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TINNITUSTODAY
To Promote Relief, Help Prevent, and Find Cures for Tinnitus Vol. 46, No. 1, Spring 2021
Key Interventions
to Improve Quality
of Life
How Is Tinnitus
Measured?
YEARS
Don’t Wait to Get
Help
2
Declawing the
1
Tinnitus Paper Tiger
0
19 71 – 2
A publication of the
Visit & Learn More About Tinnitus at ATA.org
The ATA thrives through
the dedication of a vast number
of people who make a difference every day.
Join the Jack Vernon Legacy Society
Jack Vernon cofounded the ATA in 1971 to lead the way in researching a cure, developing
effective treatments, and creating broad-based support and awareness of tinnitus.
The ATA invites individuals and organizations to join our journey. How can you contribute?
M
onthly or annual financial Gifts of stock
contributions Gifts of real estate
Name ATA in your trust or estate Deferred gift annuities
A
sk ATA to create a Tribute Page in D
onations to ATA in lieu of flowers in
memory of a loved one memory of a loved one
C
onvert stock and/or real estate into
a unitrust
We hope you’ll be a part of the legacy of securing relief from tinnitus through a
variety of treatments and cures for the millions of people bothered by it.
For more information about adding the ATA as a beneficiary or ways to reduce
your taxes through charitable contributions, please contact Torryn Brazell, ATA’s
Chief Executive Officer, via email at tinnitus@ata.org.
Table of Contents Vol. 46, No. 1, Spring 2021
PERSONAL STORIES
22|
SPECIAL FEATURES hile Searching
W
|
for Tinnitus Cures,
16 Can Trigger
How Trauma
10 |
Considering Tinnitus Interventions Aimed at
Management Versus Management Matter Tinnitus
Cure
26| Progressive |
What Are
38 on Wall
Tense Week
Tinnitus Street
Management Triggered
(PTM) and Tinnitus
Tele-PTM?
|
32 Tinnitus Paper Tiger
Declawing the
12 | After
Still Have Tinnitus
48 Hours? It’s
Better to Get Help
Sooner Than Later |
36 Trigger?
Is Stress a Tinnitus
SCIENCE & RESEARCH NEWS
ATA NEWS |
20 Measuring Tinnitus
A Step Forward in
TINNITUS TOOLS & RESOURCES Objectively in the
04 | 1971–2021
ATA Turns 50 — Brain?
11 | Sound Machines
Useful Apps and
|
06 Vernon,
Remembering Jack
30 | Utilizing
PhD, an Tinnitus Q & A:
ATA Founder Telehealth
and Leading and Self-Help
Tinnitus Strategies
Researcher
|
43 Apps to
Meditation
09| 29 | Health
The ATA Seeks Diagnosing Mental
Innovative Tinnitus Reduce Stress Symptoms
Research Proposals in Veterans With
|
Tinnitus
44 Group Listings
Tinnitus Support
17|
Does Loud Noise
Influence Your Social
Life? |
34 Loss and
How Hearing
Tinnitus
Affect Gray
Matter
41 | Stress
Measuring How
Impacts
47 | Providers
Spotlight on Patient Tinnitus: What
a Review of 50
Studies Shows
FROM THE BOARD CHAIR
ATA Marks 50 Years
MANAGING EDITOR
Joy Onozuka
American Tinnitus Association
As the American Tinnitus Association commemorates PUBLISHER
Torryn P. Brazell, CAE
its 50th year, it’s worth looking back at a few noteworthy
American Tinnitus Association
scientific feats during that time span.
PODCAST PRODUCER AND WRITER
• In 1978, we had the first “test tube baby.” John A. Coverstone, AuD
• In 1986, high-temperature superconductivity was Sentient Healthcare, Inc.
unveiled.
EDITOR-AT-LARGE
• In 1996, Dolly the sheep was cloned. James A. Henry, PhD
• In 2001, the first draft of the Human Genome Project National Center for Rehabilitative Auditory
was published. Research (NCRAR)
U.S. Department of Veterans Affairs
• In 2019, the first-ever image of a black hole was
captured. EDITORIAL ADVISORY PANEL
Marc Fagelson, PhD
In 2021, mRNA (messenger RNA) vaccines will hopefully East Tennessee State University
Jill Meltzer, AuD Johnson City, TN USA
put the coronavirus pandemic to rest. Yes, scientific
Chair, Board of Directors
progress has been astounding, but we don’t yet have a Gail M. Whitelaw, PhD
Department of Speech and Hearing Science
cure for tinnitus. I suspect the ATA’s founders, Jack Vernon, The Ohio State University
PhD, and Charles Unice, MD, probably wouldn’t have imagined that tinnitus cures
would be so elusive. And what research has shown us is — unlike other sensory DIGITAL DESIGN & PRODUCTION TEAM
JML Design, LLC
organs — the auditory system is extraordinarily complicated, confounding
scientists across the globe who are trying to cure tinnitus, hearing loss, and ADVERTISING
hearing damage. Tinnitus Today is the official publication of the
American Tinnitus Association. It is published
It is noteworthy how far we’ve come since 1971, when the American Tinnitus three times per year in April, August, and
Association was founded. The initial collaboration between Jack Vernon, the only December and mailed to members and
tinnitus researcher in the United States at the time, and Charles Unice, who donors. The digital version is available online
at www.ata.org. To grow your company’s
sought Jack’s help for severe tinnitus, gave birth to the world’s first nonprofit
brand reach, contact tinnitus@ata.org.
dedicated to tinnitus patients as well as the first tinnitus treatment: sound
masking. ATA HEADQUARTERS
American Tinnitus Association
Further progress in scientific understanding of tinnitus and treatments has
8300 Boone Blvd, Suite 500
been achieved through ATA research grants, which have largely been seed Vienna, VA 22182 USA
grants aimed at obtaining critical data needed to seek larger funding from much T: 800.634.8978 (Toll Free)
bigger funding agencies such as the National Institutes of Health. Many of our www.ata.org
early grants were awarded to researchers who are today’s leaders in the field. TO GIVE TO THE ATA
Our hope rests with them. American Tinnitus Association
Progress in patient care, another part of our core mission, continues to c/o SunTrust Bank
PO Box 424049
advance. Research shows that Tinnitus Retraining Therapy, cognitive behavioral
Washington, DC 20042-4049
therapy, Progressive Tinnitus Management, and Tinnitus Activities Treatment all
help to mitigate the distress of living with tinnitus. They are not perfect and they The American Tinnitus Association is a non-
profit corporation, tax-exempt under 501(c) (3)
do not work for everyone, but such treatments are improving the quality of lives
of the Internal Revenue Code, engaged in
of millions. Until we have cures, the ATA will continue to fund research, help educational, charitable, and scientific activities.
tinnitus patients, and increase awareness of the dire need to quiet tinnitus. Tinnitus Today magazine is © copyrighted by
the American Tinnitus Association.
2 TINNITUS TODAY SPRING 2021
FROM THE PUBLISHER
Effective Management
ATA BOARD OF DIRECTORS
Jill Meltzer, AuD, Chicago, IL—Chair
Doesn’t Lessen the
John Minnebo, MBA, Philadelphia, PA—Vice Chair
David Hadley, MBA, San Francisco—Treasurer
Urgency of Finding Cures
Ron Zagel, Grand Rapids, MI—Assistant Treasurer
LaGuinn P. Sherlock, AuD, Bethesda, MD—
Immediate Past Chair
Shahrzad Cohen, AuD, CH-TM Over the course of half a century, the ATA’s tinnitus
Sherman Oaks, CA
community has grown from a handful of researchers,
Stelios Dokianakis, AuD, CH-TM, Holland, MI
patients, and clinicians to thousands of people determined
Phillip Gander, PhD, Iowa City, IA
to find cures for tinnitus. And with millions of people living
Michael E. Hoffer, MD, FACS, Miami, FL
with tinnitus today — bothered by it or not — cures have
Gordon Mountford, CPA, South Pasadena, CA
never been more important. Toward that end, the ATA is
Robert Travis Scott, Baton Rouge, LA
Robert M. Traynor, EdD, MBA, CH-TM,
investing $298,000 in new seed grants for tinnitus research
Ft. Collins, CO to ensure that innovative science continues to be funded.
Joseph Trevisani, New York, NY Strangely, with the advent of evidence-based
Ted Turesky, PhD, Boston, MA management strategies that lessen the burden of living
Melissa Wikoff, AuD, CH-TM, Atlanta, GA with tinnitus, we’ve seen an evolution of concerns among
Torryn P. Brazell, CAE
Jinsheng Zhang, PhD, Detroit, MI some people with tinnitus that needlessly divides us.
Publisher
Torryn P. Brazell, Vienna, VA—CEO The rationale is grounded in the thought that habituation,
HONORARY DIRECTOR tools for self-management, and treatments will translate
William Shatner, Los Angeles, CA into fewer dollars being invested in research. “If you can
‘live with it,’ then no one will want to cure it!” is how one
ATA SCIENTIFIC ADVISORY COMMITTEE The opinions expressed by
Michael E. Hoffer, MD, FACS—Chair person put it to me. contributors to Tinnitus Today
University of Miami Health System It pained me to hear that because I know that’s not are not necessarily those of
Miami, FL USA true. Indeed, the reason we have evidence-based tools the publisher or the American
Carey D. Balaban, PhD Tinnitus Association. This
for managing tinnitus is because researchers know how
University of Pittsburgh, Pittsburgh, PA USA publication provides a variety
difficult tinnitus is for millions of people and are hence of topics related to tinnitus for
Shaowen Bao, PhD
University of Arizona, Tucson, AZ USA deeply motivated to find cures and treatments. For its informational purposes only.
Christopher R. Cederroth, PhD part, the ATA offers daily support to people struggling with
University of Nottingham, United Kingdom tinnitus by providing professional guidance on tinnitus
Marc Fagelson, PhD management and direction on accessing meaningful care
East Tennessee State University because tools exist and, without them, people are left
Johnson City, TN USA
struggling on their own, which is unacceptable.
Fatima T. Husain, PhD
University of Illinois, Urbana-Champaign We can beat tinnitus by supporting one another; we
Champaign, IL USA cannot do it alone. Researchers need funding. People with
Mark S. Mennemeier, PhD tinnitus need meaningful help. Healthcare providers need
University of Arkansas, Little Rock, AR USA effective tools to help patients restore their quality of life.
Maria Rubio, PhD, MD ATA’s publication of any
And the ATA needs your financial support to keep operating.
University of Pittsburgh, Pittsburgh, PA USA advertisement in any kind
It’s also important to recognize the group we seldom talk
Tricia Scaglione, AuD of media does not, in any
University of Miami, Plantation, FL USA about in the tinnitus community: the people not bothered way or manner, constitute
Roland Schaette, PhD by tinnitus. This group, which represents 80 percent of or imply ATA’s approval
UCL Ear Institute, London, England people with tinnitus, would certainly rejoice at being able or endorsement of any
advertised product or
Grant D. Searchfield, PhD to safely eliminate tinnitus from their lives. So, let’s stand service. ATA does not favor
University of Auckland, Auckland, New Zealand
united in funding research and supporting each other so no or endorse any commercial
Jeremy G. Turner, PhD
one is left battling tinnitus alone and unrecognized. product or service.
Illinois College, Jacksonville, IL USA
Richard Tyler, PhD
University of Iowa, Iowa City, IA USA
Fan-Gang Zeng, PhD
University of California, Irvine
Irvine, CA USA
TINNITUS TODAY SPRING 2021 3
ATA NEWS
AT A T U R N S
At the time, Jack was the director
of the Kresge Hearing Research
Laboratory, which he had helped
1971 2021 found with Dr. David DeWeese,
chairman of the Department of
Otolaryngology at Oregon Health
& Science University (OHSU), who
had recruited Jack from Princeton
By Torryn P. Brazell, CAE University in 1966. Together with Dr.
ATA chief executive officer Robert Brumett, also employed by
OHSU’s otolaryngology department,
This year the ATA marks its 50th It all began when Charles they designed and built the Kresge
year as the only organization in the Unice, MD, who had unrelenting Hearing Research Laboratory, which
United States dedicated exclusively bothersome tinnitus, founded the ATA later became the Oregon Hearing
to tinnitus patients, advocacy, and in 1971 to bring greater awareness Research Center, and today is one
research. This issue of Tinnitus to the condition. When he contacted of the largest and most prominent
Today is the first of three that will the National Institutes of Health hearing centers in the world.
highlight significant milestones in to ask about tinnitus research, he As directory of the lab, Jack
the ATA’s history, beginning with the was told that Jack, as he liked to be insisted that research be directed at
extraordinary contributions of its most called, was the only researcher in the solving critical clinical problems, which
prominent founder, Jack Vernon, PhD. country investigating the condition.
Significant ATA Milestones
Jack launches the ATA Newsletter to
provide research updates and ask the
Tormented by tinnitus, Charles Dr. Unice goes to Portland to meet estimated
Unice, MD, founds the Jack Vernon, PhD, the only researcher 95 members
American Tinnitus Association in the U.S. studying tinnitus. He asks for more
in California to raise Vernon, director of the Kresge Hearing information
awareness of the condition. Research Laboratory, to lead the ATA in about their
The ATA has 25 members. the effort to advance tinnitus research. tinnitus.
1971 1973 1975
The ATA awards its first tinnitus research
The ATA coordinates Parade magazine Gloria Reich, PhD, grant to Mary Meikle, PhD, to
nationwide educational publishes an article is appointed ATA’s create the first-ever tinnitus
workshops on tinnitus, working about tinnitus and the first executive patient registry. The project, which
with more than 1,200 hearing ATA, resulting in more director, a position serves as a tool for researchers,
healthcare professionals to than 20,000 letters to she holds until later receives funding from the
improve patient care. the ATA asking for help. June 1999. National Institutes of Health.
1977 1979 1980 1980
4 TINNITUS TODAY SPRING 2021 www.ATA.org
ATA NEWS
included tinnitus, a condition that lit up in his brain: the idea for tinnitus the gentle noise of a fountain. Today,
came to Jack’s attention through the masking. tinnitus masking remains a central
otolaryngology department’s weekly Jack went on to work with three management tool.
rounds with patients. Jack began hearing aid manufacturers to develop After that meeting, Jack went on
conducting tinnitus research with wearable devices, similar to hearing to establish the world’s first Tinnitus
Rhesus monkeys that he had trained aids, that played pleasant sound like Clinic within the otolaryngology
to signal when they heard ringing. department of OHSU. In 1973, Dr.
Dr. Unice contacted Jack, hoping Unice handed over the reins of the
that he could help him. Jack insisted it ATA to Jack. It was an auspicious
was too early in his research to help, start in the ATA’s mission to provide
but Dr. Unice came from California to meaningful clinical care to people
Portland to meet him anyway. After a bothered by tinnitus and encourage
brown-bag lunch sitting next to one of innovation in a research field that was
Portland’s many remarkable fountains, just getting off the ground.
Jack noticed Dr. Unice lingering. Jack Both Jack and Dr. Unice are proof
asked if he was okay, upon which Dr. that individuals can change the
Unice exclaimed, “Standing here, “Standing here, I can’t world through vision, persistence,
I can’t hear my tinnitus!” At that
moment, Jack later said, a lightbulb
hear my tinnitus!” compassion, unwavering leadership,
and, of course, the help of others.
Gloria Reich becomes The ATA
Noting ATA activities showing ATA’s first full-time establishes
urgent patient demand, Jack volunteer, spearheading an Advisory
is given the go-ahead by the major initiatives, including Board, including
University of Oregon Health and the 1979 incorporation medical doctors,
Science University, which oversees of the ATA as a 501(c)(3) a tinnitus
his laboratory, to open the Tinnitus nonprofit registered in patient, and two
Clinic, the first in the U.S. Portland, OR. politicians.
1976 1976 1976
The ATA establishes a nationwide Ann Landers publishes a column with comments ATA Newsletter
support group network, helping from Gloria Reich about tinnitus and its management, becomes Tinnitus Today
patients to connect and learn resulting in well over 100,000 letters to the ATA. The magazine, the only
from shared experience. calls for help, including countless donations, solidified publication dedicated to
the ATA’s position as the leading advocate for patients the topic of tinnitus and
in the U.S. and the need for more research. people bothered by it.
1982 1986 1988
www.ATA.org TINNITUS TODAY SPRING 2021 5
ATA NEWS
Remembering Jack Vernon, PhD,
an ATA Founder and Leading
Tinnitus Researcher
By James A. Henry, PhD Health & Science University (OHSU).
That program was ideal because my
As the American Tinnitus Association “training lab” would be the Oregon
marks its 50th anniversary, it’s an Hearing Research Center (OHRC),
honor for me to have this opportunity which was directed by Dr. Jack Vernon.
to describe the role of Jack Vernon, Dr. Vernon also directed the Oregon
PhD, in shaping my career and Tinnitus Clinic, which was housed in
some of the many things that he the same building as the OHRC. My
accomplished in his very rich life, which research advisor was Dr. Mary Meikle,
was dedicated to improving the lives who happened to be Dr. Vernon’s
of tinnitus patients and advancing the wife. For the next six years I worked
field of tinnitus research. half-time at the VA while a full-time
After receiving my Master of student in the OHSU program. I was
Science (MS) degree in audiology, in the OHRC lab almost every day and
I began working at the VA hospital interacted continually with Drs. Vernon
in Portland, Oregon, as a research and Meikle and the rest of the staff
audiologist. That job sparked my there. The ATA was 17 years old at the
interest in auditory research, which time I joined their lab in 1988.
led me to pursue a doctorate The Oregon Tinnitus Clinic came
(PhD). I enrolled in the Behavioral into existence in 1976 and was the
Neuroscience program at Oregon first clinic in the world that was
Significant ATA Milestones
William Shatner, a powerful patient
Public Law 100-533 voice, joins the ATA as an honorary The ATA develops Road
authorizes the creation director. He testifies before Map to a Cure, an innovative
of the National Institute The ATA hosts the “Fifth International Congress with Gloria Reich on guide that identifies what
on Deafness and Other Tinnitus Seminar,” in Portland, OR. the importance of funding tinnitus is known about tinnitus and
Communication Disorders Scientists from 25 countries attend research. https://www.youtube. what information is needed
(NIDCD). and present papers. com/watch?v=E7bL9BhESYA to advance cures.
1988 1995 1995 2005
6 TINNITUS TODAY SPRING 2021 www.ATA.org
ATA NEWS completely dedicated to tinnitus care. based on their clinical data (www. Patients came to the clinic from all tinnitusarchive.org). Dr. Vernon retired over the world. In many cases, they in 1995, but he remained active for had gone from doctor to doctor, many more years by making himself and from clinic to clinic, without available every Friday to counsel people finding any relief for their tinnitus. who telephoned the Oregon Tinnitus They were often desperate. When Clinic from all over the world about they entered the door of the Oregon their tinnitus. He offered this service Tinnitus Clinic, they were greeted by free of charge. staff who cared deeply for their well- Dr. Vernon pioneered the method being and were very competent in of tinnitus masking. He was fond of providing assessment and intervention telling the story of what gave him for bothersome tinnitus. Patients the idea for tinnitus masking. Charles underwent audiometric testing for their Unice, MD, had come to see him hearing and tinnitus and completed in the clinic, and they ended up in extensive questionnaires that captured downtown Portland near a large water relevant information, including tinnitus fountain. Dr. Unice kept standing by history, hearing history, and medical the fountain and exclaiming how good history. Multiple staff worked with he felt because he could only hear the the patients, who usually ended water and not his tinnitus. Dr. Vernon up being counseled by Dr. Vernon. began thinking about how to create a Anyone who knew Dr. Vernon knows device that could be worn on the ears what a winsome, friendly, and and accomplish the same effect. The compelling personality he had. He “tinnitus masker” was born, which was the quintessential counselor for looked like a hearing aid but delivered these patients, and they absolutely broadband noise (sounds like shhhh) loved him. It seems likely that much directly to the ears. Dr. Vernon would of the clinic’s success was due to work with patients to adjust the Dr. Vernon’s extraordinary “bedside noise to a level at which the tinnitus manner.” Thousands of patients came could not be heard. At that point, the to that clinic, and a rich database exists tinnitus was completely “masked” Jack Vernon launches The ATA’s Jack Vernon, PhD, a research campaign Tinnitus becomes the leading ATA member and tinnitus historical passes away, leaving offering his hand-carved service-connected patient, Donna Brown aggregate an extraordinary totems to donors who disability for veterans, reaches the summit of Mt. funding of legacy and sense contribute $1,000 or with hearing loss Rainer, Washington, raising tinnitus research of tremendous loss more. The campaign being the second more than $300,000 for exceeds $5 within the ATA and the raises $30,000. leading disability. tinnitus research. million. tinnitus community. 2006 2007 2007 2010 2010 www.ATA.org TINNITUS TODAY SPRING 2021 7
ATA NEWS
and that was the purpose of therapy known about tinnitus and very few
with tinnitus masking. Dr. Vernon also professionals were involved in this
was responsible for the development field. Dr. Vernon influenced countless
of “combination instruments,” tinnitus researchers and clinicians,
which combined hearing aids with and he was the source of tremendous
broadband noise. help for thousands of people suffering
It didn’t take long for patients to from tinnitus-caused distress. It was
notice that their tinnitus did not have a great privilege to be his student,
to be completely masked by the friend, and colleague for so many
noise but could be partially masked years. He was an outstanding
and still accomplish a sense of relief James A. Henry, PhD, and Jack Vernon, PhD. individual who did so much for so
from the tinnitus. From that point on, many people, both professionally and
the tinnitus. The method could be
Dr. Vernon’s approach was to instruct in his personal life.
more aptly named “sound-based
patients to turn the level of the noise
tinnitus relief.” The method can
up just to the point of achieving relief
further be applied to refer to any
from the tinnitus. Whether or not the
sound that achieves a sense of relief
noise covered (masked) the tinnitus
from tinnitus — no matter what the
was irrelevant. The purpose was to
sound is and where the sound comes
provide just enough sound to offer a
from. The method of Progressive
sense of relief from the tinnitus.
Tinnitus Management refers to this
I remember sitting in a restaurant
approach as “soothing sound.” It is a
with Drs. Vernon and Meikle. Stephen
different name, but it is Dr. Vernon’s
Nagler, MD, (another tinnitus pioneer)
method of tinnitus masking.
was at the table, and he asked
Dr. Vernon was a prolific author
Dr. Vernon, “What exactly is the
who wrote articles about tinnitus
purpose of tinnitus masking?” Dr.
that appeared in scientific journals
Vernon replied, “Relief.” Although
for about a 25-year period. He also
the purpose was relief, the name
wrote book chapters and gave
“tinnitus masking” stuck, and to this
lectures all over the world. His
day many people erroneously think
was an era when not much was
the purpose is to completely mask
Significant ATA Milestones
The ATA gives Tinnitus Today a complete
graphic and content overhaul to provide
evidence-based resource tools for The ATA launches Conversations in Tinnitus podcasts
The ATA launches an organizational patients and healthcare providers, as well to bring the voices of researchers to the general
rebrand, which includes a new as coverage of the latest research news. public. The open-access series provides an important
patient-focused website with link to the patient community and the people striving
expanded resources.
TINNITUSTODAY to develop cures and improved treatments.
2015 2016 2017
8 TINNITUS TODAY SPRING 2021 www.ATA.orgTINNITUS RESOURCES
The ATA Seeks Innovative
Tinnitus Research Proposals
The American Tinnitus Association
has opened its 2021 research grant
cycle and encourages researchers
at nonprofit medical and research
institutions to submit proposals for
funding consideration.
The ATA is accepting proposals
from researchers in the United
• ATA Claymond Castro Career and The ATA’s research program is
States and abroad who are
Education Award, $3,000 grounded in funding seed grants
advancing novel approaches that
• ATA J. and J. Meltzer Career and that enable researchers to obtain
may contribute substantively to
Education Award, $3,000 significant data for innovative pilot
scientific understanding of tinnitus,
All tinnitus-related proposals are studies, which is a prerequisite for
breakthroughs in treatments, and
reviewed in a highly competitive applying for larger funding from
possible cures.
process. Scientists, academics, and bigger institutions such as the U.S.
The ATA 2021 grant cycle includes
healthcare professionals affiliated Department of Defense and the
the following:
with nonprofit medical and research National Institutes of Health. By
• ATA Golden Anniversary funding original science, the ATA
institutions are encouraged to apply.
Innovation in Tinnitus Grant, brings researchers’ ideas to life and
The funding process is guided by
$60,000 ensures that promising tinnitus
ATA’s Board of Directors and Scientific
• ATA Donald Bowman Innovation research advances.
Advisory Committee, following a peer-
in Tinnitus Grant, $60,000 For full eligibility and application
reviewed process modeled on that of
• ATA Early Career Research Grant, information, visit: www.ata.org/
the National Institutes of Health.
$25,000 research-toward-cure
The ATA moves its Gabriel Heredia, musician The ATA presents at the The ATA is invited to speak again
headquarters from Portland, and TV producer, partners American Academy of at the American Academy of
OR, to the Washington, D.C. with the ATA on the release Otolaryngology’s international Otolaryngology’s
metro area of an online public service conference to educate ENT international
to be at the announcement aimed at physicians on the importance of conference based on
center of raising awareness of tinnitus showing compassion, tinnitus feedback from 2018
research and among young people. patient referral, and providing attendees regarding
advocacy. https://www.youtube.com/ information on research-based relevance, quality,
watch?v=ejAOwazPx-A&t=1s management guidelines. and interest.
U SA
2018 2018 2018 2019
www.ATA.org TINNITUS TODAY SPRING 2021 9 SPECIAL FEATURE
Considering
Tinnitus
Management Versus Cure
By James A. Henry, PhD proven to reduce the loudness (or CBT is a specialized and structured
intensity) of tinnitus, which would be method of counseling people to learn
It is estimated that between 10 and a “partial cure.” skills to enable successful living in
15 percent of all adults, anywhere in People can be devastated by this spite of a chronic health condition.
the world, experience chronic tinnitus news and wonder if they might have to The method works well for many
— meaning they have “phantom” live the rest of their life with intrusive diseases and health conditions —
sound in their ears or head that has sound. The most important thing for even chronic pain. Since the 1980s,
persisted for at least six months. It is them to know is that, even though a CBT has been shown to be effective
also estimated that about 20 percent cure is not yet available, therapies are for managing the effects of tinnitus,
of those with chronic tinnitus are available that can enable a normal life and it is the one method mentioned
significantly bothered by it. Whether in spite of the phantom sound. most often as having research
bothered or not, almost everyone who The techniques available are many evidence for this purpose.
experiences tinnitus would choose to and varied. They are generally offered Sound therapy does not have the
have the sound eliminated (“cured”) if by audiologists and behavioral health same strength of evidence as CBT
that could be safely accomplished. professionals (usually psychologists). does, but almost any audiologist or
Having worked in the tinnitus field The scientific literature has shown patient with tinnitus will attest to
for over 30 years, the most common cognitive behavioral therapy (CBT) to the fact that some form of sound is
request by individuals with tinnitus be effective in reducing the emotional helpful in certain situations. Numerous
is for treatment to eliminate their and functional effects of tinnitus. forms of sound therapy have been
tinnitus. It is always challenging to Although the evidence is less clear, developed, including commercial
explain that a cure does not yet exist an abundance of studies and clinical devices. Dr. Jack Vernon’s method
despite decades of research. It is data have shown that sound therapy of “tinnitus masking” is possibly the
even true that no method has been is also effective. first formal method of sound therapy.
Significant ATA Milestones
The ATA inaugurates the Tinnitus Tinnitus Today magazine
Advisors Program (TinnAP™) to receives award for its
provide professional guidance to publication “Tinnitus in The ATA celebrates its 50th year by issuing
callers on tinnitus management a Time of Chaos,” which $298,000 in research grants and calling on the
and where to seek help from addresses the mental- tinnitus community to raise additional money
appropriate healthcare providers. health toll of tinnitus. for a new ATA Golden Anniversary Grant.
2019 2020 2021
10 TINNITUS TODAY SPRING 2021 www.ATA.orgSPECIAL FEATURE
Thousands of smartphone apps normal life without being distressed working to find a cure for tinnitus.
provide methods of delivering sound by your tinnitus. The key is to learn They haven’t found it yet, but there is
therapy in general, and all of these can these techniques and then use “self- certainly hope for the future!
be adapted to managing the unwanted care” to apply them to yourself daily.
effects of tinnitus. Progressive Tinnitus Management James A. Henry,
PhD, is a certified and
I have had tinnitus for over 40 (PTM) uses a combination of CBT
licensed audiologist
years and I use sound therapy daily and sound therapy as intervention for with a doctorate
— I normally listen to Baroque music bothersome tinnitus. in behavioral
while working at the computer and an Other methods can also be neuroscience. He
is employed as a
audiobook or podcast to help me fall helpful, including Acceptance and
Veterans Affairs
asleep. My tinnitus is very loud, but Commitment Therapy, Tinnitus (VA) Rehabilitation,
these approaches distract me from Retraining Therapy, Tinnitus Activities Research &
thinking about it. Treatment, and mindfulness therapy Development (RR&D) Senior Research Career
Scientist at the VA RR&D National Center for
CBT and sound therapy are the two (which has different names). There Rehabilitative Auditory Research (NCRAR)
most common methods of managing is no evidence that any one method located at the VA Portland Health Care
tinnitus. Although neither approach works better than any other, but each System. He is also Research Professor in the
Department of Otolaryngology — Head and
is intended to “cure” tinnitus, of these methods has been used
Neck Surgery at Oregon Health & Science
both methods can support tinnitus for many years, and all have been University. For the past 25 years, he has
management. If you have tinnitus and shown to be helpful for many patients devoted his career to tinnitus research. His
are only interested in a cure, I would attempting to live a normal life in overall goals are to develop and validate clinical
methodology for effectively helping individuals
suggest at least considering that CBT spite of tinnitus. In the meantime,
with bothersome tinnitus and to increase
and sound therapy can help you live a researchers around the world are accessibility to evidence-based tinnitus care.
Useful Apps and Sound Machines to Mask Tinnitus
White Noise Ambience Lite ReSound Tinnitus Relief Whist – Tinnitus Relief
The American Tinnitus
Association does not
endorse products for
tinnitus relief. The above
apps are free of charge.
The sound machines have
HoMedics SS-2000 Sound Spa not been evaluated for
Relaxation Sound Machine with their effectiveness in aiding
6 Nature Sounds Big Red Rooster White sleep, relaxation, and
available at Amazon.com, Target, and Noise Machine habituation to tinnitus.
Walmart available at Amazon.com
www.ATA.org TINNITUS TODAY SPRING 2021 11 SPECIAL FEATURE
Still Have Tinnitus
After 48 Hours? It’s
Better to Get Help
Sooner Than Later
By John A. Coverstone, AuD
Tinnitus or Not because these sounds are not really
tinnitus.
One of the most difficult periods
Tinnitus?
of living with tinnitus is the first few Not all sounds we hear internally Have You Had
days and weeks after it begins. Either are tinnitus. Many sounds are caused Recent Dental Work?
gradually or suddenly, you realize by processes within our body. Some If you have had recent dental work
that you are hearing a sound no one of those are perfectly normal, while and started hearing sounds shortly
else around you is hearing. At first, in some may be a reason to see a after, it may be due to a problem with
addition to the sound causing distress, physician or specialist. Tinnitus is not your jaw. This is particularly true if you
one might wonder about other factors, universally defined. Experts in the field hear the sounds when your jaw is in a
such as why, what, and how long. The have tried to create a single, concise, certain position or when it is moving
thoughts that follow have a lot to do universal description of tinnitus, but in a certain way. This can happen for
with how we perceive our tinnitus and haven’t yet agreed on what that would a few reasons, such as misalignment
how it affects us. What is this sound? be. Generally, though, it is thought of your jaw or changes to your bite.
Where does it come from? Am I going — and I agree — that true tinnitus is However, it can also turn into a much
crazy? Do I have a tumor? These are a neurological phenomenon. Other larger problem if not addressed.
all perfectly normal questions that sounds we hear internally are often Therefore, it is important to have this
come to mind when we first perceive called somatosounds, which simply checked out by a skilled dentist.
an internal sound (for the record, the refer to sounds that other people can’t
latter two are hardly ever the case). hear. Although it should be noted Do You Hear a
In some cases, taking the proper that some sounds in your ears can be Pulsing Sound?
first steps can make a significant heard faintly if the listener is extremely
A pulsing sound can indicate an
difference in how you react to the close. These are usually caused by
issue with blood flow to the brain.
new sound or sounds. In some cases, something happening behind the
This can be benign or something
you might even find that it is not eardrum. This ability to hear — or even
more serious. However, it is always
tinnitus. Even if you have had tinnitus record — sounds in a person’s ear
something we want to have checked
for a long time, it may be worthwhile led years ago to the term objective
out. It can be caused by a restriction of
investigating different management tinnitus, because the sounds could
blood flow in the arteries around the
strategies to help you cope with be verified. That term is still found in
brain and/or ear, high blood pressure,
tinnitus. This article describes many of some publications today. However,
arteriosclerosis (hardening of the
the conditions that can lead to tinnitus it is falling out of favor among
arteries), and other conditions. It may
and hearing internal sounds and what professionals specializing in tinnitus
also be in just one ear or in both. Your
you can do to get help. physician may order an ultrasound
12 TINNITUS TODAY SPRING 2021 www.ATA.orgSPECIAL FEATURE
of the carotid arteries to rule out any why this happens. Nonetheless, it is permanent condition. This can happen
serious conditions, but it may indicate worth seeing an ear, nose, and throat with noise such as explosions, which
a lesser condition that is treatable with physician (ENT) to have this checked many of our soldiers have experienced
medication or lifestyle changes. and be sure that nothing can be done after encountering a mine or IED.
medically to resolve it. Sometimes our auditory system may
Do You Have have had too many repeated noise
Problems With Your Have You Hit Your exposures, which result in permanent
Ears? Head? injury marked by tinnitus that doesn’t
You can frequently hear sounds that Head trauma is frequently fade away in a day or so.
are due to injury to the ears or medical associated with tinnitus, particularly Anytime you think your tinnitus
problems with your ears. It may be when it results in a concussion or may be related to noise exposure,
difficult sometimes to know whether traumatic brain injury (TBI). One of the you should see an audiologist right
injury to your ears caused tinnitus prevailing theories of tinnitus is that away. It will be important to determine
or whether there was head trauma some portion of the auditory nerves whether hearing damage exists and
associated with the incident and the becomes disrupted and does not what to do about it.
recover properly. A blow to the head
head trauma caused tinnitus. However, When You Think You
other conditions, such as prolonged certainly has the potential to disrupt
neural pathways and often does. If you Hear Fine…
ear infections, can cause tinnitus as
well. The tinnitus may subside when have had a loss of consciousness or One of the most common causes
the ear heals or it may be permanent. been diagnosed with a concussion, of tinnitus — likely THE most common
The ear is obviously a prime TBI, or even a stroke that resulted cause — is changes to the auditory
candidate for somatosounds because in tinnitus, be sure to first see a system associated with hearing loss.
such sounds are easy to hear. You neurologist and have the underlying As the sensory receptors in the ear
may experience a periodic fluttering in trauma treated. There is currently no wear out or become damaged, the
your ear or a tic-tic-tic sound that goes direct treatment for this kind of injury, auditory nerves and centers in the
on for some time. There are a pair but an audiologist can discuss sound brain no longer receive normal input.
of muscles behind the eardrum that therapy if needed to manage tinnitus When this happens, nerve cells
attach to the tiny bones that connect afterward. Physical medicine and become more sensitive to stimuli
the eardrum to the inner ear. If these rehabilitation (PMR) physicians can (which, in the auditory system, is
muscles spasm or if the brain sends also help in recovery. sound), they respond to stimuli more
a signal to these muscles to contract, robustly than normal, and they tend
Noise Exposure — to have more spontaneous activity.
you may hear a flutter, a click, or even
a sharp ringing sound. The latter sound
of Course This can also disrupt normal auditory
is often confused with true tinnitus A common cause of tinnitus is activity and cause tinnitus. However,
and not much is known about it, but noise. Most of us have experienced many people who have hearing loss
it typically lasts only a few seconds tinnitus temporarily after being do not realize it. The above changes to
or up to a minute or so. Most people exposed to loud noise, such as from auditory nerve behavior tend to fool us
experience this every now and then, power tools, firearms, explosions, into thinking we hear better than we
but some people have this happen or concerts. When tinnitus is caused really do. Therefore, if you have tinnitus
much more frequently. I have seen by a single noise event, it usually you should always see an audiologist
patients experience this up to six or begins right away and subsides by to have your hearing checked. Most of
eight times a day. Some research has the next day. At some point, though, the things that can cause tinnitus — or
linked this muscular activity to stress your auditory system may be so even somatosounds — can also cause
and anxiety, but it has not been well overwhelmed by an extremely loud hearing loss. It should also be noted
studied and we don’t know for sure noise that the tinnitus becomes a that changes in hearing can occur, and
www.ATA.org TINNITUS TODAY SPRING 2021 13 SPECIAL FEATURE
be associated with tinnitus, even when not focusing on it. Sometimes it is need to occasionally use hearing
results from a hearing test are normal. the tinnitus that may prevent you protection while you are undergoing
from sleeping well if it is particularly treatment, then your audiologist can
Tinnitus Without bothersome. I often recommend that have that discussion with you and
a Cause? patients do whatever is necessary guide you in this.
Some people have no idea what to get sleep. Keeping noise in your
environment is often enough, but
Depression and
caused their tinnitus. It is usually
related to something mentioned earlier speak with your physician, if necessary, Anxiety
(see the last couple of sentences in to see whether medication may help. People react differently to tinnitus
the preceding section), but the exact Medication, however, should not be a and that is a primary difference
cause may remain unknown. This is long-term solution. between those who are bothered by
particularly true when tinnitus has not it and those who are not. If you have
Sound Tolerance
been addressed for many years and the any signs of depression, if you are
individual forgets the circumstances Problems constantly anxious about the sound
around the start of their tinnitus. This is It is common for people with you hear, or if you can’t focus away
more often the case with mild tinnitus. tinnitus and/or hearing loss to from the sound even after working
In such cases, your audiologist can have decreased sound tolerance. with an audiologist, you should see a
rule out hearing damage and look for A clinically significant decrease in psychologist specializing in tinnitus or
signs of conditions that might require sound tolerance is called hyperacusis. at least one who practices cognitive
medical attention. I have spoken with neuroscientists behavioral therapy (CBT). A therapist
Being unable to determine the who believe strongly that everyone can give you strategies to cope with
cause of tinnitus is not reason for with hearing loss has some degree negative experiences and help you
alarm. Serious underlying conditions of reduced sound tolerance, although learn to react to tinnitus in such a
are almost always evident with a it’s subclinical in the majority of way that it becomes less (or non-)
thorough examination. That being said, cases. This is because of the changes bothersome.
if you have tinnitus for no apparent that occur within the auditory It is not possible to account for
cause — particularly if it begins nervous system, as described every possible cause of tinnitus, as
suddenly — it is worth talking to your earlier. However, if you find yourself any disruption to the auditory nervous
physician and audiologist to rule out highly bothered by loud sounds and system has the potential to cause
any serious medical condition. particularly if you find yourself taking tinnitus and many conditions may
extreme measures to avoid them, cause somatosounds. However, these
The Importance such as limiting your time around are the most common causes and
of Sleep others or wearing earmuffs all the effects of tinnitus and the healthcare
One of the most important things time, you should see an audiologist providers who can help you with them.
you can do when dealing with tinnitus for help. If you are sensitive to Addressing tinnitus immediately after
— as well as many other conditions noise, you should use hearing it begins is one of the best ways to
— is to get good sleep. If you are protection only to block sound that is ensure that it does not become highly
fatigued, it is significantly more difficult uncomfortably loud, because overuse bothersome. But even if it does, help is
to make progress on a treatment plan of hearing protection can cause the available to reduce its negative impact.
or therapy. Tinnitus also seems more auditory system to become more If you or someone you know needs
obtrusive when you are fatigued, which sensitive to sound and exacerbate help managing tinnitus, the ATA offers
means you will have more difficulty any existing hyperacusis. If your a free one-time 15-minute consultation
condition is so severe that you might with a specialist trained in tinnitus
14 TINNITUS TODAY SPRING 2021 www.ATA.orgSPECIAL FEATURE
management. The call is intended to Someone will return your call within educational audiology services. Dr. Coverstone
received bachelor degrees in speech
offer guidance only and should not 72 hours. If you’re having thoughts of
communication and in speech and hearing
be used as a substitute for working suicide or experiencing considerable science from Portland State University, a
with healthcare professionals in your distress, call the National Suicide master’s degree from Portland State University,
local community. The Tinnitus Advisors Prevention Lifeline at 1-800-273-8255, and an audiology degree from PCO School of
Audiology (now Salus University). He previously
Program (TinnAP™) was launched in or dial 911.
worked in hearing instruments and medical
honor of Jack Vernon, PhD, an ATA equipment manufacturing.
founder who spent Friday afternoons John A. Coverstone,
Dr. Coverstone is a regular contributor
AuD, is the president
speaking with people about their to Tinnitus Today and a former columnist
and CEO of Sentient
tinnitus, and in recognition of the and occasional contributor to Advance for
Healthcare, an
Audiologists, Feedback (former ADA member
difficulty that many people face when audiology consulting
publication), and Audiology Today. He is the
trying to find credible, research-based company and parent
cohost of AudiologyTalk, a monthly podcast for
company of Audiology
information on tinnitus management. audiologists available at www.audiologytalk.
Ear Care clinic in
For help, call TinnAP™ at 800-634- com, and of Conversations in Tinnitus, the
New Brighton,
official podcast for the American Tinnitus
8978, ext. 3. The service operates Minnesota, where he
Association.
seven days a week, 9 a.m.–5 p.m. EST. provides clinical and
Medical Disclaimer
The content in Tinnitus Today professional, when considering the
magazine is intended to provide best course of tinnitus management.
helpful health information for the This begins with a medical examination
general public. It is made available to rule out possible underlying medical
with the understanding that the causes for tinnitus. If you’re interested
American Tinnitus Association (ATA) in adopting guidance/suggestions
is not engaged in rendering medical, made in the magazine, you should
health, psychological, or any other discuss this first with your medical
kind of personal professional services. provider before doing so. making an evaluation for pursuing a
The magazine content should not be Any information about drugs and particular course of action.
considered complete and, therefore, supplements contained in the magazine The ATA and authors of articles in
does not cover all physical conditions is general in nature, and does not cover the magazine specifically disclaim all
or their treatment as it relates to all possible uses, actions, precautions, responsibility for any liability, loss, or
tinnitus and tinnitus management. side effects, or interactions of the risk, personal or otherwise, which is
The ATA always recommends medicines mentioned. The content of incurred as a consequence, directly or
that you consult and work with a the magazine is not intended as medical indirectly, of the use and application of
medical, health, or other competent advice for individual problems or for any of the content in the magazine.
www.ATA.org TINNITUS TODAY SPRING 2021 15 PERSONAL STORY
How Trauma Can
Trigger Tinnitus
By Art Pirozzi So, what caused my
tinnitus to suddenly appear in
When I was about 12 years old, I my life at the age of 12? I often
was at home in a quiet house when think back to an incident in school
I first noticed a peculiar sound in my that involved corporal punishment.
ears. It initially reminded me of the On the day that the ringing began,
sound I would hear when a TV was there had been an earlier incident
turned on. This was back in the days of some mischief in the classroom. tinnitus affects my ability to hear. The
when the sound of the TV shows was The teacher was very angry about the tinnitus hasn’t worsened during the
delayed as the vacuum tubes warmed disturbance and assumed a boy was coronavirus pandemic because I’m
up and emitted a high pitch. I glanced to blame. The problem was she didn’t an active person and work outside
at the TV. The TV was off. The sound know who the culprit was and no one part-time. Ambient sounds help mask
was coming from inside my head. owned up to being the mischief maker. the ringing. I feel fortunate that I am
Today, the sound of my tinnitus is As a result, all boys were lined up and, not shut in the house, where I’d be
reminiscent of the clinking of hundreds one by one, the teacher proceeded constantly reminded of the tinnitus.
of glass pieces on a huge chandelier down the line slapping both cheeks I hope and pray that the ATA and the
that reverberate after someone hits a at the same time. If the hands were research community will get to the
nearby wall or following a tremor. My a bit off the mark, as they were in my root cause of this terrible condition.
tinnitus is a lower frequency and it case, they pounded the ears. When
oscillates, wavering, so to speak. On something assaults your ears, ringing Arthur Pirozzi
occasion, another sound introduces begins, then normally subsides. In my attended grammar
school in Queens
itself for about 15 seconds. That sound case, it didn’t.
and Brooklyn, New
is like what you hear while you’re in While reading Tinnitus Today York, when corporal
the sound booth and an audiologist is magazine, I’ve never noticed an article punishment was
sending sounds at various frequencies that attributed tinnitus to trauma to allowed in New York
State public schools
and loudness to learn what you can the ears like I experienced. I recently
(practice banned in
and cannot hear. reached out to a classmate from 1985). He served in the U.S. Army, including
Fortunately for me, when I get into those days to find out whether he has a tour in Germany. After retiring from the NYC
bed and my head hits the pillow, I fall tinnitus and, if yes, whether it began Parks Department, he worked as an arborist.
off to sleep in a very short while. If I during that same period at school. With six children and 16 grandchildren, he
enjoys an active family life. Once the pandemic
wake in the middle of the night for a He confirmed that he doesn’t have
subsides, Art is looking forward to resuming
bathroom break, the first thing I notice tinnitus, so I’m left wondering if that travel — cruises, road trips, and camping —
is the sound of tinnitus. I think to was the specific event that caused it. with his wife. He is also an active member in
myself, “Well, I guess I’m still alive!” Over the years my hearing has the American Legion and the Miata Car Club.
declined, but I’m unsure whether my
16 TINNITUS TODAY SPRING 2021 www.ATA.orgATA NEWS
Does Loud Noise Influence
Your Social Life?
Over 1,700 Respondents Reveal Recreational Choices in Tinnitus Awareness Week Survey
The ATA and SoundPrint advocate for
safe sound levels in public recreational
spaces so people with tinnitus and/
or hearing loss can more easily
enjoy get-togethers with friends,
family, and colleagues. To make a
more compelling argument on the
importance of the topic, the ATA and
SoundPrint issued a survey, which was
completed by more than 1,700 people
during Tinnitus Awareness Week.
By Joy Onozuka
With the ongoing coronavirus
pandemic, most of us have led a
sequestered existence, with limited
outings for well over a year. For some
people with reactive tinnitus, which “Sixty-nine percent of respondents left a
refers to tinnitus that gets louder for a
period of time after exposure to loud venue because it was too loud, with 78
sound, or with hyperacusis (sound
sensitivity), the pandemic provided a percent of them indicating they did not return.”
reprieve and an acceptable excuse to
say no to get-togethers. Life literally American Tinnitus Association and the The 15-question survey, which was
and figuratively became quieter, which, people behind SoundPrint, the free open throughout Tinnitus Awareness
for some, meant heightened stress app that helps you find quiet spaces, Week and distributed via email to
because of increased awareness of decided now is the time to advocate people in the ATA’s and SoundPrint’s
tinnitus. for quieter recreational spaces. To respective databases, was completed
Now that we have a rollout of make that appeal, we launched a by 1,758 respondents. For self-
vaccines, we should be able to leave survey as part of Tinnitus Awareness reported information on hearing
behind our cloistered existence in the Week, February 1–7, 2021, to gather health, 98 percent of respondents had
not too distant future. In anticipation of data on how noise influences tinnitus, 17 percent had hyperacusis,
that and the knowledge that so many recreational behavior among people 80 percent had some degree of
recreational venues are struggling, the with tinnitus and/or hearing loss.
www.ATA.org TINNITUS TODAY SPRING 2021 17 ATA NEWS
hearing loss, and 6 percent had no
hearing loss.
Results confirmed that prior to the
pandemic the majority of people —
58 percent of respondents — actively
avoided restaurants, bars, cafés,
ATA and SoundPrint Survey movie theaters, and gym classes
Self-Reported Information on Hearing Health because of loud noise. Unsurprisingly,
from 1,758 Respondents of 2021 Tinnitus Awareness Week Survey just over 57 percent indicated
that they had specific restaurants,
58% of respondents cafés, and bars they frequented
98% had tinnitus actively avoid because those were typically quiet.
restaurants, bars, Despite that, 38 percent found
cafés, movie that background noise “almost
17% had hyperacusis theaters, and gym
always” interfered with their ability
classes due to noise
to converse or connect with friends
80% had some degree and family in social settings, and 51
of hearing loss percent indicated that it “sometimes”
interfered with communication.
58% A whopping 69 percent of
6% had no hearing loss
respondents left a venue because it
was too loud, with 78 percent of them
indicating they did not return. A few
0 20 40 60 80 100 people noted they returned during
off hours. Some, however, said they
preferred louder settings, as noted in
Places People Would Visit
the following comments: “I don’t seek
More Often if it Were Quieter
out quiet places because I become
66% of
respondents who more aware of my tinnitus” and “I
Restaurants (60%)
would go out more seek loud places to cover up the noise
if recreational Indoor/outdoor concerts (53%) of my tinnitus.”
venues were more Respondents were almost evenly
reliably quiet Movie theaters (32%) split on saying something to staff
about noise levels, with the majority
Bars (32%) (52%) answering in the negative.
Reasons for not saying anything about
Cafés (23%) noise included not wanting to cause
66% a fuss, not wanting to impose their
Gym classes (14%)
opinions on others, and knowing
beforehand that it was a loud venue.
For those who did complain about
0 10 20 30 40 50 60
noise, 57 percent felt the complaint
wasn’t well received or failed to result
Other notable places people would like to go include church, in a reduction in noise.
dentist, work meetings, sporting events.
18 TINNITUS TODAY SPRING 2021 www.ATA.orgYou can also read
