Tinnitus Today March 1995 Vol 20, No 1

March 1995 Volume 20, Number 1
Tinnitus Today
THE JOURNAL OF THE AMERI CAN 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:
Drugs and Tinnitus Relief
Letter to a Friend
Focus is Manifestation
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- - - __
Tinnitus T o d ~ y
Editorial and advertising offices:
American Tinnitus Association,
P.O. Box 5 Portland, OR 97207
Executive Director & Editor:
Gloria E. Reich, Ph.D.
E<litorial Advisor: Trudy Drucker, Ph.D.
Advertising sales: ATA-AD,
P.O. Box 5, Portland, OR 97207
(80Q-6348978)
Tinmtus Tbday is published quanerly in
March, June, September and December. It is
mailed to members of American Tinnitus
Association and a selected list of tinnitus
sufferers and professionals who treat
tinnitus. Circulation is rotated to 100,000
annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed
unsuitable for Tinnitus Tbday. ACceptance of
advertising by Tinnitus Tbday does not con-
stitute endorsement of the advertiser, its
products or services, nor does Tinmtus
Tbday make any claims or guarantees as to
the accuracy or validity of the advertiser's
offer. The opinions expressed by contribu-
tors to Tinnitus Tbday 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 (e)(3)
Copyright 1995 by American 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 written permis
sion of the Publisher. ISSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, L.A
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, IL
Robert A. Dobie, M.D., SanAntonio, TX
John R. Emmett, M.D., Memphis, TN
Chris B. Foster, M.D., San Diego, CA
Barbara Goldstein, Ph.D., New York, NY
Richard L. Goode, M.D., Stanford, CA
John W. House, M.D., Los Angeles, CA
Robert M. Johnson, Ph.D., Portland, OR
Gale W. Miller, M.D., Cincinnati, OH
J. Gail Neely. M.D., St. Louis, MO
Jerry Northern, Ph.D., Denver, CO
Robert E. Sandlin, Ph.D., San Diego, CA
Alexander J. Schleuning.U, MD,
Portland, OR
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Honorary Boa.rd
Senator Mark 0. Hatfield
Mr. 'Jlmy Randall
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey
Portland, OR
Board of Directors
Edmund Grossberg, Chicago, IL
Dan Robert Hocks. Portland, OR
w. F. S. Hopmeier, St. Louis, MO
Philip 0. Morton, Portland, OR, Chmn.
Aaron I. Osherow, St. Louis, MO
Gloria E. Reich, Ph.D., Portland, OR
Timothy S. Sotos, Lenexa, KS
The Journal of the American Tinnitus Association
Volume 20 Number 1, March 1995
Tinnitus, ringing in the ears or head noises, is experienced by as
many as 50 million Americans. Medical help is often sought by those
who have it in a severe, stressful, or life-disrupting form.
Contents
4 From the Editor by Gloria E. Reich
7 Drugs and Tinnitus Relief by Barbara Tabachnick
13 Book Review by Trudy Drucker
16 Bio-Ear Update
17 Focus is Manifestation by Mayte Picco-Kline
18 Letter to a Friend by Barbara Thbachnick
19 CFC Update
19 .ATA Volunt eers
23 Fifth International Tinnitus Seminar Announcement
Regular Features
5 Letters to the Editor
15 Questions & Answers
21 'Ihbutes, Sponsors, Special Donors, Professional Associates
Cover artwork: Pastel painting NNite of the Nautilus, n by Laura Pope.
Inquiries to Indigo Gallery, 311 Avenue B, Suite B, Lake Oswego, OR 97034
Tinnitus Today/March 1995 3
From the Editor
by Gloria E. Reich, Ph.D,
Executive Director
Tinnitus research received a big boost this
year. In January ATA funded its biggest research
project ever. The first grant, made from the
Robert & Eileen Barindt Memorial Research
Fund for $100,000, was awarded to Pawel
Jastreboff for a study
entitled "Tinnitus
associated with
sound induced hear-
ing loss." In Dr.
Jastreboffs words,
"Tinnitus related to
sound-induced hear-
ing loss is the most
common type
observed in clinical
practice. The project
is aimed at develop-
ing the behavioral
model of this type of
tinnitus and at initial
delineation of the
areas within the ner-
vous system involved
in processing the tin-
nitus signal. The suc-
cessful completion of
this proposal should
create a strong basis
for future work on the mechanism of hearing
loss related tinnitus and in the search for new
methods of alleviation."
Another research boost comes from the
National Institute on Deafness and Other
Communication Disorders who have announced
they will be holding a workshop to discuss
emerging auditory system research knowledge
which could be used to advance the field of tin-
nitus research. The meeting will be held March
22, 1995, from 8:30a.m. to 3:00p.m. in
Conference Room 7, Building 31, at the National
Institutes of Health, 9000 Rockville Pike,
Bethesda, MD.
4 Tinnitus 'Thday/ March 1995
The meeting is open to the public.
Attendance will be limited by seating availabili-
ty. For an agenda, list of participants, or a meet-
ing summary, please contact Dr. Kenneth A.
Gruber, Program Administrator, NIDCD/DHC,
Executive Plaza South, Room 400C, Bethesda,
MD 20892, or telephone (301) 402-3458.
Of course, the main
tinnitus research
activity this year will
be the Fifth Interna-
tional Tinnitus
Seminar to be held in
Portland, Oregon,
July 12-l5th. Please
see the back cover of
this issue for more
information or call us
at (503) 248-9985.
On a lighter note:
Last fall when I was
vacationing in China
I was surprised to
r find a Starkey hear-
ing aid office on one
of the main shopping
streets in Shanghai. I
persuaded the audio-
metrician in charge
to have her picture
taken with me and
we had a friendly exchange even though we had
no common language. I showed her my "state-
of-the-art" Starkey hearing aids and she showed
me the older models which were being offered
there. I noticed many more hearing-aid wearers
in Asia on this recent trip and, as usual, met
many people with tinnitus.
Finally, on behalf of all of our readers and
the staff at ATA I'd like to thank Cliff Collins for
four wonderful years of "Media Watch." Cliff has
decided to take a rest from the column but will
be back in these pages from time to time with
special articles.
Letters to the Editor
The opinions expressed are strictly those of the
letter writers and do not reflect an opinion or
endorsement by ATA.
!
would ~ k e t? comment on the sleep disor-
ders art1cle m the December '94 Tinnitus
Tbday. The article was interesting, however,
there was no discussion regarding the most com-
mon cause of sleep disorder in tinnitus patients,
and that is depression.
Sleep patterns can vary from having difficul-
ty going to sleep to having difficulty staying
asleep. The most common situation that I see
with tinnitus patients is a patient who goes to
sleep early and rapidly, but awakens at two,
three, or four in the morning and is not able to
go back to sleep. This is a common type of sleep
pattern associated with depression and the type
l see with my tinnitus patients.
This is why a mild antidepressant can be
very helpful, not only for sleep but also for the
tinnitus. A patient who is not getting adequate
rest will also have difficulty with the tinnitus.
Keep up the good work!
John W House, M.D., Los Angeles California
I
n the December issue of Tinnitus Tbday I
read an article from Mel Freedenberg of New
Jersey in which he mentions the use of
Klonopin for tinnitus re1ief. I believe there is an
error. I also take Klonopin, though for different
reasons, and I believe it does give me mild relief
from tinnitus but I only take 0.5 mg at night.
According to the article Mr. Freedenberg was
taking 25mg at night and 25 mg in the morning.
Is there a decimal point missing? I prefer
Klonopin over Xanax because it does not give
me a hangover.
Paul Camerino, Larchmont, New York
Editors note: Mr. PYeedenberg's letter did say 25 mg
but we too suspect a decimal error since the maxi-
mum daily dose recommended by the PDR is 20
mg. Please readers, only take drugs prescribed by
your own physician in dosages that are calculated
for you.
A
s a longtime member of the ATA, I am
writing to inform you that the suction
method for removing ear wax can be a
dangerous procedure. I am aware that you have
previously published a letter from a tinnitus
patient who was badly damaged by the suction
procedure (ATA Newsletter, September 1985,
p.3), however in the June 1991 issue of Tinnitus
Tbday, an article written by the chairman of the
Norfolk Tinnitus Group in England describes the
"Suction Clearance Method" in glowing terms.
The procedure is said to be "without doubt the
safest method of all" and it is stated that "All
those who have had this treatment have report-
ed it favorably."
I have no reason to doubt the accuracy of
this report, but apparently there is a big differ-
ence between the way this procedure is done in
England and in some clinics in the United
States. A '
1
Suction Clearance Method" was used
on me at the University of Michigan Medical
Center in Ann Arbor, and the results were
disastrous.
During the first seven years of my tinnitus, I
was able to lead a more or less normal life, as
long as I avoided sources of noise. However, in
1986 the tinnitus became very severe and my
life changed completely.
About three years ago I had wax removed
from my ears at the University of Michigan
Medical Center. I told the physician that I did
not want him to use suction, so he removed the
wax mechanically. The procedure went well,
with no adverse effects. In April of this year
when I visited the clinic once again for wax
removal, apparently the doctor wanted to use
suction. Perhaps I had become complacent
because of some recent modest improvement of
my tinnitus, so I decided, foolishly, to take a
chance. I was also influenced by the article from
the Norfolk Tinnitus group.
I told the doctor that I had tinnitus and had
to avoid loud noises. He said that if the suction
bothered me he would stop. On this basis, I
agreed to go on with the procedure. On the first
pass with the suction apparatus, I heard a horri-
ble, piercing, high pitched scream, easily in
excess of 100 dB. I recoiled in shock. The doctor
said he would change the size of the nozzle so
that there would be less noise. I don't remember
now whether any of the succeeding noises were
as bad as the first - I do know that there were
loud clicks and loud high pitched sounds.
After the procedure was complete, a senior
doctor examined my ears and said everything
looked alright. At that time, my tinnitus was
somewhat louder than before the procedure.
When I got home 30 minutes later, the tinnitus
Tinnitus Today/ March 1995 5
Letters to the Editor (contmued)
was definitely louder than "normal." By 10 or ll
that night, the intensity of the tinnitus was 2-3
times louder than "normal" and there was an
overlay of much more pure-tone tinnitus that I
usually heard. Naturally, I am worried about the
significance of this new damage.
It is possible, I suppose, that the suction
apparatus was malfunctioning when it was used
on me, and that the Clinic does not routinely
expose patients to the noise levels I experi-
enced. I don't know what the difference is
between the procedure used in England and the
procedure used on me - perhaps results depend
on the strength of the suction or some other
design feature. The chairman of the Norfolk
Group makes a point of the fact that the English
method involves "a small suction tube attached
to a little vacuum pump."
I urge you to warn your readers that the suc-
tion method can be dangerous, at least in the
wrong hands. I wish I had seen such a warning
before I allowed the Otolaryngology Clinic to
add to the burden of my tinnitus.
Morton I. Dolin, Ann Arbor, Michigan
Editors note: Mechanical removal of wax can now
be accomplished while viewing the ear canal with a
computerized otoscope. Both clinician (and patient)
can visually observe the position of the wax and
with an appropriate instrument it can be carefully
(and quietly) eased out of the ear canal. A buildup
of ear wax can be a problem now that more people
are wearing canal type hearing-aids. It is also pos-
sible to remove wax by introducing water as in the
suction method but then mopping it out rather than
using the noisy aspirator.
S
omething happened to me a few days ago
(August 1994): I had gone to bed and sud-
denly the world changed: my pulsating ear
got quiet. An absolute first in 22 years. It was a
wonderful silence, a great sensation. I wanted to
stay awake to enjoy it longer. However; I fell
asleep and when I woke up four or so hours
later the pounding had returned, and it is still
there. I asked myself what could have caused
this sudden - too short- change. Was there any-
thing that could have helped me induce it?
Recently I had gone to hear a lecture by
John MacDougal, M.D. from Santa Rosa, CA. He
advocates a non-fat/non-animal diet, to curb
high cholesterol. I already am on a fat-free diet,
6 Tinnitus 1bday/ March 1995
but I wanted to help my husband eat that way
too. Some dietary substances were recommend-
ed. One was powdered garlic and I had taken
my first one, 500mg, before my 20 minute
silence occurred. Of course, I've since taken
more of them, but the silence did not return.
Elizabeth J. Nicholson
(January 1995) Another letter from Ms.
Nicholson says, "You might not have taken that
message seriously. However, it did happen, and
last night it happened again and I think I now
know how. I am taking 1 mg Klonopin every
night. Swallowing this pill I experience a numb
feeling in the back of my throat for a brief peri-
od, five minutes, I haven't timed it. I wonder if
the ingestion of Klonopin gives me this
euphoria- ofbeing without the tinnitus?
Elizabeth J. Nicholson, San Diego, California
A
bout five years ago, I decided to lose
weight by jumping and running in place
on a small trampoline. After almost two
weeks of this, I began hearing a noise that
sounds like a whistling teapot just before it goes
into its high pitched whistle.
I went to an MD ear specialist who exam-
ined me for hearing loss. When I mentioned this
to him, he said there was no way that I could
have started tinnitus by jumping around. Thank
you for confirming what I suspected with your
article on p. 16 of the September 1994 issue of
Tinnitus Tbday which stated that a researcher
linked the jarring, and bouncing associated with
high impact aerobics to tinnitus. I would like to
hear from others who have had a similar
experience.
Robert F. Spangler, Harrisburg, Pennsylvania
I
n March 1993 out of the blue I contracted
reflux esophagitis. This condition was very
uncomfortable to say the least. I visited sev-
eral gastroenterologists and was introduced to
some heavy medication as protocol. To me the
prescriptions were too strong and unnatural so I
decided to turn towards alternative medicine, to
a holistic M.D. I will regret this move for as long
as I live. After a five minute conversation with
the doctor he said, "Let me walk you down to
my colleague who will give you some acupunc-
ture adjustments."
(continued on page 20)
Drugs And Tinnitus Relief
by Barbara Tabachnick,
Client Services Coordinator
"If they can put a man on the moon, surely
they can find a cure for tinnitus."
- several hundred ATA members
Public sentiment for space exploration dur-
ing the 1960's and 70's inspired legislators to
fund the lunar fervor of that time. To that single
end, approximately 100 billion tax dollars were
allocated. The triumphant U.S. moon missions
that followed were clear testaments to the theo-
ry that, given enough money, anything can be
realized.
Tinnitus research has the potential to take
parallel strides, but not before some big finan-
cial fires are lit. Last year's governmental spend-
ing for tinnitus research hovered around
$750,000* - a hundred thousand times less than
the cost of our lunar conquest. Somehow, the
need for tinnitus relief must be launched into
the pubhc consciousness. It must become anoth-
er national obsession.
Against a recurrent backdrop of limited
funding, this article examines drugs and drug
types that have been researched for treating
tinnitus. It is not intended as an endorsement of
any medication or their combination nor does it
recommend that drugs should be used for
tinnitus relief.
The selection of specific drugs to research
has thus far been based on anecdotal informa-
tion and medical conjecture. A relief-giving
tinnitus medication may for example be affect-
ing the hair cells, nerve fibers, auditory cortex,
or blood flow to the cochlea. On the other hand,
anxiolytics or antidepressants may simply be
enabling patients to feel better while the noises
continue. Until the mechanism of tinnitus is dis-
covered, why a drug works or doesn't work
remains theoretical.
*The National In:>titute on Deafness and other Communication
Disorders (NIDCD) spent approximately $90 million on all
hearing-related research in 1994. Whz1e speculatively any
research involving the ear could help unravel the mystery of
tinnitus, about $750,000 was channelled specifically into tinni-
tus research.
1 Brummett, R: Tinnitus: Drugs in the treatment of tinnitus. 1988
2 Shulman A, Aran JM. 1bnndorf J, Feldmann H, Vernon J : Tinnitus-
diagnosis/treatment. 1991
3 McCormick MS. Thomas JN: Mexiletine in the relief of tinnitus. 1980
Anesthetics
Clinical observation of a tinnitus-relieving
drug was first recorded in 1935. At that time,
researcher Barany noticed that
patients who'd had the local anes-
thetic procaine injected into the
lower part of their nasal cavity walls
experienced a cessation of their tin-
nitus for a "period of time."
1
In more recent
decades, research with intravenous lidocaine
seemed bordering on a breakthrough. In one
study by Emmett and Shea, 49% of 402 patients
with unilateral tinnitus had partial or complete
relief from their tinnitus for varying but short
durations (minutes to hours). Seventy-three per-
cent of 190 bilateral tinnitus patients in the
same study had partial or complete relief for the
same limited duration.
2
Lidocaine comes with problems - it must be
administered intravenously, its effects are short-
lived, and its properties as a cardiac depressant
make its use highly cautionary. Its briefbut
thorough success as a tinnitus inhibitor led to
the search for a similarly-acting drug (an analog)
with fewer side effects and in oral form, that
could produce sustained tinnitus relief. The
drug mexiletine was developed but produced
copious side effects and no tinnitus relief.
3
A
1984 study of tocainide showed a small hint of
hope. But the drug's extensive side effects
(severe rashes, dizziness, heart damage)
4
checked the research community's enthusiasm
for a working lidocaine analog. In 1987 research
on another analog, flecainide acetate
('lllmbocor), failed to demonstrate any benefit.
5
Antidepressants
Thcyclic anti-depressives appear to help tin-
nitus but researchers are unsure why. It may be
because these drugs block the "reuptake'
1
or
reabsorption of neural substances like serotonin,
chemicals considered key in alleviating brain
disorders including depression.
In 1985, a double-blind placebo study of the
tricyclic trimipramine was conducted with 19
patients. When given the drug
1
eight patients
4 Hulshof JH, vem1eij P: The effects of N lidocaine and several different
doses of oral tocainide. 1984
5 Harker LA,'JYier RS, et al: Evaluation offlccainide acetate (Thmbocor)
as a treatment for tinnitus. 1987
Tinnitus Today/March 1995 7
Drugs And Tinnitus Relief (continued)
reported relief, three noted no change, and
seven had an increase in tinnitus. When the
same 19 received the placebo, eight also report-
ed relief, seven no change, and four became
worse. Researchers Mihail et al. concluded that
while the drug was not particularly effective, the
placebo effect was significant.
6
(Note: The
"placebo effect" occurs when patients receive an
inactive medical treatment unknowingly but
respond as if they'd received the active treat-
ment. This phenomenon has an obvious impact
on the evaluation of a drug's effectiveness.
Consequently, the data collected from non-
placebo controlled studies are considered
incomplete.)
Studies by Meikle7 and House
8
both showed
that tinnitus severity and tinnitus loudness did
not correlate. Instead, people with identical tin-
nitus loudness tolerated their noises quite differ-
ently. Sullivan's research with depressed and
non-depressed tinnitus patients suggested a new
correlate- that "depression may distinguish
those disabled by their tinnitus from those who
are not disabled. "
9
In 1989, Sullivan presented the results ofhis
research with nortriptyline: Nineteen patients -
all with tinnitus and signs of major depression -
began the study. One patient's tinnitus became
worse during the trial; another chose to discon-
tinue the protocol. Upon completion of the
study, 12 patients reported their tinnitus
improved though not eliminated; five noted no
change. (Two of the 12 positive responders also
responded favorably to the placebo.) Sullivan
indicated that nortriptyline was selected for the
study because it has not been shown to cause
tinnitus. The researcher further suggested that
other tricyclic antidepressants could show simi-
lar positive results.
Responses to an informal survey were
recently evaluated at the Oregon Hearing
Research Center regarding the antidepressant
paroxetine (Pax.il). Five of the 18 who respond-
ed to the questionnaire reported tinnitus relief
with the drug, but most reported none. Three
6 Mihail RC, Fishbum J , Crowley JM, Reinwall JE, Walden B, Zajtchuk .JT:
The tricyclic trimipramine in the treatmem of subjective tinnitus. 1985
7 Meikle M, Vernon J, Johnson R: The perceived severity of tinnitus. J 984
8 Tinnitus Today/ March 1995
noted a temporary exacerbation of their tinnitus.
(Dosages were not mentioned.) While there was
a 28% positive response, the percentage was not
high enough to spark interest in further investi-
gation, according to Robert Brummett PhD. He
explained that because any drug can produce a
30% placebo response, researchers look for a
much greater positive response in an open
study before they consider mounting a larger
controlled study.

Anticonvulsants
Anticonvulsant drugs selectively
inhibit neural activity in the central
nervous system (CNS).
Consequently, they are an effective treatment
for epilepsy and have shown positive effects on
tinnitus. (Some scientists liken tinnitus to
epilepsy from the standpoint of CNS
activity.)
A 1979 study by Melding and Goodey exam-
ined the effects of 600-1000 mg daily of oral car-
bamazepine (Thgretol) and 400 mg daily of
diphenylhydantoin (Dl1antin) on 125 patients
whose tinnitus was considered "intolerable and
incurable." Before the anticonvulsants were
begun, tinnitus patients were given an IV of
lignocaine (aka lidocaine) and their responses
measured. Fifty-six percent of those who
responded well to lignocaine also responded
well to carbamazepine. (Success rates for those
who took diphenylhydantoin were not dis-
cussed.) Patients who'd had little or no response
to lignocaine, did not respond to either of the
two oral anticonvulsants. Side effects of
headaches, nausea, and sedation to varying
degrees were experienced by two-thirds of the
patients in the study.
10
These findings, despite the high incidence of
adverse effects, prompted a double-blind place-
bo study in 1981 to further examine Thgretol's
impact on tinnitus. After four months, 13 out of
78 patients who'd received 200mg daily of
Thgretol indicated good to excellent tinnitus
relief. However, eight of those 13 also experi-
8 House J , Miller L, House PR: Severe tinnitus: treatment with
biofeedback training. 1977
9 Sullivan M, Sakai C, Dobie R, Katon W: 'lreatmenr of depressed tinnitus
patients with nortriptyline. 1985
10 Melding PS, Coodey RJ: The treatment of tinnitus with oral
anticonvulsants, 1979.
Drugs And Tinnitus Relief (contlllued)
enced good to excellent relief from the placebo.
The researcher concluded that Thgretol's effect
on tinnitus remained statistically ambiguous. n
Thsts on carbamazepine continued. Drs.
Emmett and Shea tested the efficacy of 400mg
daily doses of the drug on 27 tinnitus patients in
a non-placebo study. 'TWenty-two patients indi-
cated some relief; five indicated none. Seven
patients, however, experienced serious side
effects (pneumonia, reduction in white blood
cells, worsened tinnitus) making the drug inap-
propriate for long term use in the opinion of the
researchers.
12
Other carbamazepine studies ended incon-
clusively, with placebo responses matching the
drug responses in tinnitus relief. This drug
again produced "dangerous and alarming
adverse effects" including bone marrow depres-
sion and aplastic anemia.
13
Amino-oxyacetic acid (AOAA) was tried in a
double blind placebo drug study in 1990. Of the
66 patients in the trial, 21% reported a reduction
in their tinnitus while taking AOAA. Only 3%
responded to the placebo. Meniere's patients
had a higher incidence of tinnitus reduction
than the average but were also more susceptible
to the drug's negative effects. Overall, 71% of
those in the study experienced one or more side
effects (nausea, disequilibrium, drowsiness,
vomiting) making this drug, according to the
researchers, "unacceptable for clinical use."
14
Another anticonvulsant epilepsy drug, prim-
idone (Mysoline), was used in a study with 41
tinnitus patients. Five of the 41 had serious side
,
effects; more than half experienced nausea and
similar gastrointestinal ailments. Eighty-five per-
cent, however, did report some tinnitus relief.
No placebos were used in this study.
15
Antianxiety agents
Some antianxiety drugs enhance chemicals
in the brain that cause the central nervous sys-
tem to slow down. If a patient's tinnitus is
II Donaldson I: Thgretol: A double blind trial in tinnitus. 1981
12 Emmett JR. Shea JJ: Treatment of tinnitus with tocainide hydrochloride.
1980
13 Murai K, 1Yler R S, Harker LA, Stoufer J L. Review of Pharmacologic
treatment of tinnitus. 1992
14 Guth. Risey, et al: Evaluation of amino-oxyacetic acid as a palliative in
tinnitus. 1990
caused by a need to have these chemicals affect-
ed, it is postulated that the use of these drugs
will relieve that tinnitus. Anxiolytic drugs typi-
cally have a sedating effect and are therefore
prescribed with caution.
A 1984 study of oral tranquilizers and their
effects on tinnitus showed the following:
Diazepam (Valium) given to 15 patients offered
some relief to one. Side effects of nausea, vomit-
ing and sedation were noted. F'lurazepam
(Dalmane) given to 14 patients offered some
relief to two. Oxazepam (Serax) and clon-
azepam (Klonopin) were given to 23 and 26
patients respectively. More than 50% ofboth
groups experienced slight to significant improve-
ment. Researchers stated that these drugs "pro-
duced no adverse reactions." None of these anxi-
olytics was tested against a placebo.
1
6
A double-blind placebo study of alprazolam
(Xanax) was conducted in 1987. Of the 20 tinni-
tus patients who were given this drug, 13 report-
ed being helped by it. Only one in the placebo
group reported benefit. The researchers suggest
careful regulation of the dosage since individu-
als differ considerably in their sensitivity to it.
Side effects of drowsiness and disorientation
have been noted. Because Xanax and all benzo-
diazepine drugs can be addictive, long-term use
is unadvisable.
17
In 1978, a placebo study with amylobarbi-
tone was conducted. After 12 weeks, all 20
patients on this oral barbiturate reported bene-
fit. In fact, four of the 20 claimed that their tin-
nitus had disappeared. The researcher suggested
that the improvement probably corresponded to
a lowering of the tinnitus frequency, which
made the noises more easily masked by envi-
ronmental sounds, as opposed to an actual
reduction in the tinnitus volume. 'TWo of the 20
placebo recipients also reported some improve-
ment.1a In general, barbiturates have a high
potential for abuse and for that reason are used
infrequently.
15 Emmett JR and Shea JJ: Treatment of tinnitus with tocainide
hydrochloride. 1980
16 Lechtenberg R, Shulman A: Benzodiazepines in the treatment of tinnitus.
1984
17 Johnson RM, Brummett R. Schleuning A: Use of alprazolam for relief of
tinnitus. 1993
18 Donaldson I: Tinnitus: A theoretical view and a therapeutic study using
amylobarbitone. 1978
Tinnitus Thday/ March 1995 9
Antihistamines
Histamine, a chemical found in all body tis-
sues contnbutes to blood vessel dilation includ-
'
ing blood vessels in the cochlea. In a non-con-
trolled clinical report, researchers noted that the
combined therapy of a vasodilator (Arlidin,
6mg. daily) and an antihistamine
( chlortrimeton, 8 mg. daily) showed therapeutic
promise for tinnitus patients who'd had
eustachian tube and middle ear dysfunction.
The significant side effects of palpitations,
tremors, and nervousness were the basis for the
limited dosages tried. In the presence of cardio-
vascular disease, the researchers advise close
medical supervision.
19
Other non-placebo stud-
ies with antihistamines demonstrated minimal
help for tinnitus patients. Three out of 10
patients using dexchlorpheniramine experi-
enced some relief, and one had a worsening of
tinnitus. Of 11 patients who used chlorpheni-
ramine one had relief and one worsened. Of 16
I
patients using meclizine, none experienced
relief and one worsened. The relatively low inci-
dence of relief did match the low incidence of
adverse side effects.
20
An informal study at Thlane School of
Medicine recently tested the antihistamine
terfenadine (Seldane) on 28 tinnitus patients.
Those in the trial who experienced improve-
ment with this drug were those who'd had aller-
gy problems to begin with, forcing researchers
to conclude that further study of the drug was
unwarranted.
21
Misc. Drugs - U.S.
In 1991, misoprostal (Cytotec), a synthetic
prostoglandin (PG), was tested for its effect on
tinnitus. The usefulness of PG's in achieving tin-
nitus relief is hypothetical, based on the fact
that PG levels are reduced by non-steroidal anti-
inflamatory drugs known to cause tinnitus.
(Changes in PG levels in the body have also
been noted after exposure to loud noise.) Out of
the 24 patients in this two-month double-blind
19 Shulman A: Vasodilator-antihistamine therapy and tinnitus control.
20 Lechtenberg R, Shulman A: Benzodiazepines in the treatment of tinnitus.
21 Amedee RG, Risey J, Thlane School of Mcdlcine, 1430 Thlane Ave, .New
Orleans LA 70112, 504/588-5454
22 Briner WE, House JW, O'Leary MJ: The synthetic prostoglandin
misoprostal as a treatment for tinnitus. 1991
10 Tinnitus 'Ibday/March 1995
study, eight reported that they were helped by
the drug. None of those who received the place-
bo reported any relief. Interestingly, five of the
eight who responded favorably to the drug iden-
tified noise or acoustic trauma as the cause of
their tinnitus. Researchers optimistically noted
that PG analogs have a "very low side effects
profile. "
22
In 1991, 20 out of 40 patients experienced a
suppression of their tinnitus after receiving
80mg of IV furosemide (Lasix), a diuretic that
specifically exerts its effect on the kidney and
the inner ear. (Six of the "positive responders"
later experienced tinnitus suppression from a
SOOmg IV of chlorothiazide, a diuretic that does
not affect the ear.) 1Welve of the 20 furosemide
responders were then tested in an open trial to
determine appropriate oral drug dosage. The
result: 10 out of the 12 responded to doses of
furosemide ranging from 80-160mg per day.
Patients were instructed to drink electrolyte-
replacing fluids to compensate for excessive uri-
nation, the only cited side effect.
23
In 1993, another open, non-placebo study of
oral furosemide was conducted on 20 tinnitus
patients. After four weeks, eight patients
dropped out of the study due to unspecified side
effects. 1Wo of the remaining 12 reported some
tinnitus relief. The researcher noted that
patients in this study, unlike those in the 1991
study, were not pre-screened for responsiveness
to the IV form of furosemide.
24
Oxypentifylline-U.K. / Pentoxifylline-U.S.
(ltental) was selected for a placebo trial in 1989
based on its propensity to improve blood flow.
Although eight of the 13 patients who received
the drug noted a decrease in the pitch of their
tinnitus the researchers' overall impression was I .
that oxypentifylline offered "little value in the
management of idiopathic tinnitus."
25
Additional
research on this drug began in 1993 at the
University of Michigan Hospital.
In the early 1950's, two uncontrolled studies
examined vitamin A and its usefulness in ame-
liorating hearing loss and tinnitus. In one trial,
23 Guth PS, Risey J. Amedee R, Norris CH: A pharmacological approach to
the treatment of tinnitus. 1991
24 Dobie RA: Research study: furosemide Lash:, Tinnitus Today 18:1. 1993
25 Salama NY, Bhatia P, Robb PJ: Efficacy of oral oxypemuylline in the
management of idiopathic tinnitus. 1989
50,000 units were given by injection twice a
week for six weeks. Seventeen of 23 patients
with tinnitus reported improvement.2
6
Another
study involved injections of 50,000 units of vita-
min A twice weekly for two weeks then 100,000
units thereafter for a total of 20 injections. Of 17
tinnitus patients, four improved, one improved
temporarily, and four worsened temporarily.
Slight to severe side effects of nausea, dizziness,
headache, and irritation at the injection site
were noted.
27
(Prolonged high doses of Vitamin
A are known to be toxic to the liver.)

Misc. Drugs -
Outside of the U.S.
In a double-blind placebo study in
The Netherlands, the calcium
channel-blocker flunarizine was studied.
Patients whose tinnitus was accompanied by
vertigo experienced some relief from their tinni-
tus (but not the vertigo). Overall, the differences
reported between the placebo and flunarizine
groups were considered too small to declare
this a useful tinnitus treatment.
28
Recent animal
research by Drs. Jastreboff, Nguyen, et al. using
the calcium channel-blockers nifedapine and
nimodipine has shown promise, but has not yet
made the crossover to human studies.
29
An Austrian research project in 1991 studied
glutamic acid diethy lester (GDEE) and its
effects on 130 patients with probable synaptic
tinnitus - tinnitus associated with sudden hear-
ing loss, presbycusis, or noise-induced hearing
loss. (Previous investigation showed that tinni-
tus of other origins was not affected by this
drug.) In this uncontrolled non-placebo study,
researchers used GDEE as a glutamate antago-
nist, hypothesizing that an excessive accumula-
tion of glutamate in the cochlea could be caus-
ing tinnitus. More than 77% of the patients
reported improvement. However, according to a
letter from the researchers, GDEE is no longer
available for study.
30
In 1993, the same clinic
26 Anderson JR, Zoller HJ, Alexander LW: Observations on the treatment of
deafness and tinnitus with parenteral vitamin A in massive doses. 1950
'1.7 Baron, SH: Experiences with parenteral vitamin A therapy in deafness
and tinnitus. 1951
28 Hulshof JH, Vcrmeij, P: The value of flunarizine in the treatment of
tinnitus. 1986
29 Brummett RE: Ti011itus: common causes and treatment
recommendations. 1994
conducted a placebo trial with Caroverine,
another glutamate antagonist. Seven of the 11
patients who received the drug reported a tinni-
tus reduction of 50% or greater.
31
Full details of
this study and the drug's suspected side effects
have not yet been published.
In Brazil, a double-blind placebo study evalu-
ated aniracetam, a drug known to affect the
central nervous system. Forty patients with ver-
tigo, hearing loss, nausea, and tinnitus were
tested. After six weeks, the only difference
noted between the placebo and drug groups was
an improvement in tinnitus in the drug group .
Curiously, patients taking the placebo experi-
enced more negative side effects than those tak-
ing the drug.
32
The muscle relaxant eperisone hydrochlo-
ride (EMPP) was studied in Japan in 1986. The
164 drug-treated tinnitus patients were given
oral doses of EMPP, vitamin B-12, and sulpiri.de,
an antidepressant. Fifty-four patients in a con-
t rol group were given all but the EMPP A report-
ed disappearance of tinnitus occurred in 13% of
the drug group vs. 1% of the control group.
Overall, 39% of the EMPP group and 15% ofthe
control group reported that the loudness of their
tinnitus had been reduced by at least half.
Researchers were able to eliminate the drug's
side effects of dizziness and weakness by reduc-
ing the dosage.
3
3
In 1941, the use of niacin or nicotinic acid, a
B-complex vitamin, was introduced for treating
symptoms of Meniere's disease. In 1954, 22 tin-
nitus patients participated in research in
Norway that involved daily IV doses of up to
100mg. of niacin. Fifteen in the trial reported
relief. A placebo study was not possible because
of niacin's observable side effect - a reddened
skin flush.3
4
In 1986, nicotinimide, a variation of
niacin, was selected for use in a double-blind
placebo study in The Netherlands.
(Nicotinimide behaves chemically like niacin
but without the vasodilating effect. A skin flush
is avoided with nicotinimide's use.) An oral
.30 Ehrenberger, Denk, Brix, Dept. of Oto, University of Vienna, Austria
31 Brummett, RE: Tinnitus: Common causes and treatmcm
recommendations. 1994
32 Gananca MM. Albernaz PLM, Amand R: Efficacy of aniracetam in the
treatment of labyrinthine disorders. 1986.
33 Kitano H, Kitahara M, et al.: 1tcatmem of tinnitus wirh muscle relaxant.
1987
34 Flottrop G, Wille C: Nicotinic acid treatment of tinnitus. 1955
Tinnitus Thday/March 1995 11
daily dose of 200mg was administered for four
weeks with results quite different from the pre-
vious niacin study: two out of 24 who received
the drug and three out of 24 who received the
placebo noted a tinnitus reduction.
35
The drug Stugeron, sometimes in combina-
tion with antianxiety agents, is currently used in
Spain for treating hyperacusis, tinnitus, and/ or
dizziness. Formal studies on this drug have not
been conducted but are being considered.3
6
Many of these research projects, conducted
initially to measure the wisdom of further study,
now beg a closer look. The interest remains
intense; the ideas abundant. The only lacking is
in funding - frustratingly out of proportion to
tinnitus' incidence. ATA continues its pursuit of
a fair portion of the federal research money
reserve, while broadcasting the realities of tinni-
tus distress and prevalence across the U.S. It
could well be that funding fueled by a national
passion is all that stands between tinnitus and
its cure.
OJ
*Known research conducted on this
drug; most abstracts available in
ATA's bibliography. Drugs listed with-
out the "*"are known to us only anec-
dotally as useful treatments. (This list
is not all-inclusive.)
Anesthetics
lidocaine/ lignocaine (Xylocaine - IV)
procaine (Novocaine - IV)
tocainide (Thnocard) - oral lidocaine analog
flecainide acetate ('Thmbocor)
Mexiletine - oral lidocaine analog
Antidepressants (Tricyclics)
trimipramine (Surmontil)
nortriptyline (Pamelor)
paroxetine (Paxil) non-tricyclic *
fluoxetine (Prozac)
sertraline (Zoloft)
bupropion (Wellbutrin)
amitriptyline (Elavil)
35 Hulshof JH. Vermeij P: The effect of nicotinamide on tinnitus: a double
blind controlled study. 1987
12 Tinnitus Thday/ March 1995
Anticonvulsants
carbamazepine (Thgretol)
phenytoin (Dilantin)
primidone (Mysoline) *
amino-oxyacetic acid (AOAA) *
Antianxiety agents (benzodiazepines,
tranquilizers, barbiturates)
alprozolam (Xanax)
clonazepam (Klonopin)
protriptyline (Vivactil)
diazepam (Valium) *
oxazepam (Serax)
flurazepam (Dalmane)
amylobarbitone (barbiturate)
Antillistannines
terfenadine (Seldane)
chlortrimeton
dexchlorpheniramine
chlorpheniramine
meclizine *
Diuretics
furosemide (Lasix) *
chlorothiazide
Calcium Channel-blockers
flunarizine (Sibelium) - the Netherlands *
nifedapine
nimodipine
Others
misoprostal (Cytoteo-synthetic prostaglandin)
glutamic acid diethylester- Austria*
Caroverine - Austria
amylobarbitone - England
aniracetam
nicotinamide (niacin/ nicotinic acid)
oxypentifylline/ pentoxifylline (Thental)
vitamin A*
Arlidin *
eperisone hydrochloride (EMPP-muscle relaxant)
clonidine (Catapres-TTS, anti-hypertensive)
Stugeron!Stugeron Forte - Spain
36 Antoli Candela, lnstituto ORL, Art1.1ro Soria 117119, Madrid 28043, Spain,
91-413-2347
Book Review
Jack A. Vernon and Aage R. Mller, eds.
Mechanisms of Tinnitus. Boston: Allyn and
Bacon, 1994.
reviewed by 'Dudy Drucker
In recent years numerous books have been
published to help people with tiimitus cope with
their problem. Publications for physicians and
other specialists have also proliferated, many of
them excellent. The Ciba Foundation
Symposium (1981) and Abraham Shulman's
massive Tinnitus (1991) are landmarks. A new
book for professionals now takes a place on the
top shelf. One ofthe editors, Jack Vernon, is
world renowned as a pioneer in the study and
management of tinnitus. His co-editor, Aage
M11er, has done a great deal of important
research.
More than two dozen scientists, including
Harald Feldmann, John Graham, Jonathan
Hazell, Pawel Jastreboff, and the late Juergen
'Ibnndorf, provided the 18 chapters. Two of
Vernon's associates at the Oregon Hearing
Research Center, Mary Meikle and Robert
Brummett, contributed excellent chapters.
Researchers are from Germany, Austria, Japan,
England, Canada, and Australia as well as the
United States.
The central premise of this book is that tin-
nitus cannot be rationally treated until the
mechanisms are understood. The editors
emphasize that the book is a compendium of
speculations, and contributors were encouraged
to be imaginative - even to guess.
Perhaps the scope of the work can be best
illustrated by summarizing some of the ques-
tions that the researchers have posed to them-
selves and are attempting to answer:
One of the most thoroughly argued aspects
of tinnitus research is, does the condition origi-
nate in the ear or the brain? Recent evidence
suggests that the sites are not mutually exclu-
sive in producing tinnitus.
What is the role of associated pathology in
the auditory system? If, as seems likely, tinnitus
indicates that something is amiss in the organs
of hearing, why do many profoundly deaf peo-
ple remain free from tinnitus while many peo-
ple with tinnitus demonstrate normal hearing?
How do drugs work to either ameliorate or
exacerbate tinnitus? Why, most mysteriously,
can the same drug both worsen and improve tin-
nitus - and sometimes in the same patient?
It is well known that the perceived volume
of tinnitus is quite low, certainly when com-
pared to the external sounds of everyday life.
Why, then, do some people adapt so poorly to
such a weak sonic signal, expressing distress
sometimes to the point of agony and incapacity?
External noise that is much louder than the tin-
nitus is easier to ignore except by the relatively
few people who also have hyperacusis.
The low volume of tinnitus makes masking a
rational and often effective therapy. Why does
masking for tinnitus seem to operate differently
from the masking of external sound? Do the
widely varying responses to masking provide
clinically useful information?
The unpredictability of patients' response to
the tinnitus and to its treatment suggests that
psychological factors are at work. How, then,
can objective measurements of tinnitus be
obtained, and will these measurements correlate
to the subjective experience of patients? What
clinical use can be made of objective measure-
ments of the quality and loudness of the tinni-
tus signal, assuming that such measurements
will be more reliable than they are at present?
Why do children with tinnitus rarely com-
plain of it, and why is tinnitus in children likely
to be reported as intermittent although adults'
tinnitus is usually reported as constant?
Interestingly, children whose tinnitus results
from exposure to mega-decibel music are more
likely to complain of tinnitus than are children
whose tinnitus is apparently congenital.
Why can tinnitus sometimes be suppressed,
although only briefly, by intravenous lidocaine
or by electrical stimulation? These treatments,
like masking, sometimes provoke residual inhi-
bition, a mysterious phenomenon that might
eventually become clinically valuable.
Most of the contributors involve themselves
in the continuing debate about psychological
versus physiological factors in patients with
severe tinnitus. One investigator suggests that
people who suffer greatly from this condition
might have elevated " ... a relatively innocuous
everyday experience into a malignant obses-
Book Review (continued)
sion." My experience with people in a large self-
help group suggests that most people who are
miserable because of tinnitus would not agree.
A good deal of clinical and laboratory evi-
dence validates the analogy between perception
of tinnitus and perception of pain. Does this
analogy have implications for the management
of tinnitus?
Many paths of investigation are being
explored by the writers of this book, and per-
haps some useful leads to treatment will be
found. The authors have devoted much effort to
writing clearly about extremely complex mat-
ters. Inevitably, some information is repeated;
for example, all contributors begin with a defini-
tion of tinnitus - a task not as easy as it might
seem - and go on to review the anatomy and
"COPING WITH TINNITUS"
e STRESS MANAGEMENT &. TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
RIJNFORCEMENT AND SUPPORT ROM THE
STRESS OF TINNiniS WITHOUT COMPLEX
INSTRUMENTATION&. VALUABLE OmCE TIME
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
9
9 5 recordings can be used to induce
$ 5 1!11 "a"6
11
"
9
sleeping or as a soothing back-
l drop for activity and can be played
on a portable cassette player.
ALL ORDERS MUST BE ACCOMPANIED
I""C:NT BY CHECK, VISA, MASTERCARD,
\,.c;; OR INSTITUTIONAL P.O.
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physiology of the auditory system. From there,
each diverges to differing theories and results.
One interesting chapter is in the form of a dia-
logue between an otolaryngologist and an audi-
tory physiologist.
This handsomely printed book is meticulous-
ly edited and every article is thoroughly docu-
mented. Mechanisms of Tinnitus is a model of
medical scholarship.
(Good news: Vernon is completing a book for
patients, to be published in paperback and thus
affordably priced. Watch this space.)
Mechanisms of Tinnitus may be ordered directly
from Allyn & Bacon. 1-800-278-3525. Price is
$42.95
WANTED!
HEARING-AIDS AND/OR
MASKERS IN ANY CONDITION
If you have ever wondered what to
do with those aids that are just sitting
in the drawer, think no further. ATA
will be happy to receive them.
Donations to ATA are tax deductible,
and we'll provide a receipt. Simply
package them up carefully (a small
padded mailing bag is fine) and send
to: ATA, PO Box 5, Portland, OR 97207. If
you are using UPS or another alternate
shipper- our street address is 1618 SW
First Avenue, #417, Portland, OR 97201 ,
telephone (503)248-9985.
What happens to the aids you turn
in? In some cases they can be repaired
and given to needy people or used in
charitable missions to underdeveloped
countries. Even if they can't be re-used
as is, the parts are needed for repairing
other aids. Also, the plastic can be recy-
cled. Your old aid could give someone
the gift of hearing!
Questions & Answers
by Jack A. Vernon, Ph.D., Director,
Oregon Hearing Research Laboratory,
3515 SW Veterans Hospital Rd. Portland, OR
[Q]
Ms. F. from San Francisco wrote some
time ago to say that the sound of her
pacemaker bothered her and that she
could hear it 24 hours a day. Her cardiologist
told her it was not possible for her to hear a
pacemaker but she insists that she does hear it,
and I believe her.
Back when Ms. F. wrote in, I did not
realize that pulse sounds were so low
pitched, and I did not realize that the
Marsona Sound Conditioner (sold by the Marpac
Co., 1-800-999-6962, ask for Mr. David Theisen)
could provide an adequate masking sound for
pulsatile sounds. I now think that there is an
excellent chance that most pulsatile sounds can
be masked, and while it is not a wearable or
portable unit, it, nevertheless, may provide the
opportunity to get relief from pulsatile tinnitus
from time to time. It is worth trying. Besides,
Marpac Co. will refund your money within 30
days if the Marsona Sound Conditioner does not
relieve your pulsatile tinnitus.
[Q]
Mr. H. from Washington State writes the
following. "I've had tinnitus for 16 years
and have taken every step I can to pre-
vent it from getting worse. One of the few activi-
ties I really enjoy is surfing but after each surf-
ing adventure, my tinnitus is increased which I
assume is due to the noise of the surf crashing
as well as the traffic noise involved in getting
there and back."
I realize that the surf can make a lot of
noise but my guess is that it is the
exercise that is temporarily exacerbating
your tinnitus. Many patients have noted that
exercise will increase their tinnitus but that, and
here is the important part, it always returns to
its normal level. As you know, if you temporari-
ly exacerbate tinnitus with loud sounds and con-
tinue to do so, soon the increase will become
permanent. But that is not the case with tempo-
rary exacerbation by exercise. Keep surfing and
enjoy. However, to be on the safe side, measure
the time required for the tinnitus to return to its
normal level and, if that time begins to length-
en, you might then reconsider the advisability
of continued surfing.
[Q]
Ms. E. from New York writes that one
day she inserted her canal hearing aid,
pressed down on it and immediately
heard a severe buzzing which has remained ever
since along with additional hearing loss. Ms. E's
first request is whether any other reader of
Tinnitus 1bday has had a similar experience and
the nature of the outcome.
Ms. E. goes on to say that she is on
Papaverine (150mg B.I.D.) Her middle
ear was explored to determine if she had
a fistula (an abnormal passage between two
internal organs) and although that report came
back negative, it is almost surely the case that
pressing in on the canal aid imparted damage to
the inner ear and that such damage could have
occurred without creating a fistula. The high fre-
quency portion of the inner ear lies immediate-
ly adjacent to the middle ear space. Thus I
would assume that the increased hearing loss
was for the high frequency tones. We will all be
interested to know if the Papaverine gives you
any relief of your tinnitus. If it does not, I would
suggest that you try masking by using a tinnitus
instrument (combination hearing aid and tinni-
tus masker) in a behind-the-ear configuration,
available from any dispensing audiologist or
hearing aid dispenser.
[Q]
Ms. G. from Kentucky asks, "What does
sensorineural hearing loss mean, and is
there any treatment for it? Also, are
anti-depressants used to treat tinnitus?"
A. Sensorineural hearing loss simply means the
loss of the hair cells in the inner ear which con-
vert sound energy into auditory neural impuls-
es. Once these hair cells are lost, they are gone
forever. The chicken and probably most birds
can regenerate their hair cells but we are not so
fortunate.
There is a group of investigators who have
used anti-depressants to combat tinnitus. They
reason that the state of depression has produced
the tinnitus and that relieving the depression
will automatically relieve the tinnitus. My per-
Tinnitus 1bday/ March 1995 15
Questions & Answers (contlllUed)
sonal view is that the state of tinnitus can, and
often does, produce depression especially if one
repeatedly hears health care professionals tell
them that nothing can be done for tinnitus. I
contend that if the tinnitus can be relieved, the
depression will automatically go away. (Ed.
note: See Drugs for Tinnitus Relief article in this
issue.)
[Q]
Another Ms. G. from Delaware states
that Elavil has given her relief of
tinnitus and good sound sleep (people
do vary in their response to drugs) for which
she is grateful since a sleepless night was invari-
ably followed by a day of severe tinnitus. She is
concerned that Elavil will be taken off the
market because it has been identified as a dan-
Bio-Ear
Update
Bio-Ear, Tinnitus Relief, ProZainE and other
herbal preparations labeled as tinnitus treat-
ments have been available for years through
mail order catalogs. And over the years, we have
asked the manufacturers and distributors of
these products the same question: What
research has been done to establish your prod-
uct's effectiveness and insure its safety? We
have never received a response.
We first contacted the U.S. Food and Drug
Administration (FDA) in 1990 about claims
made on the packaging of Tinnitus Relief. If the
claims were true, we certainly wanted to know.
If they were fallacious and the product was dan-
gerous, we wanted to know that too. (An herbal
concoction is not a drug unless the product label
makes a medical claim. This product fell under
the jurisdiction of the FDA not because the FDA
classified it as a drug, but because the product
1 6 Tinnitus 1bday/ March 1995
gerous drug for the elderly. She, as well as three
others, sent in the advertisement for BIO-EAR,"
an over-the-counter herbal remedy'' for
tinnitus.
Ms. G., don't worry about Elavil being
taken off the market. The drug manufac-
turer would fight such an effort with all
their capability. It is too valuable a resource for
them to allow it to go away.
As for BIO-EAR, I am exceeding skeptical
about such medications and their claims. I guess
I worry about those folks who feel that some-
thing cannot have side effects and must be good
for you if it is "herbal" or "natural." Natural or
herbal drugs can have side effects and they can
be harmful. (See BIO-EAR Update, below)
manufacturer did.) The FDA sent a warning let-
ter to the manufacturer, Swiss Labs, and in the
tangle of red tape, we heard nothing more.
A newer product, Bio-Ear, has recently been
claiming "blissful tinnitus relief' in its catalog
ads. But because Bio-Ear's label avoids mention-
ing tinnitus, the FDA has no authority over the
product. The Federal Trade Commission is now
involved in tracking down information to help
prove or disprove the advertising claims.
We have heard from a few people who've
tried these products. Some have been mildly
helped; some had a worsening of their tinnitus.
Most, however, noticed no effect. Although Bio-
Ear's ingredients seem innocuous, it is impor-
tant to remember that untoward reactions are
possible with any drug or herb.
Bio-Ear contents: Aloe in an alcohol base,
ginseng root, bitter orange, dandelion root,
myrrh, saffron, senna leaves, camphor, rhubarb
root, zedoary root, carline thistle root, and
angelica root.
Distributor: Alive and Alert.,
31566 Railroad Canyon Rd
#2000, Canyon Lake CA
92587. (no phone available)
Focus is Manifestation
by Mayte Picco-Kline
Once in a while, something happens in our
daily routine that truly challenges our ability to
manage changes in our lives. That's what I expe-
rienced when I first encountered a severe case
of tinnitus. It was a very threatening situation.
As I lost control of my business and personal
activities, I felt I lost control of my life.
With time, I have developed a series of
strategies to adjust to the new circumstances.
Now I'm able to see the situation as a creative
challenge rather than an overwhelming obstacle.
How did I make that transition?
Stage I.
Confronting New Reality. When I first
encountered tinnitus, I experienced an initial
phase of rejection and denial - I didn't want to
believe things had changed.
Stage II.
Uncertainty. For ten weeks, I went through a
stage of chaos and confusion, with high emo-
tional stress - I didn't know what to do.
Stage III.
Rebuilding. Then I realized I needed to
move ahead, so I started developing a series of
strategies to manage tinnitus and create a new
identity, new goals, and to some extent, a new
future.
Each stage provided me with insights that
became a step forward in developing new strate-
gies. Here's what has been useful to me.
Stage I.
Confronting New Reality
Get involved in a low risk, high reward commitment
(for example, exercise, swimming, etc.)
Reach out for ideas and support from meaningful
people.
Give it time.
Have some fun!
Stay in touch with own thoughts and feelings.
Seek medical advice.
Implement practical treatments and test how
they work.
Start a journal.
Seek out information.
Focus forward rather than backward.
Stay in contact with family and friends.
Re-examine daily activities and see how they fit into
new circumstances.
Stage II. Uncertainty
Strengthen meaningful relationships.
Do small things well.
Thst talents in new areas.
Learn at each new step.
Read.
Listen to favorite music.
List strengths.
Celebrate small achievements.
Revisit old goals.
Keep moving!
Expand a hobby.
Initiate a daily period for reflection/ meditation.
Don't act just for the sake of action.
Remember own motivators.
Develop new ideas.
Transform ideas into action.
Relax and think.
Stage III. Rebuilding
Visualize success.
Decide on the routine that you want to have in your
life and do it.
Keep open communication with meaningful people
about feelings, plans.
Set new priorities.
Put concentration into different activities.
List the positive things that are happening.
Think creatively - brainstorm.
Establish new goals.
List accomplishments.
Notice the difference - and celebrate progress.
Carefully prioritize time.
Continue assessing interests.
Remember it is a process - it takes time for results.
Be aware of new stress factors.
Be optimistic - there is always hope.
List needed adjustments.
Communicate needs.
Realize plans can change as information is gathered.
See strategies to manage new circumstances as sources
of strength.
Sources of Strength
a. Exercise (any type)
b. Nutrition (no caffeine, no MSG, use of supplements)
c. Medical Resources (traditional and complementary)
d. Hearing protection devices (avoid extreme noises!, use
of ear plugs and ear muffs)
e. Maskers (best on the market, and listening to
favorite music)
f. Daily reflection/ meditation to maintain psychological
balance
g. Information (American Tinnitus Association,
Hyperacusis Network, support group, books)
h. Monitoring (tinnitus chart, biofeedback)
i. People
One of the most important elements in this
process has been my emphasis on what a close
friend used to say: "That which you focus on,
you strengthen." I'm thankful for her advice.
Focus is Manifestation, that is, how you
think is what will be, is my approach to life. My
positive thinking helps me transcend my limita-
tions. As a result, the tinnitus is better, and I
now have a great sense of well-being.
Tinnitus Thday / March 1995 17
Letter to a friend
by Barbara Tabachnick,
Client Services Coordinator
Dear Gladys,
1b the best that anyone who
does not suffer with tinnitus is
able to, I understand your exas-
peration and anger. We also want
to splash the headline of "TINNI-
TUS CURE FOUND!" on Tinnitus
7bday and USA 7bday too for that
matter. But today we can't.
All of us here have talked with people who
have "crippling tinnitus" like yours, people
who've tried every drug, stress reduction tech-
nique, and angle possible and who've found
that nothing works. Nothing yet.
So what do they do, Gladys? The same thing
you do! They hold on. They talk to each other
over telephones and modems, write to each
other, read everything they can about tinnitus
and financially support research through ATA..'
They run through the list again of things that
might be exacerbating their tinnitus: stress, caf-
feine, alcohol, nicotine, salt, allergies, high
blood pressure, drug side effects. They run
through the list again of things that might help
quiet their tinnitus: hearing aids, masking,
relaxation techniques, drug therapy, TMJ treat-
ment, hypnosis, chiropractic, acupuncture, mas-
sage, nutritional counseling. Some run as fast as
they can to a local support group or start one
themselves. Others 1mte to their representa-
tives in Washington, DC to insist that they back
tinnitus research in a big way and in a hurry.
Then there are those who immerse themselves
in the busy-ness of life and do only things that
most especially do not remind them of their
tinnitus. These varying means are all to a sin-
gular end: living the best life possible until the
day that headline appears in earnest.
And what do we do in the meantime? The
search for viable and appropriate research is
our number one priority. Since the bottom line
to any successful research project is money,
our fund raising mission continues full steam.
(Our goal is to raise $5 million for research by
1996.) We send tinnitus information to hospi-
tals, libraries, doctors, audiologists, dentists,
educators, health agencies, our elected officials,
18 Tinnitus 'Ibday/ March 1995
and to hundreds of thousands of people who
thought they were alone with their affliction. We
also send Tinnitus 7bday to the editors of every
health or senior's magazine and newspaper, and
to every syndicated health columnist in the
country so that when they do write about tinni-
tus, they'll have the goods in hand. We attend
research conferences and health meetings to
investigate new tinnitus treatments and studies.
We sponsor medical and self-help referral net-
works, maintain the most complete tinnitus
bibliography in the country, and work nationally
to elevate the seriousness with which tinnitus is
regarded - publicly and politically. We present
yearly testimony to the Senate and House
Appropriations Committees in Washington, D.C.
about the millions of tinnitus sufferers in
America who need help and about the ethical
obligation our government has to help them.
The sluggishness with which the political wheels
move, though, is discouraging but we push on
because there is no other choice.
Your question is the one we hear most
frequently - "Is there anything new?" Yes, the
technique of auditory habituation offered at the
Tinnitus Center in Maryland is somewhat new
(see the article "Jastreboff & Co." in the March
1994 Tinnitus 7bday) but not convenient for
many people in terms of location or the waiting
list. This technique, which really is different
from masking, has worked for people in your sit-
uation. A call to Susan Gold, the audiologist at
the Tinnitus Center (410/ 328-6866), will get the
basic questions answered. But no, there are no
new drug treatments available today.
Even though Xanax, Nortriptyline, Prozac,
ginkgo, and biofeedback didn't help you, they do
work for some people. I recently got a call from
a woman who was "released from a 17-year-long
tinnitus sentence" because she had tried
Nortriptyline after reading about it in our maga-
zine. If someone new is helped by "old informa-
tion," then Tinnitus 7bday is fulfulling its intent.
As long as ATA exists, Gladys, all tinnitus suf-
ferers in this country have a voice. It doesn't
matter if they've never contacted us or even
heard of us. They are here in our work and
hearts. And for now, the headline we splash has
to read, "Someday a Tll\TNITUS CURE will be
FOUND!" Please, don't ever doubt it.
We never do.
Combined Federal
Campaign Update
by Patricia Daggett, Executive Assistant
Another charitable Combined Federal
Campaign has come to a close with continuing
support from many fronts. In spite of military
base closures and downsizing of numerous gov-
ernment agencies, people seem willing to con-
tribute to a good cause. The number of donors
was down but the amount of the average gift
increased.
Our opportunities for distributing ATA litera-
ture at health fairs were definitely greater this
year and, thanks to volunteers, we were able to
reach many more people with our information.
Our grateful appreciation goes to Don Schrickel,
AZ; Dick Dawes, CO; Shirley & Mort Rosenhaft,
DC; Terry Hamilton, GA; Sterling Brown, NJ;
Bob Luthmann, NY; Stan Lewis, TN; and Fred
Berek, VA.
It can be very rewarding to talk with others
who have tinnitus or educate those who are sim-
ply curious. If any of our readers are interested
in attending health fairs or similar events on
behalf of ATA during the 1995 campaign, please
contact Pat Daggett at the .ATA office. We'll sup-
ply you with a poster stand, tee shirt, and print-
ed handouts. You'll be part of an important
effort to provide services for all those who are
attempting to live with their tinnitus!
Bob Luthmann, ATA Volunteer; left; Ann Geissler; Public
Relations, NYC Combined Federal Campaign, center; and Alex
Matich, Executive Director of NY's NVHA, right.
Annual Volunteer Luncheon
A faithful band of volunteers, who keep
things rolling at the ATA headquarters, gathered
for lunch in the board room on September 13th.
Lisa Cochran prepared relish and fruit trays,
lasagna, tossed salad, garlic bread, and chocolate
mousse cake - very tasty! As you can see by the
picture below, everyone looks pretty well satis-
fied and it was decided that this should become
an annual event. Thank you one and all for
your loyal support!!
BACK ROW: Jean Warner; Arnold Kagan, Chuck Inman,
Pheobe Jensen, Lisa Cochran (volunteer coordinator), Shirley
Vanelli, Rene McCullough, Don Cahill. FRONT ROW: Barbara
Blaine, Samantha Ngeth, Geneva 7bner; Heather Leonetti and
Baby Jordan, Estelle George, Suzanne Schofield. UNABLE TO
ATTEND: Ruth Beckman, Betty Mathis, Gladys Paulson, Alan
Walker; Joe Walker.
Our Support Network has
grown again!
Two new self-help groups have formed and
we extend grateful welcome to the coordinators:
Ira Breiter, 7 Victorian Lane, Brookville NY
11545-3322, (516) 626-3017 and
Pete Clements, 954 W Alder St,
Louisville CO 80027, (303) 665-7990.
Welcome also to our new telephone and
letter support contact:
Carmen Jean Guajardo, 588 N Marvin Dr,
San Bernardino CA 92410, (909) 885-8778.
If you are interested in starting a support
group in your town or in joining the nationwide
network of telephone and/ or pen pal contacts,
please wlite to us for our Self-Help Packet of
materials. We can help you help.
Letters to the Editor (oontU1Uedfrompage6)
The acupuncturist, who spoke little English,
stuck needles around my ears. He also gave me
a very rough massaging. When I left the office I
was "rocked." That evening I started to hear a
crackling, buzzing and hissing that has never
left me.
Since then I have visited many ENTh, otolo-
gists, and tinnitus specialists, but I have yet to
find relief I have run the gamut from psychia-
trists, psychologists, biofeedback, relaxation
tapes, special diets, prayers, psychic healers,
wax candles burning in my ears, but still 1 can't
rid myself of this thing.
I joined a support group on Long Island and
met many terrific people with my problem, but
hardly anyone got tinnitus in the same way. I
did find that the support I got from my friends
in the group helped me more than all the doc-
tors and medicine.
If anyone out there got their tinnjtus from
acupuncture on the ears or any type of outer
ear trauma I would like to hear from them. I
ATA member and former First Lady Rosalynn Carter (left)
visited Portland, Oregon in January to sign copies of her new
book Helping Yourself Help Others. Barbara Thbachnick,
ATA's Client Services Coordinator (right) discussed the book
with Mrs. Carter. Helping Yourself Help Others is a resource
for the care givers of those who are housebound with cata-
strophic illnesses or disabilities. The author offers a directory of
social service agencies and practical coping strategies for care
givers. One of her suggestions for helpers and for those
afflicted: Attend a support group.
believe the more information we Carl get about
our conditions the better chance we have of
finding a cure.
Sharyn Friedman, Mt. Vernon, New York
A
fter lO months of severe tinnitus l
learned of Homeopathy and decided to
try a non-classical doctor. I was tested and
diagnosed with having a micro-infection caused
by microorganisms so tiny they cannot be
detected by traditional medical practice.
Following this I was given a homeopathic pre-
scription of Cousticum. This was to be taken
twice daily for two weeks under the tongue with
no water 30 minutes before or after. ln two days
I noticed a great decline and much relief of my
condition.
Although it is not the only remedy that can
be beneficial, as tinnitus has various causes, the
sufferer must continue to look for solutions arid
have patience. I am still undergoing therapy; to
get it under control is a long process.
Jackie Evans, Aurora, Colorado
THE TOP SELLING TINNITUS BOOK
Tinnitus ... When Silence is a Stranger
by Leslie Sheppard, edited by Dr. Clive Sheppard
MA,MB,B. Chir(Camb)MRCGP
This is the author's second successful book
on Tinnitus following "Tinnitus ... Learning to Live
with it" first published in 1987 and currently out
of print. The work is the result of years of
research by the author during his close contact
with many people who have tinnitus during his
seven years as Chairman and Counsellor to the
Norfolk Tinnitus Society in England.
The aim of the book is to demystify tinnitus.
It contains a comprehensive survey of the sub-
ject from its historical background from around
2500 BC to the present day. The work has been
written in conjunction with the author's son,
D1: Clive Sheppard, a practicing physician with
a great interest in the subject. All aspects of
this distressing condition are covered, together
with self-help strategies, theories, causes, and
much more.
Endorsed as recommended reading by the
American Tinnitus Association, the book may be
ordered by calling (503) 248-9985 ext. 14 (for
Visa/Mastercard), or by sending $21 .00,
US Funds, ($16.50 ATA member price) to ATA,
PO Box 5, Portland, OR 97207. Shipping is
included.
Tributes, Sponsors, Special Donors
Champions of Silence are a select group of donors demonstrating their commitment in the fight
against tinnitus by making annual contributions of $500 or more. Sponsors and Associates contribute
at the $100 and above level. The ATA tribute fund is designated 100% for research. We send our
thanks to all those people listed below for sharing memorable occasions in this helpful way.
Contributions are tax deductible and are 1Jromptly acknowledged with an appropriate card. The gift
amount is never disclosed. GIFTS FROM 10-1-94 to 1-15-95.
Champions of
Richard W. Cooper Jim H. McElroy J. Michael Wiggins Ted Hofmeister
Silence
Neil M. Daniels, Ph.D. David L. Mehlum, M.D. Robert A. Willis, M.D. James lrving
Lawrence J. Danna, M.D. Michael R. Minnich Keith C. Winters Lucille J . Jantz
Richard Allegretti
Jeffrey J. Derossette Stuart M. Mitchell James H. Winzenburg Nils P. J ensen
Julia R. Amaral
David Dewindt Dr. John D. Montroy Dan P. Wright John B. Kent
Ronald Berger
[rene Duffield Charles Moon Pauline Zwick Gerald F. Kiplinger
Allen R. Bernstein
Helen L. Duffy Mary T/ James Moran Marvin Kowit
Robert H. Boerner
John Dunlop Randy Morgan
Research
Dr. Stuart Krasney/ SK&A
Thomas W. Buchholtz,
Josephine M. Elias Bo Niles Donors Research
M.D.
Frederick A. Elkind Gene O'Neill Charles L. Adams Robert N. Lando
Jack D. Clemis, M.D.
Robert Entenmann Dennis W. Organ Ronald C. Allan Sonny Landreth
Joyce Coffman
Douglas C. Erikson David Oringdulph Richard Allegretti Donald Lemmons
Jean & Lou Fockele
Burdell S. Faust Aaron I. Osherow Julia R. AmaraJ Stephen W. Lewis
Cyrus 0. Harper
Eldin L. Fisher M. M. Osman Gerald W. Ape! Mary Jane Lillis
Dan R. Hocks
Bernard Fishman R. J. Palombit Alan J. Arnold M.D. Peter J. Lubalin
Ann K1imczak
Joy A. Fogarty John R. / Sara A. Patterson Ruth G. Banks Heather Lutley
Dr. Stuart Krasney I
Florence M. Frank Robert Petroelje, M.D. David M. Bartlett Vince Majerus
SK& A Research
Lewis/ June A. Freedman Glen Provenzano Thelma P. Batchelder John Malcolm
John Malcolm
FrankL. Giancola A. 0. Quinn Ronald Berger Phil E. Marshall
MI M Stephen Moksnes
Veva J. Gibbard James K. Quire Deborah/ Charles Bern WM M. Richard May
Mary E. Molisky
Alasdair G. Gilchrist, M.D. Rob Reiter Allen R. Bernstein Jim H. McElroy
Elisabeth J . Nicholson
Donna/ Harold Graham B. A. Rickard Robert H. Boerner Ed Leigh McMillan Tl
Pittsburgh Hearing
Claude H. Grizzard William P. RobertS Robert W. Booth Jean Mentis
Speech & Deaf
Raymond P. Harris Nicholas M. Romano Alain G. Boughton Patrick Michael, Jr.
Services/ Hope Feldman
James/ Colleen Hartel Nancy M. Rosen Marianne Brandon ErnestM. Moeller
Wanda M. Shannon
Dennis D. Heindl Arthur Rudd, D.D.S. Eric R. Bryant Donald D. Morrison
monsor
Aldred E. Heller Richard Rush Helen S. Burkey Elisabeth J. Nicholson
embers
Donald L. Herman Jack Salerno Carl H. Carlson Bernice R. Pardue
Thd Hofmeister William B. Salsgiver Stephen Chandler Phil R. Pearcy
H. E. (Bud) Adams
Max Horn Stephen G. Savegh Glen Heather Clark Anthony S. Petru
Joseph G. Alam
Jonathan S. Horwitz Joseph J. Schall Joyce Coffman Margaret S. Powell
Richard Allegretti
Jasper J. Jaser Don T. Seaquist Michael L. Connolly Anthony M. Raia M.D.
Richard Ambrose
Frank H. Jellinek Benson Selitsky, D.O. Joseph A. Conti Jr. David Rapaport
Lynn Anderson
Bernard Kaminsky Alice/ David Sengstack Lawrence A. Coppola Marta Ridd
Patty Andrews
Charles W. Kiker, Jr. Bruce A. Shachat Patrick M. Costigan Martha Jo Rodgers
Jeffrey R. Bauder
Donald King Don L. Six, Sr. George Crandall .Jr. Edward P. Rosenberg
McLaren Beatty
William 0. King Patricia/Richard Smith Gregory K. Crouch Thomas J. Ryder, IV
David P. Becker
Robert A. Kirkman Martin V. Socha L. D. Daugherty John B. Sampson
M. Craig Bell
Laura P. Kleppick Maxwell Solomon Ronald V. Dinger Myron L. Semrad
Thrrie Bergman
Barbara L. Kohn Ronald L. Spagnardi 'Ihldy Drucker Wanda M. Shannon
M/ M Jack M. Besser
Ken Krake H. Ben Stone, Ill, M.D. H. Renwick Dunlap Mrs. Alice L. Shields
R. John Bishopp
James Krasno Orloff w. Styve Ray E. Fankhauser Jerome D. Shine
Hugo/ Jenny Blad
Robert N. Lando Richard F. Swenson James T. Fehon M/ M Fred H. Smith, fV
Mal'io J. Bonello
Gary E. Lanterman Leon/ Carol Thger Ronald T. Ferguson John Souroumanis
Ronald R. Bowden
Esther Lee David Hollis Taylor John W. Finger Ronald L. Spagnardi
Maurice H. Brown
Barbara Legge Jerry R. Thompkins James J. Fischer Larry Spoden
Richard W. Brunner
Sharon Ann Lemke William R. Thwer, Jr. D. Jeanne Frantz l. William Spraitzar
Robert B. Budelman, Jr.
Romulus Z. Linney Dr Robert D. Utsey, Sr. Charles W. Gilbert Thomas E. Stegman
Helen S. Burkey
Gary L. Lombardi Agnes Varis Johnie Mae Gilmore James J. Steponik
William R. Cagney, Ph.D.
Lorraine M. Love Alan L. Walters Fred W. Gollash Thomas F. Sullivan
Charles J. Callaghan, Jr.
William Don Lovell Florence Waterman Richard L. Goode M.D. Marilyn L. Thrgrimson
Arthur Cellini
Alice J. Mandel Michael Webber W.J./Helen GotschaJJ Albert E. Wareikis
Frederick W. Champ
Christopher Marken Robert F. Weimer Donna/ Harold Graham David P. Weiner
Stephen Chandler
Ernest V. Marsh Sheldon Weinig Robert Hager Mrs. H. A. Wheeler
Gary M. Chase
Aaron J ./Jean Martin Rita Weisner .Elsie Louise Hahn Henry J. Williams
Robert W. Cole
John M. Me Namara Edward R. Weiss Cyrus 0. Harper Susan V. Zabinski
Delight E. Colombatto
David L. McClintock Beverly J. Wells Raymond P. Harris
Michael L. Connolly
Robert M. Whittington A. James Heins
Tinnitus Thday/ March l 995 21
Tributes, Sponsors, Special Donors
Professional
John Hendricks
Arlo & Phyllis Nash
Associates
Margaret Higgins
Abdul H. Abbass, M.D.
Ken & Anna Bradley
Sherwin A. Basil, M.A.
Carolyn Delany-Reif
Emmett E. Campbell, M.D.
e:d & Marilyn Forshay
Sayong Chae, M.D.
Nan & AI Gallagher
Jack D. Clemis, M.D.
Lehigh University Football Staff
Stephen Epstein, M.D.
Helen Loh
Elio J. Fornatto, M.D.
LoriiauberMarcus
Barbara Goldstein, Ph.D.
Colette McDermott
Claude P. Hobeika, M.D.
Michael & Teresa McGuinness
Carey Kenyon, M.A.-C.C.C.A.
Janice & Don Messick
R. J. Kramer, M.D.
Annie Murtaugh
Zoe Lambert
Jeanettte Nast
Gale W. Miller, M.D.
Mr & Mrs Edward Pryor
William Lee Parker, Ph.D.
Scholastic Bus Company
Ira D. Rothfeld, M.D.
John & Frances Tonelli.
Lucy Shih, M.D.
The Wallace Family
Abraham Shulman, M.D.
Kathleen Walsh
In Memory Of
,John & Barbara Williams
John G. Jaser
Helen Beld
Jasper & Dolores Jaser
Arlo & Phyllis Nash
Maxine 1i'eadway
Curtis E. Bowman
Margaret K. Leventis
Helen Bowman
John Tully
Steven J. Geisenhof
Joseph Alam/1htdy Drucker
John & Faye Schleter
John E Greve
In Honor of
Jim & Joanne Cooper
Anniversary-
Lou Hanei
John &'Julie Alam
Frances W. Janiga
Joseph Alarn/Trudy Drucker
Guidelines for Writers
Tinnitus Tbday, the Journal of the
American Tinnitus Association, welcomes
submission of original articles about tinnitus
and related subjects. The articles should speak
to an audience of people with tinnitus, audiol-
ogists, otolaryngologists, otologists, hearing
aid specialists, and other medical, legal, and
governmental specialists with an interest in
tinnitus.
Manuscripts should be typewritten, dou-
ble-spaced, on plain paper and should include
title; author(s) name(s) and biographical infor-
mation; and when appropriate, footnotes, ref-
erences, legends for tables, figures, and other
illustrations and photo captions. Our readers
like to "see" you. Please include a repro-
ducible photo. Generally, articles should not
exceed 1500 words and shorter articles are
preferred. If possible, submit manuscripts on
3.5" diskette in WordPerfect format.
22 Tinnitus Thday/March 1995
Mrs. Jo Alexander Shirley Rosenhaft
Emily S. Kerley Naomi Swerdlin
Nick Andrews Recovery - Ginny Thurston
Paul S. Holbrook Joseph Alam/Trudy Drucker
Pat Sickel Jack A. Vemon Ph.D.
Birtbday-'frudy Drucker Ronald C. Allan
Adele B. Alam Recovery- Ray Wilkinson
Joseph G. Alam 'Trudy Drucker
Jules Drucker Wedding - Leanne Willis &
MoraEmin James Caress
Mary & Patrick 'fully Elizabeth Boyd
John R. Emmett M.D.
Matching Gifts
Luther J. Smith, lJ M.D.
Luther J. Smith Ill
You might be able to double or
Birthday - Virginia Fitzgerald
triple the size of your gift to the
Hermine Shapiro
American Tinnitus Association
Birthday - Mark Graham
by taking advantage of your
Donna & Harold Graham
employer's Matching Gift
Birthday - Ludwig W. Balk
Program. Many companies have
Joseph Alam/'Thldy Drucker
matched contributions to ATA.
Birthday - Jack Ha:rary
We urge you to ask if your
Mike & Cindy Harary
employer will match your gift
Robert & Deborah Harary
or call ATA for the names of
J. Michael Holbrook
companies that match
Paul S. Holbrook
contnbutions.
Eugene B. Kem M.D.
Hearing Aid
Duane D. Mead, M.D.
Don 0 . Larson
Donations
Clarissa Larson
628 pre-owned Hearing Aids
Birthday- Dr. Max M. Novicb
and Maskers have been
Joseph Alam/Trudy Drucker
received and recycled. Thank
A. C . Pellegrino Ph.D.
you. We'll be glad to receive
Bergen County Tinnitus Group
more!
Please do not submit previously published
articles unless permission has been obtained
in writing (and attached to the article submit-
ted) for their use in Tinnitus Tbday.
All letters accompanying manuscripts
submitted for publication should contain the
following language: "In consideration of
Tinnitus Tbday taking action in reviewing and
editing my (our) submission, the author(s)
undersigned hereby transfer(s), or otherwise
convey(s) all copyright ownership to Tinnitus
Tbday in the event that such work is pub-
lished by Tinnitus Tbday."
Tinnitus Tbday also welcomes news items
of interest to those with tinnitus and to tinni-
tus healthcare providers, and information or
review copies of new publications in the field.
All such items should contain the name and
telephone number of the sender or person to
contact for further information.
Please address all submittals or inquiries
to: Editor, Tinnitus Tbday, P. 0. Box 5,
Portland, OR 97207-0005. Thank you for your
consideration.
Fifth International Tinnitus Seminar
Next Year in Portland, Oregon
Fifth quadrennial meeting, July 12-15, 1995,Port-
land Marriott Hotel, Portland, Oregon, USA. Spon-
sored bj!_ the American Tinnitus Association.
The Fifth International Tinnitus Seminar
brings you the best in the field of tinnitus- most
distincruished speakers, the most provocatJ.ve ad-
dress:S and panels, and the latest in research find-
ings. This meeting is the preeminent quadrennial
event for all scientific investigators, because we
offer a carefully crafted program that transcends
the boundaries of specialties and explores tinnitus
from a variety of perspectives.
The 1995 Tinnitus Seminar features cutting
edcre research while at the same time integrating
findings to clinical treatments. Diverse
poster presentations highlight specific research
questions and findings, all in a format allows
the audience time to absorb, react, and discuss the
data one-on-one with individual presenters.
In addition to the impressive scientific pro-
gram, the Fifth International Tinnitus Semi-
nar offers exhibits featuring the latest
equipment, publications, and services,
and opportunities to network with col-
leagues at social events. Another key at-
traction is the satellite meeting of the
International Tinnitus Support Associa-
tions; the self-help group leaders work-
shop; and the special session devoted to
legal issues related to tinnitus.
Don' t forget the lure of the Pacific Northwest
itself. Pmtland has a splendid array of museums,
monuments, restaurants, theaters, and most of all its
sunounding natural attractions; the Columbia River
Gorge, Mt. St. Helens, now 14 years past her great
emption; the Pacific coast; Mt. Hood, where you can
probably ski in July; the high desert country of Eastern
Oregon; gateway to Alaska cmising or
entertainments. These are just a few of the special
attJ.actions you can enjoy with your entire family.
Recristration forms and hotel information will
0 .
be mailed automatically to those people presentmg
papers or posters or they may also be requested by
callincrtheATAofficeafterJanuary 1,1995. (Tel:
(503t248-9985, Fax: (503) 248-0024), E-Mail:
reichg @ ohsu.edu OR gloria @ ata.org
The most important component of the Fifth
International Tinnitus Seminar is the patticipation
of those involved in tinnitus research. New compo-
nents for 1995, featuring legal issues and self-help
have been included by popular demand. The Inter-
national Tinnitus Advisory Committee is con-
stantly looking to improve the quadrennial
by incorporating your ideas, recommendatiOns,
and submissions. For more information on pro-
grammatic issues, or to seek advice on your sub-
mission, please contact Jack A. Vernon, P.h.D. ,
Co-Chairman, at (503) 494-8032, or Glona E.
Reich, Ph.D., Co-Chailman, at (503)248-9985.
See you in Portland in 1995!
Yes! I'm looking forward to being part of the
Fifth International Tinnitus Seminar. Please send
me the following information.
0 1 am an investigator and wish to present a paper
about my tinnitus studies. Please send specific in-
structions for proposal preparation.
0 1 am a Self-Help Group leader or member and
would like to attend the session about tinnitus sup-
port. Please send me information about how to en-
roll in the Self-Help workshop.
0 1 am a lawyer representing clients with tinnitus: .
I'm interested in attending the Legal Aspects of Tinni-
tus presentations. Please send me information.
0 I'm an ATA member who would like to register for
the entire Tinnitus Seminar, attend all the meetings
and ancillary activities, but I will not be presenting a
scientific paper.
Name __________________________ ___
Affiliation --------------
Street Address
City/State/Zip--------------
Phone (with area code) ______________ _
'Tinnitus 'TOday/ March 1995 23
FIFTH INTERNATIONAL TINNITUS SEMINAR
JULY 12-15, 1995
PORTLAND,OREGON,USA
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
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Tinnitus Today March 1995 Vol 20, No 1

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March 1995 Volume 20, Number 1

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