor Members, Professional Associates
19 Books Available, Donation Form
The cover illustration "March Lions" is the work of Elaine Sauer, Audiometric
Technician at Saskatchewan Health, Saskatoon, Canada. Elaine also shares the
tinnitus experience.
The Interaction of Earmold Acoustics, Real Ear
by Robert W. Sweetow, Ph.D., Patricia E.
Cato, M.S., Malvina C. Levy, M A. of the San
Francisco Hearing & Speech Center
Tinnitus maskers and other instruments de-
signed to mask the unwanted perception of tinnitus
have helped thousands of tinnitus sufferers but
have been less than satisfactory for many others. A
variety of factors account for these frequent fail-
ures. When tinnitus maskers are rejected, users
often cite reasons such as "the masker doesn't
completely cover my tinnitus" or "to cover my
tinnitus I have to set the masker volume so high that
I can't hear speech" or "the masking noise is un-
comfortably loud." The real possibility exists that
the noise spectrum produced by the masking device
and ultimately received at the eardrum is not appro-
priate for that individual's tinnitus. After all, it is
likely that in order to achieve successful masking
for the many different sounds (hissing, ocean
waves, sirens, ringing, roaring, etc) that tinnitus
mimics, the noise spectra of the masker must be
shaped in a very specific manner.
We know that the ear canal and the wide
variety of available earmold coupling systems have
an enormous effect on the spectrum of sound reach-
ing an eardrum. Hearing aid specialists employ this
knowledge to enhance individualized fitting tech-
niques using a relatively recent technique known
as probe microphone real ear measures. Tinnitus
specialists can also use this information to improve
our fitting of tinnitus maskers. Thus, the objectives
of this investigation were:
1) to determine the range of acoustic spectra
that can be obtained through electroacoustic and/or
earmold acoustic modifications for commercially
available maskers;
2) to determine the effects of typical and atyp-
ical ear canal resonance effects on masking noise
spectra;
4 Tinnitus Today/March 1992
3) to develop procedures for utilizing certain
earmold and potentiometer arrangements to obtain
noise peaks at desired frequencies.
PROCEDURES
Measurements were made on 20 adult ears of
the REUR (Real Ear Unaided Response ),a measure
depicting the effects of the ear canal on sound, and
the REMR (Real Ear Masking Response). REMRs
were determined after coupling a masker to either
a custom fit unvented silhouette earmold, or an
open mold retainer tube, on each of the test ears.
The assumption was made (and experimentally
verified) that REMRs obtained through vented ear-
molds (i.e. various select-a-vents) would lie some-
where between those obtained through these two
earmolds representing the extremes of the occlu-
sion continuum.
The tinnitus masker most extensively studied
in this project was the Starkey TM 5. It contains a
three position tone switch (L, N, H) and two sepa-
rate potentiometers that alter the noise spectra.
This, and the stronger TM 3 masker, also were
measured in a standard hard walled 2 cc coupler in
order to compare the outputs of the two maskers
and to compare 2 cc coupler measures to real ear
measures.
RESULTS
Real Ear Unaided Responses:
The average adult human ear produces a res-
onant peak of approximately 17 dB at about 2700
Hz. REURs generated in this project were all in
close approximation to this average, though a few
deviated by producing secondary peaks.
Effect of the Tone Switch on the Acoustic
Spectra:
Closed Earmolds:
The amplitude of the noise produced by the
TM 5 was consistently greatest for the N setting,
least for the H setting, and somewhere in between
for the L setting (except above 3200Hz). A typical
Vo1.17No.l
Resonances, and Tinnitus Masker Responses
example of these relationships is shown in Figure 1.
. . . .
. .
60 : : : : : : : . . : . .

: : : : : : . : : : : : : : :
50: : : : : . : : . : : : .
... ,: ... . \'
L J. : \. N
30
: ....... : ... : ... : ... : .. . : .. . : .. . : .. . : ... : .. . ... : ... : ... ; .. . : .. . :
: ; . . . :
..
c
. -'
:;: KHz
Figure 1.
Closed eannold REMRs depicting effects of tone switch.
Statistical analysis revealed an insignificant corre-
lation between the amplitude of the resonant peak
found in REUR measures and the intensity pro-
duced by the masker. This correlation was similarly
low for all of the tone settings. Thus, the magnitude
of the REUR is not an accurate predictor of the
REMR.
Similarly, the relationship between theN, L,
and H curves varied widely among ears with or
without similar REURs in a non-systematic fash-
ion. Intensity differences produced by the various
tone switch settings among ears encompassed as
much as a 20 dB range. It was not possible to predict
the shape of the REMR on the basis of the REUR
resonant peak frequency. An example of this is
illustrated in Figure 2, where two different REMRs
Out put :-----:- .--:- . --:- . --:- . - .:-------:- . --:- . -....,_,........, _---,. __
SPL . : l l j ; j : : .< l j
::
: j : : : : j : j : j RE
: : : : : : : : ; : : : : : : : :
40
l ... , ... , ... , ... ll, ... , ... , ...
30 ... : ... : ... : ... ... : ... ... : ... ... : ... j . .. : ... j ... j ... j . .. j ... :
. . . . . . . . ....... .
c
""
1 2
Figure 2.
Closed earmold REMRs depicting two ears having similar REURs.
Vol.l7 No.1
occur despite the fact that both of these ears yielded
similar primary peaks regardless of the N-L-H setting
(see Figure 3), while others (Figure 4) showed
significant shifts .
Ou t::mt :-----:---:---:---:---:-....,--:--:---:--.,....-.,.--:--:---,.--.,
SPL : : :
. .
60
: : : :: : ;:
so
-iO
30
c
oJ 1
:;: KHz
Figure 3.
Closed eannold REMRs showing minimal primary peak frequency
shifts as a function of tone switch setting.
Output ,...--,---:---:---:---:---:-....,--:---:---:--.,....-.,.--:--:---:----:
SPL
..
. .
60 . . .
:::= := == :
. .. . . .
: : : ; : :
40
30
c
. .;...... 1
::: KHz
Figure4.
Closed eannold REMRs depi cting effects of tone switch. Not e
shifts in primary peaks.
Open Earmolds:
Similar to the closed earmold data, masker
intensity was always greatest for theN setting. The
amplitude of the H and L settings varied, in terms
of which was greater, depending on frequency. For
most ears, the noise intensity below 2000-4000 Hz
was greater for the L setting than for the H setting,
but H produced greater amplitude for the higher
frequencies (see Figure 5, next page).
Tinnitus Today/March 1992 5
The Interaction of Earmold Acoustics, Real Ear
Out::;ut
SPL
60
50
40
30
Figure 5.
Open earmold REMRs depicting effects of tone switch.
Note that RMS intensity was 82dB SPL for N, 68dB SPL for H,
and 67dB SPL for L.
With closed earmolds, the H setting REMR also
exceeded L for the very high frequencies, however
the closed earmold maintained enough of the low
and mid frequencies to account for a higher overall
intensity level (RMS) for L than for H. For open
earmolds, RMS values for L and H were usually
quite close. The implication of this finding will be
discussed later.
Also similar to the closed earmold data,
switching from N to H to L produced a wide range
of intra and inter-subject differences. The ears that
displayed greater N-H-L setting differences for the
open earmolds were not the same as those demon-
strating the largest differences for the closed ear-
molds, and it was not possible to predict the
location of the primary and/or secondary resonant
peaks on the basis of the REUR.
Effects of Earmold Coupling:
Opening the earmold (see Figure 6) reduces
the amount of low frequency masking, but actually
enhances the amount of high frequency masking.
The vital importance of establishing REMRs is
illustrated by Figures 7 and 8. These figures depict
the open vs. closed REMRs of the right and left
ears, respectively, of an individual whose REURs
were virtually identical for the two ears. Note that
despite similar REURs, the effects of occluding the
ear canal are dramatically different for the two ears.
6 Tinnitus Today/March 1992
:- . -:;---:-:---:- ;
60
\ . .. 1 ... \ ... ... ... l ... j .. -l- lll\
. . . . . . . . . . ; I . . . . .
50
.. ; .. : ;
40 L .. L .. L) ... l/.:1 ... L) ... ) ... [.) ... Closed
: : : : . : : : : : : : :
30 : : : j j j j j j j j j ;
... ... ... I ... ... ; ... ... .. . :.: ... ... : .. . : ... ... : .. .
... . .......... ' ..
C'
'
8 KHz
Figure6.
REMRs for N setting depicting effects of closed vs.
open earmold for one subject.
: ; ; : : : : :
60 : : : : : : : :
50
:3 KHz
Figure 7.
REMRs for N setting depicting effects of closed vs. open
earmold for subject TC' s right ear.
Output
SPL ..
60
: :
. .
. . . .
. ... . . . .
: : : : : :: : :
: : : : : : : : .
.... ' ....
. . . . . . . . .
: : ! : : : : . :
50 : : : : : :
. . . ... : . . : ...
. : : :
. . ...
: : : : :
: :
.......

-10 . . . . . . . . . : : : : : : : :
,, Lrxrrrrrr1r: 1 1rri
1
8 KHz
Figure B.
REMRs for N setting depicting effects of cl osed vs. open
earmold for subject TC' s left ear. Not e that this subject's ri ght
and left ears showed similar REURs.
Vol.l7No.l
Resonances, and Tinnitus Masker Responses
In the right ear, the shunt effect of the open mold
is present up to 3000 Hz and is as great as 20 dB at
1600Hz, but in the left ear it is only apparent up to
1900 Hz and is never greater than 10 dB. The
effects of these differences can be quite important
depending on the perceived pitch of the tinnitus and
the acoustic noise spectra desired to mask the tin-
nitus without producing a further unwanted audi-
tory disturbance.
In addition, the use of an open earmold also
tended to produce a secondary peak for several
ears. Notice, in Figure 9,
Output---:---:---.,........,---:---:---:--:---:--.,--,---:---,
SPL : ; : ; ;
50 1: .. ; .. \ .. : ... , .. [
ClosedL ] : [ : j : : : ] . : : :
cr.x!o \"'>:; ... .. .. ; .. ((!' ..
30 ... : ... : ... \ .. . ... : ... : ... \ .. . \ .. . ... . .. : ... \ ... ... ... \ ...
: : : : : : : : : : : : : : : :
20 : : : j : : : : : : : : : : : : :
: :: : : : :: :: : : ::
. . . . . . : : . : : : : :
C'
....
.. ,
...
y
::: KHz
Figure 9.
REMRs for H setting depicting effects of closed vs. open
eannold for RWS's left ear.
that the use of the H setting resulted in similar
primary peaks for open vs. closed conditions, but
that the open mold condition had the effect of
producing a significant secondary peak (around
2500-3000 Hz). This is an important finding be-
cause it suggests that an individual with multi-tonal
tinnitus could utilize an open mold masker fitting
to obtain low frequency masking, as well as greater
high frequency masking. If the patient had low or
mid frequency tinnitus only, the same setting
would be chosen, but a closed mold would be
preferred so as not to produce further masking in
the 2000-3000 Hz region. Above 2000Hz, the open
mold condition resulted in greater amounts of noise
energy than did the closed earmold condition.
VoL17No.l
DISCUSSION
An enormously wide range of acoustic noise
spectra can be obtained by manipulating the tone
controls, potentiometers, and most importantly, the
earmold coupling system. One can, for example,
obtain primary REMR peaks as low as 700 Hz by
using the L setting coupled to a closed earmold or
as high as 6000 Hz by using the H setting coupled
to an open earmold. Furthermore, a nearly limitless
number of secondary and tertiary peaks can be
obtained via the interaction of potentiometer set-
tings, tone switches, and individual ear canal reso-
nances. The locations and magnitudes of these
peaks can only be ascertained through real ear
measures. They cannot be determined from 2 cc
coupler data. In fact, the 2 cc responses of the
maskers had little resemblance to most of the wide
variety of REMRs collected. Therefore, it does not
appear feasible to construct a simple conversion
table that would allow predictions from 2 cc
measures to be applied to a real ear.
Interestingly, it appeared that the REUR had
the least important influence on the final REMR,
the potentiometer setting had the second smallest
influence, and the tone control and the earmold
coupling had the greatest influence.
The data clearly show that many of the general
traits of the effects of earmold acoustics on hearing
aids also apply to the effects of earmold acoustics
on tinnitus maskers. For example, the use of an
open earmold coupling system serves as a low
frequency shunt, conversely a closed system
retains the greatest amount of low frequency
amplitude as well as overall loudness percep-
tion. Very important was the finding that one can
produce shifts in resonant peak and amplitude to
desired frequencies without necessarily producing
a concomitant increase in either overall RMS
intensity or loudness perception, both of which
could be quite unwanted. The significance of this
is that it is possible to minimize the overall noise
exposure to the patient, thus reducing the likeli-
hood of permanent threshold shift, exacerbated
Tinnitus Today/March 1992 7
The Interaction of Earmold Acoustics, (continued)
tinnitus, or disruption of speech reception while
still focusing the masking noise directly on the
pitch of the tinnitus. Of course, it is not yet certain
whether the most efficient masking noise is one in
which a band of noise is centered directly on the
frequency associated with the tinnitus pitch percep-
tion.
Furthermore, one can utilize real ear measures
to determine the optimal combination of coupling,
potentiometer setting, and tone setting to optimize
masking without producing unwanted effects. For
example, one could use an open earmold and an L
setting to produce a softer loudness perception and
relatively low RMS intensity, and still obtain both
a low and a high frequency peak, thus yielding a
more "mellow, bass" masking sound, while still
maintaining masking in the high frequencies.
CONCLUSIONS:
The information gleaned from this investiga-
tion suggests that the use of real ear measures can
be combined with both electroacoustic and acoustic
modifications of tinnitus maskers and couplers to
obtain a closer match to a "target" masker spectrum
that effectively masks the perception of the tinnitus,
yet is unobtrusive to the patient. The need for
research defining what constitutes an "effective"
masking spectrum for a given patient remains
enormous. Future research must concentrate on
developing algorithms based on improved
tinnitus matching procedures. In addition,
professionals and patients must continue to
encourage manufacturers to produce tinnitus
maskers and instruments that allow for
maximum fitter and user flexibility.
Acknowledgement: The authors wish to
express their gratitude to the A TA for its
support of this project.
*(A detailed report of the procedures used and
results obtained in this study may be obtained by
writing to the authors or to the AT A.)<>
8 Tinnitus Today/March 1992
Notices:
AT A is pleased to welcome Mr. Aaron
Osherow, St. Louis, MO, and Mr. Edmund
Grossberg, Northbrook, ll.., as new members to its
Board of Directors. Mr. Osherow has recently
retired as CEO of a large national direct mail frrm.
He will be helping AT A with advice about direct
mail and fulfillment programs. Mr. Grossberg is a
certified life underwriter who brings a wealth of
business and non-profit experience to the board.
Their terms of service began as of January 24, 1992.
We are saddened by the death of our good
friend Mr. George Callison of Portland, OR.
George brought a ray of sunshine to our office
during the hundreds of hours he spent working as
a volunteer for ATA. We extend sympathy and
condolences to his family.
At the winter meeting of the Association for
Research in Otolaryngology (February 2-6, 1992)
tinnitus was the topic of several papers and posters.
A recent study of the drug Xanax was reported
by Dr. Robert Brummett of the Oregon Hearing
Research Center, Portland, Oregon.
Dr. Pawel Jastreboff reported on recent work
being done at the University of Maryland School
of Medicine. These continuing studies involve
changes occuring in the cochlea as a result of
salicylate induced tinnitus.
Dr. William Martin from Temple University
Medical School in Philadelphia reported results of
a study involving direct recording of spontaneous
activity from the auditory nerve.
Dr. Robert Dobie, University of Texas, San
Antonio, reported a recent study in which nortrip-
tyline was used to treat tinnitus but positive results
may have been influenced by non-tinnitus
changes.<>
Vol.l7 No.1
Questions & Answers
By Jack A. Vernon, Director, 0 regon Hearing Research
Center
Q uestion: "My doctor suggested that I try
Robinul for tinnitus. Do you have any informa-
tion about the use of Robinul for tinnitus?" Mrs.
M .. from Connecticut.
A nswer: I have never heard of using Robinul for
tinnitus, indeed I had never heard of Robinul. I
looked it up in The Physician's Desk Reference and
find that it is used for treatment of peptic ulcer but
there was no mention of any association (side
effect or otherwise) with hearing or tinnitus.
Perhaps your physician knows of some study or
has had experience with Robinul for tinnitus.
Would you ask him? Don't scoff, gentle reader,
this would not be the first time the stomach has been
associated with the ear. In 1854 James Yearsley
wrote a book on deafness in which, among other
things, he described "stomach deafness." He was
convinced that disorders of the stomach could
cause hearing impairment since both contained
mucus linings. He did not, however, carry the day.
Q uestion: Mention of the drug Deseryl in a pre-
vious Q & A brought in several comments. One of
these reports indicated that Deseryl was responsi-
ble for initiating a permanent tinnitus.
A nswer: Deseryl is an anti-depressant medica-
tion which lists tinnitus as one of the possible side
effects. The incidence of tinnitus as a side effect is
1.4% which means that only 1.4% of the patients
taking the drug can expect to experience that side
effect. When a side effect is listed it does not mean
that everyone who takes the drug will experience
that particular side effect, thus when you are inquir-
ing about side efffects (and you should always do
that) of any medication you should also ask for the
percentage of incidence. In most cases side effects
are temporary but keep in mind that anything which
gets into the ear can do so rapidly but getting out is
another matter--it takes a very long time.
Vol.l7No.l
Q uestion: "Is there any ointment or medicine for
the relief of muscle pain which does not exacerbate
tinnitus?" Mr. P. from South Africa.
A nswer: I have two suggestions to make but frrst
I want you to understand that you must discuss both
suggestions with your primary physician. The
drug Tolectin, is an anti-steroidal anti-inflamma-
tory medication which may be of help for muscle
pain. It does not contain salicylates thus it should
not exacerbate your tinnitus. Also there is a treat-
ment for muscle pain which does not involve any
medicine but rather uses electrical stimulation.
Typically it is termed TENS which means Trans-
cutaneous Electrical Nerve .S.timulation. One such
unit is the Alpha-Stim CS produced by Elec-
tromedical Products International, Inc. 12591
Crenshaw Blvd. Hawthorne, California 90250.
This device costs about $800 and can be purchased
only by a prescription from a physician. There are
less expensive TENS devices but I do not know
what kinds are available in South Africa. Check
with the neurologists in your area. The Alpha-Stim
CS was utilized in a study of tinnitus by Engelberg
and Bauer (see: "Transcutaneous Electrical Stim-
ulation for Tinnitus" in Laryngoscope, Vol. 95 No.
10, 1985,pp 1167-1173) who claim 82% of33 ears
in 20 patients experienced relief of tinnitus with the
electrical stimulation. I think
you and your physician should
read that article before pro-
ceeding but if the claims are
correct you may be able tore-
lieve your muscle pain and
your tinnitus with the same de-
vice. Yes, I know it does sound
too good to be true but there is
only one way to find out and
that is to try it. It is my personal
belief that electrical stimula-
tion can be made to relieve tin-
nitus but that a great deal of
research is needed in this area.
Fortunately such research is
Tinnitus Today/March 1992 9
Questions & Answers, (continued)
currently underway. If you or your physician wish
additional information about the use of electrical
suppression of tinnitus, permit me to refer you to a
review article I wrote on this topic some time ago
(February, 1987) in a publication entitled Seminars
in Hearing. The article, "The Use of Electricity to
Suppress Tinnitus", may be ordered from the ATA
Bibliography service.
I cannot comment about the Alpha-Stim CS
since I have not used it and thus do not know what
kind of wave form or stimulus pattern it delivers
and these are, I suspect, critical features for the
production of tinnitus relief.
Q uestion: I saw a TV presentation of a scientist
at Stanford University who was recording sounds
emanating from the human ear. Was this a record-
ing of tinnitus? Mr. B., Rhode Island.
A nswer: What you saw demonstrated is a very
interesting and fascinating capability of the ear.
That is, the ear can not only receive sound but it can
actually generate sound as well. This phenomena
was first discovered by David Kemp working at the
University of London in 1978 and is termed
otoacoustic emissions. He found two kinds of
emissions produced by the ear, spontaneous and
elicited, and as you can easily imagine, spontane-
ous emissions were initially assumed by one and
all to be tinnitus. That turned out not to be the case,
which is unfortunate because such indicators could
have provided a much needed objective measure of
tinnitus.
Spontaneous and elicited emissions are con-
sidered to be a part of the function of normal ears,
and they tend not to be present in damaged ears. A
considerable amount of investigation continues in
this area but whether or not it will be of value to the
understanding of tinnitus remains to be seen. One
thing does seem certain, if the spontaneously emit-
ted sound from a tinnitus ear is amplified and
played back to the patient, it does not sound like
their tinnitus.
10 Tinnitus Today/March 1992
Q uestion: "Is there a connection between tinnitus
and high frequency tones emanating from televi-
sion sets?" Mr. M., California.
A nswer: The high frequency tone emanating
from TV sets is a 16,000 Hz tone which is beyond
the hearing capability of most of us beyond the age
of about 40 or so. Young, non-damaged ears are
capable of detecting 16,000 Hz tones but only if
they are sufficiently intense. Even then I doubt that
there is a connection with tinnitus. On the other
hand, it may be possible, Mr. M., that your partic-
ular TV set has an unusually intense tone and that
your tinnitus is triggered by it. See if other and
newer TV sets have the same adverse effect upon
your tinnitus.
Q uestion:Mrs. K. from IL writes that the book,
The Complete Medical Exam by Isadore
Rosenfeld, M.D., claims that the "garden variety of
tinnitus is due either to Meniere's disease or to
hardening of the arteries in and around the ear."
Mrs. K. asks, "Is this a correct statement?"
A nswer: There are many, many causes of tinnitus
besides the two possibilities listed by Dr.
Rosenfeld. Indeed, the most frequent cause is ex-
posure to loud sounds. Remember, the medical
community says tinnitus is not a disease, it is a
symptom associated with just about everything
which can go wrong in the auditory system. If
arteriosclerosis produces obstructions to blood
flow in vessels near the ear, a special form of
tinnitus, pulsatile tinnitus, may result. Patients
with pulsatile tinnitus, which is synchronous with
the heart beat, probably would see cardiovascular
specialists, although I have been able to success-
fully use low frequency masking for some of these
patients.
In Dr. Rosenfeld's book the advice is to
" ... avoid fruitless, expensive redundant consulta-
tions. All you need is one good examination to tell
you where the trouble is - and isn't. Don't waste
Vo1.17No.l
Questions & Answers, (continued)
your money on medications. There is none that
will stop these noises." I fmd these generalizations
overly restrictive and disagree with them. You
may have to see several specialists depending upon
what kind of tinnitus you have. And I certainly
think there is medication worth trying (see Dec. '91
onXanax).
Q uestion: Our next letter is from Mrs. M. in
Maryland. She is concerned that most of the tinni-
tus patients we deal with have hearing loss, and she
does not. She goes on to indicate that her tinnitus
is probably related to head and neck trauma. She
asks if there are orthopedists who treat tinnitus.
A nswer: The reason attention is given to hearing
loss is due to the fact that 90% of tinnitus patients
have hearing loss in addition to the tinnitus. Very
often 'it is necessary to compensate for the hearing
loss in addition to attempting to deal with the
tinnitus.
It is true that some tinnitus patients who have
their tinnitus initiated by head and/or neck trauma
do not have hearing loss, although they very well
may have hearing losses in the very high frequency
region above 8000Hz, which is not routinely tested
in hearing tests.
I know of no orthopedists who treat tinnitus
nor are there, to my knowledge, any medicines to
treat degenerative disc disease which will cure
tinnitus. Remember, Mrs. M., there are, as yet, no
cures for tinnitus but it is hoped that relief is possi-
ble for you and that relief is not predicated on the
issue of whether or not you have a hearing loss. In
our clinic, the use of tinnitus maskers as opposed
to tinnitus instruments is often appropriate for those
patients who do not have hearing loss.
I do not see why you, Mrs. M., should feel
isolated because most tinnitus patients do have
hearing loss. You are more fortunate than most in
that you only have one problem involving the ears.
In that regard, let me repeat an instruction we have
given to many tinnitus patients who have hearing
Vol.l7No.l
loss. If you can only compensate the hearing loss,
that will leave a lot more reserve to fight the tinni-
tus.
Q uestion: A report from Ms. T. in Canada indi-
cates a history of otosclerosis which failed to re-
spond to the initial surgery but then briefly
responded to a second surgery. She has no hearing
in that ear and, in addition, is confronted with a
"tremendous roaring" as well as other symptoms
such as tingling in the left hand, numbness in the
left arm and general weakness.
A nswer: The symptoms you describe seem to
indicate the possibility of more than tinnitus and,
of course, there is every reason that any of us may
be burdened with multiple health problems. Your
other symptoms, if persistent, suggest the need to
be seen either by a neurologist, or a cardiologist, or
possibly both.
The tinnitus you describe is that typically
associated with a middle ear conductive problem.
The description of "roaring" suggests a low pitched
noise-type tinnitus. Let us assume that the tinnitus
ear bas such hearing loss that hearing aids are not
practical as far as understanding speech is con-
cerned. However, that does not necessarily mean
that the hearing aid cannot help the tinnitus. I
would suggest that you try a hearing aid for the sake
of relieving the tinnitus. The test can be very brief.
Try on the hearing aid to see if it immediately
masks the tinnitus when in normal environmental
noise (in other words, not in a sound shielded
chamber). If the hearing aid works, use it. If it does
not work, ask the dispenser to try to mask your
tinnitus with bands of low frequency noise to de-
termine whether a custom-made masker might
work for you. Here again, you will know im-
mediately if relief is produced.
Q uestion: This letter is from Mrs. J. of California.
"I have a bottle of "Tinnitus Relief' and have found
it helpful. I should like to get another bottle before
Tinnitus Today/March 1992 11
Questions & Answers, (continued)
this one is used up. Can you sell me a bottle or tell
me how I can procure it?"
A nswer: I think "Tinnitus Relief' is the same
product as ProZaine so you may have some diffi-
culty obtaining it now.
Now, let's take a different look and attempt to
explain how these ear drops might have helped you.
As you know, debris such as ear wax on the ear
drum can cause tinnitus and, if your tinnitus was
due to such a cause, then it is understandable that
the ear drops may have cleaned the drum of debris
and made the tinnitus better. I don't think you
should accept my explanation. Wait until your
tinnitus has returned and then have an otolaryngol-
ogist examine your eardrums to see if debris of any
sort is present and, if so, whether removal of it
relieves the tinnitus. As you know, as we age we
tend to produce more ear wax. I know of some
elderly patients who develop so much wax as to
effectively plug their ears. If you have tinnitus and
also need to have periodic cleaning of the ear by an
otolaryngologist, be sure he knows that you have
tinnitus so that he may avoid any noisy procedures.
Ed. note: Refer to June, 1991 Tinnitus Today issue
on methods for removing ear wax.
S everal readers have written in either to inquire
about ear plugs or to offer information about spe-
cific types of ear plugs. In the near future, we will
put these thoughts together and offer a section on
ear protection. For the present, remember that
probably the single most important thing for tinni-
tus patients is to protect their ears from loud sounds.
If you are in a noisy situation where it is necessary
to raise your voice in order to be heard, that noise
level is too loud for tinnitus. Initially, exposure to
loud sound may temporarily exacerbate tinnitus but
continued exposures will cause the elevation to be
permanent. Protect those ears, and if you must be
exposed to loud sounds, then wear ear protectors.<>
12 Tinnitus Today/March 1992
Questions for Dr. Vernon should be ad-
dressed to him c/o AT A Questions & Answers,
PO Box 5, Portland, OR, 97207-0005.
All questions will be forwarded to Dr.
Vernon but only questions of broad general
interest will be answered in this column.
Classified
SPECIAL PILLOW CAN RELIEVE EAR
NOISES AND AID SLEEP
Your sleeping habit may be robbing you of a proper
night's sleep. The Ear Relaxer can change your life. Austin
Skaggs, the inventor of the Ear Relaxer Pillow, reports that it
has helped him and many other people who have tried it. It is
comfortable for those who wear their hearing aids or maskers
to bed. Testimonials are availableonrequestfrom Mr. Skaggs.
To order, send$17 .95 (postpaid), outside U.S. send$20.95
(U.S. funds), for postage paid shipment to:
EAR RELAXER
POBOX90
VICTOR, WV 25938
American Tinnitus Association
is a participant in the
Combined Federal Campaign
#0514 in the CFC Brochure
Thank You For Helping
To Fight Tinnitus
Vo1.17 No.1
Update on Federal Funding & Programs
NIDCD Budget Update
The Friends of the National Institute on
Deafness and Other Communication Disorders
has advised that it is again important for all of us
to write to our legislators in support of funding for
the Institute. The fisca11993 budget hearings take
place in March and April and, as you well know,
letters from constituents go a long way toward
helping to make up the minds of those who serve
on the Appropriations committees. Letters in sup-
port of expanded allocations for NIDCD to fund
research on hearing and especially on tinnitus
should be addressed to legislators from your own
state as well as the following committee members.
Senators:
The Honorable Robert C. Byrd (D-WV)
The Honorable Tom Harkin (D-IA)
The Honorable Mark 0. Hatfield (R-OR)
The Honorable Arlen Specter (R-PA)
Representatives:
The Honorable Jamie L. Whitten (D-MS)
The Honorable William H. Natcher (D-KY)
The Honorable Carl D. Pursell (R-MI)
The Honorable Joseph M. McDade (R-PA)
Sample Letter to be copied on
personal/professional stationery
Date
The Honorable
Washington, DC (ZIP, 20510 for Senators,
20515 for Congressmen)
Dear Congressman .......... ... . or
Dear Senator. ............ .. ..
I am tremendously grateful for your strong support
of the FY"92 Appropriations funding for the National
Institute on Deafness and Other Communication Disor-
ders.
As the House (or Senate) FY "93 Appropriations
Subcommittee on Labor, Health and Human Services
(HHS), Education, and Related Agencies prepares to
meet a ~ a i n , I encourage you to continue to foster the
promotion of research and training opportunities for this
Vol.17No.l
new Institute, as a strong base is critical for its growth
and development.
Your leadership in helping to facilitate the commu-
nications disorders program is deeply appreciated, and
I would be so pleased if you would again give it your
steadfast commitment.
It is estimated that over 48 million people are
affected with hearing and speech disorders. and with
over 50 million people affected with tinnitus and more
than 12 million suffering from it severely. it is urgent that
we plan now to reduce the long-range effects of these
invisible, but debilitating disorders.
In my own (family/institution/profes-
sionletc.) ......... (insert personal story).
Thank you for the opportunity to share my con-
cerns with you.
Sincerely,
Rehabilitation Act Update
This year the Rehabilitation Act of 1973 is up
for reauthorization. The Rehabilitation Act is a
comprehensive piece oflegislation authorizing var-
ious programs and services to persons with disabil-
ities. Some of the areas included are employment,
independent livihg, client assistance, industry pro-
jects, rehabilitation training, and recreation. AT A,
as a member of the Council of Organizational
Representatives, has been actively involved in
identifying issues of concern to persons with a
hearing loss that might be addressed through
changes in the act. Although the current law is a
good one, many programs authorized under the law
are not accessible to persons who are deaf and hard
of hearing. COR has recommended 10 major
changes to remedy the situation. If you are inter-
ested, a full report is available from:
COR c/o Department of Counseling, School of Education and
Human Services, Gallaudet University, Kendall Green, 800
Florida Ave, NE, Washington DC 20002-3695.
We urge you to contact the Senate and House
subcommittees responsible for the reauthorization
with your suppon for these changes:
Senate Subcommittee on Disability Policy
Chair, Senator Tom Harkin, Washington DC 20510
House Subcommittee on Select Education
Chair, Representative Major Owns, Washington DC 20515
Tinnitus Today/March 1992 13
Media Watch: Tinnitus in the News
by Cliff Collins, an Oregonfreelance
writer. He invites clips, including source and
date, to Media Watch, PO Box 5, Portland, OR
97207-0005.
Tom Clancy? Nah. Stephen King? Forget it.
The most widely read writers on the planet are the
Twin Towers: Ann Landers and her sister, Abigail
Van Buren (Dear Abby). If you don't believe it,
check mail call at the ATA these days.
During the last week of December, Dear Abby
featured letters from readers who heard "crickets,"
crackling sounds, roaring and other ear noises. Van
Buren reassured them that they're far from alone,
labeled their complaints as tinnitus, and referred
them to the A TA.
The ATA staff and dedicated volunteers who
open letters had almost reached the point of being
able to see one another across the stacks of mail on
the table when Van Buren's formidab.le sibling,
Landers, cranked out a February 19 piece also
tackling tinnitus and listing the AT A's address.
The results of these columns will be felt for
months. Landers is the most widely syndicated
columnist in the nation, and the two's combined
readership reaches into the multimillions. The
ATA owes much of its growth to Landers' and Van
Buren's previous mentions of tinnitus over the
years. Each advice columnist is inundated with
requests from health-related groups who want to
14 Ti.nnitus Today/March 1992
reach this vast audience, but Landers and Van
Buren have consistently been generous in includ-
ing the A TA and tinnitus, probably because they
know it affects so many people.
The inevitable landslide response also con-
firms that the AT A's estimate that tinnitus affects
perhaps 50 million Americans is probably quite
accurate. That's about one in five folks you pass on
the street.
More Beethoven: Knowing we're not the
only ones with tinnitus gives us reassurance; know-
ing that notable people also suffer from it-- and still
excel -- additionally provides us inspiration. After
our September item on Ludwig van Beethoven's
ear woes, Western Michigan University professor
HaroldL. Bate, Ph.D., sent several articles relating
to the matter. Beethoven's extensive letters reveal
the heartbreak his hearing loss, recruitment and
tinnitus ("My ears ring and buzz continuously")
caused him, depriving the master oflistening to his
own greatest works. He wrote, "Let some unfortun-
ate person gain solace in the thought that he has
found someone else equally unfortunate, who, in
spite of all the hardships imposed by nature, yet did
all in his power to be raised to the noble ranks of
human beings."
Pleas for quiet: Two consistent themes in
news stories this time were hearing-aid im-
provements and noise-prevalence complaints. Pa-
rade magazine December 8 reported that 21 million
Americans could benefit from the newest hearing
aids, but just 4 million do. Chicago Tribune Mag-
azine (October 6) covers much the same ground,
documenting the progress that's been made. Both
recommend working with a competent audiologist
and avoiding mail-order aids. Some people with
both hearing loss and tinnitus find that hearing aids
benefit both problems.
Ann Landers ran several columns with letters
from readers who were sick of piped-in music and
cacophony that are present nearly everywhere in
modem society. Among the most abominable and
VoL17No.l
Media Watch (cont.) I Know What You are Hearing
prevalent offenders are so-called leaf-blowers,
which seem to have replaced push brooms as well
as rakes, and disturb the spirit as well as the ear. A
letter writer in The (Portland) Oregonian lamented
how leaf-blowers had ruined her annual visit to a
public oriental garden devoted to beauty and con-
templation. Told that the machines would run most
of that day, she left. "The sound of a bamboo rake
would be fitting and would do the job as quickly,"
she wrote.
Family Circle's "Hidden Hazards of Chronic
Noise" November 5 chronicles the toll "the cumu-
lative clamor of modem life" has taken on the
hearing of youth and young adults. The number of
35- to 44-year-olds with hearing problems jumped
70 percent between 1977 and 1985, it says. One
fourth of student musicians among seniors at a
California high school flunked a hearing test! The
article mentions tinnitus.<>
Sponsors and Professional Associates to January 31, 1992
Continued from Page 18.
VVandaMShannon
Alice Shields
Jerome D Shine
K Thomas Shipley
G E Shultz
Claire Simon
Roger Sloan
G S VVhitney & Assoc
Keith C Winters & As soc
Myrna E VVoellert
VV VVohlgemuth
Larry VV York
Paul VV Zerbst
LutherJ Smith Ill ATA PROFESSIONAL
Raymond & Sylvia Smith ASSOCIATES
Richard & Patricia Smith Sherwin A Basil, MA
Kenneth J Smithee Bruce S Bloom, MD
Joseph Souto Stanley J Cannon, MD
larry Spoden Anne L Curtis, MS
Dan Stange Elio J Fornatto, MD
Howard C Stidham Gregory Frazer, PhD
Douglas Stumbaugh Michael G Genz, MS
Stephen F Sullivan Norman Goldstein, MD
Ruth Swan C Marke Hambley
Richard Swenson Robert R Harmon
Harold G Tabb, MD Soraya Hoover, MD
Fred D Thompson John VV House, MD
Jim Thompson Jim Kaloris
Tinnitus Selbsthilfe Gemeinschaft Timothy B Klar, BA
VVilliain R Tower, Jr Peter & Connie Marcola
Arlene Van Norden C Randall Nelms, Jr, MD
Edward L. Vadnais Jerry Northern, PhD
Margaret C Verharen Meredith K L Pang, MD
Jack A Vernon, PhD Philip A Rosenfeld, MD
Duane D VValters Robert Southard
Michael VVebber Raymond A Stassen, MA
Robert F VVeimer Hollis Underwood
FA VVest Harry R Zimmerman, CCC-A
Vernon E VVestcott
Vol.l7No.l
by Elaine Sauer, Saskatchewan Health
Hearing Aid Plan
Do you hear ringing, banging, buzzing, or
clanging -- those dreadful shrieking or whistling
noises? Yes, I hear them too.
Doctors tell us to learn to live with it. That's
always the answer we get. What is it? It is called
tinnitus, a subjective ringing or noise in a person's
ears or head.
Just as there are many different sounds of
tinnitus, there are many different loudness levels.
The loudness can vary throughout a day, through-
out an hour, or even throughout a half hour. Along
with these variations, there is a variation in the
number of different sounds existing at the same
time. I recently spoke to a person who could iden-
tify seven different sounds all going on at ~ h e same
time.
Some people have mild tinnitus that does not
bother them, and since it does not bother them, they
fail to understand why some tinnitus patients com-
plain about their tinnitus. They fail to understand
there is a form of tinnitus that is SEVERE, whereby
the sufferer finds their quality of life greatly af-
fected by the tinnitus. The presence of such severe
tinnitus is a debilitating experience, a mystery to
the affected, interfering with their ability to concen-
trate and disrupting their entire lives. People with
tinnitus are justifiably frustrated by having some
professionals categorize all tinnitus as being the
same.
Tinnitus patients should not be discouraged
because someday cures will be found. In the mean-
time, I recommend patients be as well informed as
they can about tinnitus by reading articles, by join-
ing tinnitus associations and by participating in
local tinnitus support groups.
Don't fight it, accept it, talk about it, know
everything there is to know about it. The tinnitus
sufferer is not alone, there are a lot of us who are
hearing what you hear.<>
Tinnitus Today/March 1992 15
Bang! Went the Sounds in My Night
by Philip M. Coston, California
Planning is thinking ahead and projecting
and others into future activities. By doing
thts, you can select the best available course of
action to reach an objective. When the planning
process breaks down in prosecuting war people get
hurt; typically your own people.
.on a cool summer evening in 1983 a group of
heavtly armed, camouflaged security policemen
slipped into the forests surrounding Camp New
Amsterdam, practicing the profession of anns. At
a wye on a seldom used footpath the fire team
leaders converged with the CO. We had spent the
prior day discussing our plan at length. Analysis of
scout reports, aircraft overflights, and interrogations
of captured "enemy" troops gave us every confidence
of success. We taped equipment to harnesses, removed
earplug cases to prevent the smallest of sounds from
reaching anxious enemy ears. Hearing is an essential
tool of the foot soldier.
Fire teams had been given time windows to
reach certain marks. The commanding officer cau-
tioned us again concerning radio silence and implored
each of us to make every effort to reach our marks on
time. Some of the teams had to take offensive
at the marks --for some it was merely a
pomt on the road; a road ending in a fight.
We set our watches and returned quickly to
our resting forces. I was the NCO in charge of fire
team Charlie and Charlie One. Charlie's task was
to secure the south brim behind an encampment and
hold area while the other fire teams swept the
camp, in hopes of rescuing two downed F-15 pilots
in the process. Charlie One was an additional four-
roan element assigned to secure a safe retreat across
a known enemy convoy route.
Exercise safety is a critical part of military
planning. The signal to begin the sweep was to be
two ground-burst simulators ignited on the north-
western rim of the camp. This would simulate the
destruction of an enemy quad-fifty anti-aircraft gun
16 Tinnitus Today/March 1992
position. The explosion, away from the troops,
would backlight the suspected enemy headquarters
and save night vision.
We reached our first mark at 0+46 minutes.
Four minutes within our time target. At this point
we cut through a barbwire maze, locating a safe
overview and posted Charlie One. Fire team Charlie
continued on. We arrived at our designated security
point at 0+61 minutes, one minute off the time line,
but well within tolerances.
Suddenly, all hell broke loose! The CO
changed the plan and had made no attempt to
inform his deploying fire teams. The explosives
were ignited ten feet in front of me. Two cannisters
of gun powder with the explosive potential of five
sticks of dynamite. My defensive position was
compromised, my night vision lost, and my hearing,
my precious hearing was gone! In a matter of seconds
I could neither see nor hear. Pungent cordite filled
my lungs. Dang-Nang revisited.
Somehow I got my troops into positions of
safety. We secured the exit and managed to secure
the pilots. The mission was a success-- my
heanng has been a disaster ever since.
The doctor at the base clinic told me the next
day that my problem was not the result of the
explosion, but resulted from excessive use of coffee.
Now it was my turn to explode. I forced them to
refer me to a civilian doctor in the Dutch commu-
nity. I was ordered into the Dutch military hospital
fortreatmentoftinnitus caused by "massive trauma
to the hearing ear." I spent two weeks in the hospital
with an IV stuck in my arm in a desperate struggle
against severe heru;iflg loss.
I urge anyone reading this article to protect
themselves and others from loud noises. Use ear
plugs and stay out of noisy environments. If exposed
to violent noises seek medical help. If you don't like
the answer the doctor gives you, seek a second
opinion. It took the Air Force seven days to refer
me to the Dutch. Perhaps if they had referred me
that day I would not suffer from tinnitus now.'i>
VoL17No.l
Self-Help Group News
by Laurie H. Bauer
Many of you have written to explain that
although you'd like to take part in a tinnitus support
network, you either cannot attend local meetings or
that a group simply does not exist in your area. We
have an alternative that may be perfect for you!
Lorraine Cramer-Mooney of Spring Hill,
Florida, has put her interest in sharing support for
people with tinnitus together with her love of
letter-writing. The result will benefit many. We
are happy to announce and invite you to participate
in the new tinnitus Pen-Pal Support Network.
Lorraine explains that since the beginning of
her tinnitus (she also has Meniere's Disease), she
has been searching not only for information about
each condition but more important! y, for "someone
who could relate" to what she was going through.
RefeJ!ing to others with tinnitus, she asks, "Who
can understand better than we can?" The Pen-Pal
Network is designed to make it easy for you to gain
the strength and support of those who have been
through it all and understand.
To participate, send a long self-addressed
stamped envelope to:
Lorraine Cramer-Mooney
%Pen-Pal Support Network
12534 Elgin Blvd
Spring Hill FL 34609
Lorraine requests a $2.00 donation to help
cover her expenses. You'll receive a list of others
wishing to participate, along with Lorraine's own
suggestions for creative letter-writing.
Vol.l7No.l
A Warm Welcome to New Self-Help Groups
Around the Country:
Marlboroua:h. MA. Contact: Ernest Johnson,
(508) 481-8752
Mora:antown, PA. Contact: Pastor Mark
Rains (215) 286-9607
Minneapolis, MN. Contact: Intnl Hrg Fdn,
(612) 339-2120
Honolulu, HI. Contact: Paul Yamashige,
(808) 526-1405
Tacoma, W A. Contact: Lee Leggore, (206)
565-6120
Groups are now being formed in Atlanta. GA
Harrisbuq:. P A, and neighborhood areas of
Philadelphia, PA. If you'd like to become in-
volved, please contact the national office. We can
put you in touch with others who'd like to help and
also with current group leaders who will share their
ideas and advice.
More than 50 people packed into Jeff Caine's
office in Seminole, FL when Gloria Reich and Pat
Daggett visited the Tampa Bay Tinnitus Group.
Their visit was planned in conjunction with their
trip to the February ARO meeting (see P.8). Some
of us didn't have places to sit but we enjoyed each
other's company and shared much information in
a lively question and answer session about every-
thing from acupuncture to zinc. If you would like
to participate in this group and weren't able to
attend, you can call Jeff at (813) 785-5554 for
information about the next meeting. <i>
TINNITUS BIBLIOGRAPHY
The Tinnitus Bibliography 1991 Supple-
ment (Update #4) is now available. Price:
$10.00 U.S. Funds.
Address prepaid requests for supple-
ments and other bibliography services to the
attention of Patricia Daggett
Tinnitus Today/March 1992 17
Tributes, Sponsors, Professional Associates
The AT A tribute fund is designated 100% for research. Thank you to all those people listed below for
sharing memorable occasions in this helpful way. Contributions are tax deductible and are promptly ac-
knowledged with an appropriate card. The gift amount is never disclosed.
IN MEMORY OF
Mrs. Billingsly
Mae & Albert Feluren
Golda & William Bowman
Don Bowman
Bernard Brown
Betty Brown
MIM Czarnecki
Jane & Peter Czech
Mark Denburg
Shirley Kesselman
Lewis Decker
Pauline/Nate Markowitz
Tom Hand
lloyd & lucy Hand
Charles Hardin
Mrs Marilyn Hardin
Ed Kalinowski
Bill Haskin
Dorothy Kanner
Florence & Hal linden
Marie Kelly
Frances Janiga
Irving Knopmacher
M!M Milton Berko
Bee LeKashman
Claire Simon
Gertrude & Nat LeKashman
Claire Simon
Mrs. Sara Levy
Carolyn Werner
Dora & Ell Lipschitz
Dianne Egherman
Phyllis Magill
Decision Dynamics, Inc.
Jean Megaro
Sidney & Dorothy Cohen
Gerald Moore
M!M Sammy Hayward
Robert A Palmer
Elizabeth Palmer
Hilma Ramos
Frances Janiga
Jack Reich
Florence Reich
Alfred Rosen
Nancy M. Rosen
Edna & Paul Shapiro
Richard Shapiro
Norman Weaver
Brownie Williams
Harvey Wilson
UsaKWilson
IN HONOR OF
VIcki & Tom Akers
Jack & Dorothy Akers
William Consalo, Jr.
Kathy/Bert Bifulco & Children
Jacqueline Doyle-Birthday
Joseph AlamfTrudy Drucker
18 Tinnitus Today/March 1992
Birthday of Trudy Drucker
AdeleBAiam
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Lyn & Sol Birenbaum
Yongwon Choo
M!M James P Doyle
Jules H Drucker
Mabel L Hopper
Sam & lorraine Spivak
Rosalie & Jim Traver
Mary & Patrick Tully
John Emmett, MD
Luther J Smith Ill
MIM Jack Harary
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Jeffrey HeroldBirthday
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Bergen Co Tinnitus Group
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Joseph AlamfTrudy Drucker
Wolf levy
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Joseph AlamfTrudy Drucker
Ralph Revere
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Ronald C Allan
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Kenneth J Smithee
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leda M Baker
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SPONSOR MEMBERS NOVEM
BER 1991 TO JANUARY 1992
Charles l Adams
H E (Bud) Adams
Joseph G Alam
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John & Linda Anderson
Jeffrey B Banyas, MD
M Craig Bell
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Robert Boemer
Charles T Brown
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William E Brown, Jr
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William R Cagney, PhD
Charles J Callaghan, Jr
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Gretchen S Conlan
Richard W Cooper
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WSCowling II
M!M Willard l Crawford
l D Daugherty
G Kirby Dawson
Keith Davis
Edwin DeVilbiss
AJ Diani
Trudy Drucker
Randall Ducote
H Renwick Dunlap
John Dunlop
Irwin Durben
Theodore J Eckberg, MD
Annette Ehrhardt
Katherine A Elberfeld
Frederick & Sydelle Elkind
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leroy Mills
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Otologic Medical Services
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Robert Senteneri
Continued on Page 15
Vo1.17No.l
A
ASSOOATED
HEARING
CENTERS
"COPING WITH TINNITUS"'
e STRESS MANAGEMENT l!t TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMJ"LICATED BY t\NXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STRESS OF TINJ'IIITUS WITHOUT COMJ"LEX
INSTRUMENTATION l!t VALUABLE OFFICE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids, tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered and can be performed daily in the
patient's home environment. It has been demonstrated that the relaxation response can release muscle
tension, lower blood pressure and slow heart and breath rates.
A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
has successfully treated for many years chronic pain, tension headaches. insomnia and many other
conditions.
The program consists of one cassette tape of Metronome Conditioned Relaxation and two additional
tapes of unique masking sounds which have demonstrated substantial benefit whenever the patient
feels the need of additional relief. These recordings can be used to induce sleeping or as a soothing
backdrop for activity and can be played on a simple portable cassette player.
AU. ORDeRS MUST Be ACCOMPANIW BY
CH&:K VISA. ~ O C A R O . OR INSTI1UriONAL P.O.
6796 MARKET ST., UPnR DARBY, PA 19082
Phone (215) 528-5222
AMERICAN TINNITUS ASSOCIATION
P.O. BOX 5, PORTLAND. OR 97207
NON-PROFIT ORG.
U.S. POSTAGE
PAID
American Tinnitus
Association
ADDRESS CORREGriON REQUESTED