bers of visits in 2018 and 2019. In Israel, virtual visits to community physicians by telephone became available during the COVID-19 pandemic. Because SSNHL is abrupt and substantially impairs the conduct of normal life, it is less likely that patients ignore the symptoms when there is immediate availability of health care services.Another explanation for these findings might be related to the substantial decrease in the occurrence of viral respiratory infections during the COVID-19 pandemic. 5 The Israel Center of Disease Control reported that influenza was not detected in all sentinel clinics between March and December 19, 2020. This lack of cases was most likely associated with social distancing, lockdown, and the use of masks. A possible association between infectious diseases and SSNHL might be supported by the observation of a time-clustered presentation of SSNHL, suggesting an environmental or infectious cause. 6 Although an attractive theory, if this were true, one would have expected that the occurrence of SSNHL would have remained low for the entire pandemic period because social distancing and face masks continued to be implemented, although to lesser extent later in 2020. The present study relied on data originally collected for administrative and clinical management and not specifically for the current study; thus, a possible limitation may be related to the quality of the data. In addition, International Classification of Diseases, Ninth Revision codes include only diagnosis of sensorineural hearing loss with no specific codes for SSNHL. However, to identify patients with SSNHL, our search included new diagnosis of hearing loss with a concurrent prednisone treatment, which is the standard of care for this condition. Therefore, the study did not include patients with SSNHL who were treated with intratympanic steroid injection as primary treatment in either 2020 or 2018 and 2019.

The genus Salvia (Sage) -the largest in the Lamiaceae family, includes over 700 species /1,2/. Some of its representatives -S. sclarea L. and S. officinalis L. -known as sources of essential oils with commercial value. Thus, S. sclarea L. is grown in the Ukraine and is included in the concept of essential oil industry of the Autonomous Republic of Crimea as a promising form.In our study we investigated by GC/MS method a composition of CO 2 -extract of S. stepposa, which was collected in Kazakhstan in Akmola region, Arshaly district in 14. 06.2007 (flowering).It should be noted that the composition of essential oil of S. stepposa has not been studied before. Supercritical Fluid Extraction (SCFE) parameters ( It has been found, that in the extract of Salvia stepposa 26 compounds (Fig. 2, Table) were found and main from them are: bis(2-ethylhexyl) phthalate -78,1%, hexadecanoic acid ethyl ester -3,3% and 2,4-dioctylphenol -2,9%. Also revealed the presence of unidentified components 1and 2 with area 2,8 and 1,3% respectively. the mass spectra of unidentified components are shown..

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consistency foods. She denied odynophagia, otalgia, hematemesis, or hemoptysis. In the past, she had multiple esophagogastroduodenoscopies with dilations for her Schatzki ring that provided some relief; however, they did not completely resolve her symptoms. The patient presented to the otolaryngology clinic to discuss her symptoms. She underwent a clinical and video swallow evaluation and was found to have hypertrophy of the cricopharyngeus muscle as evidenced by her preoperative esophagographic imaging (Figure 1A). The patient subsequently underwent an open cricopharyngeal myotomy, during which a palpable thick broad cricopharyngeus muscle was identified and resected. On postoperative day 1, a barium swallow study showed no persistent or remnant pharyngeal bar and no extravasation of contrast (Figure 1B). The patient tolerated a diet and was discharged later that day. Histopathologic examination of the resected cricopharyngeus muscle revealed nonnecrotizing granulomas and mononuclear inflammatory infiltrates, primarily in the endomysium. Adipose tissue deposition, endomysial fibrosis, increased variation in muscle fiber size, increased internal nuclei, and rare necrotic fibers were also noted (Figure 2). Special stain results for acid-fast, fungal, and bacterial microorganisms were negative. These histologic features were consistent with a diagnosis of granulomatous myositis of the cricopharyngeus muscle, which, in this patient, was most consistent with sarcoid involvement. At the patient's postoperative follow-up visit, her symptoms of dysphagia had completely resolved.Discussion | Sarcoid involvement of the upper esophageal sphincter is a rare manifestation. Dysphagia related to sarcoidosis is more likely to result from mediastinal lymphadenopathy, nervous system involvement, or direct involvement of the larynx/esophagus, with only very rare reports of isolated involvement of the cricopharyngeal muscle as the cause of dysphagia. 4 In this case, the patient underwent a cricopharyngeal myotomy, which resolved her symptoms.