Objective:
To determine if post-lingually deaf adult cochlear implant (CI) users
have better environmental sound awareness (ESA) compared to adult patients
eligible for CIs who have not yet undergone implantation.
Study Design:
Cross-sectional cohort study.
Setting:
Tertiary referral center
Patients:
A group of 39 post-lingually deaf adult patients who are experienced
CI users (ECI), and a group of 20 post-lingually deaf adult patients who are
cochlear implant candidates (CIC) awaiting implantation.
Intervention:
Cochlear implantation
Main outcome measure:
Environmental sound awareness as measured by accuracy (percent
correct) using the computerized, Familiar Environmental Sounds
Test—Identification (FEST-I).
Results:
There was no significant difference between ESA in our sample of ECI
users versus CIC patients. The ECI users scored an average FEST-I accuracy
of 59.9% (SD 14.3). In comparison, the CICs had an average FEST-I accuracy
of 54.7% (SD 26.4). This difference was not statistically significant.
Conclusions:
Our findings suggest that, despite the commonly held notion that
improved ESA may be a benefit of cochlear implantation, our sample of ECI
users did not demonstrate superior performance compared to CICs.
Anastomotic leaks are one of the most feared and morbid complications after colorectal anastomosis. Management of leaks depends on the severity of the leak and focuses on controlling sepsis and saving the anastomosis. The lower the anastomosis, the more amenable it is to transanal approaches for salvage. However, when a complication exists higher up in the rectum, the surgeon is more limited in the ability to visualize and intervene. With the advent of transanal minimally invasive surgery (TAMIS) and the advancement of endoscopic procedures, there are now more options for surgeons to visualize and intervene in anastomotic colorectal leaks. Prior reports have described the use of TAMIS for the management of anastomotic leaks in the acute phase. However, this same approach can be useful in the management of chronic leaks. This report highlights the benefit of TAMIS to allow visualization and marsupialization of a chronic abscess cavity following an anastomotic leak.
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