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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Anaesthesist 2020; 68:520-529. [PMID: 31396674 DOI: 10.1007/s00101-019-0622-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Chirurg 2019; 90:652-659. [PMID: 31359112 DOI: 10.1007/s00104-019-0993-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland.,Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Schmerz 2019; 33:287-294. [PMID: 31342162 DOI: 10.1007/s00482-019-0389-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Erlenwein J, Koschwitz R, Pauli-Magnus D, Quintel M, Meißner W, Petzke F, Stamer UM. A follow-up on Acute Pain Services in Germany compared to international survey data. Eur J Pain 2015; 20:874-83. [PMID: 26517182 DOI: 10.1002/ejp.812] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND After the introduction of instruments for benchmarking, certification and a national guideline for acute pain management, the aim of this study was to describe the current structure, processes and quality of German acute pain services (APS). METHODS All directors of German departments of anaesthesiology were invited to complete a postal questionnaire on structures und processes of acute pain management. The survey asked for staff, techniques and quality criteria, which enabled a comparison to previous data from 1999 and surveys from other countries. RESULTS Four hundred and eight (46%) questionnaires were returned. APS have increased considerably and are now available in 81% of the hospitals, mainly anaesthesia based. However, only 45% fulfilled the minimum quality criteria, such as the assignment of personnel, the organization of patient care during nights and weekends, written protocols for postoperative pain management, regular assessments and documenting pain scores. Staff resources varied considerably, but increased compared to 1999. Two daily rounds were performed in 71%, either by physicians and nurses (42%), by physicians only (25%) or by supervised nurses (31%). Most personnel assigned to the APS shared this work along with other duties. Only 53% of the hospitals had an integrated rotation for training their specialty trainees. CONCLUSIONS The availability of APS in Germany and other countries has increased over the last decade; however, the quality of nearly half of the APS is questionable. Against the disillusioning background of recently reported unfavourable pain-related patient outcomes, the structures, organization and quality of APS should be revisited.
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Affiliation(s)
- J Erlenwein
- Clinic for Anaesthesiology, Centre for Anaesthesiology, Emergency Medicine and Intensive Care Medicine, University Medical Centre, Georg-August-University of Göttingen, Germany.,Section 'Acute Pain', German Pain Society, Berlin, Germany.,Section 'Pain Medicine', German Society for Anaesthesiology and Intensive Care, Nürnberg, Germany
| | - R Koschwitz
- Clinic for Anaesthesiology, Centre for Anaesthesiology, Emergency Medicine and Intensive Care Medicine, University Medical Centre, Georg-August-University of Göttingen, Germany
| | - D Pauli-Magnus
- Section 'Acute Pain', German Pain Society, Berlin, Germany.,Department of Anaesthesiology, Pain Medicine, Intensive Care and Emergency Medicine, DRK Hospital Berlin Westend, Germany
| | - M Quintel
- Clinic for Anaesthesiology, Centre for Anaesthesiology, Emergency Medicine and Intensive Care Medicine, University Medical Centre, Georg-August-University of Göttingen, Germany
| | - W Meißner
- Section 'Acute Pain', German Pain Society, Berlin, Germany.,Section 'Pain Medicine', German Society for Anaesthesiology and Intensive Care, Nürnberg, Germany.,Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Germany
| | - F Petzke
- Clinic for Anaesthesiology, Centre for Anaesthesiology, Emergency Medicine and Intensive Care Medicine, University Medical Centre, Georg-August-University of Göttingen, Germany.,Section 'Pain Medicine', German Society for Anaesthesiology and Intensive Care, Nürnberg, Germany
| | - U M Stamer
- Section 'Acute Pain', German Pain Society, Berlin, Germany.,Section 'Pain Medicine', German Society for Anaesthesiology and Intensive Care, Nürnberg, Germany.,Department of Anaesthesiology and Pain Medicine, Inselspital, Bern, Switzerland.,Department of Clinical Research, University of Bern, Switzerland
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Pauli-Magnus D, Hoch G, Strenzke N, Anderson S, Jentsch TJ, Moser T. Detection and differentiation of sensorineural hearing loss in mice using auditory steady-state responses and transient auditory brainstem responses. Neuroscience 2007; 149:673-84. [PMID: 17869440 DOI: 10.1016/j.neuroscience.2007.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 08/03/2007] [Accepted: 08/26/2007] [Indexed: 11/18/2022]
Abstract
Sensorineural hearing loss (SNHL) comprises hearing disorders with diverse pathologies of the inner ear and the auditory nerve. To date, an unambiguous phenotypical characterization of the specific pathologies in an affected individual remains impossible. Here, we evaluated the use of scalp-recorded auditory steady-state responses (ASSR) and transient auditory brainstem responses (ABR) for differentiating the disease mechanisms underlying sensorineural hearing loss in well-characterized mouse models. We first characterized the ASSR evoked by sinusoidally amplitude-modulated tones in wild-type mice. ASSR were robustly elicited within three ranges of modulation frequencies below 200 Hz, from 200 to 600 Hz and beyond 600 Hz in most recordings. Using phase information we estimated the apparent ASSR latency to be about 3 ms, suggesting generation in the auditory brainstem. Auditory thresholds obtained by automated and visual analysis of ASSR recordings were comparable to those found with tone-burst evoked ABR in the same mice. We then recorded ASSR and ABR from mouse mutants bearing defects of either outer hair cell amplification (KCNQ4-knockout) or inner hair cell synaptic transmission (Bassoon-mutant). Both mutants showed an increase of ASSR and ABR thresholds of approximately 40 dB versus wild-type when investigated at 8 weeks of age. Mice with defective amplification displayed a steep rise of ASSR and ABR amplitudes with increasing sound intensity, presumably reflecting a strong recruitment of synchronously activated neural elements beyond threshold. In contrast, the amplitudes of ASSR and ABR responses of mice with impaired synaptic transmission grew very little with sound intensity. In summary, ASSR allow for a rapid, objective and frequency-specific hearing assessment and together with ABR and otoacoustic emissions can contribute to the differential diagnosis of SNHL.
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MESH Headings
- Acoustic Stimulation
- Animals
- Diagnosis, Differential
- Evoked Potentials, Auditory/physiology
- Evoked Potentials, Auditory, Brain Stem/physiology
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/genetics
- Hearing Loss, Sensorineural/physiopathology
- KCNQ Potassium Channels/genetics
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Otoacoustic Emissions, Spontaneous/physiology
- Phenotype
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Affiliation(s)
- D Pauli-Magnus
- InnerEarLab, Department of Otolaryngology and Center for Molecular Physiology of the Brain, University of Goettingen, Goettingen, Germany
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