The Effects of Preoperative Pain Education on the Decision to Discharge Patients Following Single-Incision Laparoscopic Appendectomy

Purpose@#Few studies have analyzed the effects of preoperative pain education on the postoperative decision to discharge. The purpose of this study was to determine the effects of pain education and management on the decision to discharge patients after single-incision laparoscopic appendectomy (SILA). @*Methods@#We analyzed 135 patients who had undergone SILA for acute appendicitis between March 2017 and April 2018 in a single medical center. Of these, 72 patients (53.3%) had received preoperative pain education (group 1), and 63 (46.7%) had not (group 2). We compared perioperative outcomes and complications between the groups. @*Results@#Baseline characteristics of sex, age, body mass index, American Society of Anesthesiologist score, and systemic inflammation factors (neutrophil-lymphocyte ratio, C-reactive protein level) did not differ significantly between the groups. There were no postoperative complications for patients in either group. Perioperative consequences and pathologic findings were not significantly different between the groups; however, length of hospital was significantly shorter in group 1. @*Conclusion@#Preoperative pain education in relation to postoperative pain management influenced the decision to shorten the postoperative hospital length of stay after SILA.

A Personal Sound Amplification Product Compared to aBasic Hearing Aid for Speech Intelligibility in Adults withMild-to-Moderate Sensorineural Hearing Loss

This study aimed to compare functional hearing with the use ofa personal sound amplification product (PSAP) or a basic hearing aid (HA) among sensorineuralhearing impaired listeners. Subjects and Methods: Nineteen participants with mild-to-moderatesensorineural hearing loss (SNHL) (26-55 dB HL; pure-tone average, 0.5-4 kHz) wereprospectively included. No participants had prior experience with HAs or PSAPs. Audiograms,speech intelligibility in both quiet and noisy environments, speech quality, and preference wereassessed in three different listening conditions: unaided, with the HA, and with the PSAP. Results:The use of PSAP was associated with significant improvement in pure-tone thresholds at 1, 2,and 4 kHz compared to the unaided condition (all p<0.01). In the quiet environment, speechintelligibility was significantly improved after wearing a PSAP compared to the unaided condition(p<0.001), and this improvement was better than the result obtained with the HA. The PSAPalso demonstrated similar improvement in the most comfortable levels compared to those obtainedwith the HA (p<0.05). However, there was no significant improvement of speech intelligibilityin a noisy environment when wearing the PSAP (p=0.160). There was no significant differencein the reported speech quality produced by either device or in participant preference for thePSAP or HA. Conclusions: The current result suggests that PSAPs provide considerable benefitsto speech intelligibility in a quiet environment and can be a good alternative to compensatefor mild-to-moderate SNHL. J Audiol Otol 2020;24(2):91-98

The Effects of Preoperative Pain Education on the Decision to Discharge Patients Following Single-Incision Laparoscopic Appendectomy

Purpose@#Few studies have analyzed the effects of preoperative pain education on the postoperative decision to discharge. The purpose of this study was to determine the effects of pain education and management on the decision to discharge patients after single-incision laparoscopic appendectomy (SILA). @*Methods@#We analyzed 135 patients who had undergone SILA for acute appendicitis between March 2017 and April 2018 in a single medical center. Of these, 72 patients (53.3%) had received preoperative pain education (group 1), and 63 (46.7%) had not (group 2). We compared perioperative outcomes and complications between the groups. @*Results@#Baseline characteristics of sex, age, body mass index, American Society of Anesthesiologist score, and systemic inflammation factors (neutrophil-lymphocyte ratio, C-reactive protein level) did not differ significantly between the groups. There were no postoperative complications for patients in either group. Perioperative consequences and pathologic findings were not significantly different between the groups; however, length of hospital was significantly shorter in group 1. @*Conclusion@#Preoperative pain education in relation to postoperative pain management influenced the decision to shorten the postoperative hospital length of stay after SILA.

A Trainable Hearing Aid Algorithm Reflecting Individual Preferences for Degree of Noise-Suppression, Input Sound Level, and Listening Situation

OBJECTIVES: In an effort to improve hearing aid users’ satisfaction, recent studies on trainable hearing aids have attempted to implement one or two environmental factors into training. However, it would be more beneficial to train the device based on the owner’s personal preferences in a more expanded environmental acoustic conditions. Our study aimed at developing a trainable hearing aid algorithm that can reflect the user’s individual preferences in a more extensive environmental acoustic conditions (ambient sound level, listening situation, and degree of noise suppression) and evaluated the perceptual benefit of the proposed algorithm. METHODS: Ten normal hearing subjects participated in this study. Each subjects trained the algorithm to their personal preference and the trained data was used to record test sounds in three different settings to be utilized to evaluate the perceptual benefit of the proposed algorithm by performing the Comparison Mean Opinion Score test. RESULTS: Statistical analysis revealed that of the 10 subjects, four showed significant differences in amplification constant settings between the noise-only and speech-in-noise situation (P<0.05) and one subject also showed significant difference between the speech-only and speech-in-noise situation (P<0.05). Additionally, every subject preferred different β settings for beamforming in all different input sound levels. CONCLUSION: The positive findings from this study suggested that the proposed algorithm has potential to improve hearing aid users’ personal satisfaction under various ambient situations.

Effects of the Simultaneous Application of Nonlinear Frequency Compression and Dichotic Hearing on the Speech Recognition of Severely Hearing-Impaired Subjects: Simulation Test

OBJECTIVES: The clinical effects of the simultaneous application of nonlinear frequency compression and dichotic hearing on people with hearing impairments have not been evaluated previously. In this study, the clinical effects of the simultaneous application of these two techniques on the recognition of consonant-vowel-consonant (CVC) words with fricatives were evaluated using normal-hearing subjects and a hearing loss simulator operated in the severe hearing loss setting. METHODS: A total of 21 normal-hearing volunteers whose native language was English were recruited for this study, and two different hearing loss simulators, which were configured for severe hearing loss in the high-frequency range, were utilized. The subjects heard 82 English CVC words, and the word recognition score and response time were measured. RESULTS: The experimental results demonstrated that the simultaneous application of these two techniques showed almost even performance compared to the sole application of nonlinear frequency compression in a severe hearing loss setting. CONCLUSION: Though it is generally accepted that dichotic hearing can decrease the spectral masking thresholds of an hearing-impaired person, simultaneous application of the nonlinear frequency compression and dichotic hearing techniques did not significantly improve the recognition of words with fricatives compared to the sole application of nonlinear frequency compression in a severe hearing loss setting.

A Case of Brain Abscess in a Patient with Primary Mucociliary Transport Failure

The authors present a case of brain abscess in a patient with primary mucociliary transport failure. Primary mucociliary transport failure is unfamiliar term to neurosurgeon. It encompasses three hereditary disorders, that is, primary ciliary dyskinesia, cystic fibrosis and Young's syndrome. Clinical manifestations in these disorders appear to overlap each other, e.g., male infertility and chronic sinopulmonary infections. These are characterized by ciliary dysfunction or abnormality of mucus secretion therefore recurrent infection occurs in organs containing the mucociliary transport system. Major causes of non-traumatic brain abscess are sinusitis and pulmonary infection. So the possibility of brain abscess is much higher if mucociliary transport failure exists. Especially, young patients who have brain abscess coexisting with chronic sinopulmonary infection should be considered primary mucociliary transport failure.