American Tinnitus Associiltion

Advisory Board
Chrlrlos Uttftt, M.D.
10601 Horlty
Downey, talifornia90241
David OtWuse. M.D.
Chi&rman Oap1. Oto"'yl'lgology
of Oregon
HQIIb Cemtr
Jact Vtfnon, Ph.D.
Oirtt:tor of Kresge Heattng
Resurd'l Lfboratory
Uni\'tUily of Ore,on
Ht.afth ScMntl!$ Center
Albetl Allyth, M.O
Vic:t Prt.Sidt.nt AlA
Del Cl.ewson
House of Rtp,estntatrvts
United States Congre:u
Bob M.D.
Asstmbtvman
C.tlfo(nia legislature
w,lktns, M.D.
MtmbK Cllifornia Stalt Board of
Mtdul Examtners
Oallls Finntll
Director of Oe\ .. topmtnt
Salk Institute
Tony Habttb
Vice President Metro Media
Corpo111ion
Kay M.D.
Clldorn11 State Boatd of Mldial
Robert Hocb
Hocks laboratOC"iu
Portland,
NahOI'Ill Olftet: AmttiAn TinMut
AssociatJOA
10601 HOlley A\'II'Wt
Downey, talifornia 90241
IL ETT E
Vol. 1, No. 2 August, 1975
Dear Friends:
The returns fran the questiormaire have begun to taper off, so it is
nCM t:i.rre to give you a report of the findings. First, and very im-
portantly, of the 95 questiormaires sent out 57 have been returned.
That represents a return of 60% which as "retw:ns" go is a very high
percentage. I take this as evidence of interest as well as your will-
ingness to help.
You will recall that you actually had two items to return: 1) the
results of the faucet test and 2) the rrore lengthy NrA questiormaire.
It is the results of the faucet test which will be reported in this
issue. Recall that in the faucet test you were instructed to place
your ear near a water faucet and then detennine whether or not the
sound of running water caused a reduction in the loudness of your
tinnitus.
An.o.th.Vt de.m on. :the. .tr..e!.>pon6 e. c.a..tr..d Wa.6 a.6 fioUoW6:
"My tinnitus is best described as:"
O high pit ched
O very loud
0 lav pitched
0 chirping sounds
0 not very loud
D hissing
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RESULTS
Of the 57 people who returned the cards, 3 did not take the faucet-
test (tw::> were rearing-aid dealers who do not suffer with tinnitus but
joined ATA to support research for those who do suffer and the third per-
son has very intenni.ttent tinnitus which is not currently a problem).
Of these 57 people, 48 said "yes" the som1d of running water does re-
duce the loudness of tinnitus. In other words, of the people taking
the test 89% fom1d that the som1d of running water reduced the inten-
si ty of their tinnitus or, said differently, the sound of running water
masks tinnitus for nost people.
More about masking later but first consider the six people (11%) for
whan water-sounds did not mask the tinnitus. Three of these described
their tinnitus as "hissing", three said it was "high pitched"; of those
tw::> said it was "very loud", tw::> described it as "chirping som1ds" and
tw::> said it was not "vecy loud". In other words, no consistent pat-
tern of description emerged for those cases where masking did not work.
It oould be that masking will w:Jrk for these people but that tl:.e sound
of running water was not the proper masking sound to use.
VESCRIPTION OF TINNITUS WHERE MASKING WORKEV: (Each person could use
several categories, thus the totals oo not add up to 48)
SOUNDS
high pitched
low pitched
hissing
chirping sounds
very loud
not vecy loud
NUMBER OF PEOPLE
37
1
21
5
15
7
Of those describing tinnitus as "high pitched" or as "high pitched and
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hissing", there were 14 who indicated that it was "very loud" . This
is probably the group of tinnitus-sufferers who are in the greatest
trouble and they represent 26% of our sarrple group. Many of these
people wrote separately to indicate the severe degree to which their
tinnitus disturbed than.
THE USE OF MASKING
,.1
- - - - . . = . . ~ . > ! - - - - ~ . . . : ! ! -
"Re.p!U.n-te.d by pe.-'l.m{..o.oion. ofi .the. Ne.w Yo!tk Ne.w.o In.c..
Copy!U.gh:t 7975. AU Righ.t6 Re..oeJtve.d."
The Catfish cartoon above cones close to indicating sanething about
masking. Obviously it is possible to make so much noise that tinnitus
could not be heard. It is also obvious that such noise would be .rrore
objectionable than the tinnitus, and that is not the kind of masking
we wish to prop::>se to you.
An.y .oou.n.d c.an. be. mMke.d i6 :the. mMkin.g .oou.n.d i.e .ou.fi6ic.ie.n..ily f.ou.d.
On the other hand, if the masking sound is properly selected according
to the nature of the sotmd to be masked it is possible to produce
efficient masking where loudness is not necessarily great. Masking
is actually rrore than just "covering-up" the tinnitus. The masking
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sound and the tirmi tus interact in such a way as to reduce the inten-
sity of the tinnitus. If we had perfect and total control of all the
oondi tions it would re theoretically J:X>ssible to canpletely cancel
the tinnitus. Since such oontrol is rx>t J:X>Ssible it is our expectation
to re able to reduce the tinnitus so that it will be less loud and
hence less objectionable. I contend that each of us would rather have
two sounds of only noderate or less loudness than to have one very
loud sour:rl. This would mean making a masking sound continoously avail-
able and to do that we will have to produce a device which can be worn
by the patient much like a hearing aid is worn. The project is cur-
rently under way.
MJRE AB){]l' ~
The masking test which each of you performed utilized a masking sound
which was <XillfOSed of nore different kinds of sounds than was needed.
The sound of running water contains all the different frequencies or
pitches which the human ear can appreciate, and such sounds are called
''white noise". The lc:Mest frequency which can be perceived as a tone
by man is about 20 Hertz (frequency is rreasured in Hertz (Hz) which
rreans the number of vibrations per second) The highest frequency that
younger good ears perceive is about 20,000 Hz. Our water sounds had
all the frequencies between these two extrares.
Returning to the results of the faucet test, note that nost of you
(77%) described your tinnitus as "high-pitched". That suggests we
need only use high frequency maskin:J noise in order to combat tinnitus.
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The water sounds YJe used were oot only effective in reducing tirmitus
but they are also effective in reducing or destroying the ability to
hear speech and other sounds which are undesirable.
Speech is primarily located between about 300 Hz and 3,000 Hz; there-
fore it may be possible to mask high-pitched tinnitus without overly
disturbing speech reception, by restricting the masking sound to higher
frequencies as indicated below.
Speech Range
20 300
I -- - - - - -- - -- -j
: Possible Range of :
1 Masker 1
bv/d//Xd
3,000 Possible 10,000
Range of 20,000
Tinnitus
---- -----
4,000 8,000
At this point a really far-out idea occurs to rre. It might be possible
to use a masker whose fre::ruency is so high that it canoot be heard.
That would truly be an ideal condition: -<-n we. c.ouid e.6{}e.ctive.y mMk
.tinn-UU6 by a tone. wh-Lc.h c.ouid no.t be. he.aJtd. We need to study this ap-
preach first because the effectiveness of a masker is reduced as it
rroves farther CMa.y fran the sound to be masked. Even if it works it may
be too ineffective to be of practical use.
Back to the original case of a masking sound which is a band of noise
extending from 4, 000 Hz to about 8, 000 or 10,000 Hz. These frequencies
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are above tlx>se needed for speech and thus should oot interfere with
speech reception. The best arran:Janent ~ u l d provide an adjustable
device allCMing the fre:;JUency carposition of the masker to be tailored
to fit each person's tinnitus. Obviously the intensity would be ad-
justable so that the maxinn.ml mask.in:] with mini.nun intensity is possible.
It is essential that you understand what is being attenpted here. This
awroach is oot suggested as a possible cure of tinnitus, rather it is
an attanpt to interfere with tinnitus so as to make it nore tolerable.
~ tinnitus would still be present only it would not be as loud. In
order to effect such a mask.in:] on a cnntinoal basis it would be nee-
essa.ry for one to wear the masking devioe - it would probably look
much like a cnnventional hearing aid. (As yet the exact design has oot
been detennined.)
1) One of you has been requested to try-out the wearing of a cnn-
tinual masking sound. (In that case no special device was produced,
instead a portable FM radio with an ear plug is to be used. The radio
is detuned so that oo program is received, but the noise is, and that
noise will be used as the masking sound. ) This patient has been asked
to wear his radio on a 24 hour basis for a ~ or two and then to file
a report with us.
2) We are currently working with ~ electronic engineers on the
possible developrelt of a ''masking device" which cnuld be worn and which
can be adjusted so as to "fit" (or best mask) each patient's tinnitus.
~ this device is ready I will cnntact scm= of you with the request that
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you be the guinea pigs for testing.
* * * *
In :the nex.t NeJAJ6leftelt we hope :to have ctdcUtional. .ln6o}[J1Jafun ILUtdting
6Mm the above attemp:t6. You w.<.U. be app!U6ed o6 devei.opmen:t6 a6 -they
oc.ewt.
* * * *
One of our nanbers, Mr. Fobert Panara, has been profoundly deaf for
nost of his life. As if that isn't bad emugh Mr. Panara also suffers
wi. th tinnitus - to ll'Ost of us that would be the worst of both possible
worlds. 'Ib Mr. Panara, ~ v e r , tinnitus is the only sound he rears so that
he enjoys and uses it as illustrated by his poem, On H-<.6 Ve.at)ne6.6. Mr.
Panara refers to his tinnitus as the
11
50\.md of silence".
My e.a!L6 aJte dea6, and ye-t 1 .o eem .to heaJt
Swee.t nat:Wte.
1
.o mU6-i.c. and the .oong.o o6 man,
FoiL 1 have .teaJtned 6Jtom Fanc.y
1
.6 aJLt,i,6an
How wJUften wolld6 c.an .thJUR.1. .the. .lnne.Jt e.aJt
Jcu,.t a.6 .they move. the. heall.t, and .6o 6oJt me.
The.y alAo .oeem .to lUng ou.t loud and
0
1Le.e.
In .oile.n.t .o.tudy 1 have .te.aJtned .to -tell
Eac.h .6 ec.Jte-t .6 hade o6 me.a.J'l).ng, and .to heaJt
A mag-i.e. haJtmo ny, a,t o nc.e .6-i.nc.e.Jte,
Tha.t .oome.how no.tu .the tinkle o6 a bell,
The. c.oo.lng o6 a dove., .the .ow.Uh o6 leave6,
The. !La..i.ndJtop
1
.6 pLtte.Jt-pa:tte.Jt on .the. e.ave6,
The. .to v e.Jt
1
.o .o..i.g h, the. .tJvwmmLng o 6 g lUtaJt,
And, ..i.6 1 c.hoo.oe, .the. ILU6fte. o6 a .o-tall
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~ are housed in the Portiarrl Center for Hearing arrl Speech Building, lo-
cated on the University of Oregon Health Sciences Center canpus. The ground
floor is given over to public service functions as a pre-school for the deaf,
audiology, speech pathologists, esophageal speech patients, asphasia patients
and office space. The second floor is where our laborato.ry is located. It
was built in 1967 by a grant from the Kresge Foundation, and is a part of the
Otolaryngology Department of the Medical School. OUr goal is dedicated to the
study of problems effecting man's hearing.
In conc..tu.6ion may I on.c.e. a.giUn thank. e.a.clt on you 6oJt yoWl. in:teJte.J.d, Jte!.>pono e.,
and .6uppo)();. I:t .-i.-6 not by bJte.a.d ai.one. .that ma.n UveJ.> a.rz.d the. k..-i.nd o6 Jte..6pon.6e.
you people. ha.ve. given .to U6 he.lp.6 ma.k.e. U.6 Jtea.Uze. the. hnpo)();a.nce. 0 n the. .ta..6 k.
be.t)oJte. U6. Trz..t.Jtoduc.e. U6 .to anyone. who would be. .-i.rz..teJteJ.>.te.d in the. ATA Ne.w.6le.:t:teJt.
Th.-i.-6 bJt.-i.ng.6 but pe!t.6 onai. Jte.ga.Jtd-6,
Ja..c.k. A. VeJtnon, Ph.V.
V .-i.Jte. c.to Jt, Kite!.> g e. H e.a.Jt.-i.ng
Ru e.a.Jtch La.boJta..toJtfj