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Feng-Yu Chiang

Publications and source records attributed to Feng-Yu Chiang.

13 recordsLinked to original sources
PubMed2006

Giant lipoma arising from deep lobe of the parotid gland.

BACKGROUND: Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. CASE PRESENTATION: A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT) scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 x 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. CONCLUSION: Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.

Journal Article↗
PubMed2006

The efficacy of intraoperative corticosteroids in recurrent laryngeal nerve palsy after thyroid surgery.

BACKGROUND: Recurrent laryngeal nerve palsy (RLNP) is one of the most common complications after thyroidectomy. We aim to evaluate the role of intraoperative corticosteroids in preventing or treating postoperative RLNP. MATERIALS AND METHODS: We conducted a prospective study of 295 patients who underwent either total lobectomy or total thyroidectomy with or without using intraoperative corticosteroids. All cases were operated on by the same surgeon. Measurement of the RLNP rate was based on the number of nerves at risk. Data were analyzed for differences in postoperative temporary or permanent RLNP rate and recovery days. RESULT: The rate of temporary/permanent RLNP was 5.7% (11 out of 194)/0.52% (1 out of 194) and 6.9% (12 out of 173)/0.58% (1 out of 173) according to groups with and without corticosteroids. This difference did not reach statistical significance. Among those 23 patients who recovered from RLNP, the mean time to recovery was significantly shorter for patients receiving intraoperative steroids (28.6 vs. 40.5 days, P = 0.045). CONCLUSION: A single dose of intraoperative corticosteroids did not produce any benefit in terms of reducing the postoperative temporary/permanent RLNP rate, but it did shorten the recovery time for patients suffering from temporary RLNP.

Adolescent↗
PubMed2006

Thyroid tumors with preoperative recurrent laryngeal nerve palsy: clinicopathologic features and treatment outcome.

BACKGROUND: The aim of this present study is to define the significance of recurrent laryngeal nerve palsy (RLNP) detected before surgery for thyroid diseases with regard to the incidence of malignancy, histopathologic distribution, extrathyroidal invasion, management, and prognosis. METHODS: Six hundred and twenty-two patients underwent operation for various thyroid disease and were treated by the same surgeon. The study was confined to 16 (3%) patients who suffered from a thyroid tumor with preoperative RLNP. RESULTS: Of these 16 patients, 1 had benign thyroid disease, while the other 15 had malignancy (94%). Among the 15 cancer patients, 14 had extrathyroidal invasion and needed more extensive surgical procedures than total thyroidectomy. The recurrent laryngeal nerve could be dissected from the thyroid neoplasm in 3 patients, 2 of whom experienced recovery of this nerve's function postoperatively. CONCLUSIONS: Thyroid tumor associated with RLNP is strongly suggestive of malignancy. The RLN should be preserved if it has not been invaded by the tumor, because it offers a good chance of functional recovery postoperatively. Well-differentiated thyroid cancer accounts for only half of these patients who tend to present at an older age and feature a much higher incidence of upper aerodigestive tract invasion. The operations for these patients often are complex and should be performed by experienced surgeons. Radical excision of a resectable anaplastic or squamous cell carcinoma of the thyroid gland offers the chance, albeit small, of long-term survival in this study.

Aged↗
PubMed2006

Neurofibroma of the lingual nerve: a case report.

A neurofibroma of the lingual nerve is a rare clinical finding, the most common lesion site of a lingual neurofibroma being the tongue. In most situations, it is difficult to determine the precise nerve origins. Herein, we report a case of lingual nerve neurofibroma that presented as a submandibular mass, mimicking a submandibular gland tumor or solitary lymphadenopathy. Complete surgical excision of such a lesion for histopathologic examination provides a better treatment and final diagnosis. For a patient presenting with neurofibromatosis and a submandibular mass, a neurofibroma of nerve origin should be considered in the differential diagnosis.

Adult↗
PubMed2006

Morbidity after total thyroidectomy for benign thyroid disease: comparison of Graves' disease and non-Graves' disease.

The purpose of this study was to review the safety of total thyroidectomies for benign thyroid disease, with special emphasis on the comparison between Graves' disease and non-Graves' disease. In this study, 107 patients who underwent total thyroidectomies for clinically benign thyroid disease performed by the same surgeon between January 1987 and December 2004 were enrolled; 48 had Graves' disease and 59 had non-Graves' disease. The rates of temporary vs. permanent hypoparathyroidism, hematoma requiring surgical intervention, and temporary vs. permanent recurrent laryngeal nerve palsy (RLNP) after total thyroidectomy for benign thyroid disease were 34.6% vs. 3.7%, 6.5%, and 6.5% vs. 1.85%, respectively. The rates of permanent hypoparathyroidism and temporary RLNP in the Graves' disease group were significantly different when compared with the non-Graves' disease group (8.3% vs. 0% and 11.5% vs. 2.5%, respectively). However, comparing the rates of temporary hypoparathyroidism, permanent RLNP, and postoperative hematoma, there was no statistically significant difference. Compared with total lobectomy, the rates of postoperative hematoma increased significantly for total thyroidectomy (6.5% vs. 0.48%). Total thyroidectomy for non-Graves' benign thyroid disease may be performed with minimal morbidity as has been advocated by many authors. For patients with Graves' disease in this study, however, the complication rates of permanent hypoparathyroidism and temporary RLNP were significantly increased. Therefore, we suggest that total thyroidectomy for Graves' disease should be performed by an experienced surgeon.

Graves Disease↗
PubMed2005

Exposure to carcinogenic PAHs for the vendors of broiled food.

Three types of popular vendors, including meat and non-meat food (e.g, fishballs), vendor group (I), rice sausage sandwiches vendor group (II), and roasted corn on-the-cob vendor group (III), from the night markets of Taiwan were chosen for this research. The average concentrations of carcinogenic polycyclic aromatic hydrocarbons (car-PAHs) were 2445 ng/m3 for vendor (II), 2276 ng/m3 for vendor (II), and 133 ng/m3 for vendor (III). Vendors groups (I) and (II) had exposure levels of Benzo(a)pyrene (BaP)-equivalent doses (BaPeq) approximately 16 and 13 times higher than those for vendor group (III). The daily exposure doses of BaPeq in working duration for vendor group (II) and (II) were 2.80 and 2.28 microg/day, respectively. The employees of five offices on campus were chosen as a control group. The daily exposure doses of BaPeq during working hours for vendor group (II) and (II) were about 22 times and 18 times, respectively, higher than those for control group. This exposure dose for vendors group (III) (0.18 microg/day) was comparable with the dose for control group (0.13 microg/day). The whole-day exposure doses of t-PAHs, car-PAHs, BaP, and BaPeq for vendor groups (I) and (II) were very close to those during daily working hours. However, the daily exposure doses of BaPeq during working hours for vendor group (III) occurred only in a proportion of 62% of the whole-day exposure doses.

Air Pollutants↗
PubMed2005

Different impact from betel quid, alcohol and cigarette: risk factors for pharyngeal and laryngeal cancer.

The risks of betel quid chewing with or without tobacco, alcohol drinking and cigarette smoking have been well explored in the oral cavity but not in the pharynx and larynx. We conducted a case-control study to investigate the association of these three risk factors to cancers of the pharynx and larynx in Taiwan. A total cases of 148 pharyngeal cancer, 128 laryngeal cancer and 255 hospital controls, all men, were recruited. Betel quid chewing was a significant independent risk factor (adjusted odds ratio [aOR] = 7.7; 95% confidence interval [CI] = 4.1-15.0) similar to that of alcohol drinking (aOR = 6.6; 95% CI = 3.5-13.0) for pharyngeal cancer, but not for laryngeal cancer (aOR = 1.3; 95% CI = 0.7-2.5) on which cigarette smoking (aOR = 7.1) exerts a stronger significant independent risk than alcohol drinking (aOR = 3.8). For pharyngeal cancers, chewers who consumed >20 quid/day, chewed with inflorescence in the quid or swallowed the betel quid juice were at higher risks; significant dose-response effects were found in daily quantity of drinking and chewing, and cumulative quantity of drinking. Synergistic effects from the 3 risk factors existed both on the pharynx (aOR = 96.9) and the larynx (aOR = 40.3), and attributed for 93.1% and 92.9% respectively. Our study is the first evidence to show that betel quid chewing without tobacco has different impact on the pharynx (digestive tract) and the larynx (airway), and supports the concept that exposure quantity and direct mucosal contact with the betel quid juice may contribute to carcinogenesis. Our results show an important insight into the impact of betel quid chewing on other sites of the digestive tract other than the oral cavity.

Adult↗
PubMed2005

Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve.

BACKGROUND: The aim of this study was to assess the risk of recurrent laryngeal nerve palsy (RLNP) after thyroidectomy with routine identification of the recurrent laryngeal nerve (RLN) during the operation. METHODS: The present study was confined to 521 patients, 348 total lobectomies and 178 total thyroidectomies, treated by the same surgeon. Temporary and permanent RLNP rates were analyzed for patient groups with stratification of primary operation for benign thyroid disease, thyroid cancer, Graves' disease, and reoperation. Measurement of the RLNP rate was based on the number of nerves at risk. Twenty-six RLNs in 20 thyroid cancer patients with intentional sacrifice were excluded from analysis. RESULTS: Forty RLNs (40 patients) developed postoperative RLNP. Complete recovery of RLN function was documented for 35 of the 37 patients (94.6%) whose RLN integrity had been ensured intraoperatively. Recovery from temporary RLNP ranged from 3 days to 4 months (mean, 30.7 days). Overall incidence of temporary and permanent RLNP was 5.1% and 0.9%, respectively. The rates of temporary/permanent RLNP were 4.0/0.2%, 2.0/0.7%, 12.0/1.1%, and 10.8/8.1% for groups classified according to benign thyroid disease, thyroid cancer, Graves' disease, and reoperation, respectively. CONCLUSIONS: Operations for thyroid cancer, Graves' disease, and recurrent goiter demonstrated significantly higher RLNP rates. Invasion of RLN was identified in 19.4% of patients with thyroid cancer. Postoperatively, the RLN recovered in most of the patients without documented nerve damage during the operation. Total lobectomy with routine RLN identification is recommended as a basic procedure in thyroid operations.

Adolescent↗
PubMed2005

Treatment of laryngeal radionecrosis with hyperbaric oxygen therapy: a case report.

An 81-year-old male with early-stage laryngeal carcinoma had been treated with 60 Gy curative radiotherapy. He complained of a sore throat, foul odor in the mouth, progressive dyspnea, and fever 2 months after the completion of radiotherapy. Direct laryngoscopy revealed narrowing of the glottis with diffuse ulcerative necrotic tissue. Biopsies at multiple sites and pathology revealed intense coagulation necrosis with complete denudation of covering epithelium without any malignancy. Since laryngeal radionecrosis was suspected, the patient received hyperbaric oxygen (HBO) therapy 40 times for 1 hour of 100% O2 at 2 atm absolute pressure. His clinical symptoms gradually improved and repeated endolaryngeal biopsies were undertaken near the end of HBO therapy and again 6 months later. The patient's larynx healed completely with diffuse fibrosis and no malignant cells were found on pathology. Radionecrosis must be differentiated from cancer recurrence following curative radiotherapy for early laryngeal cancer. HBO therapy could be a useful treatment adjunct for laryngeal radionecrosis.

Aged↗
PubMed2004

Risk of vocal palsy after thyroidecitomy with identification of the recurrent laryngeal nerve.

The purpose of this study was to assess the risk of vocal palsy after thyroidectomy with identification of recurrent laryngeal nerve (RLN) during surgery. In all, 521 patients treated by the same surgeon were enrolled in this study. Temporary and permanent vocal palsy rates were analyzed for patient groups classified according to surgery for primary benign thyroid disease, thyroid cancer, Graves' disease, and reoperation. Measurement of the vocal palsy rate was based on the number of nerves at risk. Twenty-six intentionally sacrificed RLNs were excluded from analysis. Forty patients developed postoperative unilateral vocal palsy. Complete recovery of vocal palsy was documented for 35 of the 37 patients (94.6%) whose RLN integrity had been ensured intraoperatively. Recovery from temporary vocal palsy ranged from 3 days to 4 months (mean, 30.7 days). The overall incidences of temporary and permanent vocal palsy were 5.1% and 0.9%, respectively. The rates of temporary/permanent vocal palsy in groups classified according to underlying disease were 4.0%/0.2% for benign thyroid disease, 2.0%/0.7% for thyroid cancer, 12.0%/1.1% for Graves' disease, and 10.8%/8.1% for reoperation. Surgery for thyroid cancer, Graves' disease, and recurrent goiter were associated with significantly higher vocal palsy rates. Most patients without documented nerve damage during the operation recovered from postoperative vocal palsy. Total lobectomy with routine RLN identification is recommended as a basic procedure in thyroid surgery.

Adolescent↗
PubMed2004

Microsurgical pressing excision technique for vocal nodules and simple epithelial hyperplasia of the vocal fold.

Precise bimanual microsurgical excision of sessile, thin benign epithelial lesions of the vocal folds can be difficult. During microlaryngeal surgery, the potential risks of over-excision and under-excision are of major concern. We introduce a microsurgical technique using horizontally-opening curved microforceps and microscissors, instead of the conventional vertically-opening microinstruments, to remove vocal nodules and simple epithelial hyperplasia. The treatment results were satisfactory, with 208 (90.8 per cent) of patients retaining a satisfactory/normal (G(0)) voice. No patient had a worsened voice after the procedure. This microsurgical pressing excision technique is an alternative precise method for microlaryngosurgery.

Epithelium↗
PubMed2003

Prevalence of thyroid cancer in hyperthyroidism treated by surgery.

The reported prevalence of thyroid cancer with concurrent hyperthyroidism varies from 0.21% to 9.0%. This variability may be due to multiple factors, such as indications for surgery and histopathologic accuracy. However, this condition is not rare and its prevalence has increased in recent surveys, perhaps as a result of more detailed examinations. The aim of this retrospective study was to determine the prevalence of thyroid cancer in hyperthyroid patients at surgery. Forty-five patients, 34 women and 11 men, underwent surgery for hyperthyroidism in our department between 1989 and 2000. Ages ranged from 14 to 67 years. There were 42 cases of Graves' disease, one of functional multinodular goiter, and two of single toxic nodules. Forty-three patients underwent total thyroidectomy and two underwent total lobectomy. Six cases (13.3%) of thyroid cancer were found, two men and four women with ages ranging from 19 to 48 years. Final histologic examination revealed three papillary carcinomas, one follicular carcinoma, one follicular carcinoma combined with clear-cell carcinoma, and one clear-cell carcinoma. Thus, in our department, the prevalence of thyroid cancer in hyperthyroidism treated using surgery was 13.3%. Our study showed that even a single toxic nodule may occur with concurrent thyroid cancer. Careful evaluation of such patients is needed to exclude the presence of associated malignancy and to determine the most appropriate therapeutic plan.

Adolescent↗