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Published in: Journal of the Association for Research in Otolaryngology 3/2009

01-09-2009

Human Medial Olivocochlear Reflex: Effects as Functions of Contralateral, Ipsilateral, and Bilateral Elicitor Bandwidths

Authors: Watjana Lilaonitkul, John J. Guinan Jr.

Published in: Journal of the Association for Research in Otolaryngology | Issue 3/2009

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Abstract

Animal studies have led to the view that the acoustic medial olivocochlear (MOC) efferent reflex provides sharply tuned frequency-specific feedback that inhibits cochlear amplification. To determine if MOC activation is indeed narrow band, we measured the MOC effects in humans elicited by 60-dB sound pressure level (SPL) contralateral, ipsilateral, and bilateral noise bands as a function of noise bandwidth from 1/2 to 6.7 octaves. MOC effects were quantified by the change in stimulus frequency otoacoustic emissions from 40 dB SPL probe tones near 0.5, 1, and 4 kHz. In a second experiment, the noise bands were centered 2 octaves below probe frequencies near 1 and 4 kHz. In all cases, the MOC effects increased as elicitor bandwidth increased, with the effect saturating at about 4 octaves. Generally, the MOC effects increased as the probe frequency decreased, opposite expectations based on MOC innervation density in the cochlea. Bilateral-elicitor effects were always the largest. The ratio of ipsilateral/contralateral effects depended on elicitor bandwidth; the ratio was large for narrow-band probe-centered elicitors and approximately unity for wide-band elicitors. In another experiment, the MOC effects from increasing elicitor bandwidths were calculated from measurements of the MOC effects from adjacent half-octave noise bands. The predicted bandwidth function agreed well with the measured bandwidth function for contralateral elicitors, but overestimated it for ipsilateral and bilateral elicitors. Overall, the results indicate that (1) the MOC reflexes integrate excitation from almost the entire cochlear length, (2) as elicitor bandwidth is increased, the excitation from newly stimulated cochlear regions more than overcomes the reduced excitation at frequencies in the center of the elicitor band, and (3) contralateral, ipsilateral, and bilateral elicitors show MOC reflex spatial summation over most of the cochlea, but ipsilateral spatial summation is less additive than contralateral.
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Literature
go back to reference Backus BC. Bias due to noise in otoacoustic emission measurements. J. Acoust. Soc. Am. 121:1588–1603, 2007.PubMedCrossRef Backus BC. Bias due to noise in otoacoustic emission measurements. J. Acoust. Soc. Am. 121:1588–1603, 2007.PubMedCrossRef
go back to reference Backus BC, Guinan JJ. Measurement of the distribution of medial olivocochlear acoustic reflex strengths across normal-hearing individuals via otoacoustic emissions. J. Assoc. Res. Otolaryngol. 8:484–496, 2007.PubMedCrossRef Backus BC, Guinan JJ. Measurement of the distribution of medial olivocochlear acoustic reflex strengths across normal-hearing individuals via otoacoustic emissions. J. Assoc. Res. Otolaryngol. 8:484–496, 2007.PubMedCrossRef
go back to reference Boyev KP, Liberman MC, Brown MC. Effects of anesthesia on efferent-mediated adaptation of the DPOAE. J. Assoc. Res. Otolaryngol. 3:362–373, 2002.PubMedCrossRef Boyev KP, Liberman MC, Brown MC. Effects of anesthesia on efferent-mediated adaptation of the DPOAE. J. Assoc. Res. Otolaryngol. 3:362–373, 2002.PubMedCrossRef
go back to reference Brown MC. Morphology and response properties of single olivocochlear fibers in the guinea pig. Hear. Res. 40:93–110, 1989.PubMedCrossRef Brown MC. Morphology and response properties of single olivocochlear fibers in the guinea pig. Hear. Res. 40:93–110, 1989.PubMedCrossRef
go back to reference Brown MC, Kujawa SG, Duca ML. Single olivocochlear neurons in the guinea pig. I. Binaural facilitation of responses to high-level noise. J. Neurophysiol. 79:3077–3087, 1998.PubMed Brown MC, Kujawa SG, Duca ML. Single olivocochlear neurons in the guinea pig. I. Binaural facilitation of responses to high-level noise. J. Neurophysiol. 79:3077–3087, 1998.PubMed
go back to reference Cooper NP, Guinan JJ. Efferent-mediated control of basilar membrane motion. J. Physiol. 576:49–54, 2006.PubMedCrossRef Cooper NP, Guinan JJ. Efferent-mediated control of basilar membrane motion. J. Physiol. 576:49–54, 2006.PubMedCrossRef
go back to reference Dallos P, Wu X, Cheatham MA, Gao J, Zheng J, Anderson CT, Jia S, Wang X, Cheng WH, Sengupta S, He DZ, Zuo J. Prestin-based outer hair cell motility is necessary for mammalian cochlear amplification. Neuron. 58:333–339, 2008.PubMedCrossRef Dallos P, Wu X, Cheatham MA, Gao J, Zheng J, Anderson CT, Jia S, Wang X, Cheng WH, Sengupta S, He DZ, Zuo J. Prestin-based outer hair cell motility is necessary for mammalian cochlear amplification. Neuron. 58:333–339, 2008.PubMedCrossRef
go back to reference de Boer E, Nuttall AL. The mechanical waveform of the basilar membrane. II. From data to models—and back. J. Acoust. Soc. Am. 107:1487–1496, 2000.PubMedCrossRef de Boer E, Nuttall AL. The mechanical waveform of the basilar membrane. II. From data to models—and back. J. Acoust. Soc. Am. 107:1487–1496, 2000.PubMedCrossRef
go back to reference Francis HW, Nadol JB. Patterns of innervation of outer hair cells in a chimpanzee: I. Afferent endings and reciprocal synapses. Hear. Res. 64:184–190, 1993a.PubMedCrossRef Francis HW, Nadol JB. Patterns of innervation of outer hair cells in a chimpanzee: I. Afferent endings and reciprocal synapses. Hear. Res. 64:184–190, 1993a.PubMedCrossRef
go back to reference Francis HW, Nadol JB. Patterns of innervation of outer hair cells in a chimpanzee: II. Efferent endings. Hear. Res. 64:217–221, 1993b.PubMedCrossRef Francis HW, Nadol JB. Patterns of innervation of outer hair cells in a chimpanzee: II. Efferent endings. Hear. Res. 64:217–221, 1993b.PubMedCrossRef
go back to reference Gifford ML, Guinan JJ. Jr. Effects of electrical stimulation of medial olivocochlear neurons on ipsilateral and contralateral cochlear responses. Hear. Res. 29:179–194, 1987.PubMedCrossRef Gifford ML, Guinan JJ. Jr. Effects of electrical stimulation of medial olivocochlear neurons on ipsilateral and contralateral cochlear responses. Hear. Res. 29:179–194, 1987.PubMedCrossRef
go back to reference Guinan JJ. Jr. Effect of efferent neural activity on cochlear mechanics. Scand. Audiol. Suppl. 25:53–62, 1986.PubMed Guinan JJ. Jr. Effect of efferent neural activity on cochlear mechanics. Scand. Audiol. Suppl. 25:53–62, 1986.PubMed
go back to reference Guinan JJ. Jr. Changes in stimulus frequency otoacoustic emissions produced by two-tone suppression and efferent stimulation in cats. In: Dallos P (eds) Mechanics and Biophysics of Hearing. Madison, WI, Springer, pp. 170–177, 1990. Guinan JJ. Jr. Changes in stimulus frequency otoacoustic emissions produced by two-tone suppression and efferent stimulation in cats. In: Dallos P (eds) Mechanics and Biophysics of Hearing. Madison, WI, Springer, pp. 170–177, 1990.
go back to reference Guinan JJ. Jr. The physiology of olivocochlear efferents. In: Dallos PJ (eds) The Cochlea. New York, Springer, pp. 435–502, 1996. Guinan JJ. Jr. The physiology of olivocochlear efferents. In: Dallos PJ (eds) The Cochlea. New York, Springer, pp. 435–502, 1996.
go back to reference Guinan JJ. Jr. Olivocochlear efferents: Anatomy, physiology, function, and the measurement of efferent effects in humans. Ear Hear. 27:589–607, 2006.PubMedCrossRef Guinan JJ. Jr. Olivocochlear efferents: Anatomy, physiology, function, and the measurement of efferent effects in humans. Ear Hear. 27:589–607, 2006.PubMedCrossRef
go back to reference Guinan JJ, Jr. Gifford ML. Effects of electrical stimulation of efferent olivocochlear neurons on cat auditory-nerve fibers. III. Tuning curves and thresholds at CF. Hear. Res. 37:29–46, 1988.PubMedCrossRef Guinan JJ, Jr. Gifford ML. Effects of electrical stimulation of efferent olivocochlear neurons on cat auditory-nerve fibers. III. Tuning curves and thresholds at CF. Hear. Res. 37:29–46, 1988.PubMedCrossRef
go back to reference Guinan JJ, Jr. Warr WB, Norris BE. Differential olivocochlear projections from lateral vs. medial zones of the superior olivary complex. J. Comp. Neurol. 221:358–370, 1983.PubMedCrossRef Guinan JJ, Jr. Warr WB, Norris BE. Differential olivocochlear projections from lateral vs. medial zones of the superior olivary complex. J. Comp. Neurol. 221:358–370, 1983.PubMedCrossRef
go back to reference Guinan JJ, Jr. Warr WB, Norris BE. Topographic organization of the olivocochlear projections from the lateral and medial zones of the superior olivary complex. J. Comp. Neurol. 226:21–27, 1984.PubMedCrossRef Guinan JJ, Jr. Warr WB, Norris BE. Topographic organization of the olivocochlear projections from the lateral and medial zones of the superior olivary complex. J. Comp. Neurol. 226:21–27, 1984.PubMedCrossRef
go back to reference Guinan JJ, Backus BC, Lilaonitkul W, Aharonson V. Medial olivocochlear efferent reflex in humans: otoacoustic emission (OAE) measurement issues and the advantages of stimulus frequency OAEs. J. Assoc. Res. Otolaryngol. 4:521–540, 2003.PubMedCrossRef Guinan JJ, Backus BC, Lilaonitkul W, Aharonson V. Medial olivocochlear efferent reflex in humans: otoacoustic emission (OAE) measurement issues and the advantages of stimulus frequency OAEs. J. Assoc. Res. Otolaryngol. 4:521–540, 2003.PubMedCrossRef
go back to reference Kalluri R, Shera CA. Comparing stimulus-frequency otoacoustic emissions measured by compression, suppression, and spectral smoothing. J. Acoust. Soc. Am. 122:3562–3575, 2007.PubMedCrossRef Kalluri R, Shera CA. Comparing stimulus-frequency otoacoustic emissions measured by compression, suppression, and spectral smoothing. J. Acoust. Soc. Am. 122:3562–3575, 2007.PubMedCrossRef
go back to reference Kawase T, Delgutte B, Liberman MC. Anti-masking effects of the olivocochlear reflex, II: Enhancement of auditory-nerve response to masked tones. J. Neurophysiol. 70:2533–2549, 1993.PubMed Kawase T, Delgutte B, Liberman MC. Anti-masking effects of the olivocochlear reflex, II: Enhancement of auditory-nerve response to masked tones. J. Neurophysiol. 70:2533–2549, 1993.PubMed
go back to reference Keefe DH, Ellison JC, Fitzpatrick DF, Gorga MP. Two-tone suppression of stimulus frequency otoacoustic emissions. J. Acoust. Soc. Am. 123:1479–1494, 2008.PubMedCrossRef Keefe DH, Ellison JC, Fitzpatrick DF, Gorga MP. Two-tone suppression of stimulus frequency otoacoustic emissions. J. Acoust. Soc. Am. 123:1479–1494, 2008.PubMedCrossRef
go back to reference Kemp DT, Chum RA. Observations on the generation mechanism of stimulus frequency acoustic emissions—two tone suppression. In: van den Brink G, Bilsen FA (eds) Psychophysical, Physiological and Behavioral Studies in Hearing, vol 5. Delft, Delft University Press, pp. 34–42, 1980. Kemp DT, Chum RA. Observations on the generation mechanism of stimulus frequency acoustic emissions—two tone suppression. In: van den Brink G, Bilsen FA (eds) Psychophysical, Physiological and Behavioral Studies in Hearing, vol 5. Delft, Delft University Press, pp. 34–42, 1980.
go back to reference Kemp DT, Souter M. A new rapid component in the cochlear response to brief electrical efferent stimulation. Hear. Res. 34:49–62, 1988.PubMedCrossRef Kemp DT, Souter M. A new rapid component in the cochlear response to brief electrical efferent stimulation. Hear. Res. 34:49–62, 1988.PubMedCrossRef
go back to reference Liberman MC. Response properties of cochlear efferent neurons: monaural vs. binaural stimulation and the effects of noise. J. Neurophysiol. 60:1779–1798, 1988.PubMed Liberman MC. Response properties of cochlear efferent neurons: monaural vs. binaural stimulation and the effects of noise. J. Neurophysiol. 60:1779–1798, 1988.PubMed
go back to reference Liberman MC, Brown MC. Physiology and anatomy of single olivocochlear neurons in the cat. Hear. Res. 24:17–36, 1986.PubMedCrossRef Liberman MC, Brown MC. Physiology and anatomy of single olivocochlear neurons in the cat. Hear. Res. 24:17–36, 1986.PubMedCrossRef
go back to reference Lilaonitkul W, Guinan JJ Jr. Reflex control of the human inner ear: A half-octave offset in medial efferent feedback that is consistent with an efferent role in the control of masking. J. Neurophysiol, 101:1394–406, 2009.PubMedCrossRef Lilaonitkul W, Guinan JJ Jr. Reflex control of the human inner ear: A half-octave offset in medial efferent feedback that is consistent with an efferent role in the control of masking. J. Neurophysiol, 101:1394–406, 2009.PubMedCrossRef
go back to reference Lisowska G, Smurzynski J, Morawski K, Namyslowski G, Probst R. Influence of contralateral stimulation by two-tone complexes, narrow-band and broad-band noise signals on the 2f1–f2 distortion product otoacoustic emission levels in humans. Acta. Otolaryngol. 122:613–619, 2002.PubMedCrossRef Lisowska G, Smurzynski J, Morawski K, Namyslowski G, Probst R. Influence of contralateral stimulation by two-tone complexes, narrow-band and broad-band noise signals on the 2f1–f2 distortion product otoacoustic emission levels in humans. Acta. Otolaryngol. 122:613–619, 2002.PubMedCrossRef
go back to reference Maison SF, Liberman MC. Predicting vulnerability to acoustic injury with a noninvasive assay of olivocochlear reflex strength. J. Neurosci. 20:4701–4707, 2000.PubMed Maison SF, Liberman MC. Predicting vulnerability to acoustic injury with a noninvasive assay of olivocochlear reflex strength. J. Neurosci. 20:4701–4707, 2000.PubMed
go back to reference Maison S, Micheyl C, Andeol G, Gallego S, Collet L. Activation of medial olivocochlear efferent system in humans: Influence of stimulus bandwidth. Hear. Res. 140:111–125, 2000.PubMedCrossRef Maison S, Micheyl C, Andeol G, Gallego S, Collet L. Activation of medial olivocochlear efferent system in humans: Influence of stimulus bandwidth. Hear. Res. 140:111–125, 2000.PubMedCrossRef
go back to reference Micheyl C, Maison S, Carlyon RP, Andeol G, Collet L. Contralateral suppression of transiently evoked otoacoustic emissions by harmonic complex tones in humans. J. Acoust. Soc. Am. 105:293–305, 1999.PubMedCrossRef Micheyl C, Maison S, Carlyon RP, Andeol G, Collet L. Contralateral suppression of transiently evoked otoacoustic emissions by harmonic complex tones in humans. J. Acoust. Soc. Am. 105:293–305, 1999.PubMedCrossRef
go back to reference Norman M, Thornton ARD. Frequency analysis of the contralateral suppression of evoked otoacoustic emissions by narrow-band noise. Br. J. Audiol. 27:281–289, 1993.PubMedCrossRef Norman M, Thornton ARD. Frequency analysis of the contralateral suppression of evoked otoacoustic emissions by narrow-band noise. Br. J. Audiol. 27:281–289, 1993.PubMedCrossRef
go back to reference Oxenham AJ, Plack CJ. A behavioral measure of basilar-membrane nonlinearity in listeners with normal and impaired hearing. J. Acoust. Soc. Am. 101:3666–3675, 1997.PubMedCrossRef Oxenham AJ, Plack CJ. A behavioral measure of basilar-membrane nonlinearity in listeners with normal and impaired hearing. J. Acoust. Soc. Am. 101:3666–3675, 1997.PubMedCrossRef
go back to reference Puria S, Guinan JJ, Liberman MC. Olivocochlear reflex assays: Effects of contralateral sound on compound action potentials vs. ear-canal distortion products. J. Acoust. Soc. Am. 99:500–507, 1996.PubMedCrossRef Puria S, Guinan JJ, Liberman MC. Olivocochlear reflex assays: Effects of contralateral sound on compound action potentials vs. ear-canal distortion products. J. Acoust. Soc. Am. 99:500–507, 1996.PubMedCrossRef
go back to reference Rajan R. Protective functions of the efferent pathways to the mammalian cochlea: A Review. In: Dancer A (eds) Noise-Induced Hearing Loss. St. Louis, Mosby Year Book, pp. 429–444, 1992. Rajan R. Protective functions of the efferent pathways to the mammalian cochlea: A Review. In: Dancer A (eds) Noise-Induced Hearing Loss. St. Louis, Mosby Year Book, pp. 429–444, 1992.
go back to reference Robertson D. Horseradish peroxidase injection of physiologically characterized afferent and efferent neurones in the guinea pig spiral ganglion. Hear. Res. 15:113–121, 1984.PubMedCrossRef Robertson D. Horseradish peroxidase injection of physiologically characterized afferent and efferent neurones in the guinea pig spiral ganglion. Hear. Res. 15:113–121, 1984.PubMedCrossRef
go back to reference Sato S, Henson M, Smith DW. Synaptic specialization associated with the outer hair cells of the Japanese macaque. Hear. Res. 108:46–54, 1997.PubMedCrossRef Sato S, Henson M, Smith DW. Synaptic specialization associated with the outer hair cells of the Japanese macaque. Hear. Res. 108:46–54, 1997.PubMedCrossRef
go back to reference Schuknecht HF, Churchill JA, Doran R. The localization of acetylcholinesterase in the cochlea. AMA Arch. Otolaryng. 69:549–559, 1959. Schuknecht HF, Churchill JA, Doran R. The localization of acetylcholinesterase in the cochlea. AMA Arch. Otolaryng. 69:549–559, 1959.
go back to reference Shera CA. Laser amplification with a twist: traveling-wave propagation and gain functions from throughout the cochlea. J. Acoust. Soc. Am. 122:2738–2758, 2007.PubMedCrossRef Shera CA. Laser amplification with a twist: traveling-wave propagation and gain functions from throughout the cochlea. J. Acoust. Soc. Am. 122:2738–2758, 2007.PubMedCrossRef
go back to reference Shera CA, Tubis A, Talmadge CL, Guinan JJ. The dual effect of “suppressor” tones on stimulus-frequency otoacoustic emissions. Assoc. Res. Otolaryngol. Abstr. 27:776, 2004. Shera CA, Tubis A, Talmadge CL, Guinan JJ. The dual effect of “suppressor” tones on stimulus-frequency otoacoustic emissions. Assoc. Res. Otolaryngol. Abstr. 27:776, 2004.
go back to reference Shera CA, Tubis A, Talmadge CL. Testing coherent reflection in chinchilla. J. Acoust. Soc. Am. 123:3851, 2008.PubMedCrossRef Shera CA, Tubis A, Talmadge CL. Testing coherent reflection in chinchilla. J. Acoust. Soc. Am. 123:3851, 2008.PubMedCrossRef
go back to reference Siegel JH, Temchin AN, Ruggero M. Empirical estimates of the spatial origin of stimulus-frequency otoacoustic emissions. J. Assoc. Res. Otolaryngol. 26:172, 2003, (#679). Siegel JH, Temchin AN, Ruggero M. Empirical estimates of the spatial origin of stimulus-frequency otoacoustic emissions. J. Assoc. Res. Otolaryngol. 26:172, 2003, (#679).
go back to reference Siegel JH, Cerka AJ, Recio-Spinoso A, Temchin AN, van Dijk P, Ruggero M. Delays of stimulus-frequency otoacoustic emissions and cochlear vibrations contradict the theory of coherent reflection filtering. J. Acoust. Soc. Am. 118:2434–2443, 2005.PubMedCrossRef Siegel JH, Cerka AJ, Recio-Spinoso A, Temchin AN, van Dijk P, Ruggero M. Delays of stimulus-frequency otoacoustic emissions and cochlear vibrations contradict the theory of coherent reflection filtering. J. Acoust. Soc. Am. 118:2434–2443, 2005.PubMedCrossRef
go back to reference Thiers FA, Burgess BJ, Nadol JB. Prevalence and ultrastructural morphology of axosomatic synapses on spiral ganglion cells in humans of different ages. Hear. Res. 150:119–131, 2000.PubMedCrossRef Thiers FA, Burgess BJ, Nadol JB. Prevalence and ultrastructural morphology of axosomatic synapses on spiral ganglion cells in humans of different ages. Hear. Res. 150:119–131, 2000.PubMedCrossRef
go back to reference Thiers FA, Burgess BJ, Nadol JB. Axodendritic and dendrodendritic synapses within outer spiral bundles in a human. Hear. Res. 164:97–104, 2002a.PubMedCrossRef Thiers FA, Burgess BJ, Nadol JB. Axodendritic and dendrodendritic synapses within outer spiral bundles in a human. Hear. Res. 164:97–104, 2002a.PubMedCrossRef
go back to reference Thiers FA, Burgess BJ, Nadol JB. Reciprocal innervation of outer hair cells in a human infant. J. Assoc. Res. Otolaryngol. 3:269–278, 2002b.PubMedCrossRef Thiers FA, Burgess BJ, Nadol JB. Reciprocal innervation of outer hair cells in a human infant. J. Assoc. Res. Otolaryngol. 3:269–278, 2002b.PubMedCrossRef
go back to reference Thiers FA, Nadol JB, Jr, Liberman MC. Reciprocal synapses between outer hair cells and their afferent terminals: evidence for a local neural network in the mammalian cochlea. J. Assoc. Res. Otolaryngol. 9:477–489, 2008.PubMedCrossRef Thiers FA, Nadol JB, Jr, Liberman MC. Reciprocal synapses between outer hair cells and their afferent terminals: evidence for a local neural network in the mammalian cochlea. J. Assoc. Res. Otolaryngol. 9:477–489, 2008.PubMedCrossRef
go back to reference Thompson GC, Thompson AM. Olivocochlear neurons in the squirrel monkey brainstem. JCN. 254:246–258, 1986.CrossRef Thompson GC, Thompson AM. Olivocochlear neurons in the squirrel monkey brainstem. JCN. 254:246–258, 1986.CrossRef
go back to reference Velenovsky DS, Glattke TJ. The effect of noise bandwidth on the contralateral suppression of transient evoked otoacoustic emissions. Hear. Res. 164:39–48, 2002.PubMedCrossRef Velenovsky DS, Glattke TJ. The effect of noise bandwidth on the contralateral suppression of transient evoked otoacoustic emissions. Hear. Res. 164:39–48, 2002.PubMedCrossRef
go back to reference Winslow RL, Sachs MB. Effect of electrical stimulation of the crossed olivocochlear bundle on auditory nerve response to tones in noise. J. Neurophysiol. 57:1002–1021, 1987.PubMed Winslow RL, Sachs MB. Effect of electrical stimulation of the crossed olivocochlear bundle on auditory nerve response to tones in noise. J. Neurophysiol. 57:1002–1021, 1987.PubMed
go back to reference Winslow RL, Sachs MB. Single-tone intensity discrimination based on auditory-nerve rate responses in backgrounds of quiet, noise, and with stimulation of crossed olivocochlear bundle. Hear. Res. 35:165–190, 1988.PubMedCrossRef Winslow RL, Sachs MB. Single-tone intensity discrimination based on auditory-nerve rate responses in backgrounds of quiet, noise, and with stimulation of crossed olivocochlear bundle. Hear. Res. 35:165–190, 1988.PubMedCrossRef
Metadata
Title
Human Medial Olivocochlear Reflex: Effects as Functions of Contralateral, Ipsilateral, and Bilateral Elicitor Bandwidths
Authors
Watjana Lilaonitkul
John J. Guinan Jr.
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Journal of the Association for Research in Otolaryngology / Issue 3/2009
Print ISSN: 1525-3961
Electronic ISSN: 1438-7573
DOI
https://doi.org/10.1007/s10162-009-0163-1

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