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Chih-Feng Tai

Publications and source records attributed to Chih-Feng Tai.

17 recordsLinked to original sources
PubMed2006

Analysis of mastoid findings at surgery to treat middle ear cholesteatoma.

OBJECTIVES: To analyze mastoid findings, such as facial nerve dehiscence (FND), labyrinthine fistula, and dural exposure; to review its incidence at cholesteatoma surgery; to analyze its association with semicircular canal fistula; and to elucidate its relationship with dural exposure. DESIGN: One hundred fifty-two patients (65 males and 87 females; 155 ears) were enrolled in a retrospective study of tympanoplasty with or without mastoidectomy. SETTING: Medical university center hospital. RESULTS: The incidence of FND after exenteration of disease was 29.7% (46/155 ears) for total surgical procedures, 29.7% (43/145 ears) for initial procedures, and 30% (3/10 ears) for revision procedures. The prevalence of FND in the tympanic segment only was 87%, with 8.7% in the vertical segment only and 4.3% in both segments. Three patients (2.0%) developed facial palsy postoperatively, with 8 lateral semicircular canal fistulas (5.2% of total ears operated on), half of these with concomitant FND. The incidence of dural exposure of the mastoid tegmen in the entire surgical group was 16.8% (26 ears), 38.5% with concomitant FND. CONCLUSIONS: The overall incidence of FND in our sample was high at 29.7%, with rates of lateral semicircular canal fistula and dural exposure of 5.2% and 16.8%, respectively. The relationship between FND incidence and presence of lateral semicircular canal fistula was positive in our study. The surgeon should bear in mind that the location of FND with cholesteatoma coincides with the most common area of iatrogenic facial nerve injury during otologic surgery.

Adolescent↗
PubMed2006

Huge Thornwaldt's cyst: a case report.

Thornwaldt's bursa, also known as nasopharyngeal bursa, is a recess in the midline of the nasopharynx that is produced by persistent notochord remnants. If its opening becomes obstructed, possibly due to infection or a complication from adenoidectomy, a Thornwaldt's cyst might develop. Here, we present a 53-year-old man who complained of nasal obstruction that had progressed for 1 year. Nasopharyngoscopy showed a huge nasopharyngeal mass. Thornwaldt's cyst was suspected. Magnetic resonance imaging showed a lesion measuring 3.6 x 3.4 cm, intermediate on T1-weighted and high signal intensity on T2-weighted imaging, neither bony destruction nor connection to the brain. The patient underwent endoscopic surgery for this huge mass. Afterwards, his symptoms improved significantly. We present the treatment and differential diagnosis of a nasopharyngeal cyst.

Cysts↗
PubMed2006

The prognostic value of proliferating cell nuclear antigen (PCNA) and p53 protein expression in patients with advanced nasopharyngeal carcinoma.

CONCLUSION: p53 protein and proliferating cell nuclear antigen (PCNA) were not ideal prognostic indicators in advanced nasopharyngeal carcinoma (NPC). Further investigation in searching for other potential biomarkers is needed to enhance the prediction of treatment outcome. OBJECTIVE: To assess the prognostic significance of p53 protein and PCNA expression in patients with advanced NPC. PATIENTS AND METHODS: This study included 46 patients with advanced NPC who had received treatment and regular follow-up for at least 5 years. We used immunohistochemistry (IHC) staining to assess p53 protein expression and PCNA labeling index, and correlate them with pathological subtypes, TNM stage, the presence of locoregional recurrence, and 5-year survival rate. RESULTS: p53 nuclear staining was positive in 32 patients (69.6%). All cases had positive PCNA nuclear staining with labeling index (LI) ranging from 6.5% to 92.9% (mean 53.4%). Only advanced T stage was found to be associated with high PCNA LI. Overexpression of p53 and PCNA LI had no impact on 5-year survival in this study group.

Adult↗
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

Giant rhinolith: a case report.

A rhinolith is a stone that forms in the nose. It occurs as a result of the solidification of mucus and nasal debris by mineral salts, calcium, magnesium phosphate and carbonate. It can be seen on radiographs as a radiopaque object in the nasal fossa and may be confused with several pathologic entities that will call for more invasive surgical procedures. We present the first case of a giant rhinolith, possibly arising from aspergillosis, and discuss its clinical and radiologic features.

Aspergillosis↗
PubMed2005

Nasal septum chondroma: a case report.

Chondromas of the nasal septum are rare. Since its first literary description in 1842, only about 140 cases have been reported. We present the case of a 38-year-old female who reported intermittent nasal bleeding and nasal obstruction for 3 months. A reddish mass arising from the nasal septum was found by endoscope. The tumor was removed under endoscopic guidance and histopathologic examination revealed chondroma composed of well-differentiated chondrocytes. No recurrence was noticed after 6 months of follow-up. Despite their rarity, chondromas should be taken into consideration in the differential diagnosis of nasal tumors, especially those arising from the nasal septum.

Adult↗
PubMed2004

Neuropathology in rhinosinusitis.

Pathophysiologic differences in neural responses to hypertonic saline (HTS) were investigated in subjects with acute sinusitis (n = 25), subjects with chronic fatigue syndrome (CFS) with nonallergic rhinitis (n = 14), subjects with active allergic rhinitis (AR; n = 17), and normal (n = 20) subjects. Increasing strengths of HTS were sprayed into their nostrils at 5-minute intervals. Sensations of nasal pain, blockage, and drip increased with concentration and were significantly elevated above normal. These parallels suggested activation of similar subsets of afferent neurons. Urea and lysozyme secretion were dose dependent in all groups, suggesting that serous cell exocytosis was one source of urea after neural stimulation. Only AR and normal groups had mucin dose responses and correlations between symptoms and lysozyme secretion (R(2) = 0.12-0.23). The lysozyme dose responses may represent axon responses in these groups. The neurogenic stimulus did not alter albumin (vascular) exudation in any group. Albumin and mucin concentrations were correlated in sinusitis, suggesting that nonneurogenic factors predominated in sinusitis mucous hypersecretion. CFS had neural hypersensitivity (pain) but reduced serous cell secretion. HTS nasal provocations identified significant, unique patterns of neural and mucosal dysregulation in each rhinosinusitis syndrome.

Acute Disease↗
PubMed2004

Chlorine inhalation produces nasal airflow limitation in allergic rhinitic subjects without evidence of neuropeptide release.

BACKGROUND: Seasonal allergic rhinitic (SAR) subjects are more physiologically reactive to airborne irritants than non-rhinitic (NR) subjects; however the mechanism underlying this difference is unclear. OBJECTIVE: We sought to determine whether irritant-induced nasal airflow limitation involves neuropeptide release into nasal lining fluid, and if so, whether such release occurs differentially by rhinitic status. METHODS: Eight SAR and 8 NR subjects were exposed to 1.0 ppm chlorine and filtered air in random order during separate visits; exposures were via nasal mask and lasted 15 min. Rhinomanometry was performed before, immediately post-, and 15 min post-exposure. Following a minimum of 2 weeks' time, exposures and symptom reporting were repeated with nasal lavage pre- and post-exposure. Neuropeptides (substance P, cacitonin gene-related protein, vasoactive intestinal peptide, and neuropeptide Y) as well as markers of plasma leakage (albumin and urea) and glandular secretion (lysozyme and 7F10-mucin) were measured using standard methods. RESULTS: Cl(2) provocation significantly increased nasal airway resistance in SAR but not NR subjects (p<0.05). Neuropeptide levels in nasal lavage fluid, on the other hand, were unaffected, with the exception of a paradoxical increase in vasoactive intestinal peptide in non-rhinitic controls post-Cl(2) provocation. CONCLUSIONS: Irritant-induced nasal airflow limitation is more pronounced among SAR than NR subjects. We could not, however, demonstrate a role for neuropeptide release in the nasal congestive response of SAR subjects.

Administration, Inhalation↗
PubMed2004

Multiple symmetric lipomatosis (Madelung's disease): report of two cases.

Multiple symmetric lipomatosis (Madelung's disease) is a rare disease characterized by non-encapsulated adipose deposits in the neck, the superior part of the trunk and, very rarely, in the limbs. It is common in middle-aged Caucasian Mediterranean males but very rare in Chinese people. We describe two cases of Madelung's disease: both patients presented complaining of a development of a painless neck mass that was increasing in size. Panendoscopy was normal. Both underwent incisional biopsies that revealed benign adipose tissue characterizing Madelung's disease. We discuss the clinical presentation, associated morbidity, and treatments for Madelung's disease.

Adult↗
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↗
PubMed2003

A tale of two neurons in the upper airways: pain versus itch.

Pain and itch sensations are induced by depolarization of distinct populations of unmyelinated type C, and possibly other, neurons. Both sets of neurons and sensations serve critical protective mechanisms that maintain the integrity and patency of the upper airways. When noxious or pruritic stimuli are applied on the afferent nerve ending, pain and itch are appreciated at the thalamic and parietal cortex. In the mucosa, this neuronal depolarization spreads via the peripheral efferent axon response mechanism. Neuropeptides such as substance P and calcitonin gene-related peptide are released from neurosecretory varicosities on the nociceptive C fibers. The exact functions of axon responses differ between humans and rodents, and in health and disease. Separate itch- and pain-specific peripheral type C fibers, secondary relay interneurons in the spinal cord dorsal horn, anatomical locations in the lateral spinothalamic tract, and thalamic nuclei demonstrate that all nociceptive nerves are not the same. Other types of irritant-sensitive trigeminal neurons might be discovered that could mediate other unique sensations, specific axon responses, or central nervous system functions.

Axons↗
PubMed2002

Upper airway neurogenic mechanisms.

Stimulation of the nasal sensory nerves leads to sensations of pain and stuffiness. Type C nociceptive nerve releases neuropeptides including substance P and calcitonin gene related peptides that increase plasma extravasation and glandular secretion. This axonal response acts as an immediate protective mucosal defense mechanism. Recruited parasympathetic reflexes cause submucosal gland secretion via acetylcholine and muscarinic M(3) receptors. Itching, sneezing, and other avoidance behaviors rapidly clear the offending agents from the upper airways and protect the lower airways. Dysfunction of these nerves may contribute to allergic rhinitis, infectious rhinitis, nasal hyperresponsiveness, and possibly sinusitis. Sympathetic arterial vasoconstriction reduces mucosal blood flow, sinusoidal filling, and mucosal thickness, and so restores nasal patency. Loss of sympathetic tone may contribute to some chronic, nonallergic rhinopathies. Human axon responses differ from those in animals, an important distinction that limits extrapolation from other species.

Animals↗
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↗