Diğer Yayınlar Koleksiyonu
Bu koleksiyon için kalıcı URI
Güncel Gönderiler
Öğe Chronic Rhinosinusitis—Could Phenotyping or Endotyping Aid Therapy?(SAGE Publications Inc., 2019) Bayar Muluk N.; Cingi C.; Scadding G.K.; Scadding G.Objectives: We reviewed the phenotyping and endotyping of chronic rhinosinusitis (CRS) and treatment options. Methods: We searched PubMed, Google, Google Scholar, and the Proquest Central Database of the Kırıkkale University Library. Results: Phenotypes are observable properties of an organism produced by the environment acting upon the genotype, that is, patients with a particular disorder are subgrouped according to common characteristics. Currently, CRS is usually phenotyped as being with (CRSwNP) or without (CRSsNP) nasal polyps. However, this is not immutable as some individuals progress from nonpolyp to polypoid CRS over time. Phenotypes of CRS are also based on inflammatory patterns, generally CRSwNP is eosinophilic, CRSsNP neutrophilic; but there is a spectrum, rather than a clear-cut division into 2 types. An endotype is a subtype of a condition defined by a distinct functional or pathobiological mechanism. Endotypes of CRS can be (1) nontype Th2, (2) moderate type Th2, and (3) severe type Th2 immune reactions, based on cytokines and mediators such as IL4, 5, 13. CRS endotyping can also include a (1) type 2 cytokine-based approach, (2) eosinophil-mediated approach, (3) immunoglobulin E-based approach, and (4) cysteinyl leukotriene-based approach. Subdivisions of CRSwNP can be made into nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, allergic fungal sinusitis, and eosinophil pauci-granulomatous arteritis by testing. General treatment for all CRS is nasal douching. The place of surgery needs careful reconsideration. Endotype-directed therapies include glucocorticosteroids, antibiotics, aspirin, antifungals, anticytokines, and immunoglobulin replacement. The recognition of united airways and the co-occurrence of CRSwNPs and severe asthma should lead to common endotyping of both upper and lower airways in order to better direct therapy. Conclusion: Endotyping can allow for the identification of groups of patients with CRS with a high likelihood of successful treatment, such as patients with a moderate type 2 immune reaction or those with acquired immune deficiency. © The Author(s) 2018.Öğe Current indications for balloon sinuplasty(Lippincott Williams & Wilkins, 2019) Cingi, Cemal; Muluk, Nuray Bayar; Lee, Jivianne T.Purpose of review The purpose of the review is to evaluate the current indications and contraindications for balloon sinuplasty and review the clinical trials performed in this area. Recent findings The indications for balloon sinus dilatation are somewhat similar to those for endoscopic sinus surgery. Balloon sinus ostial dilation (BSD) has been found to be most effective in the treatment of recurrent acute sinusitis (RARS) and chronic rhinosinusitis without nasal polyposis (CRSsNP) that has been refractory to medical therapy. Multiple randomized clinical trials have demonstrated the efficacy of BSD in improving quality-of-life outcomes in patients with limited CRSsNP in both the clinic and operating room settings. However, because BSD merely dilates blocked sinusal ostia without removing tissue, it is typically restricted to addressing disorder involving the frontal, sphenoid, and maxillary sinuses. Individuals who have significant disease of the ethmoid sinus may have BSD adjunctively with endoscopic sinus surgery. BSD is unsuitable as a primary treatment modality in pansinus polyposis, widespread fungal sinusitis, connective tissue disorders at an advanced stage, or potential malignancy. A recent expert clinical consensus statement also concluded that BSD is not appropriate for treatment of patients with headache that do not meet the diagnostic criteria for CRS or RARS or patients who do not have both positive findings of sinus disease on computed tomography and sinonasal symptoms. Summary Balloon sinuplasty is an option in the treatment of sinusitis that has failed appropriate medical therapy. Evidence is best for limited disease in patients with CRSsNP affecting the frontal, sphenoid, and maxillary sinuses. Because BSD can be performed in the office setting, it can be a viable therapeutic alternative in patients with comorbidities who are unable to tolerate general anesthesia.Öğe Consensus on the methodology for experimental studies in allergic rhinitis(Elsevier Ireland Ltd, 2019) Kar, Murat; Muluk, Nuray Bayar; Bafaqeeh, Sameer Ali; Cingi, CemalObjectives: Allergic rhinitis (AR) is a symptomatic disorder of the nose induced by allergen exposure, which triggers immunoglobulin E (IgE)-mediated inflammation of the nasal membranes. Allergic rhinitis is one of the most common health problems and has a major effect on the quality of life. Methods: In this review, we aimed to provide a consensus for experimental studies on allergic rhinitis in terms of allergic rhinitis models. For this purpose, we searched for experimental studies in the PubMed, Proquest Central, and Google electronic databases over a 20-year period from the current time (1996-2016). The literature survey was performed using keywords including "allergic rhinitis", "experimental", "animal", "model", "rat", "rabbit", "guinea pig", and "mice" alone or in various combinations. The search identified a total of 285 papers, which were included in this review. Results: It is vital to select a suitable animal for an allergic model. Rodents like rats, guinea pigs, and mice can produce allergen-specific antibodies with the use of adjuvants. Rats are cheap and the vast majority of the allergen-specific antibodies are immunoglobulin E (IgE). Still, intraperitoneal sensitization is inescapable and adjuvants are required for sensitization. Rats, mice, rabbits, and guinea pigs can be utilized for this reason. Conclusion: This review presented allergic rhinitis models in rats, mice, guinea pigs, and rabbits. Using these methods, researchers may perform well-designed studies.Öğe Anti-IgE treatment in allergic rhinitis(Elsevier Ireland Ltd, 2019) Muluk, Nuray Bayar; Bafaqeeh, Sameer Ali; Cingi, CemalObjectives: To review the efficacy of anti-IgE therapy in allergic rhinitis (AR). Methods: Literature search was performed using the PubMed and Proquest Central databases at Kirikkale University Library. Results: Although the skin prick testing in patients suffering from AR is positive (indicating that antigen-specific Immunoglobulin E has been produced), there is no association with overall circulating IgE levels. Correlation was lacking between circulating IgE level and either skin prick tests or laboratory testing for specific IgE. Omalizumab binds to uncomplexed IgE in man more avidly than does Fc-epsilon. The effect of omalizumab is to lower the level of IgE and downgrade production of FceRI receptors (which bind IgE) in mast cells and basophils, causing less mast cell recruitment and responsivity and thus diminishing eosinophilic infiltration and activation. Anti-IgE therapy through omalizumab may shorten the lifetime of mast cells and causes dendritic cells to downgrade their production of FceRI. There are reports indicating benefit from omalizumab in managing food allergies, nasal polyp formation, essential anaphylaxis, AR, venom allergy and eczema. Omalizumab acts to lessen circulating IgE levels, whilst reducing production of FceRI by mast cells and basophils. The fact that omalizumab influences how eosinophils respond may be down to disruption of the antigen-IgE-mast cell interactions, with mast cells being recruited at lower levels and thus chemotactic eosinophilic recruitment via cytokines being greatly reduced. Omalizumab has the effect in cases of perennial AR of blocking the increased eosinophilic recruitment and tissue infiltration initiated by seasonal antigens. Likewise, in omalizumab-treated cases, circulating unbound IgE levels showed significant decreases. For patients with perennial AR, the average daily nasal severity score was significantly reduced where omalizumab was administered, compared to placebo. Conclusion: Omalizumab has efficacy in ameliorating symptoms and reduces the necessity for additional medication in both seasonal and perennial allergic rhinitisÖğe Changes in the Anatomical Nomenclature of Sella Turcica: Turkish Saddle(Bentham Science Publ Ltd, 2018) Akgul, Mehmet Huseyin; Burulday, Veysel; Muluk, Nuray BayarBackground: 'Sella turcica' was first described in 1543. The "De humani corporis fabrica" is the name of a book by Andreas Vesalius that first described the 'sella turcica'. After this date, it was called the 'sella ephippi', 'sphenoidis sella', or 'sella equine'. In 1627, the famous anatomist Adrianus Spigelius developed the current definition of the term. Discussion: The Ottoman military power was at its highest level and a serious threat to Europe at the time so it was indicative of the sense of Turkish power to use 'sella turcica' as a medical term. Spigelius had investigated Turkish daily life, art, and culture in the sixteenth century, and Turks were common exemplars of an orientalist fashion that was being pioneered in Europe, which may be how this term came about. 'Sella' was used because of its similarity to the Turkish saddle; other such similarities included the amygdala and pear, hippocampus and almond, and priformis and seahorse. Conclusion: In this study, the anatomical, hormonal, and historical characteristics of 'sella turcica' are reviewed.Öğe Jetlag related sleep problems and their management: A review(Elsevier Sci Ltd, 2018) Cingi, Cemal; Emre, Ismet Emrah; Muluk, Nuray BayarObjectives: We reviewed Jetlag, particularly in view of its effects on sleep and how it can be managed. Methods: The Proquest Central database of Kirikkale University, PubMed and Google scholar were used while searching for the following key words: "Jetlag", "symptoms", "sleep", "melatonin" and "treatment". Results: Flight dysrhythmia, otherwise known as jetlag, is caused by flying globally over various time zones. Most passengers who fly over six or more different time zones generally require 4-6 days after travelling to resume their usual sleep patterns and to feel less lethargic during the day. Signs of jet lag can vary between debilitated awareness, insomnia, feeling tired during the day and frequent waking during the night. During the night our pineal glands excrete a hormone called melatonin; dim lights cause the continuation of excretion of these hormones whereas any exposure to bright lights stems the flow of release. Common precautionary measures are specific diets, bright lights and melatonin agonists (Ramelteon, Agomelatine). Conclusion: Sleep issues derived from jetlag were found to be most common in passengers who flew through various time belts. Melatonin assumes a critical part in adjusting the body's circadian rhythms and has been utilized restoratively to re-establish irritated circadian rhythms.Öğe The possible mechanisms of the human microbiome in allergic diseases(Springer, 2017) Ipci, Kagan; Altintoprak, Niyazi; Muluk, Nuray Bayar; Senturk, Mehmet; Cingi, CemalIn the present paper, we discuss the importance of the microbiome in allergic disease. In this review paper, the data from the Medline (PubMed) and search engine of Kirikkale University were systematically searched for all relevant articles in June 15th, 2015 for the past 30 years. The keywords of "microbiome'', "dysbiosis'', "allergy'', "allergic rhinitis'', "allergic disease'', "mechanisms'' and "treatment'' were used alone or together. In this paper, microbiomes were presented in terms of "Definition'', "Influence of \the human microbiome on health'', "The microbiome and allergic diseases'', and "Modulation of the gut microbiota in terms of treatment and prevention''. Microbiological dysbiosis is also reviewed. The microbiome is the genetic material of all microbes (bacteria, fungi, protozoa, and viruses) that live on or in the human body. Microbes outnumber human cells in a 10: 1 ratio. Most microbes live in the gut, particularly the large intestine. Changes in the immune function of the respiratory tract are (at least in theory) linked to the immunomodulatory activity of the gut microbiota via the concept of a "common mucosal response''. The gut microbiota shapes systemic immunity, thus affecting the lung mucosa. Alternatively, changes in the gut microbiota may reflect alterations in the oropharyngeal microbiota, which may in turn directly affect the lung microbiota and host immune responses via microaspiration. Dysbiosis is defined as qualitative and quantitative changes in the intestinal flora; and modern diet and lifestyle, antibiotics, psychological and physical stress result in alterations in bacterial metabolism, as well as the overgrowth of potentially pathogenic microorganisms. All immune system components are directly or indirectly regulated by the microbiota. The nature of microbial exposure early in life appears to be important for the development of robust immune regulation; disruption of either the microbiota or the host response can trigger chronic inflammation. Dysbiosis is also an important clinical entity. Antibiotics, psychological and physical stress, and dietary factors contribute to intestinal dysbiosis.Öğe Aspirin-exacerbated respiratory disease and current treatment modalities(Springer, 2017) Sakalar, Emine Guven; Muluk, Nuray Bayar; Kar, Murat; Cingi, CemalAspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients. Clinical features of AERD include the onset of nasal congestion with anosmia, progressing to chronic pansinusitis and nasal polyps that regrow rapidly after surgery. Aspirin desensitization, Leukotriene-modifying agents, biologic agents, management of asthma, chronic rhinosinusitis, and nasal polyposis are recommended as treatment modalities. Immunotherapy is prescribed only to those AERD patients who experience clear seasonal or perennial allergy symptoms in addition to the symptoms attributable to chronic nasal polyposis. There are also investigational and dietary therapies. In this review, the important aspects of AERD will be presented, along with a literature survey.Öğe Reply to the letter to the editor concerning: 'Fat-plug myringoplasty of ear lobule vs abdominal donor sites'(Springer, 2017) Acar, Mustafa; Yazici, Demet; San, Turhan; Muluk, Nuray Bayar; Cingi, Cemal…Öğe Pyriform aperture enlargement in all aspects(Cambridge Univ Press, 2017) Esen, E.; Muluk, N. Bayar; Altintoprak, N.; Ipci, K.; Cingi, C.Background: The pyriform aperture comprises the central area of facial bone structure. It is formed by the free corners of the nasal bone and the frontal processes of the maxillae, which articulate with each other at the nasomaxillary suture lines. Congenital nasal pyriform aperture stenosis might be linked to various craniofacial problems. This review presents all aspects of pyriform aperture stenosis and enlargement. Methods: A literature search was conducted. Pyriform aperture definition, nasal development, congenital nasal pyriform aperture stenosis and pyriform aperture enlargement were reviewed. Results: One of the most common abnormalities is holoprosencephaly, which is a midline developmental deficiency that may also be present in combination with facial clefting. The aetiology of nasal pyriform aperture stenosis remains unclear. When diagnosed, the choice of treatment is between non-surgical and operative methods, depending on the seriousness of the problem. Provided the sufferer can maintain a secure air passage with the help of specialised medical procedures and respiratory tract adjuvants, operative therapy may be delayed. Conclusion: The operative outcomes are extremely good, and the prognosis relies mainly on coexisting neural and endocrine problems. This paper evaluates the nasal pyriform aperture in detail.Öğe Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report(Biomed Central Ltd, 2017) Cingi, C.; Gevaert, P.; Moesges, R.; Rondon, C.; Hox, V.; Rudenko, M.; Bousquet, J.This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.Öğe Effects of pregnancy on olfaction(Deomed Publ, Istanbul, 2017) Dikici, Oğuzhan; Muluk, Nuray Bayar; Şahin, Ethem; Altıntoprak, NiyaziIn this review, we aimed to report the effects of pregnancy on olfaction function of the women. Since estrogen and progesterone levels change in specific physiological conditions, pregnancy and postmenopausal period exert an effect on the capability to sense and identify smells. Nasal stuffiness increased during pregnancy. 66.6% of the pregnant women were suffering olfactory dysfunction in the second trimester; while 95.8% in the first and third trimesters. Olfactory function was lessened following birth and throughout the first 6-12 weeks; however, it seemed to improve entirely. In pregnant women, olfactory dysfunction was observed in all trimesters; while it was less in the second trimester and high in the first and third trimesters. The smell abnormalities were almost absent at postpartum period. As olfactory functions improved after delivery of the baby, olfactory changes during pregnancy may be accepted as physiological changes which were observed in many pregnant women.Öğe Aesthetic analysis of the ideal eyebrow shape and position(Springer, 2016) Yalcinkaya, Esin; Cingi, Cemal; Soken, Hakan; Ulusoy, Seckin; Muluk, Nuray BayarThe aesthetic importance of the eyebrow has been highlighted for centuries. In this paper, we investigated ideal eyebrow. Eyebrows and eyelids, varies among different races, ages and genders. It is considered to be of primary importance in facial expression and beauty. We present one form of the ideal eyebrow aesthetic and discuss methods of optimising surgical results. For the modern acceptable concept of the ideal brow, the medial brow should begin on the same vertical plane as the lateral extent of the ala and the inner canthus and end laterally at an oblique line drawn from the most lateral point of the ala through the lateral canthus. The medial and lateral ends of the brow lie approximately at the same horizontal level. The apex lies on a vertical line directly above the lateral limbus. Individual perceptions and expectations also differ from person to person. The brow should over lie the orbital rim in males and be several millimetres above the rim in female. Male tend to have a heavier, thicker brow with a little arch present. There are some pitfalls in brow aesthetics. Overelevation creates an unnatural, surprised and unintelligent look which is the most common surgical mistake in brow lifting. Medial placement of the brow peak would create an undesired 'surprised' appearance. Moreover, a low medial brow with a high lateral peak induces an angry look. Overresection of the medial brow depressors may lead to widening and elevation of the medial brow, which creates an insensitive look and can also lead to glabellar contour defects. It is impossible to define an ideal eyebrow that is suitable for every face. However, one must consider previously described criteria and other periorbital structures when performing a brow surgery.Öğe Immunotherapy in all aspects(Springer, 2016) Hanci, Deniz; Sahin, Ethem; Muluk, Nuray Bayar; Cingi, CemalAllergen immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. In this review, we presented the important topics in immunotherapy. The important aspects of immunotherapy are considered to be "ImmunologA +/- cal responses to immunotherapy"; "The principal types of immunotherapy"; "Effectiveness"; "Indications"; "Contraindications"; "Allergen immunotherapy in children"; "Safety"; and "Anaphylactic reactions after immunotherapy". The principal types of immunotherapy are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy. Both of them can be used in indicated cases. When using SCIT, physicians must be more careful because of reported rare fatal cases. The risks and benefits of continuing allergen immunotherapy in patients who have experienced severe systemic reactions should be carefully considered.Öğe Update on local allergic rhinitis(Elsevier Ireland Ltd, 2016) Altintoprak, Niyazi; Kar, Murat; Muluk, Nuray Bayar; Oktemer, Tugba; Ipci, Kagan; Birdane, Leman; Cingi, CemalWe here provide an update on the literature regarding local allergic rhinitis (LAR). In reviewing LAR, we have included an updated definition, classifications, mechanisms, comorbidities, and recommendations for diagnosis and treatment for LAR, as well as the defined research areas for future evidence-based studies. LAR is a localised nasal allergic response in the absence of systemic atopy characterised by local production of specific IgE (sIgE) antibodies, a TH2 pattern of mucosal cell infiltration during natural exposure to aeroallergens, and a positive nasal allergen provocation test response, with the release of inflammatory mediators. The localised allergic response of LAR is an important topic for the study of allergies. This review provides an update on the current knowledge of LAR. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Antileukotrienes in adenotonsillar hypertrophy: a review of the literature(Springer, 2016) Kar, Murat; Altintoprak, Niyazi; Muluk, Nuray Bayar; Ulusoy, Seckin; Bafaqeeh, Sameer Ali; Cingi, CemalWe assessed the use of antileukotrienes for treating adenotonsillar hypertrophy. We reviewed the current literature on the anatomy of adenotonsillar tissue, adenotonsillar hypertrophy/hyperplasia (and the associated pathophysiology and symptoms), and the effects of antileukotrienes used to treat adenotonsillar hypertrophy. Leukotrienes (LTs) are inflammatory mediators produced by a number of cell types, including mast cells, eosinophils, basophils, macrophages, and monocytes. There are several types (e.g., LTA4, LTB4, LTC4, LTD4, and LTE4). By competitive binding to the cysLT1 receptor, LT-receptor antagonist drugs such as montelukast, zafirlukast, and pranlukast block the effects of cySHLTs, improving the symptoms of some chronic respiratory diseases. High numbers of LT receptors have been found in the tonsils of children with obstructive sleep apnea. Antileukotrienes reduce the apnea-hypopnea index and adenotonsillar inflammation. Antileukotrienes may be useful for children with adenotonsillar hypertrophy due to their anti-inflammatory effects, which help to reduce adenotonsillar inflammation.Öğe Nasobronchial interaction(Baishideng Publishing Group Inc, 2015) Cingi, Cemal; Muluk, Nuray Bayar; Cobanoglu, Bengu; Catli, Tolgahan; Dikici, OguzhanUpper and lower airways can be considered as a unified morphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature. To discuss nasobronchial interactions, literature review from PubMed since 1982 is evaluated. Data base was including the terms "nasobronchial interaction, nasal and bronchial". Asthma and rhinosinusitis may be associated with environmental factors and immunological predisposition. Treatment of rhinosinusitis may decrease asthma exacerbations. It was concluded that "one airway, one disease"-concept may be accepted when considering naso-bronchial interaction. Asthma treatment should also mean treating the nose as good as treating patients with nasal symptoms. To reach the succesful results it should be associated with evaluation of lung functions.Öğe Antileukotrienes in Upper Airway Inflammatory Diseases(Current Medicine Group, 2015) Cingi, Cemal; Muluk, Nuray Bayar; Ipci, Kağan; Şahin, EthemLeukotrienes (LTs) are a family of inflammatory mediators including LTA(4), LTB4, LTC4, LTD4, and LTE4. By competitive binding to the cysteinyl LT1 (CysLT(1)) receptor, LT receptor antagonist drugs, such as montelukast, zafirlukast, and pranlukast, block the effects of CysLTs, improving the symptoms of some chronic respiratory diseases, particularly bronchial asthma and allergic rhinitis. We reviewed the efficacy of antileukotrienes in upper airway inflammatory diseases. An update on the use of antileukotrienes in upper airway diseases in children and adults is presented with a detailed literature survey. Data on LTs, antileukotrienes, and antileukotrienes in chronic rhinosinusitis and nasal polyps, asthma, and allergic rhinitis are presented. Antileukotriene drugs are classified into two groups: CysLT receptor antagonists (zafirlukast, pranlukast, and montelukast) and LT synthesis inhibitors (5-lipoxygenase inhibitors such as zileuton, ZD2138, Bay X 1005, and MK-0591). CysLTs have important proinflammatory and profibrotic effects that contribute to the extensive hyperplastic rhinosinusitis and nasal polyposis (NP) that characterise these disorders. Patients who receive zafirlukast or zileuton tend to show objective improvements in, or at least stabilisation of, NP. Montelukast treatment may lead to clinical subjective improvement in NP. Montelukast treatment after sinus surgery can lead to a significant reduction in eosinophilic cationic protein levels in serum, with a beneficial effect on nasal and pulmonary symptoms and less impact in NP. Combined inhaled corticosteroids and long-acting beta-agonists treatments are most effective for preventing exacerbations among paediatric asthma patients. Treatments with medium-or high-dose inhaled corticosteroids, combined inhaled corticosteroids and LT receptor antagonists, and low-dose inhaled corticosteroids have been reported to be equally effective. Antileukotrienes have also been reported to be effective for allergic rhinitis.Öğe Time Course of Auditory Processing, Visual Processing, Language and Speech Processing(Mediterranean Soc Otology & Audiology, 2010) Muluk, Nuray Bayar; Yalcinkaya, FulyaEach stimulus is processed in the brain at a certain speed/time. Hearing, vision and language are included in this process. Such as, the onset of language specific phonetic phonological analysis has been estimated at 100-200 ms. Listener the smaller the gap that can be detected. Such as, rapidly changing (gap) sounds such as /r/, /I/. There are need both short (20msec for phoneme duration signals) and long (200msec for syllable-duration signals) segments of speech. In hearing, language and speech processing functions, brain works together with all fields (auditory processing, memory, language and the image and speech recording area, etc.) synchronizely for seconds as the orchestra. If neurons can not participate this processing synchronizely, synchronization is corrupted. Processing time of information and synchronization work should be the basis for hearing, language and speech training. Phonetics in speech come to our ears in a few seconds through sound waves. If these sounds can not received within a few seconds, they get lost. If received, they were processed in the auditory pathway and brain in a few seconds. The purpose of this review is to draw attention that, if the sounds are received and processed within a few seconds, the training method used in speech training model should be intended for sounds' transmission and processing in a few seconds. In addition, all of the functions (auditory, view processing, memory and language) should be included into training by bottom-up approach. Auditory processing is the ability to listen, comprehend and respond to information that we hear through our auditory channels. It needs decoding of the neural message. Auditory processing involves attention to detection and identification of the signal; and decoding of the neural message. If we don't give full attention to heard things, listening difficulty ocuurs. In poor attention and listening conditions, rapid acoustic changes in speech can not be discriminated.Öğe A case of cheilitis glandularis superimposed on oral lichen planus: successful palliative treatment with topical tacrolimus and pimecrolimus(Blackwell Publishing, 2007) Erkek, E.; Sahin, S.; Kilic, R.; Erdogan, S.…
