tinnitus today aug 2009

August 2009Vol. 34, Number 2

Abroad and here at home, scientists move us closer to a cure.

A publication of the American Tinnitus Association

2 Tinnitus Today | August 2009

Hello. I’m the same Lisa, now with my married name of Hutton!

Thank You for Taking ATA’s Member Survey

We are very grateful to the 1,137 members who responded to our online Member Survey! Your thoughts are an important element in ATA remaining an informed and successful organization. Look for survey results at www.ata.org later this summer and in the December 2009 Tinnitus Today.

Selected Survey Highlights

Please see some early survey results on page 4 of this issue.

ATA’s Support Network

Check out the updated listings at www.ata.org or contact me at [email protected] or (800) 634-8978 x219 to learn more. We send e-mail updates to inform and remind our members of upcoming support group meetings, including those with guest

speakers. We send other important ATA updates as well. Please call or e-mail me if you would like to add your e-mail address to the list.

National Tinnitus Awareness Week (TAW)

The 2009 TAW activities truly reflected its theme, “What YOU Can Do To Cure Tinnitus.” Individuals in their own towns, cities and states celebrated TAW, raising awareness about tinnitus and the urgent need for a cure. A few TAW activities included:

n ATA held its first ever Walk For A Cure (see page 14) and “Hope & Help for Living With Tinnitus,” a seminar, (see page 10) in Southern California on May 16 – both events organized by dedicated volunteers.

Members Corner

Lisa F. Hutton, ATA Manager of Member Services

n Earl O. Hutchinson, political activist, tinnitus sufferer and radio personality, interviewed Scott C. Mitchell, J.D., ATA’s recent past board chair, on “The Hutchinson Report,” broadcast on radio station 1460 AM in Los Angeles and streamed on KTYM.com. Scott addressed ATA’s mission to cure tinnitus. The interview is available at www.ata.org/news-pubs.

n ATA honored its Congressional Champions (see page 18).

n Linda Beach, co-coordinator of the South New Jersey Tinnitus Support Group, and her husband, State Senator Jim Beach (D-NJ 6th District), cham-pioned the Tinnitus Awareness Week resolution declared in New Jersey’s state legislature.

Your Members Section and Health Professional Updates

Visit your Tinnitus Information Center in the Members Section – www.ata.org/members – with its robust archive of Tinnitus Today articles and all the health profes-sionals on ATA’s listing. We recently added icons (at right) to the listing to accurately reflect each health care professional and/or clinic’s type of ATA membership.

ATA does not award professional credentials, so please consider our listing as a starting point rather than a referral list. We include information provided by various professionals so that you can contact them and select someone whose services best fit your needs. We update the listings on a regular basis and when available, provide a link to a professional’s Web site where they often list their training and treatment options in more detail.

Research Champions

Professional Members

ATA member

As ATA members, you are the cornerstone of our organization and the reason for our commitment to a cure. Again, thank you for your ongoing support of our mission and for renewing your ATA membership.

3August 2009 | Tinnitus Today

Editorial and advertising office: American Tinnitus Association, P.O. Box 5, Portland, OR 97207 • (503) 248-9985, (800) 634-8978 • [email protected] • www.ata.org

Michael Malusevic, Executive Director Nina Rogozen, Editor

Tinnitus Today is published three times a year, in April, August and December, and mailed to American Tinnitus Association members and donors. Circulation is rotated to 75,000 annually.

The American Tinnitus Association is a nonprofit human health and welfare agency under 26 USC 501(c)(3).

©2009 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 permission of the Publisher. ISSN: 0897-6368 (print). ISSN: 1530-6569 (online).

Board of DirectorsGary P. Reul, Ed.D., Chair, Issaquah, Wash.Mark K. Johnson, J.D., Vice Chair, Anchorage, AlaskaBarbara Kennedy, Secretary, Mays Landing, N.J.J. Scott Simons, Treasurer, Sioux Falls, S.D. Anthony T. Cacace, Ph.D., Detroit, Mich.Neil Cherian, M.D., Cleveland Heights, OhioJames O. Chinnis Jr., Ph.D., Warrenton, Va.Michelle Dapolito, Hoboken, N.J.Marsha Johnson, Au.D., FAAA, Portland, Ore.Thomas J. Lobl, Ph.D., Valencia, Calif. Scott C. Mitchell, J.D., C.P.A., Houston, TexasMichael O’Rourke, Arlington, Va.Michael J. A. Robb, M.D., Phoenix, Ariz.Joseph Trevisani, New York, N.Y.

Honorary DirectorsPeter & Joan Graves, Beverly Hills, Calif.Mark O. Hatfield, U.S. Senate-Retired, Washington, D.C.William Shatner, Los Angeles, Calif.Jack A. Vernon, Ph.D., Portland, Ore.

Scientific Advisory CommitteeAnthony T. Cacace, Ph.D., Chair, Detroit, Mich.Paul J. Abbas, Ph.D., Iowa City, IowaThomas J. Brozoski, Ph.D., Springfield, Ill.Donald Caspary, Ph.D., Springfield, Ill.Craig Formby, Ph.D., CCC-A, Tuscaloosa, Ala.Donald A. Godfrey, Ph.D., Toledo, OhioJames (Jay) W. Hall III, Ph.D., FAAA, Gainesville, Fla.James Henry, Ph.D., Portland, Ore. James A. Kaltenbach, Ph.D., Cleveland, OhioPaul R. Kileny, Ph.D., FASHA, Ann Arbor, Mich.Robert A. Levine, M.D., Boston, Mass.Craig W. Newman, Ph.D., Cleveland, OhioJay F. Piccirillo, M.D., FACS, St. Louis, Mo.Michael J. A. Robb, M.D., Phoenix, Ariz.Jay T. Rubinstein, M.D., Ph.D., Seattle, Wash.Roger A. Ruth, Ph.D., Charlottesville, Va.Susan Shore, Ph.D., Ann Arbor, Mich.Hinrich Staecker, M.D., Ph.D., Kansas City, Kan.

The Publisher reserves the right to reject or edit any manuscript received for publication, and to reject any advertising deemed unsuitable for Tinnitus Today. Acceptance of advertising by Tinnitus Today does not constitute endorsement of the advertiser, its products or services, nor does Tinnitus Today make any claims or guarantees as to the accuracy or validity of the advertiser’s offer. The opinions expressed by contributors to Tinnitus Today are not necessarily those of the Publisher, editors, staff or advertisers.

The American Tinnitus Association exists to cure tinnitus through the development of resources that advance tinnitus research.

August 2009Vol. 34, Number 2

TABLE OF CONTENTS

REGULAR FEATURES

4 Passing the Baton: I’ve Had a Wonderful Year as CEO Gary P. Reul, Ed.D.

6 Letters to the Editor

24 Questions and Answers Jack Vernon, Ph.D.

26 Special Donors and Tributes

SPECIAL FEATURES

2 Members Corner Lisa F. Hutton, ATA Manager of Member Services

5 New Board Transitions at ATA Katie Fuller, ATA Executive and Development Associate

8 Family Series: Adaptability Helps the Reuls Live with Acoustical Trauma Nina Rogozen, Editor, Tinnitus Today

10 Hope and Help for Living with Tinnitus: A Seminar Recap

11 Can a Simple Kiss on the Ear Cause Auditory Problems? Levi A. Reiter, Ph.D.

14 A Walk in the Park and Across America

16 The Incidence of Tinnitus in U.S. Veterans Continues to Escalate

18 Honoring New Friends in our Nation’s Capital Jennifer DuPriest, ATA Associate Executive Director

FOCUS ON RESEARCH

12 Highlights: Selected 2008-2009 Tinnitus Research Studies Nina Rogozen, Editor, Tinnitus Today and Daniel Born, ATA Director of Research and Special Projects

17 ATA Member Participates in Tinnitus Clinical Trial: A Q&A with Mark Church about rTMS Daniel Born, ATA Director of Research and Special Projects and Jennifer DuPriest, ATA Associate Executive Director

20 Tinnitus and Hyperactivity in Dorsal Cochlear Nucleus Fusiform Paul G. Finlayson, Ph.D.

21 Clinical Trial of Acamprosate for Tinnitus William Hal Martin, Ph.D., and Yong-Bing Shi, M.D., Ph.D.


Passing the Baton: I’ve had a Wonderful Year as CEO

Selected Highlights from the 2009 Member Survey

Gary P. Reul, Ed.D., Chair, ATA Board of Directors

I am very pleased to announce that on July 1, 2009, ATA named Michael Malusevic as the new Executive Director and Jennifer DuPriest as Associate Executive Director. (This represents a change in leadership titles.) Michael and Jennifer have been with ATA for quite some time and share a strong commitment to our mission and to the smooth, effective running of this wonderful organization. As chair of the board, I look forward to continuing to work with Michael, Jennifer and the entire staff over the coming years. Go to www.ata.org to read more about these exciting changes.

My heartfelt parting words are simple, but important: Please con-tinue supporting ATA so our goal of a cure becomes a reality for all of us. Simply use the convenient envelope in the center of Tinnitus Today or go to www.ata.org and click on “Donate Now.”

I believe that during my tenure as CEO, I fulfilled the board’s expec-tations and I look forward to my second retirement. This change will accommodate my health chal-lenges and eliminate frequent and extended commuting between Portland, Ore. and Seattle, Wash. However, I am not leaving ATA, only changing positions.

On July 1, 2008, I was poised to become chair of ATA’s Board of Directors. As fate, luck or karma would have it, the board asked me to become the organization’s Chief Executive Officer (CEO) on June 28, 2008. They agreed that I had the right experience, with 20 years as an administrator and a doctorate in leadership, to step into the role.

At 71 years of age, I have had a life full of work experiences; being ATA’s CEO was the most reward-ing and satisfying. Of particular joy was directing such an experienced and talented staff; interacting with so many people with tinnitus from all over the world; and working with a great board and its very skilled chair, Scott C. Mitchell, J.D. I am pleased that my tinnitus and hyperacusis allowed many members to feel a kinship with me. I thank all of those who sent me notes or e-mails and those with whom I had interesting telephone conversations about tinnitus.

Top three things members want from ATA:n A cure for tinnitusn Ways to manage tinnitusn Advocacy efforts with national

lawmakers and leaders

Greatest sources of tinnitus information:n Tinnitus Todayn www.ata.org

Most helpful sections of Tinnitus Today:n Research articlesn Treatment articlesn Coping and managing tinnitusn Q&A

Most common tinnitus effects on day-to-day life:n Annoyingn Trouble sleepingn Trouble concentrating

Tinnitus sounds like:n Ringingn Hissingn Buzzingn High-tension wire

Responders with hearing loss:n 73 percent

Gender of survey responders:n Male – 71 percentn Female – 29 percent


New Board Transitions at ATAKatie Fuller, ATA Executive and Development Associate

She says that her favorite part of being a board member has been visiting Portland, Ore. (ATA’s head-quarters) and developing ways to deal with tinnitus. Maggie plans on “being involved with ATA as long as they put up with me.”

A Warm Welcome to ATA’s New Board Members

Michelle Dapolito, Director of Marketing at FX Solutions in

Saddle River, N.J., joined the board July 1. Michelle has over 12 years experience in online marketing

and advertising and Web site design. Before coming on as a director, Michelle volunteered her time to help ATA’s Web committee revamp our site, www.ata.org, and continues to be instrumental in its changes and further development. We are pleased to have Michelle’s contagious energy and commitment to the organization on board.

We also welcome Marsha Johnson, Au.D., FAAA, a practicing audiol-ogist in Portland who founded the

Oregon Tinnitus and Hyperacusis Clinic in 1997. Marsha brings to ATA over ten years of clinical

knowledge and experience in caring for patients with tinnitus, hyperacusis and/or hearing loss. Her sincere desire to help those who are suffering will prove indis-pensable to the organization.

A New Chair

July 1, the start of the 2009-2010 fiscal year, brought major changes

to ATA’s Board of Directors. As he addresses in his farewell column (see “Passing the Baton,” page 4) Gary P. Reul, Ed.D.,

has stepped down as ATA’s Chief Executive Officer and rejoined the board as chair.

A Huge Thank You

Scott C. Mitchell, J.D., just com-pleted three dedicated years as

chair of ATA’s Board of Directors. “With my term as board chair coming to a close,” reflects Scott, “I must say

that it has been a privilege to work with the ATA staff. To paraphrase Winston Churchill, ‘Never have so many been helped so much by so few.’ Gary’s move from CEO to chair of the board assures me that ATA will continue to focus on finding a tinnitus cure, and in the meantime, provide compassion-ate help to those who are suffer-ing. With our staff, and Gary still involved in leadership, we could not be in better hands.”

ATA thanks Scott for his excellent years as chair and the extraordi-nary time and effort he donated on behalf of ATA and the tinnitus research community. We are very pleased that Scott is continuing to work with ATA as a board director.

A Fond Farewell to Two Long-Standing Board Members

John R. Bates and Margaret (Maggie) F. Peak, Ph.D., have been on the Board of Directors for a combined total of twelve years.

John leaves after serving for six years, two of them also on the finance committee. He is currently presi-

dent and CEO of Flint Resources Company, LLC, in Tulsa, Okla., whose principal subsidiary is com-mercial construction, building large projects, such as schools, hospitals and stadiums throughout the south-ern, southwestern and western United States. John says that the best part of serving on ATA’s board was having the opportunity to work with extremely professional board members, staff and research-ers. When asked how long he plans on being involved with ATA, John says, “We don’t have ‘the cure’ [yet] so the job is not finished. Therefore, I will stay involved through ATA’s Advisory Council.”

Margaret (Maggie) F. Peak, Ph.D., has been involved with ATA since

1975. She is a champion of tinnitus suffer-ers, particularly veterans, and has helped guide the

organization’s focus toward fund-ing research and developing the Roadmap to a Cure. Maggie is the Assistant Chief of Audiology and Speech Pathology at VA Gulf Coast Veterans Health Care System in Biloxi, Miss., where she splits her time between seeing patients and managing the department’s admin-istrative operations.


Letters to the Editor

Alternative Tinnitus TreatmentsI am a 52-year-old man who has been living with severe tinnitus for over 25 years. Exposure to loud music, when I was a rock guitarist in my 20s, caused my tinnitus. I also have genetic hearing loss (my father and grandfather were hard of hearing in their later years). For the last year, I have been wearing hearing aids.

I originally went to a doctor in California who told me that there was nothing that could be done. The

with my tinnitus. Meditation and personal growth work did the most good.

Recently, I went to a doctor who works with Quantum Health, a diagnostic computer system designed to identify energy imbalances, food sensi-tivities/allergies and other risk factors. He gave me a long list of foods to avoid and a plethora of herbs, vitamins and minerals, which I adhered to for six weeks. I could only eat turkey, green vegetables and a few fruits. I had to avoid everything else, including various spices, oils, caffeine, dairy, alcohol and sugar. After the six weeks, I felt physically better than I have ever felt – I had tons of energy and felt mentally clear and very strong. At the same time I was doing this Quantum Health diet, I went to see a highly recommended Chinese acupuncturist and spiritual healer. Within a few weeks – and I don’t know how or why – I no longer needed my hearing aids. I still experience ringing in my ears, which has not signifi-cantly improved, but my hearing definitely has.

I would like to see professionals give these alterna-tive approaches a chance and even research their effectiveness in treating tinnitus.

Lon Cohen Marina del Rey, Calif.

One Woman’s Positive Experience with PsychotherapyEye Movement Desensitization and Reprocessing (EMDR) is a powerful method of psychotherapy. Practitioners use it for a wide variety of problems. I have been seeing a psychotherapist in Chicago who is on the forefront of using EMDR for tinnitus.

I have had tinnitus for twenty years. Initially the sound was similar to a smoke alarm going off; then it seemed like a million cicadas; and now it is akin to a teakettle. Like others, my original ear, nose and throat doctor (ENT) told me to either “deal with it or go crazy.” I dealt with it and by the fall of 2008, I noticed an alarming increase in my ringing. I actually

In each issue, we include letters from our members about their experi-ences with tinnitus and with non-traditional treatments. We do so in the hope that the information offered might help our readers. Please read these anecdotal reports carefully. When we include letters about treatments, consult with your physician or health care advisor and decide for yourself if a given treatment might be right for you. As always, the opinions expressed are strictly those of the letter writers and do not reflect an opinion of or endorsement by ATA.

Send your letters to Nina Rogozen, Editor at [email protected] or to Editor, Tinnitus Today, ATA, P.O. Box 5, Portland, OR 97207.

best I could hope for was to protect what hearing I had left. More recently I was shocked and dismayed to find, that after 25 years, no one I spoke with had any information whatsoever with regard to alterna-tive healing methods. They knew nothing about diet, acupuncture, cranial sacral work, meditation, chakra clearing, visualization, psychotherapy, holis-tic healing or any other alternative treatments. I had tried all of these methods to some degree with vary-ing levels of success, at least with regard to coping

7August 2009 | Tinnitus TodayATA does not endorse or recommend any tinnitus products or treatments.

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ended up in the emergency room due to Lyrica®, the medication erroneously prescribed for a separate, misdiagnosed condition, which made my tinnitus uncontrollable.

That same fall, my new ENT referred me for EMDR treatments. My initial ses-sions began with an imag-ined environment – a calm location where I could start to mentally decrease my tinnitus sounds. Sessions after that included color association, breathing techniques, visualization/meditation and eye movement exercises resulting in decreased anxiety. I also learned to take the power away from my tinnitus; to stimulate the right and left sides of my brain; and many other tools to decrease both the sound and stress of my tinnitus. EMDR has made a significant difference in my lifestyle and coping mechanisms. I am able to use the many tools I

learned from my sessions. I have noticed a differ-ence in my condition since beginning EMDR treatment. I can manage it better and although I still notice some sound fluctuations, my anxiety has decreased. I’m glad to be sharing this infor-mation with others who suffer with tinnitus.

Donna Marsh Orland Park, Ill.

Editor’s note: EMDR is a form of psychotherapy developed to help resolve symptoms resulting from disturbing and unresolved life experiences. It includes a comprehensive and integrative psychotherapy approach. Read more at www.emdr.com/briefdes.htm.


Gary and Barbara Reul enjoy traveling. They’ve been to 52 countries, most recently to China and Sweden. Like most of us, they bring home remind-ers of their adventures. But one day in 1993, they brought back something from Florida that neither of them expected – Gary’s debilitating tinnitus and hyperacusis (a decreased tolerance to some normal sounds that makes them seem unbearably loud).

Barbara, a travel agent, heard about a great-sound-ing Florida Everglades experience – an airboat ride to a quiet spot with beautiful birds and animals. The travel brochure did not mention the boat’s extremely loud engine and horn or the risk of tinnitus and hyperacusis, which struck Gary on the spot. That night, without the acoustical distractions on the street, the quiet of their hotel punctuated Gary’s agony. “I felt like a caged animal; I was climbing the walls,” he remembers. “I paced and held my head while a high-pitched noise filled my ears.”

Tinnitus and Hyperacusis Changed Their Lives

Many of Gary’s friends did not understand the prob-lem, which left him feeling very alone with his new disability. At work he endured large, intolerably noisy meetings by sitting in the hallway. “I had to constantly explain to people why I was there,” says Gary. “However, this was a learning experience for others and it drew out many who had tinnitus.”

“At first Gary’s problems were very stressful,” remembers Barbara. “I felt frustrated and often on the verge of tears. I blamed myself for arranging the airboat ride and felt guilty for not experiencing these problems myself. This was the roller coaster ride of our lives, which seemed like a blur of depression.”

That fateful trip robbed the Reuls of some activities they had always enjoyed together. At first, Barbara would not leave Gary at home and venture out to plays, movies or other places his ears could not tol-erate. No more Super Bowl parties, church, baseball games, weddings, funerals or movies. “We can’t talk in the car because I have to wear earmuffs if we go over twenty miles an hour,” laments Gary. “This struggle is also very painful because Gary looks the

A Series on Families Living With TinnitusWe often have little influence on a loved one’s chronic condition. However, we can learn about the issues, remain supportive and take care of our own well-being. For some, working to enhance treatments, find cures and raise awareness are ways to cope and create hope. This is certainly true in the tinnitus community.

This is the third story in our series on families made up of members with and without tinnitus. The series explores their experiences, the feelings that penetrate their lives and the frustrations they face. It also illuminates some of the solutions that diminish their stress and allow families to settle into a “new normal.”

Adaptability Helps the Reuls Live with Acoustical Trauma By Nina Rogozen, Editor, Tinnitus Today


same, so some friends still don’t really understand,” says Barbara.

Gary Turned to the American Tinnitus Association

Part of the Reuls’ frustration has been the lack of treatment options. Doctor after doctor told Gary to “live with it.” He took an antidepressant, which helped for a while. He tried herbal medications, including Ginkgo biloba for two years, which did not give him any relief. Counseling helped some and Tinnitus Retraining Therapy (TRT) helped his hyperacusis, but not his tinnitus.

Desperate for guidance, Gary contacted the American Tinnitus Association for emotional support and informed resources. He eagerly absorbed infor-mation in brochures and archived articles and on CDs. He shared these resources with his family, who

were anxious to understand. His involvement with ATA grew as Gary served as chair of ATA’s program commit-tee, vice chair of the Board of Directors, ATA’s CEO for the 2008-2009 fiscal year and now chair of the board.

Developing a New Normal

“We have adapted to a new normal, a way of living altered from our pre-tinnitus years, yet one that gives us as much satisfaction as possible,” says Barbara. “We aim for an acceptable balance between what I do and what he can’t do.” Gary has encouraged Barbara’s “emancipation” from her hesitancy to enjoy activities without him. Gary is not without the stress of tinnitus and hyperacusis, but his and Barbara’s adaptability and their dedication to each other’s happiness is the engine that created their new normal. What seemed to help the Reuls the most was time to adjust to lifestyle changes. Gary uses earplugs and earmuffs to keep out loud sounds he cannot tolerate. Lecturing about tinnitus and hyperacusis at their retirement community helps him as well.

The Gift of Experience

The Reuls have some good ideas that may help those of you with tinnitus in your family. If you are living with hyperacusis and crave silence, as most of us do, remember that being in the midst of some noise may actually help you become less sensitive to sound. Try going to hotel restaurants, which tend to be quieter, as are many eating estab-lishments between 2 p.m. – 5 p.m. And call ahead to inquire about quiet seat-ing. If you are anxious and/or depressed, discuss the possible use of medication with your health care pro-fessional. Always keep ear-plugs or earmuffs nearby. Use them when necessary, for instance, like Gary does around his playful grand-daughter. Ask your dentist to drill for 10 seconds, stop for 10 seconds, etc. to reduce noise trauma. “Use ATA materials to educate others about what you are hearing and experiencing,” concludes Gary. Barbara adds, ”Be as calm and understanding as possible.”

Committed to Each Other and All of Us

Gary and Barbara believe in ATA’s mission and under-stand personally how important everyone’s support is to bolstering tinnitus and hyperacusis research that will lead us to a cure. They encourage all families and indi-viduals to contribute to this very important cause.

“We have adapted to a new normal,

a way of living altered from our

pre-tinnitus years, yet one that gives

us as much satisfaction as possible.”

~ Barbara Reul

To contribute to ATA’s mission of silencing tinnitus, simply use the envelope in the center of Tinnitus Today. Remember, what may seem like a small contri-bution makes a big difference toward curing tinnitus.

Gary and Barbara Reul at The Bund (Waitan), one of the most recognizable architectural symbols of Shanghai, China, located at the west bank of a bend in the Huangpu River.


The Los Angeles Tinnitus Support Group cel-ebrated its 25th anniversary in a way consistent with its ongoing focus – providing help and hope to tinnitus sufferers. On May 16, 2009, led by support group leader Nelly Nigro, the group commemorated its 25 years of service by deliver-ing “Hope and Help for Living with Tinnitus,” a public seminar held at the VA Greater Los Angeles Healthcare System. The daylong seminar, sponsored by the American Tinnitus Association and supported by House Ear Institute and Advanced Bionics, featured an impressive list of tinnitus experts. They covered a variety of sub-jects, including current tinnitus research, existing therapies, development of novel technologies, tinnitus in the military, ATA-supported research and the Roadmap to a Cure. Also discussed were drug therapies, drug development and practical strategies to effectively manage one’s tinnitus.

Additionally, the event recognized Nelly Nigro for her many years of service to ATA and the support group, and Mr. D.G. Gumpertz for his financial contribution to the seminar and his ongoing com-mitment to and support of ATA’s mission.

Our deepest thanks to Nelly Nigro and D.G. Gumpertz for their leader-ship and support. And a heartfelt thank you to our speakers:

Jim Boswell, Ph.D., CEO, House Ear Institute

Jeff A. Carroll, Ph.D., Director, Tinnitus and Hypercusis Treatment Center, University of California, Irvine

Dhyan Cassie, Au.D., FAAA, Ear, Nose and Throat Professional Associates

Hamid R. Djalilian, M.D., Associate Professor of Clinical Otolaryngology and Director of the Division of Neurotology and Skull Base, University of California, Irvine Medical Center

Jennifer DuPriest, Associate Executive Director, ATA

John W. House, M.D., President, House Ear Institute

Thomas J. Lobl, Ph.D., VP of Research & Development, NeuroSystec Corporation and member, ATA Board of Directors

David I. Meyer, Ph.D., Executive VP of Research, House Ear Institute

Scott C. Mitchell, J.D., recent past chair, ATA Board of Directors

Eric Viirre, M.D., Ph.D., Associate Adjunct Professor of Surgery, Division of Otoloaryngology, University of California, San Diego

“Hope and Help for Living with Tinnitus”: A Seminar Recap

Left: Scott C. Mitchell, J.D., recent past chair, ATA Board of Directors and Nelly Nigro, chair, seminar planning committee and Los Angeles Tinnitus Support Group leader. Center: John W. House, M.D., House Ear Institute. Right: Jennifer DuPriest, Associate Executive Director, ATA, and Marcia Harris, first Los Angeles Tinnitus Support Group leader.

Dan Burbach is a welcome addi-tion to the ATA staff. He became our fulfillment coordinator in the winter of 2009, soon after we moved to our new offices. Dan is in charge of ATA mailings, product sales shipments and data entry. He

has a drive to make ATA’s distribution function even more fluid and continually flexible.

Dan graduated from the University of Oregon in 2005 with a double major in political science and art. His experiences in college led him toward a path in the nonprofit world and motivated him to give back to the community. He spent a year and a half working for Habitat for Humanity through AmeriCorps in New Orleans, La. and Biloxi, Miss. When not working, Dan is out exploring his neighborhood, traveling, reading and enjoying time with friends and family.

Welcome to Dan Burbach, ATA’s Fulfillment Coordinator


Although ear kissing has undoubtedly been around as long as humans, the sur-prisingly pathologic result of this simple gesture first appeared in print as recently as August 2008.3

The initial case involved a four-year-old child who hugged her mom and gave

her a loving smooch on her left ear canal. Mom’s immediate experience was severe, deep ear pain; loud, screeching tinnitus; total hearing loss; and facial twitching in the region of the ear – all on the left side. Within the next several hours, her total hearing loss recovered to a stable 35 dB SNHL in the middle hearing frequencies. The loss remains at that level two and a half years later. The patient con-tinued to suffer from tinnitus and facial spasms for about one year. During that time she also developed hyperacusis and distortion in the clarity of her hear-ing in the left ear. Today, the SNHL, hyperacusis and distortion remain. The tinnitus is now noticeable pri-marily in quiet surroundings, and the facial spasms occur only after experiencing excessively loud noise at a wedding, live concert or other noisy venue.

This first case study received a good deal of media coverage, and as a result, dozens of people came forth with their very similar stories. One indi-vidual was given a happy Mother’s Day “peck” on the ear by her loving husband, only to suffer immediate hearing loss, tinnitus and hyperacusis. In another case, a parent received a traditional, but misdirected, farewell kiss on the cheek by her son-in-law, which inadvertent-ly landed on her ear. The

Can a Simple Kiss on the Ear Cause Auditory Problems?

result was SNHL, tinnitus and hyperacusis.

To date, I have examined over one dozen cases rang-ing from 10 to 81 years of age. All show the same three symptoms: SNHL, tinnitus and hyperacusis.

There are three intriguing questions that I would like to address:

1. If this phenomenon is so old and so common, why has it taken so long to be discovered and published?

2. What is it about a kiss to the ear that causes such devastating consequences?

3. What can be done to treat or prevent this problem?

The answer to the first question is professional denial. Each patient who contacted me to have an ear-kiss injury evaluated, confided that a physician had previously denied their claim that a kiss caused their hearing problem. When several patients came across my “kiss” research, they felt validated – no, they were not imagining things. Their doctors’ pre-conceived notions about the harmlessness of a kiss had prevented further investigation into the matter via scientific or medical research.

The second question regards the cause of this ear pathology, which has been termed “REKS” for Reiter’s Ear-Kiss Syndrome.4 Research indicates that a kiss to the ear canal creates suction, which pulls the eardrum and ossicular chain (small inner-ear bones that transmit sound) forward. This in turn pulls the stapes (one of the ossicular chain) away from the inner ear, causing a tsunami-like turbulence in the inner ear fluids. This damages the

Levi A. Reiter, Ph.D., Hofstra University, Hempstead, New York

The answer to the question posed by this title is an unfortunate “yes!” Tinnitus, hyperacusis and permanent sensorineural hearing loss (SNHL) can result from a single, affectionate kiss to the ear.1,2

Levi A. Reiter, Ph.D.

continued on page 25


Tinnitus Research: Tales From a Grand Meeting at Grand Island, N.Y.1

United States, December 2008

Anthony T. Cacace, Ph.D., is the recent past editor of the American Journal of Audiology and chair of ATA’s Scientific Advisory Committee. In his words, “Scientific conferences play an important role in updating knowledge and improving our conceptualizations of selected topics of interest. They are a healthy way for promoting discussion/debate and providing seg-ues for the advancement of science.” In June 2007 the conference, “Advances in Tinnitus Assessment, Treatment and Neuroscience Basis,” was a huge success. Scientists from Belgium, Canada, China, Finland, Germany, Italy, Japan, South America and the United States attended and participated in the exchange of knowledge, research programs and enthusiasm.

Six prominent researchers, representing their indi-vidual research teams, presented papers published in the December 2008 issue of the American Journal of Audiology. Topics included: (1) The dorsal cochlear nucleus (DCN) may play a pivotal role in tinnitus development; (2) Anatomical and neurobiological evi-dence of auditory/somatosensory system interactions; (3) Synaptic plasticity at the level of the DCN can serve as a mechanism for tinnitus generation and tinnitus may be a multisensory phenomenon; (4) Using a gap detection startle-reflex procedure in rats to demonstrate behavioral evidence of tinnitus and perhaps hyperacu-sis; (5) The cortical representation of tinnitus is mani-fested by increased synchrony between sets of neurons; and (6) Identifying subgroups of tinnitus patients as a way to improve treatment outcomes. Cacace sums up the value of such a conference: “… The convergence of the basic sciences and the clinical domain … can contribute to advancing this area.”

Highlights: Selected 2008-2009 Tinnitus Research Studies Nina Rogozen, Editor, Tinnitus Today and Daniel Born, ATA Director of Research and Special Projects

Identifying Tinnitus Subgroups to Maximize Treatment 2

United States, December 2008

Richard Tyler, Ph.D., and his research team began with the premise that it is “important to uncover tinnitus subgroups to identify subsets of patients most likely to benefit from different treatments.” By reviewing strategies for subgrouping based on etiology, subjective reports, the audiogram, psychoa-coustics, imaging and cluster analysis, they obtained preliminary results. The team’s analysis of 246 participants helped them determine 26 categorical and 25 continuous variables. Results suggested four major patient subgroups – those who have (1) constant, distressing tinnitus; (2) varying tinnitus that is worse in noisy environments; (3) learned to manage their condition and whose tinnitus is not influ-enced by touch (somatic modula-tion); and (4) tinnitus that is worse in quiet environments. The team concluded that it is possible to identify subgroups of tinnitus patients using statistical approaches. Potential follow up would explore clinical tinnitus treatment trials based on utilizing subgroup analysis.

Comparing Different Frequencies of Daily Repetitive Transcranial Magnetic Stimulation for Treating Tinnitus 3

Egypt, February 2008

Repetitive transcranial magnetic stimulation (rTMS) (see page 17) uses different frequencies – 1 Hz, 10 Hz, 25 Hz and sham (occipital, 1 Hz) – to treat tinnitus. To better understand the effects of these

Once again we bring you our yearly sampling of tinnitus research being conducted in the United States and abroad. Each study gives us hope that we are moving closer and closer to the foundations of better treatments, and ultimately a cure. This year, we include a glossary of words and phrases to make it easier to understand some of the more technical references in this review (see page 23). You will find these items italicized in the body of the text below.


various frequencies, Eman M. Khedr, M.D., and his research team randomly divided 66 patients, all with chronic tinnitus, into four treatment groups. All patients received daily rTMS treatment over their left temporoparietal cortex, a region of the brain known to be involved in speech perception, for two weeks. The team assessed them using the Tinnitus Handicap Inventory, self-ratings of symptoms and audiometric measures of residual inhibition. The researchers found, before and after treatment during the next four months, no signifi-cant differences in basal measures or responses to different frequencies of rTMS among the four groups. Responses depended on tinnitus duration: those participants who had tinnitus for the longest period of time responded least to treatment. The investigators concluded that daily sessions of rTMS over the temporoparietal cortex may be a potentially useful tinnitus treatment.

Heidelberg Model of Evidence-Based Music Therapy 4 Germany, July 2008

More than a half-million patients in Germany who need tinnitus treatment suffer from tonal tinnitus (tinnitus with a well-defined frequency). Heike Argstatter, Ph.D., and her research team held the opinion that though tinnitus is one of the most common symptoms in ear, nose and throat (ENT) medicine, its treatments are polypragmatic and

often lack scientific foundation. They developed a novel music therapy and substantiated it with psychological, audiological and functional imaging procedures. They believe the advantages of this therapy are the integration of known and well proven acoustic and psychotherapeutic techniques converted to resonance training, neuroauditive cortex reprogramming and tinnitus desensitization.

The team found the music therapy an effective treatment for 190 patients with chronic tonal tinnitus and highly advantageous to treatment duration, effectiveness and follow-up stability compared with customary interventions. Brain imaging strongly suggests the usefulness of further investigation and discussion of neuronal tinnitus modeling.

Acute High-Intensity Sound Exposure Alters Responses of Place Cells in Hippocampus5

United States, March 2009

Overstimulation is known to activate neural plastic-ity (the brain’s ability to adapt to new conditions) in the auditory nervous system causing changes in function and re-organization in brain systems. Previous research demonstrated that overstimula-tion, using high-intensity noise or tones, can induce signs of tinnitus. Here, Timothy J. Goble, Ph.D., and his team utilized rat studies to show that over-stimulation causes changes in the way a subset of hippocampal pyramidal neurons (place cells) respond as rats search for rewards in a spatial maze. In familiar environments, place cells respond when the animal moves through specific locations but are relatively silent in others. This location-specific fir-ing is stable in a fixed environment.

The team assessed rats with four implanted micro-electrodes for stable single-unit place-field responses. They compared rats exposed for 30 minutes to a 4 kHz tone at 104 dB sound pressure level (SPL) to a control period in the same sound chamber. Their work demonstrated that activation of neural



A Walk in the Park and Across AmericaThe First Annual American Tinnitus Association Walk For A Cure

14 Tinnitus Today | April 2009

Setting UpSaturday, May 16, 2009, Irvine Regional Park, Orange County, Calif. The perfect day and location for the first annual ATA Walk For A Cure. At 6:30 a.m., on this beautiful spring morning, volun-teer event chair Mari Quigley-Miller and several of her Walk com-mittee members transported tables, chairs and water to the park. Other event volunteers put up directional signs throughout the park, clearly marking the way to the designated Walk area. Spirits were high as more volunteers arrived to set up the registration area, hang banners and stock the water stations.

Excitement continued to build as event walkers began arriving around 8 a.m. – many accompanied by their children and ener-getic dogs on leashes – with great enthusiasm for this unified effort to support ATA and the fight to cure tinnitus.

Warming upAt 9:00 a.m., Lindy Michaelis, daughter of entertainer Pat Boone, led the group in stretching exercises. With show business in her blood, she turned what some consider the mundane part of exer-cising into something lively and fun.

After the warm-up, Terri Baltus, past ATA chief development offi-cer, delivered a message on behalf of ATA to an attentive crowd of around 150 walkers. She thanked everyone for their support and emphasized that as a group we can accomplish what no one per-son can do alone. She defined the Walk as the center of a cross-country, virtual movement that is reaching out into communities across America.

Terri then introduced ATA-funded research scientist, Fan-Gang Zen, Ph.D., who was at the Walk with his young daughter, her friend and a few graduate students from his program at the University of California, Irvine (UCI). Zeng’s presence was a

“The walk was wonderful. It was the first walk I’ve ever been on and it felt so good to be in allegiance with everyone there.” ~ Normajean Brady

Walk participant & ATA Member


A Walk in the Park and Across AmericaThe First Annual American Tinnitus Association Walk For A Cure

Thank you to everyone who contributed to the Walk For A Cure. Thanks to Walk donations by hundreds of supporters, ATA raised $58,379 through the combined

efforts of the walkers in Orange County, the virtual walkers and a direct mailing to our membership.

powerful example of how the money ATA receives from its members and supporters is helping to fund excellent research.

Mari then sang a lovely rendition of our National Anthem, a fitting introduction to a local treasure, Sammy Lee, M.D. Accomplishing an important dream, Lee received back-to-back gold medals in diving in the 1948 Olympics in London, followed by his 1952 triumph at the Helsinki games. He

went on to become a respected ear, nose and throat (ENT) physician in Orange County. Lee, now retired, truly understands the problem of tinnitus and supports ATA’s mission.

A Walk in the ParkMari, accompanied by her dogs, Sonny and Cher, led off the mile and a half walk through Irvine Regional Park.

Event organizer Mari Quigley-Miller (second from right) and several Walk committee members.

Complimentary WalksAt the same time the Orange County participants were walking in the park, Donna Brown’s team, “Donna’s Daytrekkers,” held their own mini-walk in Denver, Colo. at Van Bibber Park. Nine team members, including local tinnitus support group leader Rich Marr, joined Donna, who climbed Mt. Rainier in support of ATA in July 2007.

We’d like to hear about anyone else who may have con-ducted their own mini-walk in support of ATA. Please send details to Nina Rogozen, Editor, Tinnitus Today, at [email protected].

Stay tuned this coming winter for details on ATA’s Second Annual Walk For A Cure, taking place in Portland, Ore. in the spring of 2010.




The group of spirited, eager walkers ambled along a peaceful creek, through lush foliage and then circled back to where the event began. Volunteers handed out goody bags containing several small, locally donated items, such as power bars, earplugs and refrigerator magnets.

After the Walk, people hung around to enjoy a sense of camaraderie and the satisfaction of a mission fulfilled. Groups clustered to share conversations with each other, Zeng, Lee, Mari and the Walk committee. One could hear enthusias-tic Chinese, Spanish and English voices, a reflection of the diverse makeup of the Walk committee and the

walkers they recruited. In addition to conventional local outlets, tinnitus stories in one Spanish and two Chinese language newspapers also covered the Walk.

A Walk in the Park and Across America

Many Virtual Walkers ParticipatedIn conjunction with the Orange County Walk, hundreds of supporters from across America – and a few beyond our borders – participated in spirit, signing up at the ATA Web site as fundraising team members and Walk supporters. We displayed the names of the hundreds of virtual walkers at the Walk site itself; you can view them by going to www.ata.org/walk-for-a-cure-list.

continued from page 15

Words About the Walk

Two young men, Jeff Dennison and Michael Conti, who both suffer with tinnitus, ran the entire Walk course. Their rationale for running at a walk? “We’re running so we can get to a cure faster!”

Supporters from Cal National Bank

For the second consecutive year, tinnitus is ranked as the number-one service-connected disability for U.S. military personnel returning from the conflicts in Iraq and Afghanistan. The chart on the left shows the mostcommon disabilities for returning personnel as of October 2007.

The Incidence of Tinnitus in U.S. Veterans Continues to EscalateMost common service-connected disabilities for Iraq & Afghanistan veterans as of October 2007

Iraq & Afghanistan veterans service-connected disability rates for tinnitus and hearing loss as of October 2008

27%

24%

2007 2008

100,00090,00080,00070,00060,00050,00040,00030,00020,00010,000

0

Information courtesy of VA Office of Public Affairs.

22%

14%

13% Tinnitus – 27%

Lumbosacral orCervical Strain – 24%

Defective Hearing – 22%

Post Traumatic Stress Disorder (PTSD) – 14%

Limitation in Flexion of Leg – 13%

TINNITUS

HEARINGLOSS

TINNITUS

HEARINGLOSS

The chart on the right illustrates the sharp increase in service-connected disability payments to Iraq and Afghanistan veterans for tinnitus from 2007-2008. The incidence of tinnitus increased more dramatically than did hearing loss. This is an indicator that other medical conditions, like the demonstrated link between tinnitus and traumatic brain injury, may be contributing to the pointed increases in tinnitus among veterans.


Q: How did you decide to participate in the study?

A: I found out through ATA that Dr. Piccirillo was conducting a new rTMS trial at Washington University in St. Louis. Because of the promising research reports I have read about the treatment, I decided that I would explore whether or not I was a viable candidate. I had an initial consultation [pre-screening] in September 2008 where the study team also explained the possible side effects. They told me I was a good candidate for the study.

ATA Member Participates in Tinnitus Clinical Trial:A Q&A with Mark W. Church About rTMSAn interview conducted by Daniel Born, ATA Director of Research & Special Projects and Jennifer DuPriest, ATA Associate Executive Director

BackgroundInterviewee: March W. Church from St. Louis, Mo., is a six-year ATA member and CEO of Application Engineering Group (AEG), an ATA corporate member. Mark is 48 years old and has had tinnitus for 10 years. He describes his bilateral tinnitus (in both ears) as “wildly fluctuat-ing tinnitus.”

Topic of study: A two-year, double-blind study of Repetitive Transcranial Magnetic Stimulation (rTMS), including 60 participants, led by Jay F. Piccirillo, M.D., F.A.C.S., at Washington University in St. Louis, Mo.

Goal of study: To determine if applying rTMS to the hearing area of the brain can lessen the perception of tinnitus. rTMS involves placing a strong magnet against a person’s scalp to generate a

small electrical field within the brain. Depending on stimulation frequency, this electrical field can either decrease or increase the electrical excitability of the brain. This study uses low-frequency stimulation since it is thought to decrease nerve activity. It is this electrical excitability of the brain that is thought to cause tinnitus.1

Hypothesis of study: rTMS can decrease the perception of tinnitus. Participants will initially receive either active rTMS or placebo rTMS for two weeks, then rest for two weeks. Next, they will receive the treatment they did not receive in the first two weeks. Treatments will be randomly administered and participants will not be told which they are receiving. Each will undergo magnetic resonance imaging (MRI) and positive emission tomography (PET) scanning of the brain at the beginning of the study and after each treatment.2

Q: Did you undergo any testing before you started treatment?

A: After the initial screening, the study team administered the Tinnitus Severity Index to determine my specific tinnitus level. My particular type of tinnitus is pretty bad; it occurs in both ears and fluctuates wildly. The next day they performed an MRI and PET scan and mapped my brain activity.

Q: What was rTMS treatment like?

A: The rTMS device was placed above my left ear and pulsed at half-second intervals for 20 minutes. There were 10 consecu-tive treatments, Monday through Friday, with a two-day week-end break. A two-week rest period took place and then rTMS was resumed for 10 additional treatments. Memory tests were administered after every treatment to make sure I was not having adverse side effects. It was a double-blind study but I could definitely tell the difference between real treatment and a placebo treatment. With the real treatment, the left side of my body jumped like during a knee reflex test.


What is rTMS?Repetitive Transcranial Magnetic Stimulation (rTMS) is a pro-cedure that uses a pulsed magnetic field to influence electrical activity in the brain. The effects of magnetic fields on humans were considered as early as the 18th century by Franz Anton Mesmer, a German physician and astrologist. However, it was not until the end of the 19th century that scientists started using magnetic energy to alter brain activity.3

Interview with Mark Church


Over the past two years, ATA has enjoyed some major advocacy accomplishments. The Department of Defense (DoD) now supports tinnitus research through its Peer Reviewed Medical Research Program (PRMRP) for the first time since the program’s inception. There is now successful inclusion of directive com-mittee report language that has accompanied the Labor Health and Human Services bill for the past three years. This language encourages the National Institutes of Health (NIH), the DoD and the Department of Veterans Affairs (VA) to come together to collaboratively address tinnitus from a multi-disciplinary approach. The result is a tinnitus-specific workshop hosted by the National Institute on Deafness and other Communication Disorders (NIDCD) regarding “Brain Stimulation for the Treatment of Tinnitus,” being held Aug. 13-14, 2009 on the NIH Campus. And lastly, the establishment of a DoD Center of Excellence on auditory systems injury for our military and veterans, who experience tinnitus dispropor-tionate in numbers, and often in severity, to the rest of the population.

We are Grateful for Congressional Support

ATA and the rest of the tinnitus community owe a debt of gratitude to the elected officials who helped make these initiatives become reality. Because of their work, ATA chose to honor two outstanding Senators whose leadership and support of ATA’s mission to cure tinnitus made these accomplish-ments possible.

Q: What sorts of safety precautions were in place?

A: The team did a hearing test [audiogram] at three different intervals to ensure no damage to my hearing center was taking place. There were constant questionnaires and memory tests, plus three psycho-logical exams to test for possible cognitive changes.

Q: Did you have any concerns about the process?

A: The MRI machine was very loud and physically uncomfortable. It is difficult to lie still for such a long period of time. I had to mentally psyche myself into getting through it as I am somewhat claustro-phobic. It was also time consuming; I spent two hours each day having rTMS treatment. Then I had six hours of PET and MRI scans and other tests.

Q: Did you experience any side effects?

A: Besides my left side jumping uncontrollably during the treatment, no. I was told that some people experience headaches, but I felt fine.

Q: Did the treatment work?

A: rTMS was not effective for me - but I want to do my part and help get us closer to a tinnitus cure.

Q: Would you participate in another tinnitus treatment study?

A: Dr. Piccirillo is a class act, and his team was very professional. I am open to taking part in other aspects of his tinnitus treatment research. In fact, he has a second part of the rTMS study that I will be participating in and will let you know how it goes.

A Q&A with Mark W. Church About rTMScontinued from page 17

1 http://clinicaltrials.gov/ct2/show/NCT00567892?term=tinnitus&rank=19.2 Ibid.3 http://www.bnl.gov/medical/tms/history.asp.


It was a double-blind study but I could definitely tell the difference between the real treatment and a pla-cebo treatment. With the real treatment, the left side of my body jumped like during a knee reflex test.

rTMS was not effective for me – but I want to do my part and help get us closer to a cure.

~ Mark Church

Honoring New Friends in Our Nation’s CapitalBy Jennifer DuPriest, ATA Associate Executive Director


On May 12-13, 2009, Scott C. Mitchell, J.D., recent past chair, ATA Board of Directors, board members John Bates and Michael O’Rourke, ATA government relations counsel Deborah Outlaw and I visited the offices of Senator John Cornyn (R-TX) and Senator Harry Reid (D-NV) to thank them personally for their support and to honor them for their essential actions toward curing tinnitus.

Senator Cornyn has always been deeply committed to serving America’s veterans. Because of ATA’s education of the Senator and his staff about the growing incidence

Conversations with a Senator: Scott C. Mitchell, J.D., John R. Bates, Jennifer DuPriest and Senator John Cornyn (R-TX) in his Washington, D.C. office.

A T A A D V O C A C Y I N A C T I O N

of tinnitus in active duty military and veterans, he supported the creation of the DoD Center of Excellence on auditory systems injury, included in the final 2009 DoD Authorization Bill. This center will not only pro-vide critical care to members of the military who suffer with tinnitus, but will provide educational materials and conduct ongoing research on its patient popula-tion. These efforts will help continue to inform the tinnitus research community about a certain kind of tinnitus and help us all get closer to our collective goal of silence.

Senator Reid is also deeply committed to serving America’s veterans and understands the importance of funding biomedical research for all who suffer from this condition. Again, ATA’s education of congressional members about this often overlooked condition resulted in Senator Reid’s gracious support of the inclusion of tinnitus as a researchable condition in the PRMRP.

We look forward to continued work with both Senators Reid and Cornyn and all the other members of Congress who are helping ATA pave the way to a cure!



In this ATA-funded study, we examined the properties of DCN neurons seven days after intense sound exposure and compared them to normal neurons. Families of special-ized proteins called “ion chan-nels” are located in neuronal membranes and selectively allow ions (charged atoms, such as sodium, potassium and chloride) to move in or out of the cell. This movement depends on the voltage across the neuron’s membrane and the difference in the concen-tration of ions between inside and outside the cell. Opening ion channels changes the voltage across the cells’ membranes. Opening and closing of specific types of ion channels produces action potentials (Fig. 1), which are the means by which neurons send infor-mation to other neurons. Other ion channels control the pattern or time between action potentials.

We have found a marked change in membrane properties in DCN neurons following intense sound exposure. The changes are consistent with an over-all increase in the opening of ion channels at rest.

In addition, after intense sound exposure, there is an increase in DCN neurons firing two action potentials (couplets) in rapid suc-cession. We also observed this firing pattern in our recent study, using recordings from outside cells; we directly observed the underlying membrane potential changes associated with firing in couplets.

Future Work

Future characterizations of the ion channel changes produc-ing these membrane potential changes, and the increase in open channels (measured as increased conductivity) following intense sound exposure, may demonstrate changes that are important in the generation of tinnitus. Changes in ion channels have also been found to be important in the change in neuronal activity asso-ciated with phantom pain, a con-dition similar to tinnitus. Studies on phantom pain provide impor-tant examples of changes that should be examined in tinnitus.

In conclusion, this study provides the groundwork for identifying and understanding specific ion channels, which may be altered in tinnitus. This information could lead to targeted treatments for tinnitus.

Paul G. Finlayson, Ph.D., is Assistant Professor of Otolaryngology and Ophthalmology for the Wayne State University School of Medicine in Detroit, Mich. He was recently named interim scientific director of the Ligon Research Center of Vision at Kresge Eye Institute, also in Detroit.

Tinnitus and Hyperactivity in Dorsal Cochlear Nucleus Fusiform Cells: What Biophysical Changes Occur in These Cells Paul G. Finlayson, Ph.D., Wayne State University, Detroit, Mich.

An effective tinnitus treatment may depend on our understanding of the alterations in the brain and in the cells/neurons which produce these phantom sound sensations. Animal models have shown that intense sound exposure increases spontaneous “firing activity” (action potentials) in neurons, such as in one of the first brain auditory centers, the dorsal cochlear nucleus (DCN). Action potentials are the major way neurons communicate information, such as sound, and an increase in their rate could produce the phantom sounds of tinnitus.

Figure 1. Dorsal Cochlear Nucleus cells were more likely to produce action potentials in couplets. This rapid pattern of activity is more likely to be perceived as sound by other areas of the brain. (“milli” = 1/one thousand; 1/1000).

Paul G. Finlayson, Ph.D.


Medical treatments for tinnitus have historically been difficult to evaluate. This is due to the extremely complex nature of tinnitus, diversity of tinnitus causes and lack of understanding about underlying mechanisms. Limited measurement tools and the challenges in the lives of those who suffer from tinnitus contribute to evaluation difficulties. The American Tinnitus Association is co-funding a clinical trial of a medication called acamprosate (brand name, Campral®) at the Oregon Health & Science University (OHSU) in Portland, Ore. Acamprosate was developed to help recovering alcoholics abstain from drinking by modifying the balance between excitatory (when nerves activate other nerves) and inhibitory (when nerves prevent others from activating) chemicals produced by the brain. It is possible that an imbalance in the hearing centers of the brain (not related to alcoholism) may be one cause of tinnitus. A pilot study in Brazil suggested that acamprosate might be helpful for some types of tinnitus.1

Bringing Participants on Board

The three-year OHSU study began in January 2008 and has been a massive endeavor. So far we have processed over 2,000 contacts from tinnitus suffer-ers interested in being in the study. Of those, 596 individuals went through screening evaluations and 234 have met the very strict inclusion criteria to par-ticipate in the study. Most of those have enrolled in Phase I of the trial.

Phases I, II and III

Phase I is an open-label trial (both the researchers and participants know the identity of the treatment) during which all participants take acamprosate for six weeks. Those who respond positively to the medication may continue into an extended Phase II of the study. We release from the study those who did not have a positive response to the acamprosate in Phase I or asked to be released for other reasons, such as side effects, logistics or time constraints. During this second phase, everyone receives acam-prosate for part of the time and a placebo for part of the time, without knowing which they are taking at any given time. This experimental design is very important because it recognizes that no treatment should be expected to work for everyone with tinni-tus. It separates non-responders from potential true responders early in the study and allows us to focus resources and research efforts on those most likely

Clinical Trial of Acamprosate for Tinnitus William Hal Martin, Ph.D., and Yong-Bing Shi, M.D., Ph.D., Oregon Hearing Research Center, Oregon Health & Science University

to benefit from the treatment.

We are continuing to enroll participants in Phase I and hope to enroll about 300 people in all. We have begun Phase II as well. During Phase III of the study, we will look back at those who did and did not respond positively to acamprosate. (This can include a decrease in the per-ceived loudness of their tinnitus, or an improvement in their overall quality of life.) During this review process, we identify factors (tinnitus pitch, loudness, duration, other medical issues, etc.) about those groups that will help us predict who should or should not benefit from acamprosate treatment. We believe that this will help us understand the role of the brain in tinnitus and help us develop more effective treatments in the future.

Recognition for Innovative Design

The tinnitus research community recognizes this study for its importance on three levels. First, every-one is interested in knowing if medications like acamprosate can be helpful to those with tinnitus. Second, we are all interested in the role of the brain in tinnitus and this experiment allows us to change brain chemistry in a very interesting way. Finally, and perhaps most importantly, this is the first time anyone has applied this type of strict experimental design to studying interventions for tinnitus. The design may prove to be the standard by which the research com-munity evaluates all future medical therapies.

William Hal Martin, Ph.D., is Professor of Otolaryngology/Head and Neck Surgery and Professor of Public Health & Preventive Medicine at the Oregon Health & Science University in Portland, Ore. He directs four programs within the Oregon Hearing Research Center: the OHSU Tinnitus Clinic, Tinnitus Research Program, Intraoperative Neurophysiological Monitoring Services and Dangerous Decibels® Noise

Jennifer Petersen, Au.D., OHSU Senior Tinnitus Specialist, Yong-Bing Shi, M.D., Ph.D., and William H. Martin, Ph.D.



plasticity through overstimulation of sound can alter the response of these hippocampus place cells.

Tinnitus in Young Patients Up to 35 Years Old6

Poland, 2008

Tinnitus can occur even in the young. According to the work of Danuta Raj-Koziak, M.D., and her team in Poland, it is becoming more common in young people. They found that about 25% of patients registered in their tinnitus clinic are below the age of 35. Their study evaluated a group of 235 tinnitus patients ranging in age from 18 to 35 years old. There were no other pre-selection criteria except age. All participants answered questions concerning the cause of their tinnitus. Their findings indicate that the most frequent tinnitus triggers among patients below 35 years are infections (68.5%), noise exposure (27.7%) and stress (23.4%).

Tinnitus Treatment: Neurosurgical Management7 France, March 2009

Tinnitus management requires a multidisciplinary approach in which neuromodulation and neurosur-gery tend to play major roles. One classification of tinnitus is objective tinnitus (sounds in the ear that can be heard by someone besides the person with tinnitus). One form is pulsatile tinnitus, synchronous with one’s heartbeat. Radiological testing should search for a vascular abnormality as well as other neurological diseases (intracranial hypertension, Arnold-Chiari malformation, vascular loops, etc.). Asynchronous objective tinnitus generally corre-sponds to muscular contractions requiring specific management.

The other classification is subjective tinnitus

(perceived only by the patient), which

is more complex and strongly analogous with post-amputation pain syndromes. After peripheral middle ear or

inner ear damage, auditory deafferen-

tation (freeing of sen-sory nerve fibers) could

result in hyperactivity and/

or functional reorganization within central auditory and nonauditory structures of the brain. According to Alain Londero, M.D., and his colleagues, this could explain the persistence of tinnitus after sever-ing the 8th auditory nerve, and associated symptoms such as hyperacusis or anxiety and depression. This model finds strong support in animal experiments and in functional neuroimagery (PET, fMRI, MEG). Without etiologically-based therapies available, severe, subjective tinnitus management only targets tinnitus tolerance with sound enrichment or cognitive behavior therapy. Soon, better knowledge of tinnitus pathophysiology and innovative therapeutic tools could emerge from neuromodulation techniques, such as repeated transcranial magnetic or epidural electric stimulation.

Educational Counseling Used in Progressive Audiologic Tinnitus Management8

United States, January-March, 2009

Exposure to loud sounds commonly causes or exacerbates tinnitus. The National Center for Rehabilitative Auditory Research conducted clinical research, led by James A. Henry, Ph.D., which resulted in a clinical model of tinnitus management: Progressive Audiologic Tinnitus Management (PATM). It involves five levels of management: triage, audiologic evaluation, group education, tinnitus evaluation and individualized management. A key part of PATM is counseling by audiologists and, as needed, mental health providers. Rather than focusing on didactic, informational counseling, it facilitates patients’ learning to better adjust to the disturbing auditory realities of tinnitus. It employs tools from two powerful skills sets advantageous to the self-management of chronic tinnitus: the use of therapeutic sound and cognitive-behavioral psychology techniques.

1Cacace A. Tinnitus Research: Tales From a Grand Meeting at Grand Island, N.Y, Am J Audiol. 2008 Dec;17(2):107. 2 Tyler R, Coelho C, Tao P, Ji H, Noble W, Gehringer A, Gogel S. Identifying tinnitus sub-groups with cluster analysis, Am J Audiol. 2008 Dec;17(2):S176-84. 3 Khedr EM, Rothwell JC, Ahmed MA, El-Atar A. Effect of daily repetitive transcranial magnetic stimulation for treatment of tinnitus: comparison of different stimulus frequen-cies. JNNP. 2008;79:212-215.4Argstatter H, Crick C, Belay HV. Music therapy in chronic tonal tinnitus. Heidelberg model of evidence-based music therapy. HNO. 2008;56:678-685.5 Goble TJ, Møller AR, Thompson LT. Acute high-intensity sound exposure alters responses of place cells in Hippocampus. Hear Res. 2009 Mar 18. [Epub ahead of print]).

continued from page 13

Highlights: Selected 2008-2009 Tinnitus Research Studies


The following definitions will assist you in reading “Highlights: Selected Tinnitus Research Studies in 2008-2009” (beginning on page 12), which describes some of the notable tinnitus research results from around the world.

Audiogram: a graphic representation of the relation of vibration frequency that shows the softest sounds a person can hear at different pitches or frequencies.

Auditory deafferentation: elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers.

Basal measures: measurements of vital organism activities, such as heartbeat and respiration.

Bilateral tinnitus: affecting both the right and left ears.

Cross-sectional survey: a study in which a statistically signifi-cant sample of a population is used to estimate the relationship between the results of the study and the various characteristics of the population studied at a certain point in time.

Dorsal Cochlear Nucleus (DCN): a cortex-like structure on the dorso-lateral surface of the brainstem where auditory nerve fibers from the ear’s cochlea form their first synapses.

Epidural region: the outermost part of the spinal canal.

Epidural electric stimulation: treatment involving implanted electrodes in the epidural region of the body.

Etiology: the cause or causes of a disease or abnormal condition; a branch of medical science dealing with the causes and origins of diseases.

Hippocampus: an area deep in the forebrain that helps regulate emotion and memory.

Hippocampal pyramidal neurons: multipolar sensory neurons located in the hippocampus region of the brain.

Hyperacusis: over-sensitivity to some frequency ranges of sound.

Intracranial hypertension: a condition where the cerebrospinal fluid (CSF) inside the skull reaches elevated levels.

Multidisciplinary approach: composed of or combining several usually separate branches of learning or fields of expertise, specialized subjects or skills.

Neuroauditive cortex: the region of the brain responsible for processing auditory (sound) information.

Neuroauditive cortex reprogramming: a therapy utilizing sound to reduce the perception of tinnitus.

Neural plasticity: the ability of neural circuits to undergo changes in function or organization.

Neuroimagery: various techniques (PET, fMRI and MEG) used to either directly or indirectly image the structure and function of the brain.

Neurons: excitable cells in the nervous system that process and transmit information by electrochemical signaling.

Objective tinnitus: head or ear noises audible to other people as well as the patient.

Occipital: of, relating to or located within or near the occiput (back of the head) or the occipital bone.

Psychoacoustics: a branch of science dealing with subjective human perceptions of sounds.

Sham: a treatment, e.g., medication or procedure, used in a scientific study as a control, usually omitting some or all key therapeutic ele-ments of the treatment being studied; commonly called a “placebo.”

Somatic modulation: movement of the jaw, head or neck that causes the loudness and/or frequency of one’s tinnitus to fluctuate.

Somatosensory: of, relating to, or being sensory activity with an origin elsewhere than in the special sense organs, e.g., eyes and ears, and conveying information about the state of the body proper and its immediate exterior environment.

Subjective tinnitus: head or ear noises audible only to the sufferer.

Synaptic plasticity: the ability of the synapse (connection) between two neurons to change in strength.

Temporoparietal cortex: a region of the brain known to be involved in speech perception.

Tinnitus Handicap Inventory: a self-reported test utilized to assess a person’s tinnitus-related handicap and to report treatment outcomes.

Tonal tinnitus: a continuous sound with a well-defined frequency; heard as ringing, buzzing, chirping.

Vestibulocochlear nerve: a sensory nerve responsible for transmit-ting sound and equilibrium information from the inner ear to the brain; also known as the 8th nerve.

Tinnitus pathophysiology: the study of the changes of normal mechanical, physical and biochemical functions affected by tinnitus.

Highlights: Selected 2008-2009 Tinnitus Research Studies

6 Raj-Koziak D, Bartnik G, Skarzynski H, Pilka A, Fabijanska A, Borawska B., Tinnitus in young patients up to 35 years old. Otolaryngologia Polska. 2008;62:476-479.7 Londero A, Chays A. Tinnitus treatment: neurosurgical management. Neurochirurgie 2009 Apr;55(2):248-258. Epub 2009 Mar 20.

8 Henry JA, Zaugg TL, Myers PJ, Kendall CJ, Turbin MB. Principles and application of edu-cational counseling used in progressive audiologic tinnitus management. Noise Health. 2009 Jan-Mar;11(42):33-48.

Glossary of Research Terms


Questions and Answers

Notice: Please feel free to call Dr. Vernon any Friday, 9 a.m. to noon and 1 to 5 p.m. Pacific Time at (503) 494-2187 (please do not leave messages). You can also e-mail your questions to Nina Rogozen, Editor, at [email protected] or mail them to Tinnitus Today, American Tinnitus Association, P.O. Box 5, Portland, OR 97207-0005.

Jack A. Vernon, Ph.D.

Q My tinnitus (mild nonstop ringing in both ears) started in 1990 and was caused by extreme stress

and worry when I received some very bad news. My theory is that this stress released chemicals in my body, including in my brain. I would like to know if stress has caused tinnitus for any other readers.

A Stress causes the human body to release stress hormones, which stimulate its ability to escape

or conquer the stressful situation. They target specific organs of the body and generally have an immediate effect. Many parts of the body can be affected by stress.

The heart and cardio-vascular system are good exam-ples of places adversely affected by stress, such as heart attacks and high blood pressure. Individuals vary con-siderably in their psychological reactions to stress, which also depend on the origin of the stress and their ability to handle it. But one thing is pretty certain: all stress – physical, psychological, emotional or spiritual – results in physiological responses. It is difficult to say whether the stress was the primary cause of your tinnitus.

Q I sometimes experience a ticking sound in my right ear. Recently when this happened,

I simultaneously felt tightness and pulsing in the area from the underside of my chin toward my neck (right side). It was more noticeable when I was lying on my back. It lasted for a few weeks and is now gone. Have you ever heard of this and is it possible that there is a muscle, tendon or ligament that is pulsing with the ticking?

Regarding your temporary ticking sounds, these and similar types of mechanically-originating sounds are not uncommon. And tinnitus is often accompanied by a sensation of pressure. Sometimes a Eustachian tube dysfunction appears to cause the problem. Also, we now know that tinnitus in some people may change when they move their jaw or neck or press on the mus-cles of the head. Those clicking sounds that you heard, and the sensation of pressure, may have been caused by spastic behavior of the complex muscles of the head or neck. It is possible that they are indicative of some temporary abnormality of your temporomandibular joint on one side. If you experience such feelings again, you may be clenching your teeth, tightening your jaw or grinding your teeth while sleeping. If it becomes too

Q I am an ATA member and here is my ques-tion. In the history of medicine, has there

ever been a case where tinnitus has stopped, gone away and left the victim alone? If so, I figure that there is still hope; and since it happened to someone else, it could happen to me. If not, I will continue to live with it and hope they find a cure during my lifetime. That’s my question du jour. Thanks for your help.

A Yes, tinnitus can disappear on its own, but this is rare and we don’t know the conditions

that cause it to do so. Sometimes the disappearance seemed to be related to the use of masking. Other times it just spontaneously went away, however that is very uncommon.

You don’t have to wait around hoping for a sponta-neous disappearance. There are things you can do to help yourself, such as masking – using a variety of sounds to block the tinnitus, such as ambient noise, TV or radio, fountains. Some people find relief with Xanax® (alprazolam, an anti-anxiety drug) and some utilize methods of counseling that help them better manage their tinnitus.


annoying, your dentist could refer you to someone who can provide you with a temporary “fix” – a plastic insert to wear in your mouth at night that prevents teeth grinding.

Q I hear a lot of comments about a cure for tinnitus but I do not hear any comments

as to how such a cure might be found. In your opinion, is a cure a realistic possibility, and if so, how will it come about?

A Yes, I think a cure is possible, at least for certain kinds of tinnitus. As you well know,

as hearing declines, tinnitus increases; it’s something of a see-saw effect. Now given that dynamic, if we can improve hearing it is my guess that tinnitus will decrease.

How do we increase hearing? Hopefully we’ll do it with stem cells. We can harvest these versatile cells from the person’s own nasopharynx (uppermost part of the pharynx, extending from the base of the skull to the upper surface of the soft palate) so that there is no or little chance for rejection. In my opinion, work with stem cells has the possibility of enhancing recovery from all manner of health problems.

“Visiting your Houston clinic was the best thing I ever did.” – Lupe G.

“You gave me my life back.” – Allan W.

Migraine-Meniere-Tinnitus ClinicWe identify and treat the causes and triggers of tinnitus

Soraya Hoover, M.D., Medical DirectorAt the Migraine-Meniere-Tinnitus Clinic, we focus our diagnosis & treatment on the patient’s physiological, pathological and anatomical malfunctions of their nose, sinuses and Eustachian tubes. Treatment corrections aim to normalize

functions and equalize the nasal airway. This may take three to 10 days.

We accept most Medical insurance plans. Please call for more information.

Dr. Hoover is a Fellow of the American Academy of Otolaryngology, Board of Allergy & Environmental Medicine and Royal Society of Medicine, London, and a Diplomat of the Royal College of Surgeons of England. Dr. Hoover has served the Houston area for 25 years, spoken in over 26 countries and published in numerous medical journals, such as:– International Rhinology. Supplement 2.all.1987– Tinnitus & Allergy. Proc II International Tinnitus Seminar, Munster, Germany.

1987. Publisher, Harch V. Karlstruhe– The Journal of Japan Rhinologic Society. Vol 30,1(1991)

Shepherd Exit – 5151 Katy Freeway, Suite 300, Houston, TX 77002

Call (713) 626-4999 to make an appointmentwww.tinnitus-menieresclinic.com/index.htm

http://www.headache-migraineclinic.com

ATA does not endorse or recommend any tinnitus products or treatments.

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delicate cilia (ear hair cells) leading to SNHL, tinnitus and hyperacusis.

Treatment for REKS has not yet been successful, but prevention is a must. A light kiss to a child’s ear produces a surprisingly rapid and intense ear canal vacuum.5 An infant cannot say, “Mommy, I can’t hear now.” Let us avoid preventable tragedies like this. Kiss, and kiss away, but please avoid that ear canal.

Dr. Levi A. Reiter is Professor of Audiology and the audiology program head at Hofstra University’s Department of Speech-Language-Hearing Sciences. He teaches courses in diagnostic audiology, anato-my and physiology, psychoacoustics, deafness and electrophysiology. He is also on the faculty of the Long Island Audiology Consortium and maintains an active audiology practice in Brooklyn, N.Y. The grandfather of 20 is a published rapper and enjoys promoting the audiology profession with songs like, “Say Whut?”

1Reiter, L.A. The kiss of deaf. The Hearing Journal. 2008 Aug;61(8):32-37.2Reiter, L.A. Pathologic sequelae of ear-kissing. Abstracts of the Meeting of the Association for Research in Otolaryngology. 2009 Feb;604.3Reiter, 2008.4Smaka, C. The kiss that caused hearing loss, or Reiter’s Ear-Kiss Syndrome (REKS). Audiologyonline. 2008 July 28.5Reiter, 2009.

Can a Simple Kiss on the Ear Cause Auditory Problems?continued from page 11

Clinical Trial of Acamprosate for Tinnituscontinued from page 21

Induced Hearing Loss and Tinnitus Prevention Program. Martin also serves as the Research Scientist in Residence at the Oregon Museum of Science and Industry (OMSI) in Portland.

Yong-Bing Shi, M.D., Ph.D., is Assistant Professor of Otolaryngology/Head and Neck Surgery at the Oregon Health & Science University. He examines and treats patients with tinnitus and hearing problems, as well as voice and swallowing disorders. He also serves as the medical director of the OHSU Tinnitus Clinic and the Northwest Center for Voice and Swallowing. In addition, Shi monitors brain, nerve and spinal cord function during surgical procedures in which those structures may be injured by the procedure.1 http://www.ncbi.nlm.nih.gov/pubmed/15000513.


Corporate Champions $5,000+

AEG is a comprehensive business solution company that provides information technology (IT) services to companies and organiza-tions throughout the U.S.

Leadership Donors $100,000+Marianna Dennis

Sustaining Donors $1,000 to 4,999Anonymous (2)Dennis W. AndersonBryan Richard AubieSandra E. BaanJoseph F. and Frances A. Bachman, M.D.John R. BatesAnthony T. Cacace, Ph.D.Stephen and Jennifer Sue Chandler of the Scottsdale FoundationNeil Cherian, M.D.Roland D. DeCastroJeffrey A. FerenzForeningen LydhoerRonald K. and Donna Mae GrangerRichard E. Haney, Ph.D.John Horst, Famous Tate Electric CompanyJim and Angela HsuWilliam H. HurtMrs. Leonard E. JohnsMark K. Johnson, J.D.Arthur F. Kuckes and Martha A. Wright Fund of the Tompkins Charitable Gift FundJohn MalcolmRobert B. MaloneyBruce F. MartinSteve Martin Charitable FoundationMary B. Meikle, Ph.D.MicrosoftGary P. Reul, Ed.D.Stephen M. Schwarcz, D.D.S. and Wendy J. McPhersonJerry ShannonJack A. Vernon Ph.D. and Mary B. Meikle, Ph.D.John L. Zabriskie and Adelaide W. Zabriskie Fund

Special Donors and TributesThank you to all of our donors. Your generosity and commitment make possible ATA’s continuing effort to support innovative tinnitus research – investigations that are searching for improved tinnitus treatments, and eventually a cure. We greatly appreciate each and every ATA member. Without you, there would not be an American Tinnitus Association.

We’d like to provide you with even more information on tinnitus on the pages of Tinnitus Today. Therefore, beginning with this issue, Supporting Donors ($100-499) will now be displayed on ATA’s Web site and can be viewed at

www.ata.org/get-involved/donor-recognition. We will be recognizing all $100+ donors in the April issues of Tinnitus Today for the previous calendar year.

All contributions to the American Tinnitus Association are tax-deductible to the extent provided by law. For more information about giving to ATA, please contact Katie Fuller at (800) 634-8978 x220 or [email protected].

The gifts listed below include those from January 1, 2009 through June 30, 2009.

Distinctive groups of individuals and organizationsATA is proud to have the following individuals and organizations support our research efforts and our crucial involvement in the tinnitus community. They include members of the Jack Vernon Legacy Society, those who have generously included ATA in their

planned giving; our Corporate Membership Program; and Professional Membership Program. The lists below include memberships through June 30, 2009.

Corporate Membership Program

Anonymous (1)Virginia BlackmanJohn U. Buchman, M.D.Carl L. CochraneSimon CouvierJules H. DruckerJoy A. FogartyDrs. Norman and Gilda Greenberg

D. G. GumpertzMarcene M. HerronGinger L. HoilandBen L. JonesHarold M. Kahn, Jr.Cliff KohlerVirginia L. LippMarita Maxey

Mary B. Meikle, Ph.D.Ruth E. OchsEdward P. RosenbergJames W. SoudrietteNeil ValentinoDelmer D. and Wanda Weisz

Jack Vernon Legacy SocietyATA offers a special thanks to our Founding Members, (names bolded below) who joined by June 30, 2008, and helped ATA successfully launch this great program. As of June 30, 2009, our Professional Membership Program includes:

Research ChampionsDhyan Cassie, Au.D., F/AAAAli A. Danesh, Ph.D.Mary B. Meikle, Ph.D.Stephen P. Ratner, BC-HIS Michael J. A. Robb, M.D. Paula Schwartz, Au.D.

Professional MembersDassan Ali, Sc.D., CCC-AMarcia L. Anderson, Au.D., FAAAMarty Ann Apa Au.D.Janie P. Barnett, Au.D.Kathleen Bartels, CCC-A/SLPRandall Bartlett, M.A.Linda BeachDenise Bickley, M.A., Au.D.Gail B. Brenner, Au.D., CCC-AFrank CardarelliMax S. Chartrand, Ph.D.Alissa Claar, Au.D.Laurie Drake, Au.D.

Professional Membership ProgramTimothy L. Drake, BC-HISMichel Eybalin, Ph.D.Melodi B. Fehl, Au.D.Flash Gordon, M.D.Mark Gulliver MSc, Au.D.(C)James A. Henry, Ph.D.Sharon T. Hepfner, MA, FAAAMelanie Herzfeld, Au.D.Michael L. Hill, Au.D.Maria Holdren, M.S.Soraya Hoover, M.D., P.A.Jacquelyn C. Jackson, Au.D.Victor Jovan, BC-HISTae Yoo KimGregory D. King, Au.D., CCC-AMartin H. Kulick, D.M.D.John Kveton, M.D.Deborah R. Lain, B.A., MSc.Gail H. Leslie, Au.D.Malvina C. Levy, Au.D. Paula Liebeskind, M.S., CCC-AJoyce LimThomas J. Lobl, Ph.D.Michael Mallahan, Au.D.Randa Mansour-Shousher, Au.D.Maura G. Marks, Ph.D., Au.D, CCC-A/SLPSara Mattson, Au.D.

David L. Mehlum, M.D.Jill B. Meltzer, Au.D.Karen Mercer, M.A., FAAACarl M. Nechtman, M.D., P.C.Alfred L. Nuttall, Ph.D.Phil Pack, M.S.Meredith K. L. Pang, M.D.Debbie Papadakis, M.Ht., BCH, C.I.Treva Paparella Margaret F. Peak, Ph.D.Stephen R. PlumleeJean-Luc Puel, Ph.D.Donald E. Regan, Ph.D.Burke RichmondTerry L. Roberts, Au.D.Allen W. Rohe, Au.D., FAAASharon Rophie, Au.D.Roger A. Ruth, Ph.D.Gabrielle Sadowsky, CCC-AKatharine Sorenson, Au.D.Edward Szumowski, Au.D.Deborah L. Taylor, BC-HISWayne Tipps, D.D.S.University of Buffalo, Speech-Language & Hearing ClinicErin Walborn, Au.D.Kim S. Worona, M.S.N., RN

Contributing Donors $500-999Patricia M. AtwoodArvest BankRod BarronRoberta M. BartikGary A. BleibergMarcia Powell Chapman, MSWJames O. Chinnis Jr., Ph.D.Clear Products, Inc.Anthony G. A. CorreaFrederick R. Entwistle, M.D.Flexion Therapeutics, Inc.Mark L. GoldbergJohn R. Grayson FundHearing Loss Association of AmericaDavid Michael KeeterJodi KleinRichard and Eva KleinRobert K. MauerMichael J. A. Robb, M.D.Thomas SylvestTom J. WalenDelmer D. and Wanda WeiszPatricia H. WestheimerRaymond V. WojtusiakJ. Richard Yourtee

TRIBUTESIN MEMORY OF:Grant Acker Henry Tobin, Ph.D.Nancy Anderson John and Faye SchleterPamela Armstrong Adella BratsosTerry Asbury Jack AsburyBear Marco T. Carpio, M.D. and Linda E. Carpio, LCSW


Joyce A. Berger L. Ralph BergerSandra Bloom John J. and Ann F. HenryRobert Branigan August E. FirgauCurtis H. Carlson Stephen C. CarlsonBert Cooper David S. and Nola RothschildTheodore J.G. Cotter C.M GucwaJoseph DeAngelo Rose DeAngeloCharles Goldstein Diane SchwabEdward Goodman Stuart J. and Marcy L. FeldmanTrudy Gottfried Barsh Hearing Aid CenterJohn Greve Catherine GreveDorothy Guttenberg Stuart J. and Marcy L. FeldmanHerbert Hand Donna Cronister Naena Grissett Nancy Huffman Florence Mugnolo Monte Nienkerk Dr. and Mrs. Ron Rainosek Steve WernerLeonard E. Johns Mrs. Leonard E. JohnsJames Ihasz Michael BellizziBob Johnson Wayne OlsenEdward J. Keels Edward W. KeelsMargie Keeter David Michael KeeterStephen Klincik Karen K. AdamsNellie Koslosky Richard Koslosky

Lettie Mannaway Alexander M. and Doris FriedmanRuby L. Masters Abbas Emami, M.D.David Loew Lisa WilsonJames McLeod Michael DoroshIrene Nelson Marco T. Carpio, M.D. and Linda E. Carpio, LCSWKarol C. Neiderfringer Alan Niederfinger Pennrose and Sallyann R. WolfAlan Nickerson Stephen and Deborah CohenRaymond Pantano Greg and Jacquie Amiriantz Linda Beach William A. Fiordimondo Ellen PantanoWilliam Patterson Shreve High School Class of 1951Leonore Mary Petito Rosemary C. PetitoSteve Rodgers Scott A. WilhelmJonathan Rushing David N. and Mary Edna RushingElizabeth V. Saunders James C. Saunders, Ph.D.George Sciarrotta, Sr. Thomas SciarrottaTheresa Senner Janice KirklandWanda Mae Shannon Jerry ShannonMerchant D. Slocum Elizabeth HoldenGert and Harold Soll Paul SollDana Lynn Spath Patricia SpathCharles Tecklenburg Morgan Keegan & Company, Inc. Daniel J. Jr. and Melissa A. Nordman

Gerald N. and Patricia A. Padawer Terry J. and Kim T. SchottPaul E. Valentino Stephen Gulyas

IN HONOR OF:Nick Andrews Kathi HolbrookJohn Bates Robin BallengerChet Carey Mr. and Mrs. Geoffrey CareyPatrick Collins James CollinsJohn DeAtley Chris H. Hansen, CFP and John M. Britton of Personal Choice Financial AdvisorsBarth Engelman Marge EnglemanLisa Freeman Joan TibbettsCraig Horn Jo WilliamsJohn Johnson Ellen J. SharpRose Kaput Stephen GulyasRichard H. Keeter David Michael KeeterJung Liu Anchi MillerDavid Loew Lisa WilsonLois Lynch Isaac Lynch, Jr.Thomas Mathews Carrol G. MathewsDonald Mitchell, Jr. Donald Mitchell, Sr.Peny Nading Elaine DavisEdith Perschall Janice M. StanleyDave Peters David W. Peters

Mari Quigley-Miller Jonna DeBlasioThe Ross Family Heidi RossJames Roth Barbara R. RothFaye and John Schleter Sandra SchleterCharles Shaw K. SternJoseph Smith David and Gail CohenTinnitus sufferers Janie P. Barnett, Au.D.Tinnitus victims of war Richard and Louise E. LaRosaKaty Thatch Donna BrownBrooklyn Marie Thomas Jack A. Vernon, Ph.D. and Mary B. Meikle, Ph.D.Peter J. Van Loon Greg SorterJack A. Vernon, Ph.D. James L. and Gail M. ShinnJack A. Vernon, Ph.D. and Mary B. Meikle, Ph.D. Richard J. Salvi, Ph.D.Daniel Williams Alberta F. WilliamsRobert Williams Derwin and Charlotte WilliamsSallyann Wolf Alan C. Niederfringer

Matching CorpsAllstateChicago Tribune FoundationGap, Inc.GE FoundationIllinois Tool Works FoundationLorton Data, Inc.MicrosoftOraclePortland General Electric Co.Symetra Financial

Corporate Visionaries $1,000 to 4,999

Corporate Leaders $500 to 999Clear Products, Inc. Cooper Mountain Wines Flexion Therapeutics, Inc. Free-credit-reports.com, Inc. Paddy’s Bar & Grill

Corporate Members $250 to 499A1 Retrofit LLC Amplisound Bizon Nursery Elliot Law Offices James Robert Construction, LLC Lagunitas Beer NeuroSystec Corporation Pacific Marketing and Publishing Trademark Landscapes, Inc.

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