ABSTRACT
Sudden postoperative hearing loss is rare, and thought to be caused by a variety of mechanisms. Here we report on a patient with Crouzon syndrome who experienced multiple episodes of postoperative hearing loss, with persistent hearing loss occurring after she received nitrous oxide as part of a general anesthetic. Nitrous oxide is known to cause pressure changes in closed air spaces. Patients with craniofacial syndromes may have acoustic nerve compression from skull base and cartilage anomalies that cause narrowing of the internal acoustic meatus. These anatomic variations may make patients more susceptible to increased middle ear pressure secondary to nitrous oxide, increasing their risk for hearing loss.
ABSTRACT
PURPOSE OF REVIEW: Simulators can be used to teach simple technical skills or used in more realistic settings to teach or assess various cognitive/affective skills. Although simulators have become widespread, their use and efficacy in these various areas have not been delineated and are still being explored. This review will discuss the present state of using medical simulation for airway-management training. RECENT FINDINGS: Airway management includes both specialized technical skills and higher-order cognitive skills and behaviors. Since no one simulator is capable of covering all the functions necessary to teach these varied skills, medical specialists will need to train on a couple of different simulators. Now widely accepted in medical education, simulator training is being mandated in certain situations at some institutions because of a belief that it alters the physician. In this article its efficacy in teaching the specific psychomotor skills of bronchoscopy were validated but its use in teaching higher cognitive skills remained inconclusive. SUMMARY: Simulators are here to stay. Presently their usage in teaching psychomotor skills has scientific validity in specific tasks but their efficacy for teaching higher-order cognitive skills is still evolving. Future studies will continue to delineate the usage in different areas by studying the outcome in skills training and retention.
