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Ling-Feng Wang

Publications and source records attributed to Ling-Feng Wang.

34 records · Page 2Linked to original sources
PubMed2004

Schwannoma of the nasal septum: a case report.

Schwannoma is a neurogenic tumor arising from the sheath of myelinated nerves. Only 4% of schwannomas located in the head and neck region involve the sinonasal tract, and those arising from the nasal septum are exceedingly rare. We report a case of a 55-year-old male who presented with only right nasal obstruction. Computerized tomography and clinical examination suggested a benign tumor before the tumor was completely removed by transnasal endoscopic surgery. When encountering a mass in the nasal cavity, schwannoma should be borne in mind in the differential diagnosis. We discuss the clinical presentation, histologic features, differential diagnosis, and therapeutic options for such a rare lesion.

Diagnosis, Differential↗
PubMed2004

Cerebral radionecrosis with cystic degeneration following radiotherapy for nasal cavity squamous cell carcinoma: a case report.

A 31-year-old man with nasal cavity squamous cell carcinoma was treated in our hospital with two courses of radiotherapy (120 Gy total dose) followed by surgical tumor resection. Three years after the last irradiation, he developed seizures as well as changes in behavior and consciousness. Medical therapy with diphenylhydantoin (Dilantin) terminated the seizures. Dysphagia, unsteady gait, and right-side limb weakness developed 37 months after the onset of seizures. Magnetic resonance imaging showed a large, cystic mass in the left temporal lobe with left to right midline shift. Following craniotomy with decompression of the cystic mass, the patient improved clinically. No malignant cells were found in the specimen. No further progression of neurologic symptoms was noted after a 1-year follow-up. Cerebral radionecrosis is an uncommon late complication of radiotherapy and needs to be differentiated from tumor recurrence or metastasis if the irradiation field covers the cerebral region in patients with head and neck malignancies.

Adult↗
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

A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy.

OBJECTIVE: To study the long-term sensorineural hearing status after radiotherapy in patients suffering from nasopharyngeal carcinoma. STUDY DESIGN: A prospective study of 220 patients (395 ears) with a median follow-up of 36 months. SETTING: A university hospital. PATIENTS: Four criteria were needed. The patient had to have had at least 12 months of audiologic follow-up, no concurrent chronic ear disease, no direct tumor invasion of ear, and no significant sensorineural hearing loss before radiotherapy. INTERVENTION: Pure-tone audiography and impedance audiometry-which were performed before and at the third month after completion of radiotherapy and at a yearly interval thereafter-formed the basis of the study. MAIN OUTCOME MEASURES: The significance level in this study was defined as a bone conduction threshold increase of more than 10 dB between the initial audiogram and those obtained after the completion of radiotherapy. An increase of more than 30 dB was defined as severe loss. RESULTS: Paired t test indicated that the mean bone conduction threshold before and after radiotherapy were significantly different (paired t test, p < 0.05). Logistic regression showed that patient age was related to the significant loss at speech frequency but not to the loss at 4 kHz. The presence of postradiation otitis media with effusion, preirradiation hearing status, and addition of chemotherapy were found to be not influential on hearing change. CONCLUSION: Hearing deterioration may begin as early as 3 months after the completion of radiotherapy. Early change may be transient, but the effect of radiation on hearing tended to be chronic and progressive.

Acoustic Impedance Tests↗
PubMed2004

Deroofing surgical treatment for pseudocyst of the auricle.

OBJECTIVES: Pseudocyst of the auricle is characterized by asymptomatic swelling caused by an intracartilaginous accumulation of fluid. If left untreated, permanent deformity of the pinna may occur. Many modalities of treatment have been reported, but problems regarding recurrence and appearance remain. The purpose of this study was to introduce more reliable treatment for pseudocyst of the auricle. DESIGN: Retrospective chart review. SETTING: Department of Otolaryngology, Kaohsiung Medical University, Kaohsiung, Taiwan. METHODS: The population used for the present report consisted of 10 patients with auricular pseudocyst that was unresponsive to aspiration followed by intralesional steroid injection or who declined conservative treatment. All patients were treated surgically with the deroofing method under local anaesthesia. MAIN OUTCOME MEASURES: Postoperative clinical outcome and recurrence of the lesion. RESULTS: All patients had excellent cosmetic outcomes, and no recurrence or complication occurred. CONCLUSIONS: Deroofing surgery for pseudocyst of the auricle is a safe, easy, and reliable procedure. If conservative measures fail or are declined by the patient, removal of the anterior cartilaginous leaflet of the lesion is an alternative method that can yield excellent results.

Adult↗
PubMed2003

Hearing loss in patients with nasopharyngeal carcinoma after chemotherapy and radiation.

In light of the possible adverse effects of radiation on hearing, we conducted a study to evaluate the long-term sensorineural hearing status following radiotherapy (RT) in patients suffering from nasopharyngeal carcinoma. Audiologic examinations were performed at regular intervals before and after RT. We also analyzed the effects of age, chemotherapy, pre-RT hearing status, and post-RT otitis media with effusion (OME) on post-RT hearing change. A total of 150 patients (261 ears) were enrolled in this study and followed up for a mean of 43.8 months. After RT, 8.9-28.8% of ears had at least a 10 dB loss in bone conduction threshold at speech frequency, which was defined as an average of hearing threshold at 0.5 kHz, 1 kHz, and 2 kHz, while the percentage was 18-34.2% at 4 kHz. Patient age was related to these changes at speech frequency, and the presence of post-RT OME was related to significant loss at both speech frequency and 4 kHz. Pre-RT hearing status and chemotherapy did not influence hearing change. To sum up, sensorineural hearing loss began as early as after completion of RT. Early changes may be transient, but the effect of radiation on hearing tended to be chronic and progressive.

Adolescent↗
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↗
PubMed2003

Expression of epidermal growth factor receptor in human middle ear cholesteatoma.

Middle ear cholesteatoma is destructive to auditory ossicles and temporal bone, and treatment usually includes surgical removal of all epithelial content in the tympanomastoid cavity. Epidermal growth factor receptor (EGFR) is a 170 kd to 180 kd transmembrane glycoprotein and its distribution density is related to the ability of the keratinocytes to differentiate and their state of differentiation. We used the avidin-biotin complex technique and EGFR monoclonal antibody to evaluate the expression of EGFR in 29 cases of cholesteatoma and 34 samples of normal postauricular skin. Of patients with cholesteatoma, 79% (23 cases) had EGFR-positive cells in the basal layer, 66% (19 cases) in the parabasal layer, and 62% (18 cases) in the upper layer of the epithelial tissue. Among patients with normal postauricular skin, 85% (29 cases) had EGFR-positive cells in the basal layer, 79% (27 cases) in the parabasal layer, and 79% (27 cases) in the upper layer of the epithelial tissue. No statistical difference in EGFR expression between each layer of cholesteatoma and postauricular skin was noted. However, there was an intensity gradient of positive EGFR immunoreactivity from the basal to the higher layers in cholesteatoma. Our results showed that the distribution of EGFR in middle ear cholesteatoma is not deranged, but is similar to that in normal skin tissue.

Adult↗
PubMed2003

Sinonasal NK/T-cell lymphoma with upper gastrointestinal bleeding: a case report.

Natural killer (NK)/T-cell lymphoma is the most common malignant lymphoma among sinonasal lymphomas. Diagnosis is difficult and prognosis is poor. Herein, we report the case of a 22-year-old male patient with sinonasal NK/T-cell lymphoma who first presented with nasal obstruction and left facial swelling. There was a mushroom-like mass over the hard palate, diffuse mucosal swelling in the left nasal cavity, and left orbital cellulitis. The patient underwent a Caldwell-Luc operation, functional endoscopic sinus surgery, and wide excision of the palate tumor. Pathologic examination of the maxillary sinus, nasal cavity, and palate tumor showed an NK/T-cell lymphoma. Two days after the operation, the patient suddenly had bloody stool and suffered hematemesis. A series of examinations revealed a small intestinal hemorrhage. Emergent exploratory laparotomy showed an ulcerative tumor mass with bleeding over the jejunum. Pathologic examination of the mass showed that it was the same as the sinonasal mass, an NK/T-cell lymphoma. We reviewed previous studies on nasal NK/T-cell lymphoma and found no report discussing patients with NK/T-cell lymphoma of both nasal and non-nasal origins. From this case, we learned that in patients with sinonasal NK/T-cell lymphoma, other sites may be involved.

Adult↗
PubMed2002

Space infection of the head and neck.

Deep neck infection may be lethal, especially when life-threatening complications occur. We conducted a retrospective analysis of 184 patients with deep neck infection who were treated at Kaohsiung Medical University Hospital during the past 6 years. Factors such as age, sex, hospitalization days, clinical presentations, involved spaces, imaging studies, microbiology, and treatment method were analyzed. There were 122 men and 62 women with a mean age of 41.7 years. The average hospitalization was 8.4 days. The involved spaces, determined by physical examination and radiologic findings, were the peritonsillar space (59 patients), parapharyngeal space (77 patients), submandibular space (55 patients), and retropharyngeal space (20 patients). Of the 49 patients for whom the origin of infection was identified, 29 were infected via the upper respiratory tract and 13 had infection of odontogenic origin. The most common isolated organism was Klebsiella pneumoniae. One hundred and thirty-seven patients (74.5%) underwent surgery, including repeated needle aspiration (87 patients) and surgical drainage (50 patients). The remaining 47 patients recovered uneventfully with antibiotic therapy alone. Eighteen patients developed life-threatening complications, such as descending mediastinitis, sepsis, airway obstruction, and jugular vein thrombosis. Two patients died of septic shock. The combination of accurate diagnosis, effective antibiotic therapy, airway maintenance, and intensive surgical debridement for those who fail to respond to conservative treatment will lead to a good prognosis.

Adolescent↗
PubMed2002

Foreign-body-induced otitis media: a case report.

Unilateral ear discharge is one of the usual complaints of the patients who visited the otolaryngology clinics, especially those patients who suffered from external or middle ear disease. We present a 33-year-old female patient who suffered from persistent ear discharge of the left ear. The local findings showed a yellowish to greenish discharge and fetid odor from her left ear canal, occupied by a large amount of granulation tissue. Wide removal of the diseased granulation tissue and tympanoplasty were performed in the patient. Four pieces of cotton were found in the external auditory canal and middle ear cavity during the operation. For more than 2 years of follow-up at our clinic, the patient has had a dry ear and her hearing ability also improved. Foreign-body-induced otitis media in adults is very rare. Therefore, we present this rare case and review the reported literature so that the clinical symptoms and signs, imaging findings, clinical treatment, prognosis, and hearing change in foreign-body-induced otitis media may be recognized and understood.

Adult↗
PubMedDate not supplied

Aspergillosis: a nidus of maxillary antrolith.

We present a case of polypoid sinusitis with maxillary sinus antrolith, which is composed of Aspergillus species. Unlike most muddy or necrotic fungal balls, this first reported fungal antrolith is solid and extremely hard. Aspergillus served as a central fungal nidus associated with long-standing sinusitis, and poor sinus drainage could be a possible pathophysiology for the formation of a sinus stone. Aspergillosis infection should be considered in the differential diagnosis of a radiopaque paranasal sinus lesion. The endoscopic sinus surgery can be a reliable and minimally invasive method not only for the removal of the stone, but also for the restoration of ventilation and drainage of the diseased sinus.

Aspergillosis↗
PubMedDate not supplied

Correlation between proliferating cell nuclear antigen and p53 protein expression and 5-year survival rate in nasopharyngeal carcinoma.

PURPOSE: To assess the prognostic significance of p53 protein and proliferating cell nuclear antigen (PCNA) expression in nasopharyngeal carcinoma. MATERIALS AND METHODS: This study included 79 patients who had received treatment and regular follow-up for at least 5 years at a single institute. We used immunohistochemistry staining to assess p53 protein expression and PCNA labeling index (LI). Analyses were conducted on the association between each of the 2 biomarkers and pathological subtypes, TNM stage, the presence of locoregional recurrence, and 5-year survival rate. RESULTS: p53 protein nuclear staining was positive in 49 patients (62%). The mean PCNA LI was 55.6%, ranging from 3.35% to 92.9%. High PCNA LI (>55.6%) might contribute to higher 5-year survival rate, but it did not reach statistical significance (P = .09). Positive p53 protein staining and low PCNA LI were associated with the presence of locoregional recurrence. No statistical significance was found between p53 protein expression and PCNA LI and pathological subtypes and TNM stage. CONCLUSION: p53 protein and PCNA LI were not an ideal prognostic indicator in predicting 5-year survival rate in nasopharyngeal carcinoma. Future work will direct toward searching for other potential biomarkers with the hope to reinforce prediction of prognosis.

Adolescent↗
PubMedDate not supplied

Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases.

PURPOSE: The incidence of deep cervical space infections has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. In this article, we try to find out whether there are predisposing factors related to complicated deep cervical space infections and prolonged hospitalization. MATERIALS AND METHODS: We conducted a retrospective analysis of medical records of 196 patients with deep neck infections during the period from March 1996 to February 2002. Among the 196 patients, 15 patients developed lethal complications. As for data analysis, multiple regression and logistic regression with dummy variable were used. RESULTS: In multiple regressions, patients with older age or with neck swelling, trismus, underlying diseases, complications, and C-reactive protein more than 100 microg/mL stayed longer in the hospital, and the P value reached statistical significance (P <.05). In logistic regression, male patients and patients with neck pain had negative correlation, and the P value reached statistical significance (P <.05). Patients with neck swelling and patients with respiratory difficulty had positive correlation, and the P value reached statistical significance (P <.05). That means female patients, patients with neck swelling, and patients with respiratory difficulty were more likely to have complicated deep neck infections. CONCLUSION: Complicated deep neck infections remain potentially fatal, but the morbidity and mortality can be reduced. Doctors should pay more attention to those high-risk patients; they are female patients, patients with neck swelling, and patients with respiratory difficulty.

Adolescent↗