ライブラリ登録: Guest
Journal of Long-Term Effects of Medical Implants

年間 4 号発行

ISSN 印刷: 1050-6934

ISSN オンライン: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

Indexed in

The Effects of Vestibular Implants and Other Existing Treatment Options of Individuals with Bilateral Vestibular Hypofunction: A Review

巻 33, 発行 4, 2023, pp. 31-42
DOI: 10.1615/JLongTermEffMedImplants.2022040056
Get accessGet access

要約

Vestibular dysfunction (VD) is an experience that is shared by nearly 35% of Americans above the age of 40 (nearly 69 million). This percentage increases to 80% when looking at the population of individuals over the age of 80. VD can have tremendously negative health outcomes for patients. Improper vestibular function can result in a loss of balance and patients often cite vertigo as a common symptom, which is often associated with dramatically reduced quality of life. Falls are another common clinically significant outcome of VD and place a huge social and financial burden on the patient and healthcare system. Although the pathophysiology and treatment options for certain vestibular disorders have been well researched, disorders such as bilateral vestibular dysfunction (BVD), have had traditionally ineffective treatment options. That said, novel therapeutics such as vestibular implants (VIs) have been recently tested and showed positive health outcomes for patients with BVD. This review aims to investigate the health outcomes of patients who have received VIs, as well as discuss the limitations and existing treatment options.

参考
  1. Agrawal Y, Ward BK, Minor LB. Vestibular dysfunction: Prevalence, impact and need for targeted treatment. J Vestib Res Equilib Orientat. 2013;23(3):113-7. doi:10.3233/VES-130498.

  2. Ward BK, Agrawal Y, Hoffman HJ, Carey JP, Della Santina CC. Prevalence and impact of bilateral vestibular hypofunction: Results from the 2008 US national health interview survey. JAMA Otolaryngol Head Neck Surg. 2013;139(8):80-10. doi:10.1001/jamaoto.2013.3913.

  3. Casale J, Browne T, Murray I, Gupta G. Physiology, vestibular system. StatPearls Publishing; 2021. Accessed July 24, 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK532978/.

  4. Guinand N, Guyot JP, Kingma H, Kos I, Pelizzone M. Vestibular implants: The first steps in humans. Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Int Conf. 2011;2011:2262-64. doi:10.1109/IEMBS.2011.6090569.

  5. Monzani D, Casolari L, Guidetti G, Rigatelli M. Psychological distress and disability in patients with vertigo. J Psychosom Res. 2001;50(6):319-23. doi:10.1016/s0022-3999(01)00208-2.

  6. McCall AA, Yates BJ. Compensation following bilateral vestibular damage. Front Neurol. 2011;2:88. doi:10.3389/fneur.2011.00088.

  7. Zingler VC, Weintz E, Jahn K, Huppert D, Rettinger N, Brandt T, Strupp M. Follow-up of vestibular function in bilateral vestibulopathy. J Neurol Neurosurg Psychiatry. 2008;79(3):284-8. doi:10.1136/jnnp.2007.122952.

  8. Pelizzone M, Fornos AP, Guinand N, van de Berg R, Kos I, Stokroos R, Kingma H, Guyot J. First functional rehabilitation via vestibular implants. Cochlear Implants Int. 2014;15(Suppl 1):S62-4. doi:10.1179/1467010014Z.000000000165.

  9. Guinand N, van de Berg R, Cavuscens, Stokroos R, Ranieri M, Pelizzone M, Kingma H, Guyot JP, Perez-Fornos A. Vestibular implants: 8 years of experience with electrical stimulation of the vestibular nerve in 11 patients with bilateral vestibular loss. ORL J Oto-Rhino-Laryngol Its Relat Spec. 2015;77(4):227-40. doi:10.1159/000433554.

  10. Guyot J-P, Perez Fornos A. Milestones in the development of a vestibular implant. Curr Opin Neurol. 2019;32(1):145-53. doi:10.1097/WCO.0000000000000639.

  11. Jones SM, Jones TA, Mills KN, Gaines GC. Anatomical and physiological considerations in vestibular dysfunction and compensation. Semin Hear. 2009;30(4):231-41. doi:10.1055/s-0029-1241124.

  12. Yates BJ, Bronstein AM. The effects of vestibular system lesions on autonomic regulation: Observations, mechanisms, and clinical implications. J Vestib Res Equilib Orientat. 2005;15(3):119-29.

  13. Highstein SM, Holstein GR. The anatomy of the vestibular nuclei. Prog Brain Res. 2006;151:157-203. doi:10.1016/S0079-6123(05)51006-9.

  14. Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T. Epidemiology of vestibular vertigo: A neurotologic survey of the general population. Neurology. 2005;65(6):898-904. doi:10.1212/01.wnl.0000175987.59991.3d.

  15. Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436-41. doi:10.1212/wnl.56.4.436.

  16. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H. Epidemiology of benign paroxysmal positional vertigo: A population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5. doi:10.1136/jnnp.2006.100420.

  17. Palmeri R, Kumar A. Benign paroxysmal positional vertigo. StatPearls Publishing; 2021. Accessed July 24, 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470308/.

  18. Helminski JO, Zee DS, Janssen I, Hain TC. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: A systematic review. Phys Ther. 2010;90(5):663-78. doi:10.2522/ptj.20090071.

  19. Harris JP, Alexander TH. Current-day prevalence of Meniere's syndrome. Audiol Neurootol. 2010;15(5):318-22. doi:10.1159/000286213.

  20. Nakashima T, Pyykkö I, Arroll MA, Casselbrant M, Foster C, Manzoor N, Megerian C, Naganawa S, Young Y. Meniere's disease. Nat Rev Dis Primer. 2016;2:16028. doi:10.1038/nrdp.2016.28.

  21. Zingler VC, Cnyrim C, Jahn K, Weintz E, Fernbacher J, Frenzel C, Brandt T, Strupp M. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. Ann Neurol. 2007;61(6):524-2. doi:10.1002/ana.21105.

  22. Krebs DE, Gill-Body KM, Riley PO, Parker SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: Preliminary report. Otolaryngol Head Neck Surg. 1993;109(4):735-41. doi:10.1177/019459989310900417.

  23. Vestibular Disorders Association (VeDA). Bilateral vestibular hypofunction. Accessed July 24, 2021. Available from: https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/bilateral-vestibular-hypofunction/.

  24. Brown KE, Whitney SL, Wrisley DM, Furman JM. Physical therapy outcomes for persons with bilateral vestibular loss. Laryngoscope. 2001;111(10):1812-7. doi:10.1097/00005537-200110000-00027.

  25. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: Data from the national health and nutrition examination survey, 2001-2004. Arch Intern Med. 2009;169(10):938-44. doi:10.1001/archinternmed.2009.66.

  26. Zecevic AA, Chesworth BM, Zaric GS, Huang Q, Salmon A, McAuslan D, Welch R, Brunton D. Estimating the cost of serious injurious falls in a Canadian acute care hospital. Can J Aging Rev Can Vieil. 2012;31(2):139-47. doi:10.1017/S0714980812000037.

  27. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc. 2018;66(4):693-8. doi:10.1111/jgs.15304.

  28. Whitney SL, Alghwiri AA, Alghadir A. An overview of vestibular rehabilitation. Handb Clin Neurol. 2016;137:187-205. doi:10.1016/B978-0-444-63437-5.00013-3.

  29. Matsumura M, Murofushi T. Vestibular rehabilitation after vestibulopathy focusing on the application of virtual reality. J Otorhinolaryngol Hear Balance Med. 2021;2(2):5. doi:10.3390/ohbm2020005.

  30. Hall CD, Herdman SJ, Whitney SL, Cass S, Clendaniel R, Fife T, Furman J, Getchius T, Goebel J, Shepard N, Woodhouse S. Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline: From the american physical therapy association neurology section. J Neurol Phys Ther. 2016;40(2):124-55. doi:10.1097/NPT.0000000000000120.

  31. Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: A systematic review. centre for reviews and dissemination/database of abstracts of reviews of effects (DARE): Quality-assessed reviews. Accessed July 24, 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK148860/.

  32. Eleftheriadou A, Skalidi N, Velegrakis GA. Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Otorhinolaryngol. 2012;269(11):2309-16. doi:10.1007/s00405-012-2019-2.

  33. Mayo NE. Patient compliance: Practical implications for physical therapists. A review of the literature. Phys Ther. 1978;58(9):1083-90. doi:10.1093/ptj/58.9.1083.

  34. Hegeman J, Honegger F, Kupper M, Allum JHJ. The balance control of bilateral peripheral vestibular loss subjects and its improvement with auditory prosthetic feedback. J Vestib Res Equilib Orientat. 2005;15(2):109-17.

  35. Kentala E, Vivas J, Wall C. Reduction of postural sway by use of a vibrotactile balance prosthesis prototype in subjects with vestibular deficits. Ann Otol Rhinol Laryngol. 2003;112(5):404-9. doi:10.1177/000348940311200503.

  36. Felipe L, Kingma H. Vibrotactile biofeedback system and bilateral vestibular loss: Pilot study. J Otolaryngol ENT Res. 2016;4(6):154-7. doi:10.15406/joentr.2016.04.00124.

  37. Goebel JA, Sinks BC, Parker BE, Richardson NT, Olowin AB, Cholewiak RW. Effectiveness of head-mounted vibrotactile stimulation in subjects with bilateral vestibular loss: A phase 1 clinical trial. Otol Neurotol. 2009;30(2):210-6. doi:10.1097/MAO.0b013e318194f84d.

  38. Dozza M, Chiari L, Horak FB. Audio-biofeedback improves balance in patients with bilateral vestibular loss. Arch Phys Med Rehabil. 2005;86(7):1401-3. doi:10.1016/j.apmr.2004.12.036.

  39. Goodworth AD, Wall C, Peterka RJ. Influence of feedback parameters on performance of a vibrotactile balance prosthesis. IEEE Trans Neural Syst Rehabil Eng. 2009;17(4):397-408. doi:10.1109/TNSRE.2009.2023309.

  40. Wuehr M, Decker J, Schniepp R. Noisy galvanic vestibular stimulation: An emerging treatment option for bilateral vestibulopathy. J Neurol. 2017;264(Suppl 1):81-6. doi:10.1007/s00415-017-8481-4.

  41. Collins JJ, Chow CC, Imhoff TT. Stochastic resonance without tuning. Nature. 1995;376(6537):236-8. doi:10.1038/376236a0.

  42. Moss F, Ward LM, Sannita WG. Stochastic resonance and sensory information processing: A tutorial and review of application. Clin Neurophysiol. 2004;115(2):267-81. doi:10.1016/j.clinph.2003.09.014.

  43. McDonnell MD, Ward LM. The benefits of noise in neural systems: Bridging theory and experiment. Nat Rev Neurosci. 2011;12(7):415-25. doi:10.1038/nrn3061.

  44. Carriot J, Jamali M, Chacron MJ, Cullen KE. Statistics of the vestibular input experienced during natural self-motion: Implications for neural processing. J Neurosci. 2014;34(24):8347-57. doi:10.1523/JNEUROSCI. 0692-14.2014.

  45. Fujimoto C, Egami N, Kawahara T, Uemura Y, Yamamoto Y, Yamasoba T, Iwasaki S. Noisy galvanic vestibular stimulation sustainably improves posture in bilateral vestibulopathy. Front Neurol. 2018;9:900. doi:10.3389/fneur.2018.00900.

  46. Fitzpatrick RC, Wardman DL, Taylor JL. Effects of galvanic vestibular stimulation during human walking. J Physiol. 1999;517(Part 3):931-9. doi:10.1111/j.1469-7793.1999.0931s.x.

  47. Wuehr M, Nusser E, Krafczyk S, Straube A, Brandt T, Jahn K, Schniepp R. Noise-enhanced vestibular input improves dynamic walking stability in healthy subjects. Brain Stimulat. 2016;9(1):109-16. doi:10.1016/j.brs.2015.08.017.

  48. Keywan A, Wuehr M, Pradhan C, Jahn K. Noisy galvanic stimulation improves roll-tilt vestibular perception in healthy subjects. Front Neurol. 2018;9:83. doi:10.3389/fneur.2018.00083.

  49. Cohen B, Suzuki JI, Bender MB. Eye movements from semicircular canal nerve stimulation in the cat. Ann Otol Rhinol Laryngol. 1964;73:153-69. doi:10.1177/000348946407300116.

  50. Gong W, Merfeld DM. Prototype neural semicircular canal prosthesis using patterned electrical stimulation. Ann Biomed Eng. 2000;28(5):572-81. doi:10.1114/1.293.

  51. Guyot J-P, Sigrist A, Pelizzone M, Kos MI. Adaptation to steady-state electrical stimulation of the vestibular system in humans. Ann Otol Rhinol Laryngol. 2011;120(3):143-9. doi:10.1177/000348941112000301.

  52. Azevedo YJ de, Ledesma ALL, Pereira LV, Oliveira CA, Bahmad Junior F. Vestibular implant: Does it really work? A systematic review. Braz J Otorhinolaryngol. 2019;85(6):788-98. doi:10.1016/j.bjorl.2019.07.011.

  53. Phillips C, Defrancisci C, Ling L, Nie K, Nowack A, Phillips J, Rubinstein J. Postural responses to electrical stimulation of the vestibular end organs in human subjects. Exp Brain Res. 2013;229(2):181-95. doi:10.1007/s00221-013-3604-3.

  54. Perez Fornos A, Guinand N, van de Berg R, Stokroos R, Micera S, Kingma H, Pelizzone M, Guyot JP. Artificial balance: Restoration of the vestibulo-ocular reflex in humans with a prototype vestibular neuroprosthesis. Front Neurol. 2014;5:66. doi:10.3389/fneur.2014.00066.

  55. Phillips JO, Ling L, Nie K, Jameyson E, Phillips C, Nowack A, Gloub J, Rubinstein J. Vestibular implantation and longitudinal electrical stimulation of the semicircular canal afferents in human subjects. J Neurophysiol. 2015;113(10):3866-92. doi:10.1152/jn.00171.2013.

  56. Perez Fornos A, Cavuscens S, Ranieri M, van de Berg R, Stokroos R, Kingma H, Guyot JP, Guinand N. The vestibular implant: A probe in orbit around the human balance system. J Vestib Res Equilib Orientat. 2017;27(1):51-61. doi:10.3233/VES-170604.

  57. van de Berg R, Guinand N, Guyot J-P, Kingma H, Stokroos RJ. The modified ampullar approach for vestibular implant surgery: Feasibility and its first application in a human with a long-term vestibular loss. Front Neurol. 2012;3:18. doi:10.3389/fneur.2012.00018.

  58. Guyot J-P, Sigrist A, Pelizzone M, Feigl GC, Kos MI. Eye movements in response to electrical stimulation of the lateral and superior ampullary nerves. Ann Otol Rhinol Laryngol. 2011;120(2):81-7. doi:10.1177/000348941112000202.

  59. Wall C, Merfeld DM, Rauch SD, Black FO. Vestibular prostheses: The engineering and biomedical issues. J Vestib Res Equilib Orientat. 2002;12(2-3):95-113.

  60. Feigl GC, Fasel JH, Anderhuber F, Ulz H, Rienmuller R, Guyot JP, Kos I. Superior vestibular neurectomy: A novel transmeatal approach for a denervation of the superior and lateral semicircular canals. Otol Neurotol. 2009;30(5):586-91. doi:10.1097/MAO.0b013e3181ab9164.

  61. Seppen BF, van Hoof M, Stultiens JJA, Boogert T, Guinand N, Guyot JP, Kingma H, Fornos A, Handschuh S, Glueckert R, Jacobi L, Schrott-Fisher A, Chacko L, van de Berg R. Drafting a surgical procedure using a computational anatomy driven approach for precise, robust, and safe vestibular neuroprosthesis placement-when one size does not fit all. Otol Neurotol. 2019;40(5 Suppl 1):S51-8. doi:10.1097/MAO.0000000000002211.

  62. Haxby F, Akrami M, Zamani R. Finding a balance: A systematic review of the biomechanical effects of vestibular prostheses on stability in humans. J Funct Morphol Kinesiol. 2020;5(2):E23. doi:10.3390/jfmk5020023.

  63. Phillips JO, Ling L, Nowack A, Rebollar B, Rubinstein JT. Interactions between auditory and vestibular modalities during stimulation with a combined vestibular and cochlear prosthesis. Audiol Neurootol. 2020;25(1-2):96-108. doi:10.1159/000503846.

  64. Rubinstein JT, Ling L, Nowack A, Nie K, Phillips JO. Results from a second-generation vestibular implant in human subjects: Diagnosis may impact electrical sensitivity of vestibular afferents. Otol Neurotol. 2020;41(1):68-77. doi:10.1097/MAO.0000000000002463.

  65. Chow MR, Ayiotis AI, Schoo DP, Gimmon PT, Lane K, Morris B, Rahman M, Valentin N, Boutros P, Bowditch S, Ward B, Sun D, Guajardo C, Schubert M, Carey J, Santina C. Posture, gait, quality of life, and hearing with a vestibular implant. N Engl J Med. 2021;384(6):521-32. doi:10.1056/NEJMoa2020457.

  66. Golub JS, Ling L, Nie K, Nowack A, Shepherd S, Bierer S, Jameyson E, Kaneko C, Phillips J, Rubinstein J. Prosthetic implantation of the human vestibular system. Otol Neurotol. 2014;35(1):136-47. doi:10.1097/MAO.0000000000000003.

  67. Guinand N, Van de Berg R, Cavuscens S, Stokroos R, Ranieri M, Pelizzone M, Kingma H, Guyot JP, Fornos AP. Restoring visual acuity in dynamic conditions with a vestibular implant. Front Neurosci. 2016;10:577. doi:10.3389/fnins.2016.00577.

  68. van de Berg R, Guinand N, Ranieri M, Cavuscens S, Nguyen K, Guyot JP, Lucieer F, Starkov D, Kingma H, Hoof M, Fornos AP. The vestibular implant input interacts with residual natural function. Front Neurol. 2017;8:644. doi:10.3389/fneur.2017.00644.

  69. Guinand N, Van de Berg R, Cavuscens S, Ranieri M, Schneider E, Lucieer F, Kingma H, Guyot JP, Fornos AP. The video head impulse test to assess the efficacy of vestibular implants in humans. Front Neurol. 2017;8:600. doi:10.3389/fneur.2017.00600.

  70. Zhang Y, QU B, Lun S, Guo Y, Liu J. The 36-item short form health survey: Reliability and validity in Chinese medical students. Int J Med Sci. 2012;9(7):521-6. doi:10.7150/ijms.4503.

  71. Gacek RR, Gacek MR. Results of singular neurectomy in the posterior ampullary recess. ORL J Otorhinolaryngol Relat Spec. 2002;64(6):397-402. doi:10.1159/000067572.

  72. Dai C, Fridman GY, Della Santina CC. Effects of vestibular prosthesis electrode implantation and stimulation on hearing in rhesus monkeys. Hear Res. 2011;277(1-2):204-10. doi:10.1016/j.heares.2010.12.021.

  73. Chambers JD, Lord J, Cohen JT, Neumann PJ, Buxton MJ. Illustrating potential efficiency gains from using cost-effectiveness evidence to reallocate medicare expenditures. Value Health. 2013;16(4):629-38. doi:10.1016/j.jval.2013.02.011.

  74. Ramos Macias A, Ramos de Miguel A, Rodriguez Montesdeoca I, Borkoski Barreiro S, Falcón González JC. Chronic electrical stimulation of the otolith organ: Preliminary results in humans with bilateral vestibulopathy and sensorineural hearing loss. Audiol Neurotol. 2019;25(1-2):79–90. doi:10.1159/000503600.

  75. Ren P, Gao Z, Han P, Chen Z, Qu J, Gong S, Deng Y, Chen F, Zhang Y, Zhang Q. Optimal design of neural modulation strategy of vestibular prosthesis. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020;34(5):389-98 (in Chinese). doi:10.13201/j.issn.2096-7993.2020.05.002.

近刊の記事

Transfer of guided emergence profile developed using customized provisional implant restoration and cementation using an abutment replica technique- A case report. Vinay Sivaswamy, Balaji Anand S D, Jacob Mathew Philip, C J Venkatakrishnan, Narasimman M, Helen Mary Abraham, Pavithra B Marijuana use is Associated with Increased Rates of Hip Dislocation and Lower Insurance Reimbursement among THA Recipients Andrew Recker, Chukwuweike Gwam, Erin Kelly, Scott Douglas, Johannes Plate Surface modification of Mg alloy AZ91D using nanopowder mixed EDM for Biodegradable Implant Alok Kumar, Abhishek Singh The history of orthopedics in the long term: from general medicine to medical specialties Pavlos Altsitzioglou, Ioannis Zafeiris, Fotini Soucacos, Pantelis Limneos, Eleftheria Souliotis, Evanthia Mitsiokapa, Theodosis Saranteas, Andreas Mavrogenis COMPARISON OF ROUGHNESS, WETTABILITY AND SCANNING ELECTRON MICROSCOPY FEATURES BETWEEN SANDBLASTED ACID-ETCHED AND OXIDIZED TITANIUM DENTAL IMPLANTS Kshitiz Chhabra, Arvina Rajasekar CORRELATION BETWEEN PRIMARY STABILITY OF DENTAL IMPLANTS AND BONE DENSITY: A RETROSPECTIVE ANALYSIS Padmaja S, Arvina Rajasekar C-Reactive Protein and Erythrocyte Sedimentation Rates after total and unicompartmental knee arthroplasty - less implant equals quicker normalization Kasım Kılıçarslan, Ömer Faruk Naldöven, Enejd Veizi, Şahan Güven, Şahin Çepni, Ahmet Fırat COMPLICATIONS FOLLOWING SHORT FEMORAL NAIL FIXATION FOR INTETROCHANTERIC HIP FRACTURES. A RETROSPECTIVE STUDY Anastasia Vasilopoulou, Antonios Trichonas, Konstantinos Palaiologos, Emmanouel Antonogiannakis, Christos Nikakis, Stavros Angelis, Spyridon Maris, Christos Grekas , Efthimios Karadimas, Alexandros Apostolopoulos FEA: Connector Designs and Pontic Stress Distribution of Fixed Partial Denture Implant-Supported Metal Framework Saja Muhsin, Enas Mohammed, Khalid Bander Design and Frequency Stability Analysis of an Adaptive Neuro-Fuzzy Inference System based Artificial Pacemaker Controller in MATLAB Nader Jafarnia Dabanloo, Asghar Dabiriaghdam, Fereidoon Nooshirvan Rahatabad, Keivan Maghooli Complications following intraosseous injections of calcium phosphate bone cement in Subchondroplasty. Christos Zachariadis, Helen Leligou, Stauros Kourkoulis, Evaggelos Magnisalis, Panayiotis Papagelopoulos, Olga Savvidou The Impact of Patient Characteristics on Outcomes of Surgically Managed Vertebral Osteomyelitis in the United States: Insights from a National Database Study Jennifer Kurowicki, Stuart Changoor, Daniel Coban, Neil Patel, Kumar Sinha, Ki Hwang, Arash Emami ASSOCIATION OF AGE, GENDER AND SITE OF IMPLANT PLACEMENT - AN INSTITUTION BASED RETROSPECTIVE STUDY Harini Sri, Nabeel Ahmed, Keerthi Shasanka
Begell Digital Portal Begellデジタルライブラリー 電子書籍 ジャーナル 参考文献と会報 リサーチ集 価格及び購読のポリシー Begell House 連絡先 Language English 中文 Русский Português German French Spain