Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Travmatik İşitme Kayıplarının Adli Tıp Açısından Değerlendirilmesi: Retrospektif Tanımlayıcı Araştırma
Evaluation of Traumatic Hearing Loss in Terms of Forensic Medicine: Retrospective Descriptive Research
Burak KAYAa , Sait ÖZSOYb , Hüseyin BALANDIZb , Hakan GENÇc , Ayşe Nur BALABANd
aAdli Tıp Kurumu, Artvin Adli Tıp Şube Müdürlüğü, Artvin, Türkiye
bSağlık Bilimleri Üniversitesi Gülhane Tıp Fakültesi, Adli Tıp ABD, Ankara, Türkiye
cSağlık Bilimleri Üniversitesi Gülhane Tıp Fakültesi, Kulak, Burun ve Boğaz Hastalıkları ABD, Ankara, Türkiye
dSağlık Bilimleri Üniversitesi Gülhane Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2024;21(1):10-20
doi: 10.5336/forensic.2023-99753
Article Language: TR
Full Text
ÖZET
 Amaç: Travmalar, insan vücudunda tüm sistemleri etkileyebilecek yaralanmalara yol açabilmektedir. Bu çalışmada, travmatik işitme kaybı gelişen olguların adli tıbbi açıdan değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Travmatik işitme kaybı gelişen ve 2017- 2021 yılları arasında başvuruda bulunan adli olgulara ait veriler retrospektif olarak incelenmiştir. Bulgular: Değerlendirilen 408 olgunun %92'si erkek olup, yaş ortalaması 30,37±8,85 idi. Olguların çoğunluğu (%80,1) güvenlik güçleri personelinden oluşmaktaydı. Tüm olgular içinde en sık travma nedeni %65,5 ile patlama (blast) yaralanmalarıydı. Olguların %70'inde birden fazla frekansta işitme kaybı olduğu tespit edilmiştir. Olguların %69'unda düşük frekans, %62'sinde saf ses ortalaması, %93'ünde ise yüksek frekanslı işitme kaybı vardı. En ileri dereceli kaybın yıldırım-elektrik yaralanmaları bağlı oluştuğu, bunu ateşli silah ve patlama yaralanmalarının izlediği tespit edilmiştir. Patlama ve ateşli silah yaralanmalarına bağlı işitme kayıplarının diğer nedenlere göre daha az iyileştiği, en az iyileşmenin yüksek frekansta olduğu belirlenmiştir. Sonuç: Travmatik işitme kayıpları sıklıkla genç erkeklerde ve önlenebilir nedenlerle tüm frekanslarda görülebilmektedir. Yüksek enerjili travma olgularında işitme testleri ihmal edilmemeli, tüm frekanslar değerlendirilmelidir. ''Taktik Haberleşme ve Koruma Sistemleri'' yüksek şiddetteki seslerin şiddetini azaltarak kulak sağlığını korumaya yardımcı olurken düşük şiddetteki seslerin şiddetini artırarak da duymayı kolaylaştırmaktadır. Özellikle patlama ve ateşli silah yaralanmalarına sıklıkla maruz kaldığı bilinen güvenlik güçlerinde bu sistemlerin kullanımını yaygınlaştırılmalıdır.

Anahtar Kelimeler: Adli tıp; travma; patlama; işitme kaybı
ABSTRACT
 Objective: Traumas can lead to injuries that can affect all systems in the human body. In this study, it was aimed to evaluate the cases who traumatic hearing loss due to from a forensic medical point of view. Material and Methods: Data on forensic cases who developed traumatic hearing loss and applied between 2017-2021 were retrospectively analyzed. Results: Of the 408 cases, 92% were male, the mean age of the cases was 30.37±8.85 years. The majority of the cases (80.1%) were security forces. The most common cause of trauma were explosion (blast) injuries with 65.5%. Of the cases 70% had multiplefrequency hearing loss. Of the cases; 69% had low-frequency, 62% had pure-tone average, 93% had high-frequency hearing loss. It was determined that the most severe loss occurred due to electricity injuries, followed by firearm and explosion injuries. It was found that hearing loss due to explosion and firearm injuries healed less than other causes, and the least improvement was at high frequency. Conclusion: Traumatic hearing losses can often be seen in young men and at all frequencies for preventable reasons. Hearing tests should not be neglected in high-energy traumas, all frequencies should be evaluated. ''Tactical Communications and Protection Systems'' are reduce the intensity of high-intensity sounds and increase the intensity of low-intensity sounds that makes it easier to hear. The use of these systems should be expanded in security forces, which are known to be frequently exposed to explosions and gunshot injuries.

Keywords: Forensic medicine; trauma; explosion; hearing loss
REFERENCES:
  1. Zeybek SM, Çulhaoğlu B, Erbek SS. Üzüm çekirdeği özünün farklı dozlarının akustik travma üzerine etkisi [Effect of different doses of grape seed extract on acoustic trauma]. KBB-Forum. 2022;21(4):222-8. [Link] 
  2. Moore BCJ. Cochlear Hearing Loss: Physiological, Psychological and Technical Issues. 2nd ed. John Wiley & Sons; 2007. [Crossref] 
  3. GBD 2019 Hearing Loss Collaborators. Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019. Lancet. 2021;397(10278):996-1009. [PubMed]  [PMC] 
  4. Jeong J, Youk TM, Oh J, Eo TS, Choi HS. Neonatal and maternal risk factors for hearing loss in children based on population-based data of Korea. Int J Pediatr Otorhinolaryngol. 2021;147:110800. [Crossref]  [PubMed] 
  5. Shangkuan WC, Lin HC, Shih CP, Cheng CA, Fan HC, Chung CH, et al. Increased long-term risk of hearing loss in patients with traumatic brain injury: a nationwide population-based study. Laryngoscope. 2017;127(11):2627-35. [Crossref]  [PubMed] 
  6. Stach BA. Clinical Audiology an Introduction. Introduction to Audiologic Treatment. 2nd ed. Newyork: Delmar Cengage Learning; 2010. p.383-91.
  7. Işık HS, Bostancı U, Yıldız O, Ozdemir C, Gökyar A. Kafa travması nedeniyle tedavi edilen 954 erişkin olgunun retrospektif değerlendirilmesi: epidemiyolojik çalışma [Retrospective analysis of 954 adult patients with head injury: an epidemiological study]. Ulus Travma Acil Cerrahi Derg. 2011;17(1):46-50. Turkish. [Crossref]  [PubMed] 
  8. Karasu A, Sabanci PA, Cansever T, Hepgül KT, Imer M, Dolaş I, et al. Kafa travmali hastalarda epidemiyolojik çalışma [Epidemiological study in head injury patients]. Ulus Travma Acil Cerrahi Derg. 2009;15(2):159-63. Turkish. [PubMed] 
  9. Peleg K, Aharonson-Daniel L, Stein M, Michaelson M, Kluger Y, Simon D, et al; Israeli Trauma Group (ITG). Gunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004;239(3):311-8. [Crossref]  [PubMed]  [PMC] 
  10. Alpsoy MY, Sönmez S, Orhan Z, Kocasoy Orhan E, Aslıyüksek H, Orhan KS. Evaluation of patients with post-traumatic hearing loss: a retrospective review of 506 cases. J Int Adv Otol. 2021;17(3):239-44. [Crossref]  [PubMed]  [PMC] 
  11. Ritenour AE, Wickley A, Ritenour JS, Kriete BR, Blackbourne LH, Holcomb JB, et al. Tympanic membrane perforation and hearing loss from blast overpressure in Operation Enduring Freedom and Operation Iraqi Freedom wounded. J Trauma. 2008;64(2 Suppl):S174-8; discussion S178. [Crossref]  [PubMed] 
  12. Podoshin L, Fradis M. Hearing loss after head injury. Arch Otolaryngol. 1975;101(1):15-8. [Crossref]  [PubMed] 
  13. Gür K, Kılınç E, Günaydın E, Gülsün H. The epidemiology of injury among adolescents with hearing loss, health beliefs regarding injury and associated factors. Disabil Health J. 2021;14(2):100994. [Crossref]  [PubMed] 
  14. Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome. Am J Otolaryngol. 2012;33(5):549-55. [Crossref]  [PubMed] 
  15. 15. Butt KAA, Bhalli NR, Siddique W, Ahmed A, Khan M, Ahmed M. Hearing loss in blast trauma victims. a multicentre retrospective study. PAFMJ. 2021;71(Suppl-1):130-5. [Crossref] 
  16. Oleksiak M, Smith BM, St Andre JR, Caughlan CM, Steiner M. Audiological issues and hearing loss among Veterans with mild traumatic brain injury. J Rehabil Res Dev. 2012;49(7):995-1004. [Crossref]  [PubMed] 
  17. Karch SJ, Capó-Aponte JE, McIlwain DS, Lo M, Krishnamurti S, Staton RN, et al. Hearing loss and tinnitus in military personnel with deployment-related mild traumatic brain injury. US Army Med Dep J. 2016;(3-16):52-63. [PubMed] 
  18. Berger G, Finkelstein Y, Harell M. Non-explosive blast injury of the ear. J Laryngol Otol. 1994;108(5):395-8. [Crossref]  [PubMed] 
  19. Sprem N, Branica S, Dawidowsky K. Tympanoplasty after war blast lesions of the eardrum: retrospective study. Croat Med J. 2001;42(6):642-5. [PubMed] 
  20. Branica S, Dawidowsky K, Sprem N, McKinnon B. Otologic blast trauma: experience from Croatian War. In: Elsayed NM, Atkins JL, eds. Explosion and Blast-Related Injuries. 1st ed. Philadelphia, PA: Elsevier; 2008. p.353-69.
  21. Brodie HA, Wilkerson BJ. Management of temporal bone trauma. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins KT, Thomas JR, et al; eds. Cummings Otolaryngology, Head and Neck Surgery. Vol. 2. 6th ed. Philadelphia: Saunders Elsevier; 2015. p.2220-33.
  22. Dougherty AL, MacGregor AJ, Han PP, Viirre E, Heltemes KJ, Galarneau MR. Blast-related ear injuries among U.S. military personnel. J Rehabil Res Dev. 2013;50(6):893-904. [Crossref]  [PubMed] 
  23. Liao YH, Young YH. Inner ear damage by firecracker trauma. Audiol Neurootol. 2018;23(2):116-21. [Crossref]  [PubMed] 
  24. Modayil PC, Lloyd GW, Mallik A, Bowdler DA. Inner ear damage following electric current and lightning injury: a literature review. Eur Arch Otorhinolaryngol. 2014;271(5):855-61. [Crossref]  [PubMed] 
  25. Myung NS, Lee IW, Goh EK, Kong SK. Cochlear implantation for severe sensorineural hearing loss caused by lightning. Am J Otolaryngol. 2012;33(6):767-9. [Crossref]  [PubMed] 
  26. Kılıç E, Genç H, Aydın Ü, Aşık B, Satar B. Variations in otological presentation of lightning strike victims: clinical report of 3 patients. Ulus Travma Acil Cerrahi Derg. 2017;23(2):163-6. [Crossref]  [PubMed] 
  27. Bergemalm PO. Progressive hearing loss after closed head injury: a predictable outcome? Acta Otolaryngol. 2003;123(7):836-45. [Crossref]  [PubMed] 
  28. Pratt H, Goldsher M, Netzer A, Shenhav R. Auditory brainstem evoked potentials in blast injury. Audiology. 1985;24(4):297-304. [Crossref]  [PubMed] 
  29. Helling ER. Otologic blast injuries due to the Kenya Embassy bombing. Mil Med. 2004;169(11):872-6. [Crossref]  [PubMed] 
  30. Remenschneider AK, Lookabaugh S, Aliphas A, Brodsky JR, Devaiah AK, Dagher W, et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol. 2014;35(10):1825-34. [Crossref]  [PubMed] 
  31. Kronenberg J, Ben-Shoshan J, Wolf M. Perforated tympanic membrane after blast injury. Am J Otol. 1993;14(1):92-4. [PubMed] 
  32. Garth RJ. Blast injury of the auditory system: a review of the mechanisms and pathology. J Laryngol Otol. 1994;108(11):925-9. [Crossref]  [PubMed] 
  33. Gaston J, Foots A, Mermagen, T, Scharine A. The effectiveness of tactical communication and protection systems (tcaps) on minimizing hearing hazard and maintaining auditory situational awareness. Advances in Intelligent Systems and Computing. 2019:382-91. [Crossref] 

.: 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