Skip to main content
Erschienen in: Journal of the Association for Research in Otolaryngology 2/2003

01.06.2003

Differential Ear Effects of Profound Unilateral Deafness on the Adult Human Central Auditory System

verfasst von: Deepak Khosla, Curtis W. Ponton, Jos J. Eggermont, Betty Kwong, Manuel Dort, Juha-Pekka Vasama

Erschienen in: Journal of the Association for Research in Otolaryngology | Ausgabe 2/2003

Einloggen, um Zugang zu erhalten

Abstract

This study investigates the effects of profound acquired unilateral deafness on the adult human central auditory system by analyzing long-latency auditory evoked potentials (AEPs) with dipole source modeling methods. AEPs, elicited by clicks presented to the intact ear in 19 adult subjects with profound unilateral deafness and monaurally to each ear in eight adult normal-hearing controls, were recorded with a 31-channel system. The responses in the 70–210 ms time window, encompassing the N1b/P2 and Ta/Tb components of the AEPs, were modeled by a vertically and a laterally oriented dipole source in each hemisphere. Peak latencies and amplitudes of the major components of the dipole waveforms were measured in the hemispheres ipsilateral and contralateral to the stimulated ear. The normal-hearing subjects showed significant ipsilateral–contralateral latency and amplitude differences, with contralateral source activities that were typically larger and peaked earlier than the ipsilateral activities. In addition, the ipsilateral–contralateral amplitude differences from monaural presentation were similar for left and for right ear stimulation. For unilaterally deaf subjects, the previously reported reduction in ipsilateral–contralateral amplitude differences based on scalp waveforms was also observed in the dipole source waveforms. However, analysis of the source dipole activity demonstrated that the reduced inter-hemispheric amplitude differences were ear dependent. Specifically, these changes were found only in those subjects affected by profound left ear unilateral deafness.
Literatur
1.
Zurück zum Zitat Adams, JC 1979Ascending projections to the inferior colliculus.J. Comp. Neurol.183519538PubMed Adams, JC 1979Ascending projections to the inferior colliculus.J. Comp. Neurol.183519538PubMed
2.
Zurück zum Zitat Belin, P, Zatorre, RJ, Lafaille, P, Ahad, P, Pike, B 2000Voice-selective areas in human auditory cortex.Nature.403309312CrossRefPubMed Belin, P, Zatorre, RJ, Lafaille, P, Ahad, P, Pike, B 2000Voice-selective areas in human auditory cortex.Nature.403309312CrossRefPubMed
3.
Zurück zum Zitat Bess, F, Klee, T, Culbertson, J 1986Identification, assessment, and management of children with unilateral sensorineural hearing loss.Ear Hear.74351PubMed Bess, F, Klee, T, Culbertson, J 1986Identification, assessment, and management of children with unilateral sensorineural hearing loss.Ear Hear.74351PubMed
4.
Zurück zum Zitat Bjorklund, RA, Lian, A 1993Interhemispheric transmission time in an auditory two-choice reaction task. Scand.J. Psychol.34174182 Bjorklund, RA, Lian, A 1993Interhemispheric transmission time in an auditory two-choice reaction task. Scand.J. Psychol.34174182
5.
Zurück zum Zitat Brosch, M, Schreiner, CE 1999Correlations between neural discharges are related to receptive field properties in cat primary auditory cortex.Eur. J. Neurosci.1135173530CrossRefPubMed Brosch, M, Schreiner, CE 1999Correlations between neural discharges are related to receptive field properties in cat primary auditory cortex.Eur. J. Neurosci.1135173530CrossRefPubMed
6.
Zurück zum Zitat Brunso–Bechtold, JK, Thompson, GC, Masterson, RB 1981HRP study of the organization of auditory afferents ascending to the central nucleus of the inferior colliculus in cat.J. Comp. Neurol.197705722PubMed Brunso–Bechtold, JK, Thompson, GC, Masterson, RB 1981HRP study of the organization of auditory afferents ascending to the central nucleus of the inferior colliculus in cat.J. Comp. Neurol.197705722PubMed
7.
Zurück zum Zitat Coleman, JR, Clerici, WJ 1987Sources of projections to subdivisions of the inferior colliculus in the rat.J. Comp. Neurol.262215226PubMed Coleman, JR, Clerici, WJ 1987Sources of projections to subdivisions of the inferior colliculus in the rat.J. Comp. Neurol.262215226PubMed
8.
Zurück zum Zitat Cuffin, BN, Cohen, D 1979Comparison of the magnetoencephalogram and electroencephalogram. Electroencephalogr.Clin. Neurophysiol.47132146 Cuffin, BN, Cohen, D 1979Comparison of the magnetoencephalogram and electroencephalogram. Electroencephalogr.Clin. Neurophysiol.47132146
9.
Zurück zum Zitat Eggermont, JJ, Komiya, H 2000Moderate noise trauma in juvenile cats results in profound cortical topographic map changes in adulthood.Hear. Res.14289101CrossRefPubMed Eggermont, JJ, Komiya, H 2000Moderate noise trauma in juvenile cats results in profound cortical topographic map changes in adulthood.Hear. Res.14289101CrossRefPubMed
10.
Zurück zum Zitat Fujuki, N, Naito, Y, Nagamine, T, Shiom, Y, Hirano, S, Honjo, I, Shibasaki, H 1998Influence of unilateral deafness on evoked magnetic field.Neuro report.31293133 Fujuki, N, Naito, Y, Nagamine, T, Shiom, Y, Hirano, S, Honjo, I, Shibasaki, H 1998Influence of unilateral deafness on evoked magnetic field.Neuro report.31293133
11.
Zurück zum Zitat Gustafson, TJ, Hamill, TA 1995Differences in localization ability in cases of right versus left unilateral simulated conductive hearing loss.J. Am. Acad. Audiol.6124128PubMed Gustafson, TJ, Hamill, TA 1995Differences in localization ability in cases of right versus left unilateral simulated conductive hearing loss.J. Am. Acad. Audiol.6124128PubMed
12.
Zurück zum Zitat Hartvig, JJ, Jensen, J, Borre, S, Johansen, PA 1989Unilateral sensorineural hearing loss in children and auditory performance with respect to right/left ear differences.Br. J. Audiol.23207213PubMed Hartvig, JJ, Jensen, J, Borre, S, Johansen, PA 1989Unilateral sensorineural hearing loss in children and auditory performance with respect to right/left ear differences.Br. J. Audiol.23207213PubMed
13.
Zurück zum Zitat Harrison, RV, Nagasawa, A, Smith, DW, Stanton, S, Mount, RJ 1991Reorganization of auditory cortex after neonatal high frequency cochlear hearing loss.Hear. Res.541119CrossRefPubMed Harrison, RV, Nagasawa, A, Smith, DW, Stanton, S, Mount, RJ 1991Reorganization of auditory cortex after neonatal high frequency cochlear hearing loss.Hear. Res.541119CrossRefPubMed
14.
Zurück zum Zitat Jacobson, GP, Lombardi, DM, Gibbens, ND, Ahmad, BK, Newman, CW 1992The effects of stimulus frequency and recording site on the amplitude and latency of multichannel cortical auditory evoked potential (CAEP) component N1.Ear Hear.13300306PubMed Jacobson, GP, Lombardi, DM, Gibbens, ND, Ahmad, BK, Newman, CW 1992The effects of stimulus frequency and recording site on the amplitude and latency of multichannel cortical auditory evoked potential (CAEP) component N1.Ear Hear.13300306PubMed
15.
Zurück zum Zitat Johnsrude, S, Zatorre, RJ, Milner, BA, Evans, AC 1992(1997) Left-hemisphere specialization for the processing of acoustic transients.Neuro report817611765 Johnsrude, S, Zatorre, RJ, Milner, BA, Evans, AC 1992(1997) Left-hemisphere specialization for the processing of acoustic transients.Neuro report817611765
16.
Zurück zum Zitat King, C, Nicol, T, McGee, T, Kraus, N 1999Thalamic asymmetry is related to acoustic signal complexity.Neurosci. Lett.2678992CrossRefPubMed King, C, Nicol, T, McGee, T, Kraus, N 1999Thalamic asymmetry is related to acoustic signal complexity.Neurosci. Lett.2678992CrossRefPubMed
17.
Zurück zum Zitat Kitzes, LM 1984Some physiological consequences of cochlear destruction in the inferior colliculus of the gerbil.Brain Res.306171178CrossRefPubMed Kitzes, LM 1984Some physiological consequences of cochlear destruction in the inferior colliculus of the gerbil.Brain Res.306171178CrossRefPubMed
18.
Zurück zum Zitat Liègeois–Chauvel, C, Musolino, A, Chauvel, P 1991Localization of the primary auditory area in man.Brain.114139153PubMed Liègeois–Chauvel, C, Musolino, A, Chauvel, P 1991Localization of the primary auditory area in man.Brain.114139153PubMed
19.
Zurück zum Zitat Liègeois–Chauvell, C, Musolino, A, Badier, JM, Marquis, P, Chauvel, P 1994Evoked potentials recorded from the auditory cortex in man: evaluation and topography of the middle latency components.Electroencephalogr. Clin. Neurophysiol.92204214CrossRefPubMed Liègeois–Chauvell, C, Musolino, A, Badier, JM, Marquis, P, Chauvel, P 1994Evoked potentials recorded from the auditory cortex in man: evaluation and topography of the middle latency components.Electroencephalogr. Clin. Neurophysiol.92204214CrossRefPubMed
20.
Zurück zum Zitat Liègeois–Chauvel, C, de Graaf, JB, Laguitton, V, Chauvel, P 1999Specilaization of left auditory cortex for speech perception in man depends on temporal coding.Cereb. Cortex.9484496CrossRefPubMed Liègeois–Chauvel, C, de Graaf, JB, Laguitton, V, Chauvel, P 1999Specilaization of left auditory cortex for speech perception in man depends on temporal coding.Cereb. Cortex.9484496CrossRefPubMed
21.
Zurück zum Zitat Mosher, JC, Lewis, PS, Leahy, RM 1992Multiple dipole modeling and localization from spatiotemporal MEG data.IEEE Trans. Biomed. Eng.39541557CrossRefPubMed Mosher, JC, Lewis, PS, Leahy, RM 1992Multiple dipole modeling and localization from spatiotemporal MEG data.IEEE Trans. Biomed. Eng.39541557CrossRefPubMed
22.
Zurück zum Zitat Mossop, JE, Wilson, MJ, Caspary, DM, Moore, DR 2000Down-regulation of inhibition following unilateral deafening.Hear. Res.147183187CrossRefPubMed Mossop, JE, Wilson, MJ, Caspary, DM, Moore, DR 2000Down-regulation of inhibition following unilateral deafening.Hear. Res.147183187CrossRefPubMed
23.
Zurück zum Zitat Näätänen, R, Picton, T 1987The N1 wave of the human electric and magnetic response to sound: A review and an analysis of the component structure.Psychophysiology24375425PubMed Näätänen, R, Picton, T 1987The N1 wave of the human electric and magnetic response to sound: A review and an analysis of the component structure.Psychophysiology24375425PubMed
24.
Zurück zum Zitat Nalcaci, E, Basar–Eroglu, C, Stadler, M 1999Visual evoked potential interhemispheric transfer time in different frequency bands.Clin. Neurophysiol.1107181CrossRefPubMed Nalcaci, E, Basar–Eroglu, C, Stadler, M 1999Visual evoked potential interhemispheric transfer time in different frequency bands.Clin. Neurophysiol.1107181CrossRefPubMed
25.
Zurück zum Zitat Ponton, CW, Don, M, Waring, MD, Eggermont, JJ, Masuda, A 1993Spatio-temporal source modeling of evoked potentials to acoustic and cochlear implant stimulation. Electroencephalogr.Clin. Neurophysiol.88478493CrossRef Ponton, CW, Don, M, Waring, MD, Eggermont, JJ, Masuda, A 1993Spatio-temporal source modeling of evoked potentials to acoustic and cochlear implant stimulation. Electroencephalogr.Clin. Neurophysiol.88478493CrossRef
26.
Zurück zum Zitat Ponton, CW, Don, M, Eggermont, JJ, Waring, MD, Masuda, A 1996aMaturation of human cortical auditory function: Differences between normal hearing and cochlear implant children.Ear17430437 Ponton, CW, Don, M, Eggermont, JJ, Waring, MD, Masuda, A 1996aMaturation of human cortical auditory function: Differences between normal hearing and cochlear implant children.Ear17430437
27.
Zurück zum Zitat Ponton, CW, Don, M, Eggermont, JJ, Waring, MD, Kwong, B, Masuda, A 1996bAuditory system plasticity in children after long periods of complete deafness.Neur report.86165 Ponton, CW, Don, M, Eggermont, JJ, Waring, MD, Kwong, B, Masuda, A 1996bAuditory system plasticity in children after long periods of complete deafness.Neur report.86165
28.
Zurück zum Zitat Ponton, CW, Moore, JK, Eggermont, JJ 1999Prolonged deafness limits auditory system developmental plasticity: evidence from an evoked potential study in children with cochlear implants.Scand. Audiol.Suppl. 511322 Ponton, CW, Moore, JK, Eggermont, JJ 1999Prolonged deafness limits auditory system developmental plasticity: evidence from an evoked potential study in children with cochlear implants.Scand. Audiol.Suppl. 511322
29.
Zurück zum Zitat Ponton, CW, Eggermont, JJ, Don, M, Waring, MD, Kwong, B, Cunningham, J, Trautwein, P 2000Maturation of the mismatch negativity: effects of profound deafness and cochlear implant use.Audiol. Neurotol.5167185CrossRef Ponton, CW, Eggermont, JJ, Don, M, Waring, MD, Kwong, B, Cunningham, J, Trautwein, P 2000Maturation of the mismatch negativity: effects of profound deafness and cochlear implant use.Audiol. Neurotol.5167185CrossRef
30.
Zurück zum Zitat Ponton, CW, Vasama, JP, Tremblay, K, Khosla, D, Kwong, B, Don, M 2001Plasticity in the adult human central auditory system: evidence from late-onset profound unilateral deafness.Hear. Res.1543244CrossRefPubMed Ponton, CW, Vasama, JP, Tremblay, K, Khosla, D, Kwong, B, Don, M 2001Plasticity in the adult human central auditory system: evidence from late-onset profound unilateral deafness.Hear. Res.1543244CrossRefPubMed
31.
Zurück zum Zitat Ponton, CW, Eggermont, JJ, Khosla, D, Kwong, B, Don, M 2002Maturation of human central auditory system activity: separating auditory evoked potentials by dipole source modeling.Clin. Neurophysiol.113407420CrossRefPubMed Ponton, CW, Eggermont, JJ, Khosla, D, Kwong, B, Don, M 2002Maturation of human central auditory system activity: separating auditory evoked potentials by dipole source modeling.Clin. Neurophysiol.113407420CrossRefPubMed
32.
Zurück zum Zitat Popelár, J, Eire, JP, Aran, JM, Cazals, Y 1994Plastic changes in ipsi-contralateral differences of auditory cortex and inferior colliculus evoked potentials after injury to one ear in the adult guinea pig.Hear. Res.72125134CrossRefPubMed Popelár, J, Eire, JP, Aran, JM, Cazals, Y 1994Plastic changes in ipsi-contralateral differences of auditory cortex and inferior colliculus evoked potentials after injury to one ear in the adult guinea pig.Hear. Res.72125134CrossRefPubMed
33.
Zurück zum Zitat Rajan, R, Irvine, DR, Wise, LZ, Heil, P 1993Effect of unilateral partial cochlear lesions in adult cats on the representation of lesioned and unlesioned cochleas in primary auditory cortex.J. Comp. Neurol.3381749PubMed Rajan, R, Irvine, DR, Wise, LZ, Heil, P 1993Effect of unilateral partial cochlear lesions in adult cats on the representation of lesioned and unlesioned cochleas in primary auditory cortex.J. Comp. Neurol.3381749PubMed
34.
Zurück zum Zitat Reale, RA, Brugge, JF, Chan, JC 1987Maps of auditory cortex in cats reared after unilateral cochlear ablation in the neonatal period.Brain Res.192281290 Reale, RA, Brugge, JF, Chan, JC 1987Maps of auditory cortex in cats reared after unilateral cochlear ablation in the neonatal period.Brain Res.192281290
35.
Zurück zum Zitat Reser, DH, Fishman, YI, Arezzo, JC, Steinschneider, M 2000Binaural interactions in primary auditory cortex of the awake macaque.Cereb. Cortex.10574584CrossRefPubMed Reser, DH, Fishman, YI, Arezzo, JC, Steinschneider, M 2000Binaural interactions in primary auditory cortex of the awake macaque.Cereb. Cortex.10574584CrossRefPubMed
36.
Zurück zum Zitat Robertson, D, Irvine, DR 1989Plasticity of frequency organization in auditory cortex of guinea pigs with partial unilateral deafness.J. Comp. Neurol.282456471PubMed Robertson, D, Irvine, DR 1989Plasticity of frequency organization in auditory cortex of guinea pigs with partial unilateral deafness.J. Comp. Neurol.282456471PubMed
37.
Zurück zum Zitat Scheffler, K, Bilecen, N, Tschopp, K, Seelig, J 1998Auditory cortical responses in hearing subjects and unilateral deaf patients as detected by functional magnetic resonance imaging.Cereb. Cortex.8156163CrossRefPubMed Scheffler, K, Bilecen, N, Tschopp, K, Seelig, J 1998Auditory cortical responses in hearing subjects and unilateral deaf patients as detected by functional magnetic resonance imaging.Cereb. Cortex.8156163CrossRefPubMed
38.
Zurück zum Zitat Scherg, M, Von Cramon, D 1985Two bilateral sources of late AEP as identified by a spatiotemporal dipole model. Electroencephalogr.Clin. Neurophysiol.623244CrossRef Scherg, M, Von Cramon, D 1985Two bilateral sources of late AEP as identified by a spatiotemporal dipole model. Electroencephalogr.Clin. Neurophysiol.623244CrossRef
39.
Zurück zum Zitat Scherg, M, Von Cramon, D 1986Evoked dipole source potentials of the human auditory cortex. Electroencephalogr.Clin. Neurophysiol.65344360CrossRef Scherg, M, Von Cramon, D 1986Evoked dipole source potentials of the human auditory cortex. Electroencephalogr.Clin. Neurophysiol.65344360CrossRef
40.
Zurück zum Zitat Scherg, M 1992Functional imaging and localization of electromagnetic brain activity.Brain Topogr.5103111PubMed Scherg, M 1992Functional imaging and localization of electromagnetic brain activity.Brain Topogr.5103111PubMed
41.
Zurück zum Zitat Snyder, AZ 1991Dipole source localization in the study of EP generators: A critique. Electroencephalogr.Clin. Neurophysiol.80321325CrossRef Snyder, AZ 1991Dipole source localization in the study of EP generators: A critique. Electroencephalogr.Clin. Neurophysiol.80321325CrossRef
42.
Zurück zum Zitat Steinschneider, M, Volkov, IO, Noh, MD, Garell, PC, Howard, MA 1999Temporal encoding of the voice onset time phonetic parameter by field potentials recorded directly from human auditory cortex.J. Neurophysiol.8223462357PubMed Steinschneider, M, Volkov, IO, Noh, MD, Garell, PC, Howard, MA 1999Temporal encoding of the voice onset time phonetic parameter by field potentials recorded directly from human auditory cortex.J. Neurophysiol.8223462357PubMed
43.
Zurück zum Zitat Suga, N, Gao, E, Zhang, Y, Ma, X, Olsen, JF 2000The corticofugal system for hearing: recent progress.Proc. Natl. Acad. Sci. U.S.A.971180711814CrossRefPubMed Suga, N, Gao, E, Zhang, Y, Ma, X, Olsen, JF 2000The corticofugal system for hearing: recent progress.Proc. Natl. Acad. Sci. U.S.A.971180711814CrossRefPubMed
44.
Zurück zum Zitat Tonnquist–Uhlen, I, Ponton, CW, Eggermont, JJ, Kwong, B, Don, M Maturation of human central auditory system activity: The T-complex.Clin. Neurophysiol.(in press) Tonnquist–Uhlen, I, Ponton, CW, Eggermont, JJ, Kwong, B, Don, M Maturation of human central auditory system activity: The T-complex.Clin. Neurophysiol.(in press)
45.
Zurück zum Zitat Vasama, J-P, Mäkelä, JP 1995Auditory pathway plasticity in adult humans after unilateral idiopathic sudden sensorineural hearing loss.Hear. Res.87132140CrossRefPubMed Vasama, J-P, Mäkelä, JP 1995Auditory pathway plasticity in adult humans after unilateral idiopathic sudden sensorineural hearing loss.Hear. Res.87132140CrossRefPubMed
46.
Zurück zum Zitat Vasama, J-P, Mäkelä, JP 1997Auditory cortical responses in humans with profound unilateral sensorineural hearing loss from early childhood.Hear. Res.104183190CrossRefPubMed Vasama, J-P, Mäkelä, JP 1997Auditory cortical responses in humans with profound unilateral sensorineural hearing loss from early childhood.Hear. Res.104183190CrossRefPubMed
47.
Zurück zum Zitat Vasama, J-P, Mäkelä, JP, Pyykkö, I, Hari, R 1995Abrupt unilateral deafness modifies function of human central auditory pathways.Neuro report.6961964 Vasama, J-P, Mäkelä, JP, Pyykkö, I, Hari, R 1995Abrupt unilateral deafness modifies function of human central auditory pathways.Neuro report.6961964
48.
Zurück zum Zitat Vasama, J-P, Mäkelä, JP, Ramsay, H 1998Modification of auditory pathway functions in patients with hearing improvements after middle ear surgery. Otolaryngol.Head Neck Surg.119125130 Vasama, J-P, Mäkelä, JP, Ramsay, H 1998Modification of auditory pathway functions in patients with hearing improvements after middle ear surgery. Otolaryngol.Head Neck Surg.119125130
49.
Zurück zum Zitat Verkindt, C, Bertrand, O, Thevenet, M, Pernier, J 1994Two auditory components in the 130–230 ms range disclosed by their stimulus frequency dependence.Neuro report.511891192 Verkindt, C, Bertrand, O, Thevenet, M, Pernier, J 1994Two auditory components in the 130–230 ms range disclosed by their stimulus frequency dependence.Neuro report.511891192
50.
Zurück zum Zitat Zatorre, RJ, Evans, AC, Meyer, E, Gjedde, A 1992Lateralization of phonetic and pitch discrimination in speech processing.Science.256846849PubMed Zatorre, RJ, Evans, AC, Meyer, E, Gjedde, A 1992Lateralization of phonetic and pitch discrimination in speech processing.Science.256846849PubMed
Metadaten
Titel
Differential Ear Effects of Profound Unilateral Deafness on the Adult Human Central Auditory System
verfasst von
Deepak Khosla
Curtis W. Ponton
Jos J. Eggermont
Betty Kwong
Manuel Dort
Juha-Pekka Vasama
Publikationsdatum
01.06.2003
Erschienen in
Journal of the Association for Research in Otolaryngology / Ausgabe 2/2003
Print ISSN: 1525-3961
Elektronische ISSN: 1438-7573
DOI
https://doi.org/10.1007/s10162-002-3014-x

Weitere Artikel der Ausgabe 2/2003

Journal of the Association for Research in Otolaryngology 2/2003 Zur Ausgabe

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.