Titulo:
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus
.
Sumario:
En el mundo se reportan más de 600 millones de personas que experimentan tinnitus. Aproximadamente 20% de las personas con tinnitus subjetivo permanente presentan incomodidad significativa, interviniendo negativamente en su calidad de vida, con inducción de estados depresivos. Existen diferentes estrategias de intervención para el manejo del tinnitus, entre ellas la estimulación acústica. El objetivo de este estudio fue evaluar el impacto de la estimulación acústica pasiva en la severidad del tinnitus y en la calidad de vida de los pacientes con tinnitus subjetivo crónico mediante la Escala Visual Análoga(VAS)y el Inventario de Discapacidad del Tinnitus(THI). Estudio descriptivo de cohorte histórico que incluyó a pacientes >18 a... Ver más
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Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus Effects of Personalized Acoustic Stimulation in Patients with Tinnitus En el mundo se reportan más de 600 millones de personas que experimentan tinnitus. Aproximadamente 20% de las personas con tinnitus subjetivo permanente presentan incomodidad significativa, interviniendo negativamente en su calidad de vida, con inducción de estados depresivos. Existen diferentes estrategias de intervención para el manejo del tinnitus, entre ellas la estimulación acústica. El objetivo de este estudio fue evaluar el impacto de la estimulación acústica pasiva en la severidad del tinnitus y en la calidad de vida de los pacientes con tinnitus subjetivo crónico mediante la Escala Visual Análoga(VAS)y el Inventario de Discapacidad del Tinnitus(THI). Estudio descriptivo de cohorte histórico que incluyó a pacientes >18 años con tinnitus subjetivo crónico que recibieron manejo con estimulación acústica pasiva entre 2017-2018. A los pacientes se les aplicó la VAS y el THI antes, durante y después del tratamiento. Se evidenciaron cambios significativos (p<0,05) entre las medianas en dos de los tres dominios del VAS y en todos los dominios pre y post tratamiento del THI. En las pruebas post hoc se encontraron diferencias (p<0.05) entre las medianas de los puntajes al inicio y a los tres meses y entre los puntajes al inicio y a los seis meses en todos los dominios y en el puntaje total de la escala THI. La estimulación acústica pasiva generó cambios en la discapacidad generada por el tinnitus. Se sugiere complementar los abordajes de tratamiento con estrategias que favorezcan también los mecanismos de memoria, atención y conciencia para aumentar la efectividad de las intervenciones. More than 600 million people worldwide are reported to experience tinnitus. Approximately 20% of people with permanent subjective tinnitus present significant discomfort, interfering negatively in their quality of life, inducing depressive states. There are different intervention strategies for the management of tinnitus, including acoustic stimulation. The aim of this study was to evaluate the impact of passive acoustic stimulation on tinnitus severity and quality of life in patients with chronic subjective tinnitus using the Visual Analogue Scale (VAS) and the Tinnitus Disability Inventory (THI). Descriptive historical cohort study including patients >18 years with chronic subjective tinnitus who received management with passive acoustic stimulation between 2017-2018. Patients were administered VAS and THI before, during and after treatment. Significant changes (p<0.05) between medians were evident in two of the three VAS domains and in all pre- and post-treatment domains of THI. In post hoc tests, differences (p<0.05) were found between the medians of scores at baseline and at three months and between scores at baseline and at six months in all of the domains and in the total THI scale score. Passive acoustic stimulation generated changes in tinnitus-generated disability. It is suggested to complement treatment approaches with strategies that also favor memory, attention and awareness mechanisms to increase the effectiveness of the interventions. Ocampo, Carmen Toro López, Angela María González Eslait, Francisco Javier Blanco Sarmiento, Pedro Visual Analog Scale Audiometry Tinnitus Acoustic Stimulation Escala Visual Análoga audiometría Tinnitus Estimulación acústica 22 1 Artículo de revista Journal article 2022-07-12T22:02:43Z 2022-07-12T22:02:43Z 2022-07-12 application/pdf Bogotá: Corporación Universitaria Iberoamericana Areté 1657-2513 2463-2252 https://arete.ibero.edu.co/article/view/art22103 10.33881/1657-2513.art.22103 https://doi.org/10.33881/1657-2513.art.22103 spa https://creativecommons.org/licenses/by-nc-sa/4.0 Areté - 2022 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. 19 26 Aazh, H., & Moore, B. (2018). Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis. Journal of the American Academy of Audiology, 29(3), 255–261. https://doi.org/10.3766/jaaa.16181. Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2016). Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States. JAMA Otolaryngology-- Head & Neck Surgery, 142(10), 959–965. https://doi.org/10.1001/jamaoto.2016.1700 Centers for disease control and prevention. (1999). Current estimates from the National Health Interview Survey, 1995. In Vital and health statistics. Cobo, P. (2018). Aproximación multidisciplinar al acúfeno. Loquens, 5(2), e051. Davis, P. B., Wilde, R. A., Steed, L. G., & Hanley, P. J. (2008). Treatment of tinnitus with a customized acoustic neural stimulus: A controlled clinical study. Ear, Nose and Throat Journal. https://doi.org/10.1177/014556130808700611 De Azevedo, A. A., De Oliveira, P. M., De Siqueira, A. G., & Figueiredo, R. R. (2007). A critical analysis of tinnitus measuring methods. Brazilian Journal of Otorhinolaryngology, 73(3), 418–423. https://doi.org/10.1016/S1808-8694(15)30088-4 De Ridder, D., Elgoyhen, A. B., Romo, R., & Langguth, B. (2011). Phantom percepts: Tinnitus and pain as persisting aversive memory networks. Proceedings of the National Academy of Sciences, 108(20), 8075–8080. https://doi.org/10.1073/pnas.1018466108 Eggermont, J. J. (2017). Effects of long-term non-traumatic noise exposure on the adult central auditory system. Hearing problems without hearing loss. Hearing Research, 352, 12–22. https://doi.org/10.1016/j.heares.2016.10.015 Haider, H. F., Bojić, T., Ribeiro, S. F., Paço, J., Hall, D. A., & Szczepek, A. J. (2018). Pathophysiology of Subjective Tinnitus: Triggers and Maintenance. Frontiers in Neuroscience, 12, 866. https://doi.org/10.3389/fnins.2018.00866 Haragopal, H., Dorkoski, R., Johnson, H. M., Berryman, M. A., Tanda, S., & Day, M. L. (2020). Paired measurements of cochlear function and hair cell count in Dutch-belted rabbits with noise-induced hearing loss. Hearing Research, 385, 107845. https://doi.org/10.1016/j.heares.2019.107845 Harris, K. C., Bielefeld, E., Hu, B. H., & Henderson, D. (2006). Increased resistance to free radical damage induced by low-level sound conditioning. Hearing Research, 213(1–2), 118–129. https://doi.org/10.1016/j.heares.2005.11.012 Kvestad, E., Czajkowski, N., Engdahl, B., Hoffman, H. J., & Tambs, K. (2010). Low heritability of tinnitus: results from the second Nord-Trøndelag health study. Archives of Otolaryngology-Head & Neck Surgery, 136(2), 178–182. https://doi.org/10.1001/archoto.2009.220 Kwak, E., & Kwak, S. (2020). Threshold sound conditioning in the treatment of sensorineural hearing loss. Laryngoscope Investigative Otolaryngology, 5(3), 438–444. https://doi.org/10.1002/lio2.399 Langguth, B., Biesinger, E., Del Bo, L., De Ridder, D., Goodey, R., Herraiz, C., … Searchfield, G. (2011). Algorithm for the Diagnostic and Therapeutic Management of Tinnitus. In A. Møller, B. Langguth, D. De Ridder, & T. Kleinjung (Eds.), Textbook of Tinnitus (pp. 381–385). https://doi.org/10.1007/978-1-60761-145-5_46 Mahboubi, H., Haidar, Y. M., Kiumehr, S., Ziai, K., & Djalilian, H. R. (2017). Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial. Annals of Otology, Rhinology & Laryngology, 126(10), 681–687. https://doi.org/10.1177/0003489417725093 Niu, X., Tahera, Y., & Canlon, B. (2007). Environmental enrichment to sound activates dopaminergic pathways in the auditory system. Physiology and Behavior. https://doi.org/10.1016/j.physbeh.2007.05.020 Noren, A. J., Chery-Croze, S., & Noreña, A. J. . (2007). Enriched acoustic environment rescales auditory sensitivity. Neuroreport, 18(12), 1251–1255. https://doi.org/10.1097/WNR.0b013e3282202c35 Noreña, A. J., & Eggermont, J. J. (2005). Enriched acoustic environment after noise trauma reduces hearing loss and prevents cortical map reorganization. J Neurosci, 25(3), 699–705. https://doi.org/10.1523/JNEUROSCI.2226-04.2005 Noreña, A. J., & Eggermont, J. J. (2006). Enriched acoustic environment after noise trauma abolishes neural signs of tinnitus. Neuroreport, 17(6), 559–563. https://doi.org/10.1097/00001756-200604240-00001 Roozendaal, B., McEwen, B. S., & Chattarji, S. (2009). Stress, memory and the amygdala. Nature Reviews Neuroscience. https://doi.org/10.1038/nrn2651 Schaette, R., König, O., Hornig, D., Gross, M., & Kempter, R. (2010). Acoustic stimulation treatments against tinnitus could be most effective when tinnitus pitch is within the stimulated frequency range. Hearing Research, 269(1–2), 95–101. https://doi.org/10.1016/j.heares.2010.06.022 Seidman, M. D., & Babu, S. (2003). Alternative medications and other treatments for tinnitus: facts from fiction. Otolaryngologic Clinics of North America, 36(2), 359–381. https://doi.org/10.1016/s0030-6665(02)00167-6 Shargorodsky, J., Curhan, G. C., & Farwell, W. R. (2010). Prevalence and characteristics of tinnitus among US adults. American Journal of Medicine, 123(8), 711–718. https://doi.org/10.1016/j.amjmed.2010.02.015 Stahn, P., Lim, H. H., Hinsberger, M. P., Sorg, K., Pillong, L., Kannengießer, M., … Wenzel, G. I. (2019). Frequency-specific activation of the peripheral auditory system using optoacoustic laser stimulation. Scientific Reports, 9(1), 4171. https://doi.org/10.1038/s41598-019-40860-8 Tunkel, D. E., Bauer, C. A., Sun, G. H., Rosenfeld, R. M., Chandrasekhar, S. S., Cunningham, E. R. J., … Whamond, E. J. (2014). Clinical practice guideline: tinnitus executive summary. Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 151(4), 533–541. https://doi.org/10.1177/0194599814547475 Van Marle, H. J. F., Hermans, E. J., Qin, S., & Fernández, G. (2010). Enhanced resting-state connectivity of amygdala in the immediate aftermath of acute psychological stress. NeuroImage. https://doi.org/10.1016/j.neuroimage.2010.05.070 Wallhäusser-Franke, E., D’Amelio, R., Glauner, A., Delb, W., Servais, J. J., Hörmann, K., & Repik, I. (2017). Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus. Frontiers in Neurology, 8, 605. https://doi.org/10.3389/fneur.2017.00605 Wu, V., Cooke, B., Eitutis, S., Simpson, M. T. W., & Beyea, J. A. (2018). Approach to tinnitus management. Canadian Family Physician Medecin de Famille Canadien, 64(7), 491–495. https://arete.ibero.edu.co/article/download/art22103/1784 info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 http://purl.org/coar/resource_type/c_2df8fbb1 http://purl.org/redcol/resource_type/ART info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication |
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CORPORACIÓN UNIVERSITARIA IBEROAMERICANA |
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Colombia |
| collection |
Areté |
| title |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus |
| spellingShingle |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus Ocampo, Carmen Toro López, Angela María González Eslait, Francisco Javier Blanco Sarmiento, Pedro Visual Analog Scale Audiometry Tinnitus Acoustic Stimulation Escala Visual Análoga audiometría Tinnitus Estimulación acústica |
| title_short |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus |
| title_full |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus |
| title_fullStr |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus |
| title_full_unstemmed |
Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus |
| title_sort |
efectos de la estimulación acústica personalizada en pacientes con tinnitus |
| title_eng |
Effects of Personalized Acoustic Stimulation in Patients with Tinnitus |
| description |
En el mundo se reportan más de 600 millones de personas que experimentan tinnitus. Aproximadamente 20% de las personas con tinnitus subjetivo permanente presentan incomodidad significativa, interviniendo negativamente en su calidad de vida, con inducción de estados depresivos. Existen diferentes estrategias de intervención para el manejo del tinnitus, entre ellas la estimulación acústica. El objetivo de este estudio fue evaluar el impacto de la estimulación acústica pasiva en la severidad del tinnitus y en la calidad de vida de los pacientes con tinnitus subjetivo crónico mediante la Escala Visual Análoga(VAS)y el Inventario de Discapacidad del Tinnitus(THI). Estudio descriptivo de cohorte histórico que incluyó a pacientes >18 años con tinnitus subjetivo crónico que recibieron manejo con estimulación acústica pasiva entre 2017-2018. A los pacientes se les aplicó la VAS y el THI antes, durante y después del tratamiento. Se evidenciaron cambios significativos (p<0,05) entre las medianas en dos de los tres dominios del VAS y en todos los dominios pre y post tratamiento del THI. En las pruebas post hoc se encontraron diferencias (p<0.05) entre las medianas de los puntajes al inicio y a los tres meses y entre los puntajes al inicio y a los seis meses en todos los dominios y en el puntaje total de la escala THI. La estimulación acústica pasiva generó cambios en la discapacidad generada por el tinnitus. Se sugiere complementar los abordajes de tratamiento con estrategias que favorezcan también los mecanismos de memoria, atención y conciencia para aumentar la efectividad de las intervenciones.
|
| description_eng |
More than 600 million people worldwide are reported to experience tinnitus. Approximately 20% of people with permanent subjective tinnitus present significant discomfort, interfering negatively in their quality of life, inducing depressive states. There are different intervention strategies for the management of tinnitus, including acoustic stimulation. The aim of this study was to evaluate the impact of passive acoustic stimulation on tinnitus severity and quality of life in patients with chronic subjective tinnitus using the Visual Analogue Scale (VAS) and the Tinnitus Disability Inventory (THI). Descriptive historical cohort study including patients >18 years with chronic subjective tinnitus who received management with passive acoustic stimulation between 2017-2018. Patients were administered VAS and THI before, during and after treatment. Significant changes (p<0.05) between medians were evident in two of the three VAS domains and in all pre- and post-treatment domains of THI. In post hoc tests, differences (p<0.05) were found between the medians of scores at baseline and at three months and between scores at baseline and at six months in all of the domains and in the total THI scale score. Passive acoustic stimulation generated changes in tinnitus-generated disability. It is suggested to complement treatment approaches with strategies that also favor memory, attention and awareness mechanisms to increase the effectiveness of the interventions.
|
| author |
Ocampo, Carmen Toro López, Angela María González Eslait, Francisco Javier Blanco Sarmiento, Pedro |
| author_facet |
Ocampo, Carmen Toro López, Angela María González Eslait, Francisco Javier Blanco Sarmiento, Pedro |
| topic |
Visual Analog Scale Audiometry Tinnitus Acoustic Stimulation Escala Visual Análoga audiometría Tinnitus Estimulación acústica |
| topic_facet |
Visual Analog Scale Audiometry Tinnitus Acoustic Stimulation Escala Visual Análoga audiometría Tinnitus Estimulación acústica |
| topicspa_str_mv |
Escala Visual Análoga audiometría Tinnitus Estimulación acústica |
| citationvolume |
22 |
| citationissue |
1 |
| publisher |
Bogotá: Corporación Universitaria Iberoamericana |
| ispartofjournal |
Areté |
| source |
https://arete.ibero.edu.co/article/view/art22103 |
| language |
spa |
| format |
Article |
| rights |
https://creativecommons.org/licenses/by-nc-sa/4.0 Areté - 2022 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 |
| references |
Aazh, H., & Moore, B. (2018). Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis. Journal of the American Academy of Audiology, 29(3), 255–261. https://doi.org/10.3766/jaaa.16181. Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2016). Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States. JAMA Otolaryngology-- Head & Neck Surgery, 142(10), 959–965. https://doi.org/10.1001/jamaoto.2016.1700 Centers for disease control and prevention. (1999). Current estimates from the National Health Interview Survey, 1995. In Vital and health statistics. Cobo, P. (2018). Aproximación multidisciplinar al acúfeno. Loquens, 5(2), e051. Davis, P. B., Wilde, R. A., Steed, L. G., & Hanley, P. J. (2008). Treatment of tinnitus with a customized acoustic neural stimulus: A controlled clinical study. Ear, Nose and Throat Journal. https://doi.org/10.1177/014556130808700611 De Azevedo, A. A., De Oliveira, P. M., De Siqueira, A. G., & Figueiredo, R. R. (2007). A critical analysis of tinnitus measuring methods. Brazilian Journal of Otorhinolaryngology, 73(3), 418–423. https://doi.org/10.1016/S1808-8694(15)30088-4 De Ridder, D., Elgoyhen, A. B., Romo, R., & Langguth, B. (2011). Phantom percepts: Tinnitus and pain as persisting aversive memory networks. Proceedings of the National Academy of Sciences, 108(20), 8075–8080. https://doi.org/10.1073/pnas.1018466108 Eggermont, J. J. (2017). Effects of long-term non-traumatic noise exposure on the adult central auditory system. Hearing problems without hearing loss. Hearing Research, 352, 12–22. https://doi.org/10.1016/j.heares.2016.10.015 Haider, H. F., Bojić, T., Ribeiro, S. F., Paço, J., Hall, D. A., & Szczepek, A. J. (2018). Pathophysiology of Subjective Tinnitus: Triggers and Maintenance. Frontiers in Neuroscience, 12, 866. https://doi.org/10.3389/fnins.2018.00866 Haragopal, H., Dorkoski, R., Johnson, H. M., Berryman, M. A., Tanda, S., & Day, M. L. (2020). Paired measurements of cochlear function and hair cell count in Dutch-belted rabbits with noise-induced hearing loss. Hearing Research, 385, 107845. https://doi.org/10.1016/j.heares.2019.107845 Harris, K. C., Bielefeld, E., Hu, B. H., & Henderson, D. (2006). Increased resistance to free radical damage induced by low-level sound conditioning. Hearing Research, 213(1–2), 118–129. https://doi.org/10.1016/j.heares.2005.11.012 Kvestad, E., Czajkowski, N., Engdahl, B., Hoffman, H. J., & Tambs, K. (2010). Low heritability of tinnitus: results from the second Nord-Trøndelag health study. Archives of Otolaryngology-Head & Neck Surgery, 136(2), 178–182. https://doi.org/10.1001/archoto.2009.220 Kwak, E., & Kwak, S. (2020). Threshold sound conditioning in the treatment of sensorineural hearing loss. Laryngoscope Investigative Otolaryngology, 5(3), 438–444. https://doi.org/10.1002/lio2.399 Langguth, B., Biesinger, E., Del Bo, L., De Ridder, D., Goodey, R., Herraiz, C., … Searchfield, G. (2011). Algorithm for the Diagnostic and Therapeutic Management of Tinnitus. In A. Møller, B. Langguth, D. De Ridder, & T. Kleinjung (Eds.), Textbook of Tinnitus (pp. 381–385). https://doi.org/10.1007/978-1-60761-145-5_46 Mahboubi, H., Haidar, Y. M., Kiumehr, S., Ziai, K., & Djalilian, H. R. (2017). Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial. Annals of Otology, Rhinology & Laryngology, 126(10), 681–687. https://doi.org/10.1177/0003489417725093 Niu, X., Tahera, Y., & Canlon, B. (2007). Environmental enrichment to sound activates dopaminergic pathways in the auditory system. Physiology and Behavior. https://doi.org/10.1016/j.physbeh.2007.05.020 Noren, A. J., Chery-Croze, S., & Noreña, A. J. . (2007). Enriched acoustic environment rescales auditory sensitivity. Neuroreport, 18(12), 1251–1255. https://doi.org/10.1097/WNR.0b013e3282202c35 Noreña, A. J., & Eggermont, J. J. (2005). Enriched acoustic environment after noise trauma reduces hearing loss and prevents cortical map reorganization. J Neurosci, 25(3), 699–705. https://doi.org/10.1523/JNEUROSCI.2226-04.2005 Noreña, A. J., & Eggermont, J. J. (2006). Enriched acoustic environment after noise trauma abolishes neural signs of tinnitus. Neuroreport, 17(6), 559–563. https://doi.org/10.1097/00001756-200604240-00001 Roozendaal, B., McEwen, B. S., & Chattarji, S. (2009). Stress, memory and the amygdala. Nature Reviews Neuroscience. https://doi.org/10.1038/nrn2651 Schaette, R., König, O., Hornig, D., Gross, M., & Kempter, R. (2010). Acoustic stimulation treatments against tinnitus could be most effective when tinnitus pitch is within the stimulated frequency range. Hearing Research, 269(1–2), 95–101. https://doi.org/10.1016/j.heares.2010.06.022 Seidman, M. D., & Babu, S. (2003). Alternative medications and other treatments for tinnitus: facts from fiction. Otolaryngologic Clinics of North America, 36(2), 359–381. https://doi.org/10.1016/s0030-6665(02)00167-6 Shargorodsky, J., Curhan, G. C., & Farwell, W. R. (2010). Prevalence and characteristics of tinnitus among US adults. American Journal of Medicine, 123(8), 711–718. https://doi.org/10.1016/j.amjmed.2010.02.015 Stahn, P., Lim, H. H., Hinsberger, M. P., Sorg, K., Pillong, L., Kannengießer, M., … Wenzel, G. I. (2019). Frequency-specific activation of the peripheral auditory system using optoacoustic laser stimulation. Scientific Reports, 9(1), 4171. https://doi.org/10.1038/s41598-019-40860-8 Tunkel, D. E., Bauer, C. A., Sun, G. H., Rosenfeld, R. M., Chandrasekhar, S. S., Cunningham, E. R. J., … Whamond, E. J. (2014). Clinical practice guideline: tinnitus executive summary. Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 151(4), 533–541. https://doi.org/10.1177/0194599814547475 Van Marle, H. J. F., Hermans, E. J., Qin, S., & Fernández, G. (2010). Enhanced resting-state connectivity of amygdala in the immediate aftermath of acute psychological stress. NeuroImage. https://doi.org/10.1016/j.neuroimage.2010.05.070 Wallhäusser-Franke, E., D’Amelio, R., Glauner, A., Delb, W., Servais, J. J., Hörmann, K., & Repik, I. (2017). Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus. Frontiers in Neurology, 8, 605. https://doi.org/10.3389/fneur.2017.00605 Wu, V., Cooke, B., Eitutis, S., Simpson, M. T. W., & Beyea, J. A. (2018). Approach to tinnitus management. Canadian Family Physician Medecin de Famille Canadien, 64(7), 491–495. |
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