|
Items in cart [0] |
Questions? Call 888-624-8373 |
PAPERBACK PDF BOOK Free Resources |
||||||||||||||||
|
||||||||||||||||
|
||||||||||||||||
| ||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Copyright © 2009. National Academy of Sciences. All rights reserved. Terms of Use and Privacy Statement |
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page R1
Tl N N ITUS
Facts, Theories, anc! Trealments
DENNIS McFADDEN
Working Group 89
CommiDee on Hearing, Bioacoustics,
and Biomechanics
Commission on Behavioral and Social Sciences
and Education
National Research Council
NATIONAL ACADEMY PRESS
Washington, D.C. 1982
OCR for page R2
Tl N N ITUS
Facts, Theories, anc! Trealments
DENNIS McFADDEN
Working Group 89
CommiDee on Hearing, Bioacoustics,
and Biomechanics
Commission on Behavioral and Social Sciences
and Education
National Research Council
NATIONAL ACADEMY PRESS
Washington, D.C. 1982
OCR for page R3
NOTICE: The project that is the subject of this report was approved
by the Governing Board of the National Research Council, whose members
are drawn from the councils of the National Academy of Sciences, the
National Academy of Engineering, and the Institute of Medicine. m e
members of the committee responsible for the report were chosen for
their special competences and with regard for appropriate balance.
This report has been reviewed by a group other than the authors
according to procedures approved by a Report Review Committee
consisting of members of the National Academy of Sciences, the
National Academy of Engineering, and the Institute of Medicine.
The National Research Council was established by the National Academy
of Sciences in 1916 to associate the broad community of science and
technology with the Academy's purposes of furthering knowledge and of
advising the federal government. The Council operates in accordance
with general policies determined by the Academy under the authority of
its congressional charter of 1863, which establishes the Academy as a
private, nonprofit, self-governing membership corporation. The
Council has become the principal operating agency of both the National
Academy of Sciences and the National Academy of Engineering in the
conduct of their services to the government, the public, and the
scientific and engineering communities. It is administered jointly by
both Academies and the Institute of Medicine. The National Academy of
Engineering and the Institute of Medicine were established in 1964 and
1970, respectively, under the charter of the National Academy of
Sciences.
This work relates to Department of the Navy Contract N00014-80-C-0159
issued by the Office of Naval Research under Contract Authority NR
201-124. However, the content does not necessarily reflect the
position or the policy of the Department of the Navy or the
government, and no official endorsement should be inferred.
The United States government has at least a royalty-free, nonex-
clusive and irrevocable license throughout the world for government
purposes to publish, translate, reproduce, deliver, perform, dispose
of, and to authorize others so to do, all or any portion of this work.
Library of Congress Cataloging in Publication Data
Main entry under title:
Tinnitus: facts, theories, and treatments.
Prepared by: Working Group 89, Committee on
Hearing, Bioacoustics, and Biomechanics, Commission
on Behavioral and Social Sciences and Education,
National Research Council
Bibliography: p.
Includes index.
1. Tinnitus. I. McFadden, Dennis. II. National
Research Council (U.S.). Working Group 89.
[DNLM: 1. Tinnitus. WV 272 M168t]
RF293.8.T56 1982 617.8 82-19028
ISBN 0-309-03328-4
Available from
NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W.
Washington, D.C. 20418
Printed in the United States of America
First Printing, November 1982
Second Printing, August 1984
OCR for page R4
Working Group 89
DENNIS McFADDEN (Chairman), Department of Psychology,
University of Texas at Austin (psychoacoustics)
LUCILLE BECK, Audiology and Speech Pathology Service,
Veterans Administration Medical Center, Washington,
D.C. (audiology)
JORGEN FEX, Laboratory of Neuro-otolaryngology, National
Institute for Neurological and Communicative
Disorders and Stroke, National Institutes of Health
(research otolaryngology/neurophysiology)
LLOYD KAUFMAN, Department of Psychology, New York
University (psychophysics)
MERRILYNN PENNER, Department of Psychology, University of
Maryland (psychoacoustics)
ABRAHAM SHULMAN, Division of Otolaryngology and Communi-
cation Sciences, Downstate Medical Center, State
University of New York (clinical otolaryngology)
ROBERT L. SMITH, Institute for Sensory Research, Syracuse
University (auditory neurophysiology)
JUERGEN TONNDORF, Department of Otolaryngology, College
of Physicians and Surgeons of Columbia University
(research otolaryngology)
PATRICK M. ZUREK, Research Laboratory of Electronics,
Massachusuetts Institute of Technology
(psychoacoustics)
iii
OCR for page R5
CommiNee on Hearing, Bioacoustics,
and Biomechanics
CHARLES S. WATSON (Chairman), Boys Town Institute for
Communicative Disorders in Children, Omaha, Nebraska
SHEILA BLUMSTEIN, Department of Linguistics, Brown
University
KENNETH ELDRED, Ken Eldred Engineering (KEE), Concord
Massachusetts
DAVID J. LIM, Otological Research Laboratories, Ohio
State University Medical School
JAMES D. MILLER, Central Institute for the Deaf, St.
Louis, Missouri
CARL E. SHERRICK, Department of Psychology, Princeton
University
DONALD C. TEAS, Institute for Advanced Study of Communi-
cation Process, University of Florida, Gainesville
PETER WESTERVELT, Department of Physics, Brown University
LAURENE R. YOUNG, Man-Vehicle Laboratory, Massachusetts
Institute of Technology
MILTON A. WHITCOMB, StudY Director
ARLYSS K. WIGGINS, Administrative SecretarY
1V
OCR for page R6
Foreworc!
Many readers who work in fields related to hearing and
deafness are familiar with the reports of working groups
of the Committee on Hearing, Bioacoustics, and Biomechan-
ics (CHABA). These reports are prepared by special study
committees, known as working groups, set up by CHABA to
advise federal agencies on issues of significant national
need.
The original impetus for this report was a request
brought to the National Academy of Sciences in 1980 by
the Food and Drug Administration (FDA) of the U.S. Depart-
ment of Health and Human Services. The FDA asked for
assistance in evaluating the efficacy and safety of tinni-
tus masking units and tinnitus instruments (masker/hearing
aid combinations). The National Institute of Neurological
and Communicative Disorders and Stroke (NINCDS) shared the
FDA' S interest in concerns about these matters and, in ad-
dition, had a broader interest in the status of knowledge
about tinnitus. In response to the joint request from
these two agencies, CHABA, with the approval of the Com-
mission on Behavioral and Social Sciences and Education
and the National Research Council, created Working Group
89 and charged it with the preparation of a general, crit-
ical review of the entire topic of tinnitus, including
tinnitus maskers and instruments.
The performance of a working group depends strongly on
the energy and wisdom of its chairman. Considerable skill
and, often, diplomacy are required in preparing a final
report that incorporates the scientific knowledge and
opinions of a range of experts while providing the prac-
tical guidance needed by those who originally raised the
question. In the case of tinnitus and tinnitus masking,
it was felt that the person charged with the preparation
of an evenhanded review and evaluation of current knowl
v
OCR for page R7
edge should be an experienced auditory scientist who was
not associated with a specific position on the issues to
be studied. The broad scope of the following report, the
balanced manner with which controversial questions are
treated, and a light touch where many would have fallen
into turgid scientific prose show how well this challenge
was met by the chairman of Working Group 89, Dennis
McFadden.
The members of CHABA deeply appreciate the efforts of
the members of Working Group 89 and especially of its
energetic chairman in providing this timely report.
CHARLES S. WATSON
Chairman
Committee on Hearing,
Bioacoustics, and Biomechanics
V1
OCR for page R8
Preface
Most of the work on this report was done during 1981 and
early 1982, but it is not possible to specify a single
cutoff date for the source materials used for the report.
In some instances, no information more recent than several
years old was uncovered; in other instances, preprints of
articles or chapters to be published later in 1981 or 1982
were available and were used. It was not possible to be
systematic, comprehensive, and up to date in all of the
various literatures touched by this report, and the purely
fortuitous way that some information was discovered makes
it believable that important facts may have been missed.
During the writing of the report, two symposium volumes
on tinnitus appeared (CIBA Foundation, 1981; Shulman,
1981a); both are widely cited throughout this report, but
the serious student of tinnitus is encouraged to examine
the originals. In an attempt to provide as comprehensive
a research bibliography as possible, some sources have
been included even though they were not cited in the
report for one reason or another.
Much of the information on tinnitus maskers/instruments
comes from a single source--the University of Oregon tin-
nitus clinic. Because I wanted the review of that infor-
mation to be as objective as possible, I tried to maintain
a degree of distance between myself and personnel at the
clinic, none of whom I have met. I did exchange several
letters with Jack Vernon, the clinic's director, and he
provided me with helpful comments on an early draft of
the section on the efficacy of tinnitus maskers/
instruments.
I wish to thank the members of the working group for
their splendid assistance in preparing this report. All
were generous with their time and prompt in their replies
to requests for comments on my successive drafts. Their
· ~
V11
OCR for page R9
cogent comments about style, substance, and organization
contributed greatly to the content and form of the report.
Beyond the members of the working group, many people
contributed to the final form of this report. Milton
Whitcomb, study director of the Committee on Hearing,
Bioacoustics, and Biomechanics (CHABA), offered excellent
counsel and guidance at critical points and, as always,
proved to be an effective, genial, and unobtrusive admin-
istrator. I am indebted to CHABA members Donald H. Eld-
redge, William D. Neff, and Charles S. Watson for their
valuable comments on the manuscript. Earleen Elkins of
the National Institute of Neurological and Communicative
Disorders and Stroke and Harry Sauberman of the Food and
Drug Administration frequently provided me with the
necessary perspective on the problem. Eugenia Grohman
of the National Research Council was meticulous in her
copy editing of the manuscript and did more than anyone
else to render it readable and correct. Judy Searcy made
preparation of the index as painless as such a job can
be. And most important, the timely preparation and form
of the report are due in large part to the word-processing
skills of Lanier Bayliss, whose careful attention to
detail and persistent good cheer are deeply appreciated.
A number of my friends have noted that tinnitus is an
unlikely topic for me to be reviewing and critiquing, and
I am the first to agree. I do not consider myself to be
an expert on tinnitus: I have never done research on the
topic, nor have I ever seen a tinnitus patient. I tried
to read all the material that is available on tinnitus
and to draft as organized, comprehensive, and critical a
summary of the topic as I could. The realities of dead-
lines being what they are, not everything I hoped to do
got done. However, as the reader will appreciate, any
tinnitus report written in the foreseeable future will
necessarily be only an interim report; far too little is
known for it to be otherwise. I would appreciate hearing
from readers about omissions, errors of fact or interpre-
tation, and differences of opinion.
DENNIS McFADDEN
Chairman
Working Group 89
· · ~
V111
OCR for page R10
Contents
1 INTRODUCTION
Overview of the Report, 1
A Definition of Tinnitus, 5
Prevalence of Tinnitus, 7
2 FACTS, THEORIES, AND ISSUES
Etiology of Tinnitus, 10
Miscellaneous Unequivocal Sources of
Tinnitus, 11
Tumors of the Eighth Nerve, 12
Noise Trauma and Presbycusis, 13
Mechanisms of Tinnitus, 14
Spontaneous Rates of Primary Fibers, 15
Decoupling of Stereocilia, 17
The Objective/Subjective Issue, 18
Can Tinnitus Exist in the Absence of
Hearing Loss?, 23
Tinnitus in Children, 24
Possible Experimental Models of Tinnitus, 24
Meniere's Disease, 27
MEASUREMENT PROCEDURES
Quality of the Tinnitus, 32
Spectral Location of the Tinnitus, 35
Pitch Matching, 35
Masking, 36
Related Masking Results, 37
Magnitude of the Tinnitus, 42
Annoyance of the Tinnitus, 45
Is the Tinnitus Monaural or Binaural?, 48
1X
1
10
32
OCR for page R11
The Issue of Beats with Tinnitus, 51
Some Ways Tinnitus Is Not Like an External
Sound, 52
Summary of Measurement Procedures, 54
4 TREATMENTS
Psychological Intervention, 55
Surgery for Tinnitus, 57
Exposure to Intense Sound, 58
Drugs and Tinnitus, 59
Drugs Causing Tinnitus, 59
SalicYlates' 60
Quinine, 62
Tobacco, 63
Caffeine, 63
Alcohol, 63
Cocaine, 63
Mariiuana, 63
Oral ContracePtiveS, 63
Heavy Metals, 63
Drug Therapy for Tinnitus, 64
Niacin, 66
Vitamin A, 66
Lidocaine, 67
CarbamazePine, 72
Tocainide HYdrochloride, 74
PhenYtoin Sodium, 75
Primidone, 76
Sodium Fluoride, 76
l
Sodium Valproate, 77
Sodium Amylobarbitone' 77
Alcohol, 78
Miscellaneous Drugs, 78
Conclusions About Drugs and Tinnitus, 79
Allergy and Diet, 81
Biofeedback, 82
Hypnotherapy, 83
Acupuncture, 84
Electrical Stimulation, 85
Alteration in Air Pressure, 87
Tinnitus Maskers/Instruments, 89
Efficacy of Tinnitus Maskers/Instruments, 92
m e Early Reports, 93
m e Later Reports, 94
Other RePorts, 101
Conclusions, 104
55
OCR for page R12
Residual Inhibition, 104
Safety of Tinnitus Maskers/Instruments, 107
spectral Characteristics, 107
Intensity of Tinnitus Maskers/Instruments
and Duration of Use, 110
Damage/Risk Criteria and Tinnitus Maskers/
Instruments, 114
STANDARDIZING PROCEDURES
Medical Examination, 117
Audiological Examination, 119
REFERENCES AND BIBLIOGRAPHY
INDEX
117
123
147
