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  1. Article: Assessment of the Effect of Subthalamic Deep Brain Stimulation on Sleep Quality of Parkinson's Disease Patients.

    Oner, Ozge Gonul / Sunter, Gulin / Jafarova, Shabnam / Agan, Kadriye / Seker, Askin / Gunal, Dilek Ince

    Turkish neurosurgery

    2022  Volume 32, Issue 3, Page(s) 398–405

    Abstract: Aim: To investigate the effects of subthalamic deep brain stimulation (STN DBS) therapy on sleep quality of Parkinson?s Disease (PD) patients and the relationship between sleep, motor symptoms, depression, and adverse effects of dopamine replacement ... ...

    Abstract Aim: To investigate the effects of subthalamic deep brain stimulation (STN DBS) therapy on sleep quality of Parkinson?s Disease (PD) patients and the relationship between sleep, motor symptoms, depression, and adverse effects of dopamine replacement therapies.
    Material and methods: A total of 26 PD patients have been included and assessed using various tools both 1 week before and 8 months after the STN DBS therapy. The data collection tools were the Unified Parkinson?s Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Parkinson?s Disease Questionnaire (PDQ-39), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and Polysomnography.
    Results: PSQI, ISI, and ESS scores were found to have significantly improved after the STN DBS therapy (p=0.002, p=0.006, p < 0.001, respectively), as were the scores obtained from several PSQI sub-scales, that is, sleep duration, sleep disturbance and daytime dysfunction (p=0.023, p=0.005, p=0.032, respectively). Additionally, Wake Times After Sleep Onset (WASO) (p=0.047) and Rapid Eye Movement (REM) sleep latency values (p=0.005) were found to have decreased after the STN DBS treatment, whereas REM sleep durations (p=0,028) and REM sleep percentages (p=0.007) were found to have increased, after the STN DBS therapy. No correlation was found between the ESS scores and Levodopa Equivalent Dosage (LED) or between the scores obtained from the sleep scales and the scores obtained from the UPDRS and BDI. There was also no correlation between sleep scores and other PD-related factors.
    Conclusion: The findings of this study indicated that STN DBS therapy positively affected the PD patients? sleep. This result was attributed to the neuromodulatory effects of the STN DBS independent of the motor symptoms, depression levels, and LED decrease.
    MeSH term(s) Deep Brain Stimulation/adverse effects ; Humans ; Levodopa ; Parkinson Disease/complications ; Parkinson Disease/therapy ; Sleep Quality ; Subthalamic Nucleus/physiology ; Treatment Outcome
    Chemical Substances Levodopa (46627O600J)
    Language English
    Publishing date 2022-12-20
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 1203779-5
    ISSN 1019-5149
    ISSN 1019-5149
    DOI 10.5137/1019-5149.JTN.33808-21.2
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  2. Article ; Online: Challenges in the Management of a 7-Year-Old Child with Thyrotropin-Secreting Pituitary Adenoma and the Review of the Literature.

    Kirkgoz, Tarik / Abali, Saygin / Seker, Askin / Gurpinar Tosun, Busra / Eltan, Mehmet / Helvacioglu, Didem / Haliloglu, Belma / Kaygusuz, Sare Betul / Yavas Abali, Zehra / Seven Menevse, Tuba / Bozkurt, Suheyla / Ones, Tunc / Guran, Tulay / Dagcinar, Adnan / Bereket, Abdullah / Turan, Serap

    Hormone research in paediatrics

    2023  Volume 96, Issue 5, Page(s) 527–537

    Abstract: Introduction: Thyrotropin-producing pituitary adenoma (TSHoma) is a very rare disease, representing less than 1% of the pituitary tumours and presenting with elevated thyroid hormones and normal/high TSH concentrations.: Case presentation: A 7-year- ... ...

    Abstract Introduction: Thyrotropin-producing pituitary adenoma (TSHoma) is a very rare disease, representing less than 1% of the pituitary tumours and presenting with elevated thyroid hormones and normal/high TSH concentrations.
    Case presentation: A 7-year-old boy with nervousness was referred by his psychiatrist for elevated free T4, T3, and TSH levels. Initial evaluation revealed an elevated α-subunit. Pituitary magnetic resonance imaging (MRI) demonstrated a macroadenoma. The patient underwent a trans-sphenoidal tumour resection (TSS) which showed positive immunohistochemical staining for TSH, growth hormone, and prolactin in tumoral tissue. Euthyroidism was achieved for 1 year after TSS, then recurrence of tumour with elevated TSH and thyroid hormone levels necessitated a re-operation with TSS followed by gamma-knife radiosurgery. The euthyroid state was achieved and lasted for 2.5 years this time, but due to the recurrence, medical treatment had been commenced with cabergoline and octreotide. Euthyroidism was maintained for the last 4 years on monthly octreotide treatment. A repeat MRI demonstrated no pituitary mass, but a mass in the sphenoidal sinus had been detected. Removal of this mass by surgery did not achieve euthyroidism. 68Ga-DOTA-TATE positron emission tomography/computed tomography showed residual tissue extending from the pituitary region to the sphenoid sinus. The patient's bone age was advanced by 2 years at diagnosis which became 4 years in 1 year after the diagnosis and remained so throughout follow-up, leading to a final height of -3.3 SDS below his target height at the age of 16 years.
    Conclusion: The diagnosis, treatment, and follow-up of TSHomas are challenging, and short stature due to accelerated bone maturation is a complication of paediatric TSHomas.
    MeSH term(s) Male ; Humans ; Child ; Child, Preschool ; Adolescent ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/therapy ; Octreotide ; Thyrotropin ; Adenoma/surgery ; Adenoma/diagnosis ; Pituitary Gland ; Hyperthyroidism
    Chemical Substances Octreotide (RWM8CCW8GP) ; Thyrotropin (9002-71-5)
    Language English
    Publishing date 2023-01-11
    Publishing country Switzerland
    Document type Review ; Case Reports
    ZDB-ID 2537278-6
    ISSN 1663-2826 ; 1663-2818
    ISSN (online) 1663-2826
    ISSN 1663-2818
    DOI 10.1159/000529070
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  3. Article ; Online: Ventriculoperitoneal Shunt Infection and Treatment in Children

    Eren Cagan / Ahmet Soysal / Askin seker / Mustafa seker

    Çukurova Üniversitesi Tıp Fakültesi Dergisi, Vol 40, Iss 1, Pp 72-

    2015  Volume 79

    Abstract: Purpose: The most important complication of ventriculoperitoneal shunt (VPS) surgery is central nervous system infections developing in the postoperative period. The incidence of VPS infection in cases with VPS inserted is known to be between 6.5-23.5%. ... ...

    Abstract Purpose: The most important complication of ventriculoperitoneal shunt (VPS) surgery is central nervous system infections developing in the postoperative period. The incidence of VPS infection in cases with VPS inserted is known to be between 6.5-23.5%. The aim of this study is to evaluate the treatment and complications relating to VPS surgery infections in pediatric patients with hydrocephalus. Material and Methods: Patients between January 2011 and January 2013 with VPS inserted for hydrocephalus and complications relating to infections after surgical intervention were included in the study. The patient files were retrospectively investigated and analyzed. Patients were evaluated based on demographic characteristics, etiology of hydrocephalus, date of shunt insertion, operation notes from the VPS insertion operation, microbiological and biochemical test results on CSF samples after diagnosis of VPS infection, surgical intervention for treatment, antibiotics administered and duration of antibiotic use. Results: Thirty-five patients monitored for VPS infection diagnosis between the ages of 3 days and 16 years were evaluated. In the 35 patients monitored for VPS infection diagnosis 19 had growth in cerebrospinal fluid (CSF) while 17 patients had no growth in CSF but inflammatory findings were present. The most frequently isolated effective pathogens were coagulase-negative staphylococci (78%). Other microorganisms isolated in the CSF of patients were Staphylococcus aureus, Enterococcus feacalis, Enterococcus gallinarium, Pseudomonas stutzeri, Candida albicans, Streptococcus mitis and ESBL (-) Klebsiella pneumonia. While one patient died during treatment, 34 patients were successfully discharged. Conclusion: We believe that early administration of antibiotic treatment and removal of the infected shunt are of vital importance. [Cukurova Med J 2015; 40(1.000): 72-79]
    Keywords Ventriculoperitoneal Shunt ; Infection ; Child ; Hydrocephalus ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 610 ; 616
    Language English
    Publishing date 2015-03-01T00:00:00Z
    Publisher Cukurova University
    Document type Article ; Online
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  4. Article ; Online: Anesthetic management of an acromegalic patient with McCune Albright syndrome for endoscopic transsphenoidal adenoma removal.

    Koc, Demet / Bayri, Yasar / Seker, Askin

    Journal of neurosurgical anesthesiology

    2014  Volume 26, Issue 3, Page(s) 267–269

    MeSH term(s) Adolescent ; Anesthesia/methods ; Craniotomy/methods ; Endoscopy/methods ; Exophthalmos/complications ; Female ; Fibrous Dysplasia, Polyostotic/complications ; Humans ; Pituitary Neoplasms/surgery ; Sphenoid Bone/surgery
    Language English
    Publishing date 2014-07
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 1018119-2
    ISSN 1537-1921 ; 0898-4921
    ISSN (online) 1537-1921
    ISSN 0898-4921
    DOI 10.1097/ANA.0000000000000008
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  5. Article ; Online: Çocuklarda Ventriküloperitoneal Şant Enfeksiyonları ve Tedavisi

    Eren ÇAĞAN / Ahmet SOYSAL / Aşkın ŞEKER / Mustafa ŞEKER

    Cukurova Medical Journal, Vol 40, Iss 1, Pp 72-

    2015  Volume 79

    Abstract: Amaç: VPS cerrahisinin en önemli komplikasyonu cerrahi sonrası dönemde gelişen santral sinir sistemi enfeksiyonudur. VPS enfeksiyonlarının insidansının VPS takılan olguların tümünde %6.5-23.5 oranında olduğu bildirilmektedir. Bu çalışmanın amacı ... ...

    Abstract Amaç: VPS cerrahisinin en önemli komplikasyonu cerrahi sonrası dönemde gelişen santral sinir sistemi enfeksiyonudur. VPS enfeksiyonlarının insidansının VPS takılan olguların tümünde %6.5-23.5 oranında olduğu bildirilmektedir. Bu çalışmanın amacı hidrosefalili çocuk hastalarda VPS ameliyatlarının enfeksiyon ilişkili komplikasyonlarını ve tedavilerini değerlendirmektir. Materyal ve Metod: Ocak 2011- Ocak 2013 yılları arasında hidrosefali nedeniyle VPS takılan ve cerrahi girişim sonrası enfeksiyon ilişkili komplikasyon gelişen hastalar çalışmaya alındı. Hastaların dosyaları retrospektif olarak incelendi ve analiz edildi. Hastalara ait demografik özellikler, hidrosefali etyolojisi, şant takılma tarihi, VPS takılmasına ait operasyon notları, VPS enfeksiyonu tanısı konulduktan sonraki BOS örneklerine ait mikrobiyolojik ve biyokimyasal testlerin sonuçları, tedaviye yönelik olarak yapılan cerrahi müdahele ve verilen antibiyotik türleri, antibiyotiklerin kullanma süreleri değerlendirildi. Bulgular: Yaşları üç gün ile 16 yaş arasında değişen, VPS enfeksiyonu tanısı ile izlenen 35 hasta değerlendirildi. VPS enfeksiyonu tanısı ile izleme alınan 35 hastanın 19’unda BOS kültüründe üreme olurken, 17 hastanın BOS kültüründe üreme olmaksızın inflamasyon bulguları mevcuttu. En sık izole edilen etken patojen coagulase negative Staphylococci () idi. Hastaların BOS’larından izole edilen diğer mikroorganizmalar; Staphylococcus aureus, Enterococcus feacalis, Enterococcus gallinarium, Pseudomonas stutzeri, Candida albicans, Streptococcus mitis ve ESBL (-) Klebsiella pneumonia idi. Tedavi sırasında bir hasta kaybedilirken, 34 hasta şifa ile taburcu edildi. Sonuç: VPS enfeksiyonların da erken antibiyotik tedavisi verilmesinin ve enfekte şantın çıkarılmasının hayati öneme sahip olduğunu düşünmekteyiz.
    Keywords - ; ventriküloperitoneal şant ; enfeksiyonu ; çocuk ; hidrosefali ; Medicine (General) ; R5-920
    Language English
    Publishing date 2015-09-01T00:00:00Z
    Publisher Cukurova University
    Document type Article ; Online
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  6. Article ; Online: Anterior third ventricular height and infundibulochiasmatic angle: two novel measurements to predict clinical success of endoscopic third ventriculostomy in the early postoperative period.

    Gürbüz, Mehmet Sabri / Dağçınar, Adnan / Bayri, Yaşar / Şeker, Aşkın / Güçlü, Hasan

    Journal of neurosurgery

    2019  Volume 132, Issue 6, Page(s) 1764–1772

    Abstract: Objective: The authors sought to develop a set of parameters that reliably predict the clinical success of endoscopic third ventriculostomy (ETV) when assessed before and after the operation, and to establish a plan for MRI follow-up after this ... ...

    Abstract Objective: The authors sought to develop a set of parameters that reliably predict the clinical success of endoscopic third ventriculostomy (ETV) when assessed before and after the operation, and to establish a plan for MRI follow-up after this procedure.
    Methods: This retrospective study involved 77 patients who had undergone 78 ETV procedures for obstructive hydrocephalus between 2010 and 2015. Constructive interference in steady-state (CISS) MRI evaluations before and after ETV were reviewed, and 4 parameters were measured. Two well-known standard parameters, fronto-occipital horn ratio (FOHR) and third ventricular index (TVI), and 2 newly defined parameters, infundibulochiasmatic (IC) angle and anterior third ventricular height (TVH), were measured in this study. Associations between preoperative measurements of and postoperative changes in the 4 variables and the clinical success of ETV were analyzed.
    Results: Of the 78 ETV procedures, 70 (89.7%) were successful and 8 (10.3%) failed. On the preoperative MR images, the mean IC angle and anterior TVH were significantly larger in the successful procedures. On the 24-hour postoperative MR images of the successful procedures, the mean IC angle declined significantly from 114.2° to 94.6° (p < 0.05) and the mean anterior TVH declined significantly from 15 to 11.2 mm (p < 0.05). The mean percentage reduction of the IC angle was 17.1%, and that of the anterior TVH was 25.5% (both p < 0.05). On the 1-month MR images of the successful procedures, the mean IC angle declined significantly from 94.6° to 84.2° (p < 0.05) and the mean anterior TVH declined significantly from 11.2 to 9.3 mm (p < 0.05). The mean percentage reductions in IC angle (11%) and anterior TVH (16.9%) remained significant at this time point but were smaller than those observed at 24 hours. The 6-month and 1-year postoperative MR images of the successful group showed no significant changes in mean IC angle or mean anterior TVH. Regarding the unsuccessful procedures, there were no significant changes observed in IC angle or anterior TVH at any of the time points studied. Reduction of IC angle and reduction of anterior TVH on 24-hour postoperative MR images were significantly associated with successful ETV. However, no clinically significant association was found between FOHR, TVI, and ETV success.
    Conclusions: Assessing the IC angle and anterior TVH on preoperative and 24-hour postoperative MR images is useful for predicting the clinical success of ETV. These 2 measurements could also be valuable as radiological follow-up parameters.
    Language English
    Publishing date 2019-05-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2019.1.JNS181330
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  7. Article: Surgical Exposure Gained in an Extended Retrosigmoid Approach to the Cerebellopontine Angle Compared to the Traditional Retrosigmoid Approach.

    Ceylan, Davut / Tatarli, Necati / Seker, Askin / Cavdar, Safiye / Kilic, Turker

    Turkish neurosurgery

    2015  Volume 25, Issue 5, Page(s) 728–736

    Abstract: Aim: Retrosigmoid approach to the posterior fossa has been a popular and dependable approach for accessing the cerebellopontine angle (CPA) and petroclival region. Although this approach is commonly used, it requires cerebellar retraction and has ... ...

    Abstract Aim: Retrosigmoid approach to the posterior fossa has been a popular and dependable approach for accessing the cerebellopontine angle (CPA) and petroclival region. Although this approach is commonly used, it requires cerebellar retraction and has limitations when the lesion is located ventral to the brainstem. The aim was to quantify the angle of view provided by extended retrosigmoid approach in comparison to the traditional approach. A secondary objective was to identify a strategic initial burr hole site for craniotomy.
    Material and methods: Ten adult human cadaver heads (20 sides) were used. First, traditional retrosigmoid approach was performed and the angle of exposure was measured on cranial computerized tomography (CT). Following, extended retrosigmoid approach was performed with mastoid bone drilling and reflection of venous sinuses. Angle of exposure was measured on CT. Two measurements of both approaches were compared.
    Results: Mean angle of view for the traditional retrosigmoid approach (31.4° ± 4.1°) was significantly smaller than that of the extended approach (46.0° ± 4.7°) (p < 0.001). Site of strategic burr hole was 5 mm below and 15 mm lateral to the asterion was defined.
    Conclusion: Extended retrosigmoid approach offers neurosurgeons approximately 50% larger angle of view and shorter working distance than the traditional approach provides. This modification permits better access to the CPA and ventral brain stem without cerebellar retraction.
    MeSH term(s) Adult ; Cadaver ; Cerebellopontine Angle/surgery ; Craniotomy/methods ; Female ; Humans ; Male
    Language English
    Publishing date 2015
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 1203779-5
    ISSN 1019-5149
    ISSN 1019-5149
    DOI 10.5137/1019-5149.JTN.11222-14.0
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  8. Article: Rapid Effect of Gamma Knife Radiosurgery on Clivus Metastasis: A Case Report

    Atik, Ahmet F. / Akpinar, Timur S. / Seker, Askin

    Indian Journal of Neurosurgery

    2016  Volume 05, Issue 01, Page(s) 25–27

    Abstract: Breast cancer may cause distant metastasis even though there is no local recurrence. Disease can spread to any part of body via lymphoid and hematogenous way, and clivus is one of the most common locations. Total excision of clival lesions carries a ... ...

    Abstract Breast cancer may cause distant metastasis even though there is no local recurrence. Disease can spread to any part of body via lymphoid and hematogenous way, and clivus is one of the most common locations. Total excision of clival lesions carries a significant risk of neurologic damage due to proximity to cranial nerves. We present 62-year-old woman who has a previously known breast cancer history. She admitted to our clinic with unilateral sixth nerve palsy and diplopia. Imaging studies revealed clivus metastasis. Patient was treated with gamma knife radiosurgery. In the next 2 months, sixth nerve palsy recovered along with diplopia. In this case report we would like to emphasize the importance of gamma knife radiosurgery at the deeply located breast cancer metastasis.
    Keywords clivus ; radiosurgery ; metastasis
    Language English
    Publishing date 2016-02-19
    Publisher Neurological Surgeons' Society of India
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2698542-1
    ISSN 2277-9167 ; 2277-954X
    ISSN (online) 2277-9167
    ISSN 2277-954X
    DOI 10.1055/s-0036-1572371
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  9. Article ; Online: Contralateral lumbar radicular pain shortly after a transforaminal epidural steroid injection: an unusual sequel.

    Gündüz, Osman Hakan / Akhlaque, Uzma / Sencan, Savas / Celenlioglu, Alp Eren / Seker, Askin

    American journal of physical medicine & rehabilitation

    2014  Volume 93, Issue 9, Page(s) 834–835

    MeSH term(s) Adult ; Anesthetics, Local/administration & dosage ; Bupivacaine/administration & dosage ; Fluoroscopy ; Humans ; Injections, Epidural ; Intervertebral Disc Displacement/drug therapy ; Intervertebral Disc Displacement/pathology ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Radiculopathy/diagnosis ; Radiculopathy/pathology ; Spasm/complications ; Spinal Stenosis/drug therapy
    Chemical Substances Anesthetics, Local ; Bupivacaine (Y8335394RO)
    Language English
    Publishing date 2014-09
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 219390-5
    ISSN 1537-7385 ; 0002-9491 ; 0894-9115
    ISSN (online) 1537-7385
    ISSN 0002-9491 ; 0894-9115
    DOI 10.1097/PHM.0000000000000150
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  10. Article ; Online: Is endoscopic endonasal transsphenoidal surgery increases the susceptibility to rhinosinusitis.

    Topuz, Muhammet Fatih / Sarı, Murat / Binnetoglu, Adem / Dogrul, Ramazan / Bugdaycı, Onur / Şeker, Aşkın

    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

    2017  Volume 274, Issue 8, Page(s) 3065–3069

    Abstract: The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major ... ...

    Abstract The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis. It was a retrospective clinical study. Forty-five cases, between 2013 and 2015, planned for endoscopic endonasal transsphenoidal surgery due to hypophyseal pathology at the Neurosurgery Departments of Marmara University Hospital were evaluated retrospectively. The patients were evaluated for the changes in the anatomy of the middle concha and the effects of these changes to paranasal sinuses by paranasal computed tomographies were studied at the preoperative second week and postoperative 12 month. The Lund-Mackay scoring system was used for the evaluation of opacification in the five major paranasal sinuses and occlusion of the osteomeatal complex in the pre- and postoperative period. The Lund-Mackay scoring system was used to analyze the paranasal computed tomography of the patients at the preoperative 2 weeks and postoperative first year. According to the Lund-Mackay scoring system, no significant difference was detected between the preoperative and postoperative opacification of paranasal sinuses (p > 0.05). Besides, there was also no significant difference between the preoperative and postoperative osteomeatal complex occlusion (p > 0.05). Considering the distance between middle concha and lamina papyracea following the out-fracture of the middle concha, a significant lateralization of 0.5 mm between the preoperative and postoperative period was observed (p < 0.05). In addition, a significant change was also detected in the volume of middle concha (p < 0.05). The volume of the area between the middle concha and lamina papyracea was decreased with a statistical significance (p < 0.05). The endoscopic endonasal transsphenoidal surgery causes some variations in the structures of the middle concha, paranasal sinuses, and OMC, but these changes do not lead to significant rhinologic pathologies.
    Language English
    Publishing date 2017-08
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1017359-6
    ISSN 1434-4726 ; 0937-4477
    ISSN (online) 1434-4726
    ISSN 0937-4477
    DOI 10.1007/s00405-017-4598-4
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