{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:41:54Z","timestamp":1791830514137,"version":"4.3.4"},"reference-count":67,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Transcranial magnetic stimulation (TMS) has been investigated as a potential treatment for chronic tinnitus for 20 years. Numerous studies have reported that repetitive TMS (rTMS) has demonstrated efficacy for reducing the severity of tinnitus and its associated co-conditions such as depression, anxiety, and insomnia. However, some researchers have reported that active rTMS is no more effective than sham (placebo) rTMS as a tinnitus treatment method. There are numerous unresolved issues in this field that need to be addressed before rTMS can become a viable treatment for tinnitus. These issues include the type or brand of TMS system and its configuration; coil type, orientation, and placement method; scalp or neural target; laterality of rTMS application; dual site vs. single site stimulation; stimulation frequency and intensity; number of sessions; number of pulses per session; determination of the resting motor threshold (rMT); characteristics of the study population and their tinnitus; and outcome measures and follow-up assessments. To address and resolve these issues, large-scale, multi-site clinical trials of rTMS for tinnitus need to be conducted to determine which rTMS protocols are the most effective. In the absence of such investigations, the issues that need to be studied and addressed remain unresolved and continue to impede the clinical application of this treatment method.<\/jats:p>","DOI":"10.3390\/jcm12144648","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T01:58:11Z","timestamp":1689213491000},"page":"4648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Unresolved Issues Associated with Transcranial Magnetic Stimulation (TMS) Treatment of Chronic Tinnitus"],"prefix":"10.3390","volume":"12","author":[{"given":"Robert L.","family":"Folmer","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Oregon Health & Science University, Portland, OR 97239, USA"},{"name":"National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Medical Center, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0194-5998(99)70123-3","article-title":"Tinnitus severity, loudness and depression","volume":"121","author":"Folmer","year":"1999","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1053\/ajot.2000.9871","article-title":"Tinnitus and insomnia","volume":"21","author":"Folmer","year":"2000","journal-title":"Am. J. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1067\/mhn.2001.114673","article-title":"Chronic tinnitus as phantom auditory pain","volume":"124","author":"Folmer","year":"2001","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/00005537-200305000-00010","article-title":"Chronic tinnitus resulting from head or neck injuries","volume":"113","author":"Folmer","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_5","first-page":"532","article-title":"Tinnitus: Questions to reveal the cause, answers to provide relief","volume":"53","author":"Folmer","year":"2004","journal-title":"J. Fam. Pract."},{"key":"ref_6","first-page":"42","article-title":"Ringing-in-the-Ears: Hope and Help for Tinnitus Sufferers","volume":"22","author":"Folmer","year":"2006","journal-title":"Hear. Health"},{"key":"ref_7","first-page":"127","article-title":"Obsessive-Compulsiveness in a Population of Tinnitus Patients","volume":"14","author":"Folmer","year":"2008","journal-title":"Int. Tinnitus J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1682\/JRRD.2010.07.0138","article-title":"Audiometric thresholds and prevalence of tinnitus among male Veterans in the United States: Data from the National Health and Nutrition Examination Survey, 1999\u20132006","volume":"48","author":"Folmer","year":"2011","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/01.HJ.0000412700.19961.b1","article-title":"Implants Can Improve Tinnitus, But Most Offer No Quick Fixes","volume":"65","author":"Folmer","year":"2012","journal-title":"Hear. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3766\/jaaa.25.1.7","article-title":"Experimental, Controversial and Futuristic Treatments for Chronic Tinnitus","volume":"25","author":"Folmer","year":"2014","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/epirev\/mxu005","article-title":"Hearing Impairment and Tinnitus: Prevalence, Risk Factors, and Outcomes in US Service Members and Veterans Deployed to Iraq and Afghanistan Wars","volume":"37","author":"Theodoroff","year":"2015","journal-title":"Epidemiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.otohns.2005.09.030","article-title":"Long-term effectiveness of ear-level devices for tinnitus","volume":"134","author":"Folmer","year":"2006","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/S0006-3223(02)01896-6","article-title":"Neuronavigated repetitive transcranial magnetic stimulation in patients with tinnitus: A short case series","volume":"54","author":"Eichhammer","year":"2003","journal-title":"Biol. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1097\/00001756-200305230-00014","article-title":"Neuronavigated rTMS in a patient with chronic tinnitus. Effects of 4 weeks treatment","volume":"14","author":"Langguth","year":"2003","journal-title":"Neuroreport"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/MAO.0b013e31827b4d46","article-title":"Repetitive Transcranial Magnetic Stimulation as a Treatment for Chronic Tinnitus: A Critical Review","volume":"34","author":"Theodoroff","year":"2013","journal-title":"Otol. Neurotol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1007\/s00405-015-3642-5","article-title":"Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: A systematic review and meta-analysis","volume":"273","author":"Soleimani","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Liang, Z., Yang, H., Cheng, G., Huang, L., Zhang, T., and Jia, H. (2020). Repetitive transcranial magnetic stimulation on chronic tinnitus: A systematic review and meta-analysis. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02947-9"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jamaoto.2020.1497","article-title":"Association of Central Noninvasive Brain Stimulation Interventions with Efficacy and Safety in Tinnitus Management: A Meta-analysis","volume":"146","author":"Chen","year":"2020","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"300060521999549","DOI":"10.1177\/0300060521999549","article-title":"An updated meta-analysis: Repetitive transcranial magnetic stimulation for treating tinnitus","volume":"49","author":"Yin","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000276835","article-title":"Focal metabolic activation in the predominant left auditory cortex in patients suffering from tinnitus: A PET study with [18F]deoxyglucose","volume":"58","author":"Arnold","year":"1996","journal-title":"ORL"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1212\/WNL.50.1.114","article-title":"The functional neuroanatomy of tinnitus: Evidence for limbic system links and neuroplasticity","volume":"50","author":"Lockwood","year":"1998","journal-title":"Neurology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00234-007-0255-8","article-title":"Lateralization of Neural Activity Associated with Tinnitus","volume":"49","author":"Folmer","year":"2007","journal-title":"Neuroradiology"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Maudoux, A., Lefebvre, P., Cabay, J.E., Demertzi, A., Vanhaudenhuyse, A., Laureys, S., and Soddu, A. (2012). Auditory resting-state network connectivity in tinnitus: A functional MRI study. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0036222"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Schmidt, S.A., Akrofi, K., Carpenter-Thompson, J.R., and Husain, F.T. (2013). Default mode, dorsal attention and auditory resting state networks exhibit differential functional connectivity in tinnitus and hearing loss. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0076488"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1038\/nrn4003","article-title":"Tinnitus: Perspectives from human neuroimaging","volume":"16","author":"Elgoyhen","year":"2015","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2384","DOI":"10.1002\/hbm.23525","article-title":"Tinnitus distress is linked to enhanced resting-state functional connectivity from the limbic system to the auditory cortex","volume":"38","author":"Chen","year":"2017","journal-title":"Hum. Brain Mapp."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.heares.2015.09.010","article-title":"Neural networks of tinnitus in humans: Elucidating severity and habituation","volume":"334","author":"Husain","year":"2016","journal-title":"Hear Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1001\/jamaoto.2015.1219","article-title":"Repetitive Transcranial Magnetic Stimulation Treatment for Chronic Tinnitus: A Randomized Clinical Trial","volume":"141","author":"Folmer","year":"2015","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.brs.2008.06.003","article-title":"Controversy: Does repetitive transcranial magnetic stimulation\/ transcranial direct current stimulation show efficacy in treating tinnitus patients?","volume":"1","author":"Langguth","year":"2008","journal-title":"Brain Stimul."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1001\/jama.2016.0075","article-title":"Transcranial Magnetic Stimulation for Chronic Tinnitus","volume":"315","author":"Piccirillo","year":"2016","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1001\/jamaoto.2016.4055","article-title":"The Case for a Definitive Multisite, Randomized Clinical Trial of Repetitive Transcranial Magnetic Stimulation for Tinnitus","volume":"143","author":"Mennemeier","year":"2017","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1001\/jamaoto.2013.233","article-title":"Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus: Four-Week Stimulation Trial","volume":"139","author":"Piccirillo","year":"2013","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.brs.2017.08.001","article-title":"1-Hz rTMS in the treatment of tinnitus: A sham-controlled, randomized multicenter trial","volume":"10","author":"Landgrebe","year":"2017","journal-title":"Brain Stimul."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"137026","DOI":"10.1016\/j.neulet.2022.137026","article-title":"One way or another: Treatment effects of 1 Hz rTMS using different current directions in a small sample of tinnitus patients","volume":"797","author":"Schoisswohl","year":"2023","journal-title":"Neurosci. Lett."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1523\/ENEURO.0287-22.2023","article-title":"Behavioral and Functional Brain Activity Alterations Induced by TMS Coils with Different Spatial Distributions","volume":"10","author":"Pell","year":"2023","journal-title":"eNeuro"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wassermann, E.M., Peterchev, A.V., Ziemann, U., Lisanby, S.H., Siebner, H.R., and Walsh, V. (2021). The Oxford Handbook of Transcranial Stimulation, Oxford University Press. [2nd ed.].","DOI":"10.1093\/oxfordhb\/9780198832256.001.0001"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10548-006-0002-1","article-title":"Transcranial Magnetic Stimulation for the treatment of tinnitus: A new coil positioning method and first results","volume":"18","author":"Langguth","year":"2006","journal-title":"Brain Topogr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1136\/jnnp.2007.127712","article-title":"Effect of daily repetitive transcranial magnetic stimulation for treatment of tinnitus: Comparison of different stimulus frequencies","volume":"79","author":"Khedr","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1080\/00016489.2017.1316870","article-title":"Comparison of treatment outcomes between 10 and 20 EEG electrode location system-guided and neuronavigation-guided repetitive transcranial magnetic stimulation in chronic tinnitus patients and target localization in the Asian brain","volume":"137","author":"Noh","year":"2017","journal-title":"Acta Oto-Laryngol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"276","DOI":"10.3109\/15622975.2012.708438","article-title":"Efficacy of different protocols of transcranial magnetic stimulation for the treatment of tinnitus: Pooled analysis of two randomized controlled studies","volume":"15","author":"Langguth","year":"2014","journal-title":"World J. Biol. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1002\/acn3.587","article-title":"Combined transcranial magnetic stimulation in the treatment of chronic tinnitus","volume":"5","author":"Formanek","year":"2018","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s10548-020-00797-y","article-title":"Dual-site rTMS is More Effective than Single-site rTMS in Tinnitus Patients: A Blinded Randomized Controlled Trial","volume":"33","author":"Noh","year":"2020","journal-title":"Brain Topogr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"fcab115","DOI":"10.1093\/braincomms\/fcab115","article-title":"Prediction of response to repetitive transcranial magnetic stimulation in phantom sounds based on individual brain anatomy","volume":"3","author":"Poeppl","year":"2021","journal-title":"Brain Commun"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"831832","DOI":"10.3389\/fneur.2022.831832","article-title":"Sequential Prefrontal and Temporoparietal Repetitive Transcranial Magnetic Stimulation (rTMS) for Treatment of Tinnitus with and Without Comorbid Depression: A Case Series and Systematic Review","volume":"13","author":"Marder","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/j.1468-1331.2010.02956.x","article-title":"Left temporal low frequency rTMS for the treatment of tinnitus: Clinical predictors of treatment outcome\u2014A retrospective study","volume":"17","author":"Frank","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1212\/WNL.48.5.1398","article-title":"Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation","volume":"48","author":"Chen","year":"1997","journal-title":"Neurology"},{"key":"ref_47","first-page":"40","article-title":"A Chart Review to Assess the Response of Veterans Suffering from Tinnitus to Alpha Burst Transcranial Magnetic Stimulation","volume":"24","author":"Ring","year":"2020","journal-title":"Int. Tinnitus J."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Hong, S.-M., Kim, S.-K., Seo, M.-Y., and Kang, S.-Y. (2021). Multiple Daily Rounds of Theta-Burst Stimulation for Tinnitus: Preliminary Results. Medicina, 57.","DOI":"10.3390\/medicina57080743"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1097\/MAO.0000000000002207","article-title":"Treatment of Tinnitus Using Theta Burst Based Repetitive Transcranial Magnetic Stimulation -- A Single Blinded Randomized Control Trial","volume":"40","author":"Godbehere","year":"2019","journal-title":"Otol. Neurotol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.otohns.2004.09.134","article-title":"Long-term effects of repetitive transcranial magnetic stimulation (rTMS) in patients with chronic tinnitus","volume":"132","author":"Kleinjung","year":"2005","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1136\/jnnp.2006.105007","article-title":"Effects of repetitive transcranial magnetic stimulation on chronic tinnitus: A randomised, cross over, double blind, placebo-controlled study","volume":"78","author":"Rossi","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/ana.10468","article-title":"Transient suppression of tinnitus by transcranial magnetic stimulation","volume":"53","author":"Plewnia","year":"2003","journal-title":"Ann Neurol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.biopsych.2009.04.034","article-title":"More lateral and anterior prefrontal coil location is associated with better repetitive transcranial magnetic stimulation antidepressant response","volume":"66","author":"Herbsman","year":"2009","journal-title":"Biol. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1001\/jamapsychiatry.2018.1483","article-title":"Effect of repetitive transcranial magnetic stimulation on treatment-resistant major depression in US Veterans: A randomized clinical trial","volume":"75","author":"Yesavage","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1176\/appi.ajp.2021.20101429","article-title":"Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial","volume":"179","author":"Cole","year":"2022","journal-title":"Am. J. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1097\/00005537-199908000-00004","article-title":"A review of randomized clinical trials in tinnitus","volume":"109","author":"Dobie","year":"1999","journal-title":"Laryngoscope"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1080\/03655230600895465","article-title":"Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Chronic Tinnitus","volume":"126","author":"Folmer","year":"2006","journal-title":"Acta Otolaryngol."},{"key":"ref_58","first-page":"238","article-title":"Efficacy of repetitive transcranial magnetic stimulation for the treatment of refractory chronic tinnitus: A randomized, placebo controlled study","volume":"31","author":"Anders","year":"2010","journal-title":"Neuro Endocrinol. Lett."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/j.1468-1331.2008.02522.x","article-title":"One-year follow up of patients with chronic tinnitus treated with left temporoparietal rTMS","volume":"16","author":"Khedr","year":"2009","journal-title":"Eur. J. Neurol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/j.1468-1331.2010.02987.x","article-title":"Burst transcranial magnetic stimulation: Which tinnitus characteristics influence the amount of transient tinnitus suppression?","volume":"17","author":"Vanneste","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1001\/jamaoto.2015.2425","article-title":"Assessment of Blinding in a Tinnitus Treatment Trial","volume":"141","author":"Keller","year":"2015","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ctim.2008.05.001","article-title":"Blinding in clinical trials, time to do it better","volume":"16","author":"Park","year":"2008","journal-title":"Complement. Ther. Med."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Folmer, R.L. (2002). Long-term reductions in tinnitus severity. BMC Ear Nose Throat Disord., 2, Available online: http:\/\/www.biomedcentral.com\/content\/pdf\/1472-6815-2-3.pdf.","DOI":"10.1186\/1472-6815-2-3"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.23937\/2378-3656\/1410023","article-title":"Experimental Use of Transcranial Magnetic Stimulation (TMS) to Treat Tinnitus in a Deaf Patient","volume":"2","author":"Theodoroff","year":"2015","journal-title":"Clin. Med. Rev. Case Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1097\/WNP.0000000000000413","article-title":"Hearing Protective Devices Should Be Used by Recipients of Repetitive Transcranial Magnetic Stimulation","volume":"34","author":"Folmer","year":"2017","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/archotol.1996.01890140029007","article-title":"Development of the Tinnitus Handicap Inventory","volume":"122","author":"Newman","year":"1996","journal-title":"Arch Otolaryngol. Head Neck Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/AUD.0b013e31822f67c0","article-title":"The Tinnitus Functional Index: A new clinical measure for chronic, intrusive tinnitus","volume":"33","author":"Meikle","year":"2012","journal-title":"Ear Hear."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4648\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:11:41Z","timestamp":1760127101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,12]]},"references-count":67,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12144648"],"URL":"https:\/\/doi.org\/10.3390\/jcm12144648","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,12]]}}}