Shih-An Liu

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.

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.

Laryngeal electromyography and prognosis of unilateral vocal fold paralysis—A long-term prospective study

To confirm the value of using laryngeal electromyography (LEMG) to predict the long‐term prognosis of unilateral vocal fold paralysis (UVFP), and elucidate the adequate timing of LEMG.

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.

Using information technology to reduce the inappropriate use of surgical prophylactic antibiotic

Despite implementation of practical guidelines, continuing education programs in our hospital, the percentage of inappropriate prophylactic antibiotic usage remains high. The aim of this study was to investigate whether information technology can reduce the misuse of surgical prophylactic antibiotic. We started physician continuing education programs in January 2005 and initiated feedback system in July 2005. The computerized reminder system was implemented in April 2006. Relevant data about the surgical prophylactic antibiotic usage were collected and was separated into three groups. Group 1 consisted of data from January 2005 to June 2005, while group 2 and group 3 consisted of data from July 2005 to March 2006 and April 2006 to December 2006, respectively. The percentage of no prophylactic antibiotic in clean procedures and the duration of prophylactic antibiotic in clean-contaminated procedures were recorded and analyzed. Furthermore, the surgical wound infection rates were also collected. In clean procedures, the percentage of no prophylactic antibiotic after surgery decreased in the long run. In parotidectomy, submandibular gland surgery and thyroidectomy patients, the percentage even reached 100% at the end of this study. In clean-contaminated procedures, the duration of prophylactic antibiotic after surgery was also reduced except in laryngectomized patients at the end of this study. Information technology such as feedback and reminder systems is an effective method to reduce inappropriate usage of surgical prophylactic antibiotic.

Somatic mutations in the D-loop of mitochondrial DNA in head and neck squamous cell carcinoma.

The purpose of this study was to characterize somatic mutations in the D‐loop of mitochondrial DNA (mtDNA) and their impact on survival in patients with head and neck cancer.

Prospective, randomized, controlled trial of tranexamic acid in patients who undergo head and neck procedures

Objectives To determine if tranexamic acid could reduce the drainage duration after head and neck procedures. Study Design Prospective, randomized, controlled trial. Methods Patients who underwent head and neck operations were included. The study group was treated with tranexamic acid during the perioperative period whereas the control group received normal saline solution. Blood samples were also collected. Results The study and control groups consisted of 26 and 29 patients, respectively. Although there was a significant difference in the drainage amount between the two groups, (49.7 vs 88.8 mL, P = 0.041), no significant difference could be found in the drainage duration between the two groups (2.69 vs 3.07 days, P = 0.146). There was also no significant difference in the coagulation profiles between the two groups. Conclusion We did not find a meaningful effect in reducing the drainage duration after head and neck procedures with the use of prophylactic tranexamic acid.

Transoral robotic surgery for early T classification hypopharyngeal cancer

For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported.

Impact of somatic mutations in the D-loop of mitochondrial DNA on the survival of oral squamous cell carcinoma patients.

Objectives The aim of this study was to investigate somatic mutations in the D-loop of mitochondrial DNA (mtDNA) and their impact on survival in oral squamous cell carcinoma patients. Materials and Methods Surgical specimen confirmed by pathological examination and corresponding non-cancerous tissues were collected from 120 oral squamous cell carcinoma patients. The sequence in the D-loop of mtDNA from non-cancerous tissues was compared with that from paired cancer samples and any sequence differences were recognized as somatic mutations. Results Somatic mutations in the D-loop of mtDNA were identified in 75 (62.5%) oral squamous cell carcinoma patients and most of them occurred in the poly-C tract. Although there were no significant differences in demographic and tumor-related features between participants with and without somatic mutation, the mutation group had a better survival rate (5 year disease-specific survival rate: 64.0% vs. 43.0%, P = 0.0266). Conclusion Somatic mutation in D-loop of mtDNA was associated with a better survival in oral squamous cell carcinoma patients.

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Transoral robotic surgery (TORS) for early glottic cancer has been reported, but the issue of anterior commissure involvement has seldom been addressed. Therefore, the purpose of this study was to preliminarily report the treatment results of TORS in this disease entity.