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Etiological classification of presbycusis in Turkish population according to audiogram configuration

Year 2015, Volume: 25 Issue: 1, 1 - 18, 10.02.2015

Abstract

Objectives: This study aims to classify age related hearing loss in Turkish population according to Schuknecht audiometric configurations for presbycusis and investigate the most common etiologies. Patients and Methods: A total of 1,134 patients 568 males, 566 females; mean age 70.5±7.7 years; range 55 to 80 years with age related hearing loss were included in the study. Audiograms of patients were classified into three categories: high frequency steeply sloping HFSS , flat, and high frequency gently sloping HFGS . Speech discrimination scores were evaluated and compared. Results: In the study population, HFSS audiogram configuration was the most frequently observed 48.5% , followed by HFGS configuration 26.9% , and flat configuration 24.5% , respectively. While HFSS audiogram configuration was statistically significantly more common in males, flat audiogram configuration was statistically significantly more common in females p=0.0001 . HFSS group mean air conduction threshold were statistically significantly higher than flat and HFGS groups p=0.0001 . No statistically significantly difference was detected in terms of speech discrimination scores between three groups p=0.796 . Conclusion: Results of this study suggest that, in Turkish population, while sensory presbycusis is more common in males, strial presbycusis is more common in females. No difference was detected in terms of the prevalence of cochlear presbycusis in males and females p=0.0001 .

References

  • Layer LV. Cump GV. Age-releated hearing impairment: ensemble playing of environmental and genetic factors. In: Alessandro Martini, Dafydd Stephens, Andrew P, editors. Genes, Hearing, and Deafness: From Molecular Biology to Clinical Practice. London: Informa UK Ltd. 2007. p. 79-90.
  • Sprinzl GM, Riechelmann H. Current trends in treating hearing loss in elderly people: a review of the technology and treatment options - a mini-review. Gerontology 2010;56:351-8.
  • Monzani D, Galeazzi GM, Genovese E, Marrara A, Martini A. Psychological profile and social behaviour of working adults with mild or moderate hearing lossActa Otorhinolaryngol Ital 2008;28:61-6.
  • Roth TN, Hanebuth D, Probst R. Prevalence of age- related hearing loss in Europe: a review Eur Arch Otorhinolaryngol 2011;268:1101-7.
  • Nelson EG, Hinojosa R. Presbycusis: a human temporal bone study of individuals with downward sloping audiometric patterns of hearing loss and review of the literature. Laryngoscope 2006;116:1-12.
  • Frisina RD, Walton JP. Age-related structural and functional changes in the cochlear nucleus. Hear Res 2006;216-217:216-23.
  • CORSO JF. Age and sex differences in pure-tone thresholds. Survey of hearing levels from 18 to 65 years. Arch Otolaryngol 1963;77:385-405.
  • Gates GA, Mills JH. Presbycusis. Lancet 2005;366:1111-20.
  • Fieuws S, Verbeke G. Pairwise fitting of mixed models for the joint modeling of multivariate longitudinal profiles. Biometrics 2006;62:424-31.
  • Schuknecht HF. Further observations on the pathology of presbycusis. Arch Otolaryngol 1964;80:369-82.
  • Schuknecht HF, Gacek MR. Cochlear pathology in presbycusis. Ann Otol Rhinol Laryngol 1993;102:1-16.
  • Gates GA, Couropmitree NN, Myers RH. Genetic associations in age-related hearing thresholds. Arch Otolaryngol Head Neck Surg 1999;125:654-9.
  • Salvi RJ, Ding D, Eddins AC, Mc Fadden SL, Henderson D. Age, noise, and ototoxic agents. In: Hof PR, Mobbs CV, editors. Functional Neurobiology of Aging. Chapter 38. San Diego: Academic Press; 2001. p. 549-63.
  • Schuknecht H. Pathology of the Ear. Cambridge: Harvard University Press; 1974.
  • Demeester K, van Wieringen A, Hendrickx JJ, Topsakal V, Fransen E, van Laer L, et al. Audiometric shape and presbycusis. Int J Audiol 2009;48:222-32.
  • Harrell, RW. Puretone evaluation. In: Katz, J, editor. Handbook of Clinical Audiology. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 71-87.
  • Kılıncarslan A. Türk Dili için Geliştirilmiş Fonetik Dengeli Tek Heceli Kelime Listelerinin Standardizasyonu. Ankara: Hacettepe University, Master of Science; 1986.
  • Gates GA, Cooper JC. Incidence of hearing decline in the elderly. Acta Otolaryngol 1991;111:240-8.
  • Davies AM, Fleishman R. Health status and use of health services as reported by the older residents of the Baka neighborhood, Jerusalem. Isr J Med Sci 1981;17:138-44.
  • Gates GA. Central auditory processing in presbycusis: an epidemiological perspective. In: Hickson L, editor. Proceedings of the Second International Adult Conference: Hearing Care for adults 2009 - the challenge of aging. Staefa, Switzerland: Phonak AG; 2009. p. 47-52.
  • Soucek S, Michaels L. Hearing Loss in the Elderly. London: Springer-Verlag; 1990.
  • Collet L, Moulin A, Gartner M, Morgon A. Age-related changes in evoked otoacoustic emissions. Ann Otol Rhinol Laryngol 1990;99:993-7.
  • Arlinger S. Audiometric profile in presbycusis. Acta Otolaryngol Suppl 1990;476:85-9.
  • Konigsmark BW, Murphy EA. Volume of the ventral cochlear nucleus in man: its relationship to neuronal population and age. J Neuropathol Exp Neurol 1972;31:304-16.
  • Christensen K, Frederiksen H, Hoffman HJ. Genetic and environmental influences on self-reported reduced hearing in the old and oldest old. J Am Geriatr Soc 2001;49:1512-7.
  • Yamasoba T. Molecular mechanism of age-related hearing loss: toward its prevention. Nippon Jibiinkoka Gakkai Kaiho 2009;112:414-21.
  • DeStefano AL, Gates GA, Heard-Costa N, Myers RH, Baldwin CT. Genomewide linkage analysis to presbycusis in the Framingham Heart Study. Arch Otolaryngol Head Neck Surg 2003;129:285-9.
  • Cruickshanks KJ, Klein R, Klein BE, Wiley TL, Nondahl DM, Tweed TS. Cigarette smoking and hearing loss: the epidemiology of hearing loss study JAMA 1998;279:1715-9.
  • Brant LJ, Gordon-Salant S, Pearson JD, Klein LL, Morrell CH, Metter EJ, et al. Risk factors related to age-associated hearing loss in the speech frequencies. J Am Acad Audiol 1996;7:152-60.
  • McFadden SL, Ohlemiller KK, Ding D, Shero M, Salvi RJ. The Influence of Superoxide Dismutase and Glutathione Peroxidase Deficiencies on Noise-Induced Hearing Loss in Mice. Noise Health 2001;3:49-64.
  • Seidman MD. Effects of dietary restriction and antioxidants on presbyacusis. Laryngoscope 2000;110:727-38.
  • Langenbeck B. Das symmetrigeretz der erbliehen taubehelt. Z Hals Nasen Ohren-heild 1936;39:223-261
  • Schuknecht HF. Pathology of the Ear. 2nd ed. Philadelphia: Lea & Febiger; 1993. p. 416-36.
  • Johnsson LG, Hawkins JE Jr. Strial atrophy in clinical and experimental deafness. Laryngoscope 1972;82:1105-25.
  • Kimura R, Perlman HB. Extensive venous obstruction of the labyrinth. A. Cochlear changes. Ann Otol Rhinol Laryngol 1956;65:332-50.
  • Schuknecht HF, Watanuki K, Takahashi T, Belal AA Jr, Kimura RS, Jones DD, et al. Atrophy of the stria vascularis, a common cause for hearing loss. Laryngoscope 1974;84:1777-821.
  • Nelson EG, Hinojosa R. Presbycusis: a human temporal bone study of individuals with flat audiometric patterns of hearing loss using a new method to quantify stria vascularis volume. Laryngoscope 2003;113:1672-86.
  • Jorgensen MB. Changes of aging in the inner ear. Histological studies. Arch Otolaryngol 1961;74:164-70.
  • Pauler M, Schuknecht HF, White JA. Atrophy of the stria vascularis as a cause of sensorineural hearing loss. Laryngoscope 1988;98:754-9.
  • König O, Rüttiger L, Müller M, Zimmermann U, Erdmann B, Kalbacher H, et al. Estrogen and the inner ear: megalin knockout mice suffer progressive hearing loss. FASEB J 2008;22:410-7.
  • Hederstierna C, Hultcrantz M, Collins A, Rosenhall U. Hearing in women at menopause. Prevalence of hearing loss, audiometric configuration and relation to hormone replacement therapy. Acta Otolaryngol 2007;127:149-55.
  • McMahon CM, Kifley A, Rochtchina E, Newall P, Mitchell P. The contribution of family history to hearing loss in an older population. Ear Hear 2008;29:578-84.
  • Lee KY. Pathophysiology of age-related hearing loss (peripheral and central). Korean J Audiol 2013;17:45-9.
  • Hequembourg S, Liberman MC. Spiral ligament pathology: a major aspect of age-related cochlear degeneration in C57BL/6 mice. J Assoc Res Otolaryngol 2001;2:118-29.
  • Fuente A, McPherson B. Organic solvents and hearing loss: The challenge for audiology. Int J Audiol 2006;45:367-81.
  • Demeester K, van Wieringen A, Hendrickx JJ, Topsakal V, Fransen E, van Laer L, et al. Audiometric shape and presbycusis. Int J Audiol 2009;48:222-32.
  • Spoendlin H. Factors inducing retrograde degeneration of the cochlear nerve. Ann Otol Rhinol Laryngol Suppl 1984;112:76-82.
  • Takeno S, Wake M, Mount RJ, Harrison RV. Degeneration of spiral ganglion cells in the chinchilla after inner hair cell loss induced by carboplatin. Audiol Neurootol 1998;3:281-90.
  • Pauler M, Schuknecht HF, Thornton AR. Correlative studies of cochlear neuronal loss with speech discrimination and pure-tone thresholds. Arch Otorhinolaryngol 1986;243:200-6.
  • Otte J, Schunknecht HF, Kerr AG. Ganglion cell populations in normal and pathological human cochleae. Implications for cochlear implantation. Laryngoscope 1978;88:1231-46.
  • Nodal JB. Disorders of aging. In: Merchant SN, Nodal JB, editors. Schuknecht’s pathology of the ear. 3rd ed. Shelton, CT: Peoble's Medical Publishing House-USA; 2010. p. 432-74.
  • Crowe SJ, Guild SR, Polvogt LM. Observations on the pathology of high-tone deafness. Bull Johns Hopkins Hosp 1934;54:315-79.
  • Divenyi PL, Stark PB, Haupt KM. Decline of speech understanding and auditory thresholds in the elderly. J Acoust Soc Am 2005;118:1089-100.
  • Jerger J, Chmiel R. Factor analytic structure of auditory impairment in elderly persons. J Am Acad Audiol 1997;8:269-76.
  • Nomura Y. Lipidosis of the basilar membrane. Acta Otolaryngol 1970;69:352-7.
  • Nadol JB Jr. Electron microscopic findings in presbycusic degeneration of the basal turn of the human cochlea. Otolaryngol Head Neck Surg 1979;87:818-36.
  • Bhatt KA, Liberman MC, Nadol JB Jr. Morphometric analysis of age-related changes in the human basilar membrane. Ann Otol Rhinol Laryngol 2001;110:1147-53.
  • Wilson DH, Walsh PG, Sanchez L, Davis AC, Taylor AW, Tucker G, et al. The epidemiology of hearing impairment in an Australian adult population.bnInt J Epidemiol 1999;28:247-52.
  • Sha SH, Kanicki A, Dootz G, Talaska AE, Halsey K, Dolan D, et al. Age-related auditory pathology in the CBA/J mouse. Hear Res 2008;243:87-94.

Türk nüfusunda presbiakuzinin odiogram konfigürasyonuna göre etyolojik sınıflandırılması

Year 2015, Volume: 25 Issue: 1, 1 - 18, 10.02.2015

Abstract

Amaç: Bu çalışmada Türk nüfusunda yaşa bağlı işitme kaybı presbiakuzi için Schuknecht odiometrik konfigürasyonlarına göre sınıflandırıldı ve en sık görülen etyolojiler araştırıldı.Hastalar ve Yöntemler: Çalışmaya yaşa bağlı işitme kaybı olan 1134 hasta 568 erkek, 566 kadın; ort. yaş 70.5±7.7 yıl; dağılım 55-80 yıl dahil edildi. Hastaların odyogramları üç kategoriye ayrıldı: yüksek frekanslı ani eğimli YFAE , düz ve yüksek frekanslı hafif eğimli YFHE . Konuşmayı ayırt etme puanları değerlendirildi ve karşılaştırıldı.Bulgular: Çalışma nüfusunda YFAE odyogram konfigürasyonu en sık görüldü %48.5 , bunu sırasıyla YFHE %26.9 ve düz konfigürasyon %24.5 izledi. Yüksek frekanslı hafif eğimli odyogram konfigürasyonu erkeklerde istatistiksel olarak anlamlı derecede daha yaygınken düz odyogram konfigürasyonu kadınlarda istatistiksel olarak anlamlı derecede daha yaygındı p=0.0001 . YFAE grubu ortalama hava yolu eşikleri düz ve YFHE gruplarından istatistiksel olarak anlamlı derecede yüksek idi p=0.0001 . Konuşmayı ayırt etme skorları açısından üç grup arasında istatistiksel olarak anlamlı farklılık bulunmadı p=0.796 .Sonuç: Bu çalışmanın bulgularına göre, Türk nüfusunda sensori presbiakuzi erkeklerde daha yaygın iken strial presbiakuzi kadınlarda daha yaygındır. Erkeklerde ve kadınlarda koklear presbiakuzi görülme sıklığı açısından farklılık bulunmadı p=0.0001

References

  • Layer LV. Cump GV. Age-releated hearing impairment: ensemble playing of environmental and genetic factors. In: Alessandro Martini, Dafydd Stephens, Andrew P, editors. Genes, Hearing, and Deafness: From Molecular Biology to Clinical Practice. London: Informa UK Ltd. 2007. p. 79-90.
  • Sprinzl GM, Riechelmann H. Current trends in treating hearing loss in elderly people: a review of the technology and treatment options - a mini-review. Gerontology 2010;56:351-8.
  • Monzani D, Galeazzi GM, Genovese E, Marrara A, Martini A. Psychological profile and social behaviour of working adults with mild or moderate hearing lossActa Otorhinolaryngol Ital 2008;28:61-6.
  • Roth TN, Hanebuth D, Probst R. Prevalence of age- related hearing loss in Europe: a review Eur Arch Otorhinolaryngol 2011;268:1101-7.
  • Nelson EG, Hinojosa R. Presbycusis: a human temporal bone study of individuals with downward sloping audiometric patterns of hearing loss and review of the literature. Laryngoscope 2006;116:1-12.
  • Frisina RD, Walton JP. Age-related structural and functional changes in the cochlear nucleus. Hear Res 2006;216-217:216-23.
  • CORSO JF. Age and sex differences in pure-tone thresholds. Survey of hearing levels from 18 to 65 years. Arch Otolaryngol 1963;77:385-405.
  • Gates GA, Mills JH. Presbycusis. Lancet 2005;366:1111-20.
  • Fieuws S, Verbeke G. Pairwise fitting of mixed models for the joint modeling of multivariate longitudinal profiles. Biometrics 2006;62:424-31.
  • Schuknecht HF. Further observations on the pathology of presbycusis. Arch Otolaryngol 1964;80:369-82.
  • Schuknecht HF, Gacek MR. Cochlear pathology in presbycusis. Ann Otol Rhinol Laryngol 1993;102:1-16.
  • Gates GA, Couropmitree NN, Myers RH. Genetic associations in age-related hearing thresholds. Arch Otolaryngol Head Neck Surg 1999;125:654-9.
  • Salvi RJ, Ding D, Eddins AC, Mc Fadden SL, Henderson D. Age, noise, and ototoxic agents. In: Hof PR, Mobbs CV, editors. Functional Neurobiology of Aging. Chapter 38. San Diego: Academic Press; 2001. p. 549-63.
  • Schuknecht H. Pathology of the Ear. Cambridge: Harvard University Press; 1974.
  • Demeester K, van Wieringen A, Hendrickx JJ, Topsakal V, Fransen E, van Laer L, et al. Audiometric shape and presbycusis. Int J Audiol 2009;48:222-32.
  • Harrell, RW. Puretone evaluation. In: Katz, J, editor. Handbook of Clinical Audiology. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 71-87.
  • Kılıncarslan A. Türk Dili için Geliştirilmiş Fonetik Dengeli Tek Heceli Kelime Listelerinin Standardizasyonu. Ankara: Hacettepe University, Master of Science; 1986.
  • Gates GA, Cooper JC. Incidence of hearing decline in the elderly. Acta Otolaryngol 1991;111:240-8.
  • Davies AM, Fleishman R. Health status and use of health services as reported by the older residents of the Baka neighborhood, Jerusalem. Isr J Med Sci 1981;17:138-44.
  • Gates GA. Central auditory processing in presbycusis: an epidemiological perspective. In: Hickson L, editor. Proceedings of the Second International Adult Conference: Hearing Care for adults 2009 - the challenge of aging. Staefa, Switzerland: Phonak AG; 2009. p. 47-52.
  • Soucek S, Michaels L. Hearing Loss in the Elderly. London: Springer-Verlag; 1990.
  • Collet L, Moulin A, Gartner M, Morgon A. Age-related changes in evoked otoacoustic emissions. Ann Otol Rhinol Laryngol 1990;99:993-7.
  • Arlinger S. Audiometric profile in presbycusis. Acta Otolaryngol Suppl 1990;476:85-9.
  • Konigsmark BW, Murphy EA. Volume of the ventral cochlear nucleus in man: its relationship to neuronal population and age. J Neuropathol Exp Neurol 1972;31:304-16.
  • Christensen K, Frederiksen H, Hoffman HJ. Genetic and environmental influences on self-reported reduced hearing in the old and oldest old. J Am Geriatr Soc 2001;49:1512-7.
  • Yamasoba T. Molecular mechanism of age-related hearing loss: toward its prevention. Nippon Jibiinkoka Gakkai Kaiho 2009;112:414-21.
  • DeStefano AL, Gates GA, Heard-Costa N, Myers RH, Baldwin CT. Genomewide linkage analysis to presbycusis in the Framingham Heart Study. Arch Otolaryngol Head Neck Surg 2003;129:285-9.
  • Cruickshanks KJ, Klein R, Klein BE, Wiley TL, Nondahl DM, Tweed TS. Cigarette smoking and hearing loss: the epidemiology of hearing loss study JAMA 1998;279:1715-9.
  • Brant LJ, Gordon-Salant S, Pearson JD, Klein LL, Morrell CH, Metter EJ, et al. Risk factors related to age-associated hearing loss in the speech frequencies. J Am Acad Audiol 1996;7:152-60.
  • McFadden SL, Ohlemiller KK, Ding D, Shero M, Salvi RJ. The Influence of Superoxide Dismutase and Glutathione Peroxidase Deficiencies on Noise-Induced Hearing Loss in Mice. Noise Health 2001;3:49-64.
  • Seidman MD. Effects of dietary restriction and antioxidants on presbyacusis. Laryngoscope 2000;110:727-38.
  • Langenbeck B. Das symmetrigeretz der erbliehen taubehelt. Z Hals Nasen Ohren-heild 1936;39:223-261
  • Schuknecht HF. Pathology of the Ear. 2nd ed. Philadelphia: Lea & Febiger; 1993. p. 416-36.
  • Johnsson LG, Hawkins JE Jr. Strial atrophy in clinical and experimental deafness. Laryngoscope 1972;82:1105-25.
  • Kimura R, Perlman HB. Extensive venous obstruction of the labyrinth. A. Cochlear changes. Ann Otol Rhinol Laryngol 1956;65:332-50.
  • Schuknecht HF, Watanuki K, Takahashi T, Belal AA Jr, Kimura RS, Jones DD, et al. Atrophy of the stria vascularis, a common cause for hearing loss. Laryngoscope 1974;84:1777-821.
  • Nelson EG, Hinojosa R. Presbycusis: a human temporal bone study of individuals with flat audiometric patterns of hearing loss using a new method to quantify stria vascularis volume. Laryngoscope 2003;113:1672-86.
  • Jorgensen MB. Changes of aging in the inner ear. Histological studies. Arch Otolaryngol 1961;74:164-70.
  • Pauler M, Schuknecht HF, White JA. Atrophy of the stria vascularis as a cause of sensorineural hearing loss. Laryngoscope 1988;98:754-9.
  • König O, Rüttiger L, Müller M, Zimmermann U, Erdmann B, Kalbacher H, et al. Estrogen and the inner ear: megalin knockout mice suffer progressive hearing loss. FASEB J 2008;22:410-7.
  • Hederstierna C, Hultcrantz M, Collins A, Rosenhall U. Hearing in women at menopause. Prevalence of hearing loss, audiometric configuration and relation to hormone replacement therapy. Acta Otolaryngol 2007;127:149-55.
  • McMahon CM, Kifley A, Rochtchina E, Newall P, Mitchell P. The contribution of family history to hearing loss in an older population. Ear Hear 2008;29:578-84.
  • Lee KY. Pathophysiology of age-related hearing loss (peripheral and central). Korean J Audiol 2013;17:45-9.
  • Hequembourg S, Liberman MC. Spiral ligament pathology: a major aspect of age-related cochlear degeneration in C57BL/6 mice. J Assoc Res Otolaryngol 2001;2:118-29.
  • Fuente A, McPherson B. Organic solvents and hearing loss: The challenge for audiology. Int J Audiol 2006;45:367-81.
  • Demeester K, van Wieringen A, Hendrickx JJ, Topsakal V, Fransen E, van Laer L, et al. Audiometric shape and presbycusis. Int J Audiol 2009;48:222-32.
  • Spoendlin H. Factors inducing retrograde degeneration of the cochlear nerve. Ann Otol Rhinol Laryngol Suppl 1984;112:76-82.
  • Takeno S, Wake M, Mount RJ, Harrison RV. Degeneration of spiral ganglion cells in the chinchilla after inner hair cell loss induced by carboplatin. Audiol Neurootol 1998;3:281-90.
  • Pauler M, Schuknecht HF, Thornton AR. Correlative studies of cochlear neuronal loss with speech discrimination and pure-tone thresholds. Arch Otorhinolaryngol 1986;243:200-6.
  • Otte J, Schunknecht HF, Kerr AG. Ganglion cell populations in normal and pathological human cochleae. Implications for cochlear implantation. Laryngoscope 1978;88:1231-46.
  • Nodal JB. Disorders of aging. In: Merchant SN, Nodal JB, editors. Schuknecht’s pathology of the ear. 3rd ed. Shelton, CT: Peoble's Medical Publishing House-USA; 2010. p. 432-74.
  • Crowe SJ, Guild SR, Polvogt LM. Observations on the pathology of high-tone deafness. Bull Johns Hopkins Hosp 1934;54:315-79.
  • Divenyi PL, Stark PB, Haupt KM. Decline of speech understanding and auditory thresholds in the elderly. J Acoust Soc Am 2005;118:1089-100.
  • Jerger J, Chmiel R. Factor analytic structure of auditory impairment in elderly persons. J Am Acad Audiol 1997;8:269-76.
  • Nomura Y. Lipidosis of the basilar membrane. Acta Otolaryngol 1970;69:352-7.
  • Nadol JB Jr. Electron microscopic findings in presbycusic degeneration of the basal turn of the human cochlea. Otolaryngol Head Neck Surg 1979;87:818-36.
  • Bhatt KA, Liberman MC, Nadol JB Jr. Morphometric analysis of age-related changes in the human basilar membrane. Ann Otol Rhinol Laryngol 2001;110:1147-53.
  • Wilson DH, Walsh PG, Sanchez L, Davis AC, Taylor AW, Tucker G, et al. The epidemiology of hearing impairment in an Australian adult population.bnInt J Epidemiol 1999;28:247-52.
  • Sha SH, Kanicki A, Dootz G, Talaska AE, Halsey K, Dolan D, et al. Age-related auditory pathology in the CBA/J mouse. Hear Res 2008;243:87-94.
There are 59 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Kamil Hakan Kaya This is me

Arzu Karaman Koç This is me

İbrahim Sayın This is me

Selçuk Güneş This is me

Sinan Canpolat This is me

Baver Şimşek This is me

Fatma Tülin Kayhan This is me

Publication Date February 10, 2015
Published in Issue Year 2015 Volume: 25 Issue: 1

Cite

APA Kaya, K. H., Karaman Koç, A., Sayın, İ., Güneş, S., et al. (2015). Etiological classification of presbycusis in Turkish population according to audiogram configuration. The Turkish Journal of Ear Nose and Throat, 25(1), 1-18.
AMA Kaya KH, Karaman Koç A, Sayın İ, Güneş S, Canpolat S, Şimşek B, Kayhan FT. Etiological classification of presbycusis in Turkish population according to audiogram configuration. Tr-ENT. February 2015;25(1):1-18.
Chicago Kaya, Kamil Hakan, Arzu Karaman Koç, İbrahim Sayın, Selçuk Güneş, Sinan Canpolat, Baver Şimşek, and Fatma Tülin Kayhan. “Etiological Classification of Presbycusis in Turkish Population According to Audiogram Configuration”. The Turkish Journal of Ear Nose and Throat 25, no. 1 (February 2015): 1-18.
EndNote Kaya KH, Karaman Koç A, Sayın İ, Güneş S, Canpolat S, Şimşek B, Kayhan FT (February 1, 2015) Etiological classification of presbycusis in Turkish population according to audiogram configuration. The Turkish Journal of Ear Nose and Throat 25 1 1–18.
IEEE K. H. Kaya, A. Karaman Koç, İ. Sayın, S. Güneş, S. Canpolat, B. Şimşek, and F. T. Kayhan, “Etiological classification of presbycusis in Turkish population according to audiogram configuration”, Tr-ENT, vol. 25, no. 1, pp. 1–18, 2015.
ISNAD Kaya, Kamil Hakan et al. “Etiological Classification of Presbycusis in Turkish Population According to Audiogram Configuration”. The Turkish Journal of Ear Nose and Throat 25/1 (February 2015), 1-18.
JAMA Kaya KH, Karaman Koç A, Sayın İ, Güneş S, Canpolat S, Şimşek B, Kayhan FT. Etiological classification of presbycusis in Turkish population according to audiogram configuration. Tr-ENT. 2015;25:1–18.
MLA Kaya, Kamil Hakan et al. “Etiological Classification of Presbycusis in Turkish Population According to Audiogram Configuration”. The Turkish Journal of Ear Nose and Throat, vol. 25, no. 1, 2015, pp. 1-18.
Vancouver Kaya KH, Karaman Koç A, Sayın İ, Güneş S, Canpolat S, Şimşek B, Kayhan FT. Etiological classification of presbycusis in Turkish population according to audiogram configuration. Tr-ENT. 2015;25(1):1-18.