Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Tinnitus Korkusu ile Tinnitus Engellilik Düzeyi ve İşitme Engellilik Düzeyi Arasındaki İlişkinin İncelenmesi: Tinnitus Korku Ölçeği'nin Türkçe Geçerlik ve Güvenirlik Çalışması-Metodolojik Çalışmalar
Investigation of the Relationship Between Fear of Tinnitus and Tinnitus Handicap Inventory and Hearing Handicap Inventory: Turkish Validity and Reliability Study of Fear of Tinnitus Questionnaire-Methodological Studies
Berfin Eylül AYDEMİRa , Mert HÜVİYETLİb , Hasan ÇOLAKc , Eda ÇAKMAKa , Eser SENDESENd , Asuman ALNIAÇIKa
aBaşkent Üniversitesi Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Ankara, Türkiye
bUniversity College London, London, Birleşik Krallık
cNewcastle University, Newcastle Upon Tyne, Birleşik Krallık
dHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2024;9(2):351-9
doi: 10.5336/healthsci.2023-100904
Article Language: TR
Full Text
ÖZET
 Amaç: Tinnitus bireye özgü ciddi psikolojik problemlere sebep olabilen bir semptomdur. Bu problemlerin anlaşılması, özelleştirilmiş terapötik yaklaşımlar için oldukça önemlidir. Bu çalışmanın amacı Tinnitus Korku Ölçeği'nin Türkçe geçerlik ve güvenirliğini incelemek ve yaş, cinsiyet, tinnitus süresi, Tinnitus Engellilik Ölçeği (TEÖ) ve İşitme Engellilik Ölçeği (İEÖ) ile ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 18-79 yaş arası 121 kronik tinnitusu olan katılımcı dâhil edilmiştir. Tinnitus süresi, tinnitus şiddeti ve işitme kaybı durumu bilgileri çevrim içi olarak doldurulan demografik bilgi formu ile elde edilmiştir. Çalışmada ölçüm aracı olarak; Tinnitus Korku Ölçeği, Tinnitus Engel Ölçeği ve İşitme Engeli Ölçeği'nin çevrim içi versiyonları kullanılmıştır. Bulgular: Ölçeğin Kaiser-Meyer-Olkin katsayısı 0,80 ve örneklem yeterliliği ölçütü iyi düzeydedir. Kaiserin öz değer kriterine göre üç faktörlü yapının toplam varyansı açıklama yüzdesi %47,50 olarak hesaplanmıştır. Ölçeğin iç tutarlılık katsayısı 0,78 ve Spearman-Brown katsayısı 0,84'tür. Tinnitus Korku Ölçeği'nin diğer ölçeklerle ilişkisinde Tinnitus Engel Ölçeği ile korelasyonu iyi düzeyde (r_s=0,73; p<0,001), İşitme Engeli Ölçeği ile korelasyonu orta düzeyde (r_s=0,40; p<0,001) elde edilmiştir. Sonuç: Çalışma sonucunda, Tinnitus Korku Ölçeği'nin Türkçe versiyonunun tinnitusa bağlı gelişen korkuyu değerlendirmede uygun olduğu sonucuna ulaşılmıştır. Tinnitus Korku Ölçeği'nin tinnitus hastalarında yaygın olarak kullanılan bilişsel davranışçı terapi uygulamasının etkinliğini değerlendirmede önemli rol oynayabileceği düşünülmüştür.

Anahtar Kelimeler: Tinnitus; korku; geçerlik ve güvenirlik; bilişsel davranışçı terapi
ABSTRACT
 Objective: Tinnitus can lead to significant psychological distress for individuals. Understanding these issues is crucial for particular therapeutic interventions. This study aimed to validate the Fear of Tinnitus Questionnaire in Turkish and explore its associations with age, gender, tinnitus duration, Tinnitus Handicap Inventory, and Hearing Handicap Inventory. Material and Methods: This study involved 121 participants with chronic tinnitus, aged 18-79. Data on tinnitus duration, severity, and hearing loss were collected through a web-based demographic form. The Fear of Tinnitus Questionnaire, Tinnitus Handicap Inventory and Hearing Handicap Inventory were administered using web-based forms. Results: The Kaiser-Meyer-Olkin coefficient of the scale is 0.80, indicating a good level of sampling adequacy. According to Kaiser's eigenvalue criterion, the three-factor structure accounts for a total variance of 47.50%. The internal consistency coefficient of the scale is 0.78, and the Spearman-Brown coefficient is 0.84. The Fear of Tinnitus Questionnaire showed a strong correlation with Tinnitus Handicap Inventory (r_s=0.73, p<0.001). Furthermore, a moderate level of correlation was observed with the Hearing Handicap Inventory (r_s=0.40, p<0.001). Conclusion: The Turkish version of the Fear of Tinnitus Questionnaire is suitable for assessing tinnitus-related fear. It may serve as a valuable tool in evaluating the effectiveness of cognitive-behavioral therapy, commonly used in tinnitus management.

Keywords: Tinnitus; fear; validity and reliability; cognitive behavioral therapy
REFERENCES:
  1. Coelho CB, Santos R, Campara KF, Tyler R. Classification of tinnitus: multiple causes with the same name. Otolaryngol Clin North Am. 2020;53(4):515-29. [Crossref]  [PubMed] 
  2. Baguley DM. Mechanisms of tinnitus. Br Med Bull. 2002;63:195-212. [Crossref]  [PubMed] 
  3. Crocetti A, Forti S, Ambrosetti U, Bo LD. Questionnaires to evaluate anxiety and depressive levels in tinnitus patients. Otolaryngol Head Neck Surg. 2009;140(3):403-5. [Crossref]  [PubMed] 
  4. Erlandsson SI, Hallberg LR. Prediction of quality of life in patients with tinnitus. Br J Audiol. 2000;34(1):11-20. [Crossref]  [PubMed] 
  5. Rossiter S, Stevens C, Walker G. Tinnitus and its effect on working memory and attention. J Speech Lang Hear Res. 2006;49(1):150-60. [Crossref]  [PubMed] 
  6. Kennedy V, Wilson C, Stephens D. Quality of life and tinnitus. Audiological Medicine. 2009;2(1):29-40. [Crossref] 
  7. McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. Front Neurol. 2014;5:196. [Crossref]  [PubMed]  [PMC] 
  8. Fuller TE, Cima RFF, Van den Bussche E, Vlaeyen JWS. The fear of tinnitus questionnaire: toward a reliable and valid means of assessing fear in adults with tinnitus. Ear Hear. 2019;40(6):1467-77. [Crossref]  [PubMed] 
  9. Cima RF, Vlaeyen JW, Maes IH, Joore MA, Anteunis LJ. Tinnitus interferes with daily life activities: a psychometric examination of the Tinnitus Disability Index. Ear Hear. 2011;32(5):623-33. [Crossref]  [PubMed] 
  10. Roelofs J, Sluiter JK, Frings-Dresen MH, Goossens M, Thibault P, Boersma K, et al. Fear of movement and (re)injury in chronic musculoskeletal pain: evidence for an invariant two-factor model of the Tampa Scale for Kinesiophobia across pain diagnoses and Dutch, Swedish, and Canadian samples. Pain. 2007;131(1-2):181-90. [Crossref]  [PubMed] 
  11. McCracken LM, Zayfert C, Gross RT. The Pain Anxiety Symptoms Scale: development and validation of a scale to measure fear of pain. Pain. 1992;50(1):67-73. [Crossref]  [PubMed] 
  12. Lethem J, Slade PD, Troup JD, Bentley G. Outline of a Fear-Avoidance Model of exaggerated pain perception-I. Behav Res Ther. 1983;21(4):401-8. [Crossref]  [PubMed] 
  13. Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153(6):1144-7. [Crossref]  [PubMed] 
  14. Møller AR. Similarities between chronic pain and tinnitus. Am J Otol. 1997;18(5):577-85. [PubMed] 
  15. Moller AR. Similarities between severe tinnitus and chronic pain. J Am Acad Audiol. 2000;11(3):115-24. [Crossref]  [PubMed] 
  16. Cima RFF, van Breukelen G, Vlaeyen JWS. Tinnitus-related fear: Mediating the effects of a cognitive behavioural specialised tinnitus treatment. Hear Res. 2018;358:86-97. [Crossref]  [PubMed] 
  17. Kleinstäuber M, Jasper K, Schweda I, Hiller W, Andersson G, Weise C. The role of fear-avoidance cognitions and behaviors in patients with chronic tinnitus. Cogn Behav Ther. 2013;42(2):84-99. [Crossref]  [PubMed] 
  18. Hesser H, Weise C, Westin VZ, Andersson G. A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress. Clin Psychol Rev. 2011;31(4):545-53. [Crossref]  [PubMed] 
  19. Fuller T, Cima R, Langguth B, Mazurek B, Vlaeyen JW, Hoare DJ. Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev. 2020;1(1):CD012614. [Crossref]  [PubMed]  [PMC] 
  20. Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143-8. [Crossref]  [PubMed] 
  21. Aksoy S, Firat Y, Alpar R. The Tinnitus Handicap Inventory: a study of validity and reliability. Int Tinnitus J. 2007;13(2):94-8. [PubMed] 
  22. Newman CW, Weinstein BE, Jacobson GP, Hug GA. The Hearing Handicap Inventory for adults: psychometric adequacy and audiometric correlates. Ear Hear. 1990;11(6):430-3. [Crossref]  [PubMed] 
  23. Aksoy, S, Aslan F, Köse A, İşitme Engeli Ölçeği-erişkin: uzun ve tarama formlarının Türkçe sürümünün geçerliğinin ve güvenirliğinin incelenmesi [Hearing Impairment Scale - adult: investigating the long and the screening forms the validity and reliability of the Turkish version] KBB forum, 2020;19(2):17-26. [Link] 
  24. Baxter MG, Murray EA. The amygdala and reward. Nat Rev Neurosci. 2002;3(7):563-73. [Crossref]  [PubMed] 
  25. Davis M, Whalen PJ. The amygdala: vigilance and emotion. Mol Psychiatry. 2001;6(1):13-34. [Crossref]  [PubMed] 
  26. Mahlke C, Wallhäusser-Franke E. Evidence for tinnitus-related plasticity in the auditory and limbic system, demonstrated by arg3.1 and c-fos immunocytochemistry. Hear Res. 2004;195(1-2):17-34. [Crossref]  [PubMed] 
  27. Møller AR. Neural plasticity in tinnitus. Prog Brain Res. 2006;157:365-72. [Crossref]  [PubMed] 
  28. Kraus KS, Canlon B. Neuronal connectivity and interactions between the auditory and limbic systems. Effects of noise and tinnitus. Hear Res. 2012;288(1-2):34-46. [Crossref]  [PubMed] 
  29. Cejas I, Coto J, Sanchez C, Holcomb M, Lorenzo NE. Prevalence of depression and anxiety in adolescents with hearing loss. Otol neurotol. 2021;42(4):e470-e5. [Crossref]  [PubMed] 
  30. Moon KR, Park S, Jung Y, Lee A, Lee JH. Effects of anxiety sensitivity and hearing loss on tinnitus symptom severity. Psychiatry Investig. 2018;15(1):34-40. [Crossref]  [PubMed]  [PMC] 
  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] 

.: Up To Date

.: Process List

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