Various forms of sensorineural hearing loss today represent our greatest unsolved challenge. The cochlear implant, brainstem-evoked response audiometry, improved forms of electro-acoustic amplification, audiologic rehabilitation, better ways of delivering comprehensive services to the public, and, of course, the tinnitus masker, are significant developments.

Thirty years of experience with the hearing impaired has convinced me that tinnitus causes as much suffering and anguish, if not more, than hearing loss itself. Who among us has not been frustrated by our inability to provide relief to the tinnitus sufferer? How often have we told our patients that they must learn to live with this problem, that we have nothing specific to offer them, that we do not even know whether a successful stapedectomy will provide amelioration of this aspect of the problem? And how often has the patient told us in one way or another that those of us who do not suffer from this condition cannot understand what it is to live with this problem for months, years, or a lifetime.

Fibro-Histiocytic neoplasms are uncommon in the respiratory tract. This paper presents a clinical and histological description of a case of fibrous histiocytoma at the level of the third tracheal ring. This case shares some features with the four cases previously described, viz., the growth occurs mainly in young adults; recurrences are common; and all have shown similar benign histological patterns. Ultrastructural investigations confirmed the fibro-histiocytic nature of the neoplasm.

The history of masking as applied to tinnitus must not be confused with the history of masking. Masking, defined as an interference of external sounds upon external sounds, has a long and well established history but the laws and principles which have evolved from those studies do not apply to the masking of tinnitus. Indeed, the masking of tinnitus is sufficiently unique that the term masking is incorrect. Unfortunately, it is too late to change the term now, but it is important that all realize that masking of tinnitus is entirely different from ordinary masking.

The use of masking for relief of tinnitus has been known for a long time. Perhaps the earliest written record is that of Hippocrates, who in 400 B.C. said: ‘Why is it that the buzzing in the ears ceases if one makes a sound? Is it because the greater sound drives out the less?’ (Book 32, paragraph 961-A). Clearly, Hippocrates had tinnitus (we would even guess that he had a noise-type tinnitus of a medium to low pitch) and clearly, he had experienced what we call masking of tinnitus.