Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
İşitsel Beyinsapı İmplantı Kullanıcılarında Sosyal Anksiyetenin Araştırılması
Investigation of the Social Anxiety in Auditory Brainstem Implant Users
Buse AÇIKGÖZa, Bensu AKCİNa, Öykü ÖZBAŞb, Tuğba ÇALIŞANa, Merve ÖZBAL BATUKa, Selen YILMAZ IŞIKHANc, Gonca SENNAROĞLUa
aHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Odyoloji, Ankara, TÜRKİYE
bSağlık Bilimleri Üniversitesi Gülhane Sağlık Bilimleri Fakültesi, Odyoloji, Ankara, TÜRKİYE
cHacettepe Üniversitesi Sosyal Bilimler MYO&Tıp Fakültesi, Biyoistatistik, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2021;6(4):893-901
doi: 10.5336/healthsci.2020-80245
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, işitsel beyinsapı implantı kullanan çocuk ve ergenlerde sosyal anksiyete düzeyini incelemek ve normal işiten yaşıtları ile karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya, 6- 18 yaş arası 15 işitsel beyinsapı implantı [auditory brainstem implant (ABI)] kullanıcısı ve 15 normal işiten çocuk olmak üzere toplam 30 çocuk dâhil edilmiştir. Araştırmanın verileri, çocuk-aile bilgi formu ve Çocuklar İçin Sosyal Anksiyete Ölçeği kullanılarak elde edilmiştir. Bulgular: İşitsel beyinsapı implantı kullanıcıları ile normal işiten yaşıtlarının sosyal anksiyete skorları arasında anlamlı farklılık tespit edilmiştir (p=0,028). Bir kulağında koklear implant (Kİ), diğer kulağında ABI kullanan bimodal kullanıcılarda sosyal anksiyete skoru ABI kullanıcılarına göre daha düşük elde edilmiştir (p=0,047). Cinsiyetin (p=0,868), ailenin sosyokültürel düzeyi, okul türü (p=0,266, p=0,406), implant kullanım süresi (p=0,306) ve implantasyon yaşı (p=0,593) ile sosyal anksiyete arasında anlamlı bir ilişki tespit edilmemiştir. Sonuç: Beyinsapı implantı kullanıcısı, çocuklarda sosyal anksiyete düzeyinin normal işiten çocuklara göre daha yüksek olduğu gösterilmiştir. Bimodal kullanıcıların, sosyal anksiyete skorunun daha düşük olması kontralateral kulakta Kİ kullanımının kaygıyı azaltmakta önemli bir faktör olduğunu ortaya koymaktadır. Bu çalışma, ABI kullanıcılarında sosyal anksiyeteyi değerlendiren ilk çalışmadır.

Anahtar Kelimeler: İşitsel beyinsapı implantasyonu; koklear implant; anksiyete, işitme kaybı
ABSTRACT
 Objective: To investigate the level of social anxiety in children and adolescents with auditory brainstem implants and compare them with their normal hearing peers. Material and Methods: A total of 30 children, 15 auditory brainstem implant users and 15 normal hearing children, aged 6-18 years were included in the study. The data of the study were obtained by using the child-family information form and the Social Anxiety Scale for Children. Results: A significant difference was found between the social anxiety scores of auditory brainstem implant users and their normal hearing peers (p=0.028). Social anxiety score was lower in bimodal users who used auditory brainstem implants in one ear and cochlear implants in the contralateral ear (p=0.047). No significant relationship was found between social anxiety and gender (p=0.868), family sociocultural level, school type (p=0.266, p=0.406), duration of implant use (p=0.306) and age at implantation (p=0.593). Conclusion: It has been shown that children with brainstem implant have higher levels of social anxiety than children with normal hearing. The lower social anxiety score of bimodal users indicates that the use of cochlear implants in the contralateral ear is an important factor in reducing anxiety. This is the first study that evaluate the social anxiety in pediatric auditory brainstem implant users.

Keywords: Auditory brainstem implant; cochlear implant; anxiety; hearing loss
REFERENCES:
  1. Özdemir G. Müziksel işitmenin gerçekleşme süreci [The process of musical hearing]. International Journal of Social Sciences and Education Research. 2016;2(1):183-90. [Crossref] 
  2. Steinberg AG, Lipton DS, Eckhardt EA, Goldstein M, Sullivan VJ. The diagnostic interview schedule for deaf patients on interactive video: a preliminary investigation. Am J Psychiatry. 1998;155(11):1603-4. [Crossref] [PubMed] 
  3. Guex A, Vachicouras N, Hight AE Hight, Brown MC, Leeb DJ, Lacour SP. Conducting polymer electrodes for auditory brainstem implants. J Mater Chem B. 2015;3(25):5021-7. [Crossref] [PubMed] [PMC] 
  4. Tobey EA, Thal D, Niparko JK, Eisenberg LS, Quittner AL, Wang NY; CDaCI Investigative Team. Influence of implantation age on school-age language performance in pediatric cochlear implant users. Int J Audiol. 2013;52(4):219-29. [Crossref] [PubMed] [PMC] 
  5. Buchman CA, Copeland BJ, Yu KK, Brown CJ, Carrasco VN, Pillsbury HC 3rd. Cochlear implantation in children with congenital inner ear malformations. Laryngoscope. 2004;114(2):309-16. [Crossref] [PubMed] 
  6. Pakdaman MN, Herrmann BS, Curtin HD, Van Beek-King J, Lee DJ. Cochlear implantation in children with anomalous cochleovestibular anatomy. Otolaryngol Head Neck Surg. 2012;146(2):295-7. [Crossref] [PubMed] 
  7. van der Straaten TFK, Netten AP, Boermans PPBM, Briaire JJ, Scholing E, Koot RW, et al. Pediatric Auditory Brainstem Implant Users Compared With Cochlear Implant Users With Additional Disabilities. Otol Neurotol. 2019;40(7):936-45. [Crossref] [PubMed] 
  8. Sennaroglu L, Colletti V, Manrique M, Laszig R, Offeciers E, Saeed S, et al. Auditory brainstem implantation in children and non-neurofibromatosis type 2 patients: a consensus statement. Otol Neurotol. 2011;32(2):187-91. [Crossref] [PubMed] 
  9. Aslan F, Ozkan HB, Yücel E, Sennaroğlu G, Bilginer B, Sennaroğlu L. Effects of age at auditory brainstem implantation: Impact on auditory perception, language development, speech intelligibility. Otol Neurotol. 2020;41(1):11-20. [Crossref] [PubMed] 
  10. Yücel E, Aslan F, Özkan HB, Sennaroğlu L. Recent rehabilitation experience with pediatric ABI users. J Int Adv Otol. 2015;11(2):110-3. [Crossref] [PubMed] 
  11. Bess FH, Klee T, Culbertson JL. Identification, assessment, and management of children with unilateral sensorineural hearing loss. Ear Hear. 1986;7(1):43-51. [Crossref] [PubMed] 
  12. Peterson DA, Asinger RW, Elsperger KJ, Homans DC, Eaton JW. Reactive oxygen species may cause myocardial reperfusion injury. Biochem Biophys Res Commun. 1985;127(1):87-93. [Crossref] [PubMed] 
  13. Davis JM, Elfenbein J, Schum R, Bentler RA. Effects of mild and moderate hearing impairments on language, educational, and psychosocial behavior of children. J Speech Hear Disord. 1986;51(1):53-62. [Crossref] [PubMed] 
  14. Şimşek A, Salman U, Ekici E, Kuşman B. İşitme engelli bireylerin sürekli kaygı düzeyi ile durum kaygı düzeylerinin karşılaştırılması [Comparison of trait anxiety level and state anxiety level of individuals with hearing impairment]. FNG & Bilim Tıp Dergisi. 2018;4(4):173-8. [Crossref] 
  15. Eriksson-Mangold M, Carlsson SG. Psychological and somatic distress in relation to perceived hearing disability, hearing handicap, and hearing measurements. J Psychosom Res. 1991;35(6):729-40. [Crossref] [PubMed] 
  16. Chavira DA, Stein MB, Bailey K, Stein MT. Child anxiety in primary care: prevalent but untreated. Depress Anxiety. 2004;20(4):155-64. [Crossref] [PubMed] 
  17. Theunissen SC, Rieffe C, Kouwenberg M, De Raeve L, Soede W, Briaire JJ, et al. Anxiety in children with hearing aids or cochlear implants compared to normally hearing controls. Laryngoscope. 2012;122(3):654-9. [Crossref] [PubMed] 
  18. La Greca AM, Dandes SK, Wick P, Shaw K, Stone WL. Development of the social anxiety scale for children: Reliability and concurrent validity. Journal of Clinical Child and Adolescent Psychology. 1988;17(1):84-91. [Crossref] 
  19. Demir T, Eralp-Demir D, Türksoy N, Özmen E, Uysal Ö. Çocuklar için sosyal anksiyete ölçeğinin geçerlilik ve güvenilirliği [Validity and reliability of the social anxiety scale for children]. Düşünen Adam Dergisi. 2000;13(1):42-8.[Link] 
  20. Schauwers K, Gillis S, Govaerts PJ. Babbling in early implanted CI children. Int Congr Ser. 2004;1273:344-7. [Crossref] 
  21. Sharma A, Dorman MF, Spahr AJ. A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear Hear. 2002;23(6):532-9. [Crossref] [PubMed] 
  22. Marschark M. Raising and educating a deaf child. A comprehensive guide to the choices, controversies, and decisions faced by parents and educators. 2nd ed. New York, NY: Oxford University Press; 2007.
  23. Marschark M, Green V, Hindmarsh G, Walker S. Understanding theory of mind in children who are deaf. J Child Psychol Psychiatry. 2000;41(8):1067-73. [Crossref] [PubMed] 
  24. Rieffe C, Terwogt MM, Smith C. Deaf children on the causes of emotions. Educ Psychol (Lond). 2003;23(2):159-69. [Crossref] 
  25. Akın I, Simşek G, Barmak E. Erken ve geç yaş koklear implant uygulamasında uzun dönem etkinliklerinin karşılaştırılması [A comparison of the long-term efficacy of cochlear implantation at early and late age]. Kulak Burun Bogaz Ihtis Derg. 2012;22(3):123-8. Turkish. [Crossref] [PubMed] 
  26. La Greca AM, Stone WL. Social anxiety scale for children revised: Factor structure and concurrent validity. J Clin Child Psychol. 1993;22(1):17-27. [Crossref] 
  27. Keilmann A, Limberger A, Mann WJ. Psychological and physical well-being in hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2007;71(11):1747-52. [Crossref] [PubMed] 
  28. Ekim A, Ocakçı AF. 8-12 yaş arası işitme engelli çocuklarda yaşam kalitesi [Quality of life in hearing-impaired children aged 8-12 years]. Ankara Sağlık Hizmetleri Dergisi. 2012;11(1):17-23. [Crossref] 
  29. van Eldik T. Mental health problems of Dutch youth with hearing loss as shown on the Youth Self Report. Am Ann Deaf. 2005;150(1):11-6. [Crossref] [PubMed] 
  30. Li H, Prevatt F. Deaf and hard of hearing children and adolescents in China: their fears and anxieties. Am Ann Deaf. 2010;155(4):458-66. [Crossref] [PubMed] 
  31. Shoham N, Lewis G, Favarato G, Cooper C. Prevalence of anxiety disorders and symptoms in people with hearing impairment: a systematic review. Soc Psychiatry Psychiatr Epidemiol. 2019;54(6):649-60. [Crossref] [PubMed] 
  32. Fellinger J, Holzinger D, Pollard R. Mental health of deaf people. Lancet. 2012; 379(9820):1037-44. [Crossref] [PubMed] 
  33. Øhre B, von Tetzchner S, Falkum E. Deaf adults and mental health: a review of recent research on the prevalence and distribution of psychiatric symptoms and disorders in the prelingually deaf adult population. International Journal on Mental Health and Deafness. 2011;1(1):3-22. [Link] 
  34. Batuk MO, Cinar BC, Yarali M, Aslan F, Ozkan HB, Sennaroglu G, et al. Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant. Clin Otolaryngol. 2020;45(2):231-8. [Crossref] [PubMed] 
  35. Sennaroğlu L, Colletti V, Lenarz T, Manrique M, Laszig R, Rask-Andersen H et al. Consensus statement: Long-term results of ABI in children with complex inner ear malformations and decision making between CI and ABI. Cochlear Implants Int. 2016;17(4):163-71. [Crossref] [PubMed] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com