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Background and Objectives: Apnea hypopnea index is the most important criterion in determining the severity of obstructive sleep apnea (OSA), while the percentage of the total number of times which oxygen saturation is measured below 90% during polysomnography (CT90%) is important in determining the severity of hypoxemia. As hypoxemia increases, inflammation will also increase in OSA. Inflammation in the respiratory tract may affect phonation. We aimed to determine the effects of the degree of OSA and CT90% on phonation. Materials and Methods: The patients were between the ages of 18–60 years and were divided into four groups: normal, mild, moderate, and severe OSA. Patients were asked to say the vowels /α:/ and /i:/ for 5 s for voice recording. Maximum phonation time (MPT) was recorded. Using the Praat voice analysis program, Jitter%, Shimmer%, harmonics-to-noise ratio (HNR), and f0 values were obtained. Results: Seventy-two patients were included. Vowel sound /α:/; there was a significant difference for Jitter%, Shimmer%, and HNR measurements between the 1st and the 4th group (p < 0.001, p < 0.001, and p < 0.001, respectively) and a correlation between CT90% and Shimmer% and HNR values (p < 0.001 and p < 0.021, respectively). Vowel sound /i:/; there was a significant difference in f0 values between the 1st group and 2nd and 4th groups (p < 0.028 and p < 0.015, respectively), and for Jitter%, Shimmer%, and HNR measurements between the 1st and 4th group (p < 0.04, p < 0.000, and p < 0.000, respectively), and a correlation between CT90% and Shimmer% and HNR values (p < 0.016 and p < 0.003, respectively). The difference was significant in MPT between the 1st group and 3rd and 4th groups (p < 0.03 and p < 0.003, respectively). Conclusions: Glottic phonation can be affected, especially in patients whose AHI scores are ≥15. Voice quality can decrease as the degree of OSA increases. The increase in CT90% can be associated with the worsening of voice and can be used as a predictor in the evaluation of voice disorders in the future.

HighlightsEpinephrine containing local anesthetics are used hemostasis in many cases.We used lidocain with epinephrine for local anesthesia on nasal mucosa.We present intracranial hemorrhagic infarction in a 41-year-old male patient.Local anesthetic medicines with adrenaline can cause intracranial hemorrhagic infarction.Checking correct dosage, and the use of basic vital signs monitoring are important.

SARS-CoV-2 infection intensely increases thromboembolic events and inflammation. The inner ear can be easily damaged as a result of circulatory disorders and inflammation. Therefore, SARS-CoV-2 may negatively affect the cochlea. Outer hairy cell damage in the inner ear is one of the first signs of sensorineural hearing loss. Otoacoustic emissions use is an effective, objective, and non-invasive method for early detection of hearing loss. Our study aims to determine whether the cochlea is affected in hospitalized patients with SARS-CoV-2 infection who did not need intensive care treatment by using Distortion product otoacoustic emission (DPOAE) measurements. This study was conducted on 26 hospitalized patients with SARS-CoV-2 infection (patient group) and 25 healthy volunteers (control group). DPOAE measurements were performed on all participants in an audiometric test room. The DP-grams were obtained between 498Hz and 10000Hz. The DPOAE measurements were compared between two groups. When evaluated as a cluster, DP1 and the SNR values were found to be significantly lower in the patient group at frequencies 498, 996, 2002, 7998, 10000 Hz and frequencies 498, 996, 2002, 4004, 6299Hz, respectively. When the right and left ears of the patient group were compared, DP1 and SNR values were found to be similar at all frequencies. SARS-CoV-2 infection can cause damage to the outer hair cells and the regions of the cochlea belonging to a wide range of frequencies according to our DPOAE measurements and due to the specific characteristics of the virus.

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