Ching-Ping Wang

Nutritional factors and survival of patients with oral cancer.

Our objective was to determine the survival rate of patients with oral cancer who were treated at a medical center in central Taiwan. Furthermore, we attempted to investigate whether nutritional factors influence the survival.

Risk factors for wound infection after surgery in primary oral cavity cancer patients.

Objectives: Few studies have discussed the predictive factors of surgical wound infection (WI) in primary oral cavity cancer patients. Therefore, we aimed to determine the relevant factors associated with postoperative WI in a large group of patients with oral cavity cancers.

Laryngeal tuberculosis: a review of 26 cases.

Objectives To review the clinical characteristics of laryn-geal tuberculosis. Study Design Retrospective case series. Subjects and Methods Medical records of 26 histopa-thology-confirmed cases in a tertiary medical center from 1992 to 2006. Results The female patients were significantly younger than male patients. Hoarseness is the most common symptom (84.6%) because true vocal fold is most commonly involved (80.8%). Infection usually involves unilateral (66.7%) and right-side larynx but multiple subsites of the larynx (57.7%). The appearance of the affected larynx may have mixed features and change before diagnosis. Laryngeal tuberculosis is usually misdiagnosed as laryngeal cancer, especially in patients with malignant signs such as enlarged cervical lymph nodes and vocal fold immobility. Chest film is better than sputum examinations for screening. Conclusion We should be especially alert about TB infection when facing young female patients with unusual laryngeal lesions. Extensive laser excision before diagnosis should be avoided because after antituberculous treatment, prognosis is usually good and vocal fold immobility could be reversible.

Carotid blowout in patients with head and neck cancer: Associated factors and treatment outcomes

The purpose of this study was to investigate factors associated with carotid blowout in the cervical portion of patients with head and neck cancer in a large cohort.

Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injection for Unilateral Vocal Fold Paralysis—Preliminary Results

OBJECTIVES The purpose of this study is to investigate the feasibility of using an injectable needle electrode to guide hyaluronic acid (HA) vocal fold injection (VFI) during laryngeal electromyography (LEMG) for unilateral vocal fold paralysis (UVFP). STUDY DESIGN Prospective study. METHODS From March to June 2010, 20 UVFP patients received LEMG examination at our clinic. Before completion of LEMG, 1.0 cc of HA (Restylane Perlane(®); Q-Med, Uppsala, Sweden) was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscle. After injection, 20 patients completed 3-months follow-up and 16 patients completed 6-months follow-up. The data before, 1 week, 3 months, and 6 months after injection, including the normalized glottal gap area (NGGA) from videostroboscopy, maximal phonation time (MPT), mean airflow rate (MAFR), phonation quotient (PQ), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain [GRBAS] scale), Voice Handicap Index (VHI), and self-grading of choking (grade 1-7), were analyzed by the Wilcoxon signed rank test. RESULTS All of the patients completed the procedure without complications. After injection, mean NGGA was significantly reduced from 8.28 units to 0.52 units (1 week), 1.79 units (3 months), and 1.36 units (6 months). The mean MPT was prolonged from 5.66 seconds to 11.73, 11.25, and 11.93 seconds, respectively. VHI was reduced from 76.05 to 38.10, 37.40 and 35.00, respectively. Other analyzed data (PQ, MAFR, GRBAS scale, and choking severity) also showed statistically significant improvement. CONCLUSION LEMG-guided HA VFI provides UVFP patients with neuromuscular function evaluation and treatment in one step. This clinical technique is feasible, and the short-term results are satisfactory.

Osteoradionecrosis of mandible bone in patients with oral cancer—associated factors and treatment outcomes

The purpose of this study was to investigate factors associated with osteoradionecrosis (ORN) of the mandible bone in a large cohort of patients with oral cancer.

Survival analysis of patients with oral squamous cell carcinoma with simultaneous second primary tumors

The purpose of this study was to investigate the rate of simultaneous second primary tumor (SPT) in patients with oral squamous cell carcinoma. The survival of patients with simultaneous SPT was also compared with patients without.

Cervical Sympathetic Chain Schwannoma

Schwannomas are benign, slow-growing tumors that arise from Schwann cells of the nerve sheath. Those originating from the sympathetic cervical chain are rare. Herein, we present three cases of cervical sympathetic chain schwannoma (CSCS) and describe our experience with the clinical presentation, surgical management, and outcomes of patients with this pathology. All three patients were found to have a pulsatile, non-tender mass located at the level of the angle of the mandible without cervical nerve function deficit. On imaging study, the location of the mass between the prevertebral muscle and carotid artery with outward displacement of the carotid sheath is a typical characteristic of CSCS. Operative excision and sacrifice of a portion of the sympathetic chain remains the treatment of choice. Postoperative Horners syndrome is predictable and vagus nerve dysfunction or first bite syndrome is also possible.

Surgical site infection after preoperative neoadjuvant chemotherapy in patients with locally advanced oral squamous cell carcinoma

We investigated whether preoperative neoadjuvant chemotherapy is associated with increased surgical site infection (SSI) rate in patients with locally advanced oral cancer.

Castleman's Disease of the Neck

Castlemans disease is an uncommon benign disease of unknown etiology that induces reactive lymph node hyperplasia. There are 2 histologic subtypes of Castlemans disease: hyaline vascular type and plasma cell type. Tissue biopsy is necessary for a definitive diagnosis. Castlemans disease of the neck occurs rarely. On reviewing the literature, most Castlemans disease of the neck presented with a single mass. We report here an 80-year-old man with 2 neck masses of 1 years duration. A 4-cm firm movable mass in the left submandibular area and another 2-cm firm movable mass in the left level IV area were noted. The patient was diagnosed with Castlemans disease of the neck after resection of 1 of the masses. There was no evidence of progression or recurrence of the disease after 21 months of follow-up. We suggest that this was a rare case of multicentric cervical Castlemans disease.