1
|
Han L, Pengfei Z, Chunli L, Zhaodi W, Xindi W, Qian C, Shusheng G, Zhenchang W. The effects of sound therapy in tinnitus are characterized by altered limbic and auditory networks. Brain Commun 2020; 2:fcaa131. [PMID: 33134919 PMCID: PMC7585694 DOI: 10.1093/braincomms/fcaa131] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 01/01/2023] Open
Abstract
To determine the neural mechanism underlying the effects of sound therapy on tinnitus, we hypothesize that sound therapy may be effective by modulating both local neural activity and functional connectivity that is associated with auditory perception, auditory information storage or emotional processing. In this prospective observational study, 30 tinnitus patients underwent resting-state functional magnetic resonance imaging scans at baseline and after 12 weeks of sound therapy. Thirty-two age- and gender-matched healthy controls also underwent two scans over a 12-week interval; 30 of these healthy controls were enrolled for data analysis. The amplitude of low-frequency fluctuation was analysed, and seed-based functional connectivity measures were shown to significantly alter spontaneous local brain activity and its connections to other brain regions. Interaction effects between the two groups and the two scans in local neural activity as assessed by the amplitude of low-frequency fluctuation were observed in the left parahippocampal gyrus and the right Heschl's gyrus. Importantly, local functional activity in the left parahippocampal gyrus in the patient group was significantly higher than that in the healthy controls at baseline and was reduced to relatively normal levels after treatment. Conversely, activity in the right Heschl's gyrus was significantly increased and extended beyond a relatively normal range after sound therapy. These changes were found to be positively correlated with tinnitus relief. The functional connectivity between the left parahippocampal gyrus and the cingulate cortex was higher in tinnitus patients after treatment. The alterations of local activity and functional connectivity in the left parahippocampal gyrus and right Heschl’s gyrus were associated with tinnitus relief. Resting-state functional magnetic resonance imaging can provide functional information to explain and ‘visualize’ the mechanism underlying the effect of sound therapy on the brain.
Collapse
Affiliation(s)
- Lv Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zhao Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Liu Chunli
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Wang Zhaodi
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Wang Xindi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Chen Qian
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Gong Shusheng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Wang Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| |
Collapse
|
2
|
Association between Anatomical Features of Petrotympanic Fissure and Tinnitus in Patients with Temporomandibular Joint Disorder Using CBCT Imaging: An Exploratory Study. Pain Res Manag 2020; 2020:1202751. [PMID: 32774565 PMCID: PMC7397445 DOI: 10.1155/2020/1202751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/07/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
Mandible displacement is known to correlate with otological conditions such as pain in the ear canal, hearing loss, or tinnitus. The present work aimed to determine the association between the displacement of the condyle in a temporomandibular joint, the structure and position of the petrotympanic fissure (PTF), and comorbid tinnitus in patients affected by temporomandibular joint and muscle disorder (TMD). We enrolled 331 subjects with TMD (268 women and 63 men). The average age of women was 40.8 ± 16.8 years (range 13–88), whereas the average age of the examined men was 38 ± 14 years (range 13–74). We performed imaging studies of the facial part of the skull in the sagittal plane using a volumetric imaging method and a large imaging field (FOV) of 17 cm × 23 cm. The habitual position of the mandible was determined and used as a reference. Based on the imaging results, we developed a classification for the topography and the structure of the petrotympanic fissure. Thirty-three TMD patients (about 10% of the sample) reported having tinnitus. These patients had PTF configurations characterized by a rear (36.59%) or intracranial-cranial (63.41%) condylar displacement of the temporomandibular joint. Our findings imply that the TMJ- and tinnitus-positive group of patients possibly represents a distinct phenotype of tinnitus. We concluded that for such patients, the therapeutic approach for tinnitus should include TMD treatment.
Collapse
|
3
|
Dawood F, Khan NB, Bagwandin V. Management of adult patients with tinnitus: Preparedness, perspectives and practices of audiologists. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2019; 66:e1-e10. [PMID: 31793315 PMCID: PMC6890539 DOI: 10.4102/sajcd.v66i1.621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 11/30/2022] Open
Abstract
Background Audiologists, globally, are generally challenged when assessing and creating intervention plans to help patients suffering from tinnitus. Tinnitus is very common among individuals and may significantly affect one’s quality of life, especially if not addressed by health care professionals. In South Africa, there seems to be limited published studies regarding the current practices of tinnitus management by audiologists. This is mainly because of limited training and a lack of guidelines and strategies for the management of tinnitus. In particular, some participants reported being unfamiliar on how to approach the identification of tinnitus and difficulty is also encountered when counselling tinnitus patients. Aim The aim of this study was to describe the preparedness, perspectives and practices of audiologists who manage adult patients with tinnitus. Method Two hundred and forty-three registered Health Professions Council of South Africa (HPCSA) participants were involved in the study by responding to an electronic questionnaire survey. Data were collected online from Survey Monkey and were exported to Statistical Packages for the Social Sciences (SPSS) (Version 23) for statistical analysis. Data were analysed using descriptive and inferential statistics. Closed-ended questions were analysed within a quantitative framework and thematic analysis for open-ended questions that were descriptively quantified. Results The results of the study are presented according to the objectives. Approximately 44% of participants (44.3%) disagreed that the undergraduate university training had sufficiently prepared them to manage adult patients with tinnitus. Very few (12.3%) had the opportunity to attend specialist training on how to assess patients with tinnitus. Similarly, only 11.6% received any specialist training with regard to tinnitus intervention. With regard to its overall management, 49.4% felt adequately informed in the assessment of patients with tinnitus, while a further 39.2% rated their experience as being limited with regard to tinnitus intervention. There is no statistical significance relationship between participants’ years of experience and tinnitus intervention (p = 0.075). Most participants did not follow any standard guidelines for its management. Some participants (26.8%) reported that further education and training are required in the overall management of patients with tinnitus, while a further 17.7% required training in all areas of tinnitus. Conclusion The feedback relating to the study suggests that overall management of tinnitus seems to be a challenge among South African audiologists, irrespective of their years of experience. Audiologists in the study perceived that tinnitus services are limited mainly because of a lack of or limited knowledge, training and guidelines, these being affected by contextual restraints.
Collapse
Affiliation(s)
- Firdaus Dawood
- Discipline of Audiology, University of KwaZulu-Natal, Durban.
| | | | | |
Collapse
|
4
|
Hall DA. Designing Clinical Trials for Assessing the Effectiveness of Interventions for Tinnitus. Trends Hear 2019; 21:2331216517736689. [PMID: 29076393 PMCID: PMC5661669 DOI: 10.1177/2331216517736689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In the face of finite resources, allocations of research and health-care
funding are dependent upon high-quality evidence. Historically,
tinnitus has been the poor cousin of hearing science, with low-quality
clinical research providing unreliable estimates of effect and with
devices marketed for tinnitus without strong evidence for those
product claims. However, the tinnitus field is changing. Key opinion
leaders have recently made calls to the field to improve the design,
implementation, and reporting of clinical trials, and there is growing
intersectoral collaboration. The Tonndorf Lecture presented at the 1st
World Tinnitus Congress and the 12th International Tinnitus Seminar in
Warsaw, Poland, provided an opportunity to reflect on the present and
future progress of tinnitus research and treatment and what is needed
for the field to achieve success. The content of that lecture is
summarized in this article. The main debate concerns the selection and
reporting of outcomes in clinical trials of tinnitus. Comprehensive
reviews of the literature confirm the diversity of the personal impact
of tinnitus and illustrate a lack of consensus in what aspects of
tinnitus should be assessed and reported in a clinical trial. An
innovative project is described which engages the global tinnitus
community (patients and professionals alike) in working together. This
project seeks to improve future tinnitus research by creating an
evidence-based consensus about minimum reporting standards for
outcomes in clinical trials of a tinnitus intervention. The output
will be a core set of important and critical outcomes to be measured
and reported in all clinical trials.
Collapse
Affiliation(s)
- Deborah A Hall
- 1 Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK.,2 Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, UK.,3 Nottingham University Hospitals NHS Trust, Queen's Medical Centre, UK
| |
Collapse
|
5
|
Skarżyński H, Gos E, Raj-Koziak D, Skarżyński PH. Skarzynski Tinnitus Scale: validation of a brief and robust tool for assessing tinnitus in a clinical population. Eur J Med Res 2018; 23:54. [PMID: 30382881 PMCID: PMC6211414 DOI: 10.1186/s40001-018-0347-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many tinnitus scales are available, but all of them have certain limitations. The aim of the current study was to present a psychometric data of a new brief and reliable questionnaire that could be conveniently used for evaluating tinnitus complaint in adults (either with normal or impaired hearing)-Skarzynski Tinnitus Scale (STS). METHODS The study included 125 participants with at least 1 month of tinnitus duration. All participants were asked to complete the STS, Tinnitus and Hearing Survey (THS), Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), and Beck Depression Inventory. Psychometric properties of the new tool were tested using exploratory factor analysis (EFA), Pearson bivariate correlation with other tinnitus questionnaires, Pearson bivariate correlation with pure-tone audiometry, Cronbach's alpha coefficient, limits of agreement, smallest detectable change, and floor and ceiling effects. Norms for tinnitus severity as measured by the STS are proposed. RESULTS As a whole, the STS has excellent reliability (ICC = 0.94) and good internal consistency (α = 0.91). The results of EFA and content analysis of wording of the items justified the three-factorial structure. The convergent validity was proven by a significant positive correlation with THI, TFI and THS Subscale A scores. Additionally, the authors proposed norms dividing the results into four tinnitus severity grades. CONCLUSIONS Statistical analysis shows that STS is a brief but robust tool well-suited to clinical practice. A feature of STS is that it takes into account the impact of tinnitus on the patient's psychological (emotional, cognitive) and functional domains as well as their ability to cope with tinnitus-related distress.
Collapse
Affiliation(s)
- Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 17 Mokra st., Kajetany / 10 Mochnackiego, 02-042, Warsaw, Poland
| | - Elżbieta Gos
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 17 Mokra st., Kajetany / 10 Mochnackiego, 02-042, Warsaw, Poland
| | - Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 17 Mokra st., Kajetany / 10 Mochnackiego, 02-042, Warsaw, Poland
| | - Piotr H Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 17 Mokra st., Kajetany / 10 Mochnackiego, 02-042, Warsaw, Poland. .,Heart Failure and Cardiac Rehabilitation Department, Second Faculty, Medical University of Warsaw, Warsaw, Poland. .,Institute of Sensory Organs, 1 Mokra st., Kajetany, 05-830, Warsaw, Poland.
| |
Collapse
|
6
|
Skarzynski PH, Raj-Koziak D, J. Rajchel J, Pilka A, Wlodarczyk AW, Skarzynski H. Adaptation of the Tinnitus Handicap Inventory into Polish and its testing on a clinical population of tinnitus sufferers. Int J Audiol 2017; 56:711-715. [DOI: 10.1080/14992027.2017.1319080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Piotr H. Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
- Heart Failure and Cardiac Rehabilitation Department, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland, and
- Institute of Sensory Organs, Warsaw/Kajetany, Poland
| | - Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Joanna J. Rajchel
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Adam Pilka
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Andrzej W. Wlodarczyk
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| |
Collapse
|
7
|
Haider H, Fackrell K, Kennedy V, Hall DA. Dimensions of tinnitus-related complaints reported by patients and their significant others: protocol for a systematic review. BMJ Open 2016; 6:e009171. [PMID: 27855082 PMCID: PMC5073661 DOI: 10.1136/bmjopen-2015-009171] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Over 70 million people in Europe and >50 million people in the USA are reported to experience tinnitus (the sensation of noise in the absence of any corresponding sound source). Tinnitus is a multidimensional concept. Individual patients may report different profiles of tinnitus-related symptoms which may each require a tailored management approach and an appropriate measure of therapeutic benefit. This systematic review concerns the patient perspective and has the purpose to find what symptoms are reported by people who experience tinnitus and by their significant others. METHODS AND ANALYSIS This protocol lays out the methodology to define what dimensions of tinnitus-related symptoms patients and their significant others report as being a problem. Methods are defined according to the Preferred Reporting Items for Systematic reviews and Meta-analyses for Protocols (PRISMA-P) 2015 and data will be collated in a narrative synthesis. Findings will contribute to the eventual establishment of a Core Domain Set for clinical trials of tinnitus. ETHICS AND DISSEMINATION No ethical issues are foreseen. Findings will be reported at national and international ENT and audiology conferences and in a peer-reviewed journal. TRIAL REGISTRATION NUMBER CRD42015020629.
Collapse
Affiliation(s)
- Haúla Haider
- ENT Department, Hospital Cuf Infante Santo—Nova Medical School, Lisbon, Portugal
| | - Kathryn Fackrell
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research (NIHR), Nottingham, UK
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Veronica Kennedy
- Department of Audiovestibular Medicine, Halliwell Health and Children's Centre, Bolton NHS Foundation Trust, Bolton, UK
| | - Deborah A Hall
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research (NIHR), Nottingham, UK
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
8
|
Hall DA, Haider H, Szczepek AJ, Lau P, Rabau S, Jones-Diette J, Londero A, Edvall NK, Cederroth CR, Mielczarek M, Fuller T, Batuecas-Caletrio A, Brueggemen P, Thompson DM, Norena A, Cima RFF, Mehta RL, Mazurek B. Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. Trials 2016; 17:270. [PMID: 27250987 PMCID: PMC4888312 DOI: 10.1186/s13063-016-1399-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no evidence-based guidance to facilitate design decisions for confirmatory trials or systematic reviews investigating treatment efficacy for adults with tinnitus. This systematic review therefore seeks to ascertain the current status of trial designs by identifying and evaluating the reporting of outcome domains and instruments in the treatment of adults with tinnitus. METHODS Records were identified by searching PubMed, EMBASE CINAHL, EBSCO, and CENTRAL clinical trial registries (ClinicalTrials.gov, ISRCTN, ICTRP) and the Cochrane Database of Systematic Reviews. Eligible records were those published from 1 July 2006 to 12 March 2015. Included studies were those reporting adults aged 18 years or older who reported tinnitus as a primary complaint, and who were enrolled into a randomised controlled trial, a before and after study, a non-randomised controlled trial, a case-controlled study or a cohort study, and written in English. Studies with fewer than 20 participants were excluded. RESULTS Two hundred and twenty-eight studies were included. Thirty-five different primary outcome domains were identified spanning seven categories (tinnitus percept, impact of tinnitus, co-occurring complaints, quality of life, body structures and function, treatment-related outcomes and unclear or not specified). Over half the studies (55 %) did not clearly define the complaint of interest. Tinnitus loudness was the domain most often reported (14 %), followed by tinnitus distress (7 %). Seventy-eight different primary outcome instruments were identified. Instruments assessing multiple attributes of the impact of tinnitus were most common (34 %). Overall, 24 different patient-reported tools were used, predominantly the Tinnitus Handicap Inventory (15 %). Loudness was measured in diverse ways including a numerical rating scale (8 %), loudness matching (4 %), minimum masking level (1 %) and loudness discomfort level (1 %). Ten percent of studies did not clearly report the instrument used. CONCLUSIONS Our findings indicate poor appreciation of the basic principles of good trial design, particularly the importance of specifying what aspect of therapeutic benefit is the main outcome. No single outcome was reported in all studies and there was a broad diversity of outcome instruments. PROSPERO REGISTRATION The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): CRD42015017525 . Registered on 12 March 2015 revised on 15 March 2016.
Collapse
Affiliation(s)
- Deborah A Hall
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Haula Haider
- ENT Department of Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro 3, 1350-070, Lisbon, Portugal
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Charite University Hospital, Chariteplatz 1, 10117, Berlin, Germany
| | - Pia Lau
- Institute of Biomagnetism and Biosignalanalysis, University Hospital Münster, Malmedyweg 15, 48149, Münster, Germany
| | - Sarah Rabau
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Julie Jones-Diette
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
| | - Alain Londero
- Service ORL et CCF, Consultation Acouphène et Hyperacousie, Hôpital Européen G. Pompidou, 20, rue Leblanc, 75015, Paris, France
| | - Niklas K Edvall
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Von Eulers väg 8, 171 77, Stockholm, Sweden
| | - Christopher R Cederroth
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Von Eulers väg 8, 171 77, Stockholm, Sweden
| | - Marzena Mielczarek
- Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, |Medical University of Lodz, 90-549 Lodz, 113 Zeromskiego Street, Lodz, Poland
| | - Thomas Fuller
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, PO Box 616, 6200, MD, Maastricht, The Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands
| | - Angel Batuecas-Caletrio
- Department of Otorhinolaryngology, IBSAL, University Hospital of Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Petra Brueggemen
- Tinnitus Center, Charite University Hospital, Chariteplatz 1, 10117, Berlin, Germany
| | - Dean M Thompson
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Arnaud Norena
- Laboratory of Adaptive and Integrative Neuroscience, Centre National de la Recherche Scientifique, Fédération de Recherche 3C, Aix-Marseille Université, Marseille, France
| | - Rilana F F Cima
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, PO Box 616, 6200, MD, Maastricht, The Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands
| | - Rajnikant L Mehta
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Birgit Mazurek
- Tinnitus Center, Charite University Hospital, Chariteplatz 1, 10117, Berlin, Germany
| |
Collapse
|