Biomedical subjects

Min-Tsan Shu

Publications and source records attributed to Min-Tsan Shu.

4 recordsLinked to original sources

PubMed2006

Squamous cell carcinoma in situ of the external auditory canal.

We report two cases of carcinoma in situ in the external auditory canal (EAC), presenting with symptoms such as pain, long-term itching of the ear, easy contact bleeding, canal otorrhea and hearing loss. Otoscopic examination revealed granulation tissue and a greyish-black tumour with irregular surface. The first patient had previously been diagnosed with otitis externa with persistent ear itching for the past three years. The second patient had received tympanoplasty for treatment of chronic otitis media on the right ear ten years ago. The first case was treated with wide excision, whereas the second patient received resection of the skin of the EAC together with its adjacent soft tissue, followed by skin grafting. No tumour recurrence was noted in the fourth and third post-operative year for the first and second patient respectively. We suggest that EAC carcinoma can be detected early and treated.

Adult↗

PubMed2005

Comparison of hearing screening programs between one step with transient evoked otoacoustic emissions (TEOAE) and two steps with TEOAE and automated auditory brainstem response.

OBJECTIVE: To compare the efficacy between one step with transient evoked otoacoustic emissions (TEOAE) and two steps with TEOAE and automated auditory brainstem response (AABR) in a newborn hearing screening program. We investigated their differences in referral rate, the accurate identification rate of congenital hearing loss (HL), and cost effectiveness. METHOD: From November 1998 to December 2004, a total of 21,273 healthy newborns were screened for HL in Mackay Memorial Hospital, Taipei. In the periods from November 1998 to January 2004 and from February 2004 to December 2004, the screening tools used were TEOAE alone (n = 18,260) and TEOAE plus AABR (n = 3,013), respectively. RESULTS: A statistically significant decrease of referral rate was achieved in the group using TEOAE and AABR as screening tools when compared with TEOAE alone (1.8% vs. 5.8%). The accurate identification rate of congenital HL was 0.45% in TEOAE protocol and 0.3% in TEOAE and AABR protocol, which was not statistically significant. The total direct costs per screening were 10.1 U.S. dollars for the program using TEOAE alone and 8.9 U.S. dollars for the TEOAE plus AABR program. The intangible cost, however, was much higher in the earlier program because of the higher referral rate. CONCLUSION: In terms of the efficacy of a hearing screening program using the one step TEOAE and two step TEOAE and AABR programs, the later significantly decreased the referral rate from 5.8% to 1.8%. No significant difference was noted between the accurate identification rates of congenital HL. The total costs, including expenditures and intangible cost, were lower in the protocol with TEOAE plus AABR.

Cost-Benefit Analysis↗

PubMed2004

Effectiveness of intratympanic dexamethasone injection in sudden-deafness patients as salvage treatment.

OBJECTIVE: To study the effectiveness of intratympanic dexamethasone (IT-DEX) in patients with severe or profound sudden sensorineural hearing loss (SSNHL) after treatment failure with conventional therapy. STUDY DESIGN: Randomized, controlled study. METHODS: Patients who met the criteria for SSNHL, with a severity of severe to profound, underwent 10 days of standard treatment with oral steroid and other facilitating agents. Patients showing poor response to standard treatment were assigned randomly to a control group or to a group receiving IT-DEX. IT-DEX injections were performed once a week for 3 consecutive weeks. Pure-tone audiometry was obtained before each injection. Minimum follow-up time was 1 month. Successful treatment was defined as a hearing improvement of greater than 30 dB. RESULTS: Thirty-nine patients meeting the inclusion criteria were studied. After treatment with oral steroid, 10 of 39 (26%) patients demonstrated hearing improvement, whereas the remaining 29 (74%) patients showed a hearing improvement of less than 30 dB. For those without hearing improvement, 15 received IT-DEX, and 14 received further standard treatment (except oral steroid and carbogen inhalation). Hearing improved in 8 of 15 (53.3%) compared with 1 of 14 (7.1%), with an average decrease in threshold of 28.4 dB and 13.2 dB for the IT-DEX group and the control group, respectively (P <.05). Prognostic factors such as age, treatment delay time, and sex did not significantly affect the response to therapy. CONCLUSIONS: IT-DEX injection effectively improves hearing in patients with severe or profound SSNHL after treatment failure with standard therapy and is not associated with major side effects. It is therefore a reasonable alternative as salvage treatment.

Adolescent↗

PubMed2002

A universal newborn hearing screening program in Taiwan.

OBJECTIVE: Mackay Memorial Hospital and the Children's Hearing Foundation established a pilot universal newborn hearing screening program in November 1998. Our objective was to assess the feasibility, accuracy and cost effectiveness of implementing universal newborn hearing screening in Taiwan. METHOD: Between November 1998 and October 2000 a total of 6765 newborns were screened for hearing loss prior to discharge from the wellborn nursery at Mackay Memorial Hospital. The average age of the subjects at the initial screening test was 52 h. The program employed a three stage hearing screening protocol using transient evoked otoacoustic emmisions (TEOAE) screening with referral for diagnostic auditory brainstem response assessment. RESULTS: The mean TEOAE screening time per ear was 41.43 s. The overall pass rate at the time of hospital discharge was 93.6%. Thus achieving an acceptable referral rate of 6.4% for diagnostic audiological assessments. Nine newborns were identified with permanent bilateral hearing impairment. 26 newborns were identified with permanent unilateral hearing impairment. Infants identified with bilateral hearing loss were immediately referred to the Children's Hearing Foundation for hearing aid assessment and fitting. Infants as young as 5 weeks of age were successfully fitted with hearing instruments and enrolled in the family centered early intervention program at the Children's Hearing Foundation. CONCLUSION: The frequency of bilateral congenital hearing loss requiring amplification in this population is shown to be approximately 1 in 752 newborns. This finding is consistent with previous research, which has indicated hearing loss to be the most frequently occurring birth defect. Universal newborn hearing screening using TEOAEs proved to be a cost effective and feasible method of identifying congenital hearing loss in Taiwan. The existence of many successful screening programs worldwide and the availability of fast, objective, reliable and inexpensive hearing screening procedures means that universal newborn hearing screening is becoming the standard of care.

Acoustic Stimulation↗