Hsin-Ching Lin's research while affiliated with Chang Gung Memorial Hospital and other places

Publications (118)

Article
Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International C...
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Objective: To determine the presence of lower urinary tract symptoms (LUTS), and overactive bladder (OAB) symptoms in men with obstructive sleep apnea/hypopnea syndrome (OSA) and the effects of transoral robotic surgery (TORS) for the treatment of OSA on these conditions. Materials and methods: One hundred twenty-three patients with a diagnosis...
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Purpose: Obstructive sleep apnea/hypopnea syndrome (OSA) results in repeated oxygen desaturation, repeated arousals, and episodic nocturnal activation of sympathetic nervous system during sleep. Untreated OSA is strongly associated with an increase of cardio- and cerebrovascular disorders, as well as the damages of ophthalmological microstructures...
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Objective To compare the cardio- and cerebrovascular outcomes and survival rates of surgical and nonsurgical interventions for patients with obstructive sleep apnea (OSA) based on a national population-based database. Study Design Retrospective cohort study. Setting Taiwan National Health Insurance Research Database. Methods We analyzed all case...
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Objectives To perform an updated systematic review for determining the surgical success rate of multilevel upper airway surgery for patients with obstructive sleep apnea/hypopnea syndrome (OSA). Methods A systematic review was performed to identify English-language studies that evaluated the treatment of adult OSA patients with multilevel OSA surg...
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The aim of this study is to determine the roles of global histone acetylation (Ac)/methylation (me), their modifying enzymes, and gene-specific histone enrichment in obstructive sleep apnea (OSA). Global histone modifications, and their modifying enzyme expressions were assessed in peripheral blood mononuclear cells from 56 patients with OSA and 16...
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Background: Unequal access to healthcare is a global medical problem. Telemedicine, recently made possible by technological advances, may mitigate this inequity. However, the usefulness of telemedicine for procedure-driven disciplines, such as otolaryngology, under infectious conditions (e.g., the COVID-19 pandemic) is unknown. Methods: Telemedi...
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Background Most previous studies reported there were higher survival rates if low birth weight babies were born in tertiary perinatal centers (inborn) than elsewhere (outborn). The objective of this study is to examine whether the number and ratio of outborn babies decrease and the neonatal mortality differs between inborn and outborn babies. Meth...
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Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies such as oral appliance, sleep hygiene and sleep positioning may help some of these pat...
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This retrospective study aimed at identifying the predictors of oxygen desaturation (OD) (i.e., SpO2 < 95%) in patients with obstructive sleep apnea (OSA) requiring deep sedation and developing an algorithm to predict OD.We studied 66 OSA patients undergoing propofol-induced deep sedation for drug-induced sleep endoscopy (DISE). The patients were d...
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Objectives To use computer-assisted quantitative measurements of upper airway changes during drug-induced sleep endoscopy (DISE) and to correlate these parameters with disease severities and physiologic changes in patients with obstructive sleep apnea/hypopnea syndrome (OSA). Design A retrospective study. Setting Tertiary academic medical center....
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Objective To investigate the changes of blood pressure (BP) on patients with obstructive sleep apnea/hypopnea syndrome (OSA) before and after upper airway surgery. Design Case series with chart review. Setting Tertiary academic medical center. Subjects and Methods Patients with OSA who underwent upper airway surgery were enrolled. We retrospecti...
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Study objectives: Autonomic impairment and white matter (WM) alterations have been noted as effects of obstructive sleep apnea (OSA). This study sought to evaluate the change of WM integrity in patients with OSA using diffusion tensor imaging (DTI) and to determine its relationship with autonomic impairment. Methods: A total of 30 patients with...
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Objective: Obstructive sleep apnea/hypopnea syndrome (OSA) could compromise oxygenation of the optic nerve and cause glaucomatous optic neuropathy; there has been no study to investigate the microstructure changes of the optic nerve and retina in OSA patients before and after continuous positive airway pressure (CPAP) therapy. In this study, we as...
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Objectives This study is designed to investigate the effects of obstructive sleep apnea/hypopnea syndrome (OSA) surgery on serum leptin levels and metabolic disturbances, both of which contribute to the risk of cardiovascular diseases. Study Design Case series with planned data collection. Setting Tertiary referral medical center. Subjects and M...
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Objective: Obstructive sleep apnea/hypopnea syndrome (OSA) could compromise oxygenation of the optic nerve and cause glaucomatous optic neuropathy; however, there were no studies to investigate the changes of visual function and retinal microstructures in OSA patients after upper airway surgery. We aim to assess the changes in the visual sensitivi...
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Objective: To identify standard clinical parameters that may predict the presence and severity of obstructive sleep apnea/hypopnea syndrome (OSA). Design: Case series with chart review. Setting: Tertiary academic medical center. Subjects and methods: A total of 325 adult patients (274 men and 51 women; mean age, 44.2 years) with habitual sno...
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Objective: Depressed baroreflex sensitivity (BRS) is reported in obstructive sleep apnea (OSA). Improvement of BRS short-term after surgical treatment is also reported. We tested the hypothesis that surgical treatment not only improves clinical outcomes, but also improves BRS after 18 months. Methods: Cardiovascular autonomic tests, polysomnogra...
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Background To investigate the toxicity, changes of quality of life (QOL), and survival for patients with nasopharyngeal cancer (NPC) treated by concurrent chemoradiotherapy (CCRT) with simultaneously integrated boost volumetric‐modulated arc therapy (SIB‐VMAT). Methods A total of 68 NPC patients treated by CCRT with SIB‐VMAT technique were collect...
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NVP-BEZ235 or BEZ235 is a dual inhibitor of adenosine triphosphate (ATP)-competitive phosphoinositide 3-kinase (PI3K)/mammalian-target-of-rapamycin (mTOR) and is promising for cancer treatment. Because it targets more than one downstream effector, a dual approach is promising for cancer treatment. The aim of this study was to evaluate the efficacy...
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Surgery for obstructive sleep apnea/hypopnea syndrome (OSA) is not a substitute for continuous positive airway pressure (CPAP) but is a salvage procedure for those who failed CPAP and other conservative therapies and therefore have no other options. The hypopharyngeal/tongue base procedures for the treatment of OSA are usually challenging to most s...
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Introduction: The aim of this study was to evaluate the effects of upper airway surgery on daytime sleepiness in nonobese patients with obstructive sleep apnea/hypopnea syndrome (OSA). Methods: This retrospective study included 121 consecutive adult nonobese patients with OSA from a tertiary academic medical center. Patients with OSA who refused...
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Objective: To develop an adequate model using reliable clinical and physical factors to predict pediatric obstructive sleep apnea/hypopnea syndrome (OSAS). Methods: Complete anthropometric measurements including BMI z score, tonsil size grading, and updated Friedman tongue position (uFTP) were evaluated. Subjective assessments of clinical sympto...
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Objective: To retrospectively study the effects of minimally invasive single-stage multilevel surgery (MISS MLS) for treating patients with obstructive sleep apnea/hypopnea syndrome (OSA) on quality of life (QOL). Methods: All OSA patients with multilevel obstruction who failed or refused continuous positive airway pressure (CPAP) treatment and...
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Solute carrier family 22 member 3 (SLC22A3), also called organic cation transporter 3 (OCT3), is responsible for organic cation transport, which can eliminate many endogenous small organic cations, drugs, and toxins. This study investigated whether SLC22A3 expression is related to cisplatin uptake and the survival of patients with head and neck squ...
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Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, rangi...
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Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these...
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Systemic inflammation and alterations to regional cerebral blood flow (CBF) have been reported previously in obstructive sleep apnea (OSA). This study utilized arterial spin labelling (ASL) perfusion magnetic resonance imaging (MRI) to evaluate CBF in OSA patients and determine its relationship with systemic inflammation. Twenty male patients with...
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Adenotonsillectomy is recommended for children who need surgery for obstructive sleep apnea syndrome (OSAS). Overnight, polysomnography (PSG) is suggested for post-surgery follow-up, but this diagnostic technique is time consuming and inconvenient. Desaturation index (DI) has been reported as a good tool for predicting both the presence and severit...
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Importance: This study adds to the literature on the efficacy and low complication rates associated with minimally invasive, single-stage, multilevel surgery for Asian adults with obstructive sleep apnea (OSA) for whom conservative treatment had failed. Overall, our experience has produced results that make this procedure an option for select pati...
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Obstructive sleep apnea (OSA) increases the risk of cardiovascular diseases, and carotid intima-media thickness (IMT) is a good indicator of the severity of atherosclerotic disease. This study tested the hypothesis that inflammation and oxidative stress determined carotid IMT in patients with OSA. The carotid IMT, mean systolic and diastolic pressu...
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Background Systemic inflammation, neurocognitive impairments, and morphologic brain changes are associated with obstructive sleep apnea (OSA). Understanding their longitudinal evolution and interactions after surgical treatment provides clues to the pathogenesis of cognitive impairment and its reversibility. In the present study, we investigate cli...
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OBJECTIVE: Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare self-limiting disorder that typically affects the cervical lymph nodes. It has occasionally been misdiagnosed as malignant lymphoma or another serious diseases; hence, clinicians should be made more aware of this disease. METHODS: From January 1986 to January 200...
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Background: Genomic imprinting is associated with many human diseases, including various types of cancers, however, no studies on gene imprinting are related to squamous cell carcinoma of the head and neck (SCCHN) directly. Materials and methods: In this study, the expression of a panel of 15 imprinted genes in cancerous and non-cancerous tissue...
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Study objectives: We hypothesized that DNA methylation patterns may contribute to disease severity or the development of hypertension and excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA). Methods: Illumina's (San Diego, CA, USA) DNA methylation 27-K assay was used to identify differentially methylated loci (DML)....
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Objectives/HypothesisTo investigate taste disturbance (TD) following endoscopic coblator open tongue base resection (Eco-TBR) for the treatment of obstructive sleep apnea (OSA)–hypopnea syndrome.Study DesignA retrospective study in a tertiary academic medical center.Methods Eighty patients with OSA who failed continuous positive airway pressure the...
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Obstructive sleep apnea (OSA) has increased risk of cardiovascular diseases. Profiles of endothelial progenitor cells (EPCs) reflect the degree of endothelial impairment. This study tested the hypothesis that surgical treatment not only improves clinical outcomes but also increases the number of circulating EPCs and antioxidant capacity. The number...
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Depressed baroreflex sensitivity (BRS) have been reported in patients with obstructive sleep apnea (OSA). This study aimed to determine if surgery can improve the clinical outcomes by investigating changes in BRS and in other cardiovascular autonomic parameters. Eighty-one OSA patients were enrolled. They were classified as mild OSA if their apnea-...
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The aim of this study was to investigate late toxicities and quality of life (QoL) of nasopharyngeal carcinoma (NPC) patients with long-term survival after treatment by intensity-modulated radiotherapy (IMRT) versus non-IMRT. An observational, cross-sectional study of QoL and late toxicities was conducted in 242 NPC patients with survival of more t...
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Toll-like receptor (TLR) 2 can heterodimerise with TLR6 to detect diacylated lipoproteins. Hypoxia inducible factor-1 α co-ordinates selective induction of TLR2 and TLR6 during persistent hypoxia. We hypothesized that TLR 2/6 co-expression may be upregulated by chronic intermittent hypoxia with re-oxygenation (IHR) in obstructive sleep apnea (OSA)....
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Objectives/HypothesisTo identify standard clinical parameters that may predict the optimal level of continuous positive airway pressure (CPAP) in adult patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Study DesignThis is a retrospective study in a tertiary academic medical center that included 129 adult patients (117 males and 12 fem...
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We have previously demonstrated altered SIRT gene family in head and neck squamous cell carcinoma (HNSCC). In the present study we aimed to investigate whether the SIRT gene family was also altered in peripheral blood (PB) of patients with HNSCC and the possibility to be used as circulating biomarkers. The expression profiles of the 7 SIRT genes of...
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Little is known about the relationships between sleep-related breathing disorders (SRBDs) and nasopharyngeal carcinoma (NPC). To clarify the impact of head and neck radiotherapy on SRBDs, we performed a pilot study to investigate the change of sleep architecture in patients with NPC before and after treatment. A retrospective review of a prospectiv...
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Study objectives: To evaluate white matter integrity in patients with obstructive sleep apnea (OSA) using diffusion tensor imaging (DTI) and to assess its relationship with systemic inflammation. Design: Cross-sectional study. Setting: One tertiary medical center research institute. Patients or participants: Twenty patients with severe OSA (...
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Objectives Prospectively investigate the cardiovascular autonomic function in patients with obstructive sleep apnea (OSA) and examine the relationship with OSA severity, since impaired cardiovascular autonomic response is independently associated with cardio- and cerebro-vascular disease. Methods Ninety-one subjects with symptoms of sleep-disorder...
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Objectives Obstructive sleep apnea (OSA) is commonly associated with neuropsychological sequelae, presumably induced by brain injury resulting from intermittent hypoxia. Newer magnetic resonance imaging modalities allow a more accurate examination of fiber integrity of the brain microstructure. Diffusion tensor imaging (DTI) is sensitive to the mic...
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Objectives Perform an updated systematic review and meta-analysis to determine the surgical success rate of multilevel upper airway surgery for patients with obstructive sleep apnea syndrome (OSA). Methods A systematic review was performed to identify English-language studies that evaluated the treatment of adult OSA patients with multilevel OSA s...
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Objectives Retrospectively investigate the taste disturbance (TD) following endoscopic Coblator open tongue base resection (Eco-TBR) for the treatment of obstructive sleep apnea syndrome (OSA). Methods Eighty patients with OSA who failed CPAP therapy and then underwent modified UPPP combined with Eco-TBR were enrolled in this study. TD in the post...
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Obesity is considered to be a major contributing factor to obstructive sleep apnea (OSA); however, there is limited evidence with regard to gender predominance. We analyzed 2345 patients (339 females) in correlation with body mass index (BMI) and OSA severity. Male AHIs were significantly higher than female AHIs in each BMI group. As the BMI increa...
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Background: Circadian clock regulates daily rhythms in various physiologic processes and deregulated circadian clock are linked to cancers. We have previously demonstrated the association between altered circadian clock genes (CCGs) and head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to investigate whether the CCGs wer...
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To investigate the safety and outcomes of Z-palatopharyngoplasty (ZPPP) combined with endoscopic Coblator open tongue base resection (Eco-TBR) for the treatment of severe obstructive sleep apnea/hypopnea syndrome (OSAHS). Review of a prospective database. Academic tertiary medical center. Thirty-nine patients with severe OSAHS who had multilevel ob...
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The objective of this study was to evaluate the relationship between subjective and objective tonsil size measurements in adult patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) and compare the tonsil size measurements with the severity of disease. Fifty-one adult patients (46 males and 5 females) who failed continuous positive airway...
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Vascular abnormalities are the predominant histologic changes associated with radiation in nasopharyngeal carcinoma (NPC). This study examined if the duration after radiotherapy correlates with the progression of carotid intima-media thickness (IMT) and investigated its relationship with inflammatory markers. One hundred and five NPC patients post-...
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Objectives Retrospectively investigate the safety and outcomes of Z-palatopharyngoplasty (ZPPP) combined with endoscopic coblator open tongue base resection (ECO-TBR) for the treatment of severe obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods Thirty-five consecutive patients with severe OSAHS who had multilevel obstruction, failed conti...
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Objectives Identify standard clinical parameters that may predict the presence and the severity of pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods Eighty-eight pediatric patients with habitual snoring who underwent a physical examination and full-night polysomnography were included in this study. Severity of nasal obstruction...
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Objectives Drug-induced sleep endoscopy (DISE) allows inspection of upper airway to accurately localize the anatomical region that collapses in obstructive sleep-apnea-hypopnea syndrome (OSAHS). The sedation technique adopted in most centers throughout Europe is the target controlled infusion (TCI) of propofol without oxygen supply. The goal of thi...
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Objectives Prospectively study the changes of biomarkers related to cardio- or cerebro-vascular diseases in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) before and after OSAHS surgery. Methods Patients who failed continuous positive airway pressure (CPAP) therapy and then underwent OSAHS surgery were enrolled in this study. We a...
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Objective: Obstructive sleep apnea syndrome (OSAS) can result in learning, behavioral, and even growth problems in children. Overnight polysomnography (PSG) is the gold standard for the diagnosis of OSAS, but this diagnostic technique is time consuming and inconvenient. It is well documented that patients with OSAS experience oxygen desaturation d...
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Head and neck squamous cell carcinoma (HNSCC) include a group of malignant neoplasms that arise from the upper aerodigestive tract and represent the seventh most common cause of cancer-related death. The overall 5-year survival rates have not significantly improved for decades in spite of the advances in the field of oncology and surgery, encouragi...
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Introduction: Baroreflex failure has been reported as a late sequalum of neck radiotherapy. In this study we investigated cardiovascular autonomic function in patients after neck radiotherapy to determine predictive factors associated with outcome. Methods: Eighty-nine patients with nasopharyngeal carcinoma were evaluated ≥6 months after radioth...
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Pillar implants provide a reasonable outcome with minimal post-operative morbidity and complications in treating patients with sleep-disordered breathing (SDB) who had obvious palatal obstruction. The palatal structure is responsible for a normal functioning Eustachian tube; however, little is known if there is any potential otologic implication of...
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Sleep-disordered breathing (SDB) such as snoring or obstructive sleep apnea and metabolic syndrome are both related to cardiovascular diseases. Being a surrogate marker of high risk for cardiovascular disorder, the high-sensitivity C-reactive protein (hs-CRP) level is thought to be elevated in patients with both SDB and metabolic syndrome. To under...
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Background This study aimed to analyze the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes of bacterial brain abscess in patients with nasopharyngeal carcinoma (NPC) following radiotherapy. Methods NPC patients with bacterial brain abscess were evaluated. Their clinical data were collected over a 22-year pe...
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Obstructive sleep apnea/hypopnea syndrome (OSAHS) is strongly associated with the increase of cardiovascular and cerebrovascular disorders. Carotid intima-media thickness (IMT) is used as a surrogate marker for subclinical or early atherosclerosis. Knowledge regarding early atherosclerosis in patients with OSAHS is scarce, and factors predicting ca...
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Evaluate the effects of continuous positive airway pressure (CPAP) on C-reactive protein (CRP) levels, reported either as a primary or secondary end point among patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) based on a meta-analysis of published studies. English-language searches of PubMed, Ovid, and the Cochrane databases were com...
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Nasal septal abscess is defined as a collection of pus between the cartilage or the bony septum and the overlying mucoperichondrium or mucoperiostium. Appropriate management of a nasal septal abscess requires prompt diagnosis, adequate surgical drainage, and parenteral administration of antibiotics. This can prevent the potentially dangerous spread...
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To determine the prevalence of normal tension glaucoma (NTG) in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) and further investigate whether the severity of OSAHS would increase the risk of glaucoma. Two hundred fifty-six participants were consecutively admitted for polysomnographic exam to diagnose OSAHS. All participants, then...
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Objective: Study the impact of Pillar implantation plus radiofrequency tongue base reduction (RFBOT) for the treatment of obstructive sleep apnea (OSA) syndrome on quality of life (QOL). Method: All OSA patients with multilevel obstruction who failed or refused the CPAP treatment and then underwent single-staged multilevel minimally invasive surger...
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Objective: Study the impact of Pillar implantation plus radiofrequency tongue base reduction (RFBOT) for the treatment of obstructive sleep apnea (OSA) syndrome on middle ear function. Method: The patients who underwent a Pillar implantation combined with RFBOT for OSA were enrolled. All subjects had normal eardrums. Pure-tone audiometry and tympan...
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Objective: 1) Determine the effect of continuous positive airway pressure (CPAP) on C-reactive protein (CRP) levels in patients with obstructive sleep apnea (OSA). 2) Demonstrate the effect of CPAP on general health status using CRP as a marker for cardiovascular health. Method: A computerized search was conducted using PubMed, Ovid, and the Cochra...
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Objective: Study the difference between subjective and objective palatine tonsil size measurements in patients with obstructive sleep apnea (OSA) syndrome. Method: Bilateral tonsillectomy was enrolled as a part of the OSA surgery. Subjective tonsil size was valuated using the 0-4 scale. Tonsil size was also objectively measured. The relationship of...
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To study the effect of Z-palatopharyngoplasty plus radiofrequency of the base of the tongue on middle ear function. A retrospective review of a prospective data set at a tertiary care center. University-affiliated medical center. The study population included 47 patients (42 men and 5 women; mean age, 40.8 years) who underwent Z-palatopharyngoplast...
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Nasal surgery is commonly involved in surgical treatment for obstructive sleep apnea (OSA). The aim of this study was to investigate the outcomes of nasal surgery for OSA using evidence-based methodology. The MedLine database (1999∼2009) was searched for original articles published in peer-reviewed journals concerning nasal surgery for snoring/slee...