BE OUR GUEST: FOR SUFFERERS OF TINNITUS, WRITER HOPES PERMANENT SOLUTION TO PROBLEM IS NOT FAR OFF

Karen Jo Roberts is a resident of Cape Girardeau and a previous contributor to this column.

Imagine for a moment, a constant ringing or hissing in your ears. This is a malady many are subjected to. As stated in the book by Dr. Robert W. Baloh, "Dizziness, Hearing Loss, and Tinnitus: The Essentials of Neurotology," "Tinnitus is a noise of ringing in the ear that is usually audible only to the patient."

The description of the noise can vary from ill-defined buzzing, ringing, hissing or whistling, to a more recognizable sound such as a cricket, seashell or motor sound.

"As many as 50 percent of patients with tinnitus do not have associated hearing lose."

My grandfather falls into that percentage whose tinnitus was caused from hearing loss. A loss due to running printing presses, with their continual clanging. It was noise so loud that normal conversation was impossible.

As a result of being subjected to this profuse noise for over 50 years in his print shop in Cairo, Ill. (he has been retired for a number of years) he is, from all practicalities, deaf.

Before deafness set in, he was one of many who suffered tinnitus.

At times, when the ear noise would become unbearable, my aunt or grandmother would give him, not a drug to reduce the noise, but the sedative, Librium.

Before long, the Librium would calm him enough to doze, and the anxiety resulting from the tinnitus would be temporarily relieved.

As revealed in the book previously mentioned, "Lidocaine taken intravaneously has produced some relief in patients. Though its relief is not long lasting, it does offer hope that a similar drug may be produced."

Masking techniques have unfortunately not been very successful. Maskers are small sound generators that can be worn behind the ear, similar to a hearing aid.

Follow-up studies to assess the efficiency of tinnitus masking units have produced variable results.

In one study only 9 of 34 patients reported they were receiving some form of relief from their tinnitus. In another study only 10 out of 31 patients who rented masking units purchased instruments after a 30-day period and only two of these were using their instruments on a regular basis.

The most extensive experience with tinnitus maskers has been accumulated by the group at the University of Oregon in Portland.

Of 493 patients seen at the tinnitus clinic, 380 were advised to be fitted with one of three instruments: a masking device, a hearing aid, or a combined masking device and hearing aid (tinnitus instrument).

In those cases where an instrument was not recommended, the tinnitus could not be effectively masked, or patients indicated that the masking sound was not an acceptable substitute for their tinnitus.

Though the ear humming I am prone to is fortunately not severe enough for such an instrument, a doctor I spoke to concerning the device was highly critical of it.

According to the book on hearing loss, "Electrical stimulation can evoke a silence sensation in patients with tinnitus. Suppression of tinnitus was totally effective in 60 percent of the patients tested. However, this procedure has obvious risks, such as potential permanent damage to the inner ear that have not been assessed relative to its potential benefit, and has yet to be compared with other less invasive methods of treatment."

Surgical treatment of tinnitus has been disappointing. Of 500 patients who had tumors removed, 83 percent had tinnitus before surgery, and in 11 percent tinnitus was the initial symptom. A post operative survey revealed that tinnitus was improved in 40 percent, worse in 50 percent, and unchanged in the remaining 10 percent.

A single exception to the generally dismal record of surgical treatment of tinnitus is complete cure of objective tinnitus after surgical correction of a vascular malformation or tumor in the mastoid.

On a dire note, I have read that incessant and profuse ear noise leads some to suicide. For this reason, as well as the relief of those who live with tinnitus, I hope a permanent solution to this often devastating problem is not far off.