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Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea‐hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU)... more
Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea‐hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU) can be employed to guide the surgery and prevent massive bleeding.
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Although substantial evidence supports a 20-30% risk reduction of colon cancer, breast cancer, and endometrial cancer by physical activity (PA), the evidence for head and neck cancer (HNC) is limited. Three published studies on the... more
Although substantial evidence supports a 20-30% risk reduction of colon cancer, breast cancer, and endometrial cancer by physical activity (PA), the evidence for head and neck cancer (HNC) is limited. Three published studies on the association between PA and HNC have generated inconsistent results. The current study examined the association between recreational PA (RPA) and HNC risk with a more detailed assessment on the intensity, frequency, duration, and total years of RPA. Data on RPA were collected from 623 HNC cases and 731 controls by in-person interview using a standardized questionnaire. The association between RPA and HNC risk was assessed using unconditional logistic regression, adjusted for sex, age, educational level, use of alcohol, betel quid, and cigarette, and consumption of vegetables and fruits. A significant inverse association between RPA and HNC risk was observed in a logistic regression model that adjusted for sex, age, and education (odds ratio (OR) = 0.65, 95...
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The aims of this study were to assess young (5- to 10-year-old) Mandarin-speaking cochlear implant (CI) users' musical pitch perception and to assess the benefits of computer-based home training on performance. Melodic contour... more
The aims of this study were to assess young (5- to 10-year-old) Mandarin-speaking cochlear implant (CI) users' musical pitch perception and to assess the benefits of computer-based home training on performance. Melodic contour identification (MCI) was used to assess musical pitch perception in 14 Mandarin-speaking pediatric CI users; the instrument timbre and the contour length were varied as experimental parameters. Six subjects received subsequent MCI training on their home computer in which auditory and visual feedback were provided. MCI performance was generally poor (grand mean=33.3% correct) and highly variable, with scores ranging from 9.3% to 98.1% correct; there was no significant effect of instrument timbre or contour length on performance (p>.05). After 4 weeks of training, performance sharply improved. Follow-up measures that were conducted 8 weeks after training was stopped showed no significant decline in MCI performance. For the 6 trained subjects, there was a ...
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Mental function is considered to affect the post-operative outcomes of deaf children with cochlear implants. The purpose of this study is to evaluate the effect of mental function on the auditory performance in children with cochlear... more
Mental function is considered to affect the post-operative outcomes of deaf children with cochlear implants. The purpose of this study is to evaluate the effect of mental function on the auditory performance in children with cochlear implants. In a retrospective review of data, 26 pre-lingual deafened children received pre-operative evaluation of mental function and were divided into normal and retarded groups. Categories of auditory performance scale (CAP) was conducted at 1-year intervals after implantation. ANCOVA was used for statistic analysis. The average scores of auditory performance in normal group (n=14) were 3.93 (S.D. 1.07) and 5.86 (S.D. 0.95) at 1- and 2-year post-implantation. While the average scores in the retarded group were 2.5 (S.D. 1.51) and 4.17 (S.D. 1.85), both groups demonstrated obvious improvement in speech perception (F 103.12, P<0.001) during the first 2 post-operative years. The auditory performance in the normal group was significantly superior to t...
Research Interests: Psychology, Auditory Perception, Audiology, Intellectual Disability, Medicine, and 15 moreHumans, Child, Cochlear Implant, Female, Male, Deafness, Health Status, Clinical Sciences, Prevalence, Hearing Impaired, Retrospective Studies, Cochlear Implantation, Cognition disorders, Neuropsychological Tests, and Paediatrics and reproductive medicine
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ABSTRACT Nonstationary noises may seriously damage speech intelligibility and reduce the performance of hearing aids. This paper proposes a novel speech enhancement approach, named forward–backward minima-controlled recursive averaging,... more
ABSTRACT Nonstationary noises may seriously damage speech intelligibility and reduce the performance of hearing aids. This paper proposes a novel speech enhancement approach, named forward–backward minima-controlled recursive averaging, that helps to solve this problem. A forward–backward estimation is developed to correctively track nonstationary noises, especially the beginnings of nonstationary noises. To suppress these nonstationary noises, a log-spectral amplitude estimator was selected as the gain function for our approach and used to effectively estimate the power spectrum of the noise. Moreover, harmonic regeneration was integrated to reduce the overestimation of noises generated by the forward–backward estimation. The experimental results demonstrated that our approach is able to improve performance compared with previous approaches using both objective and subjective measures.
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Although Sistrunk operation is the standard method to treat thyroglossal duct cyst, the reported recurrence rates after a "classic" or "modified" Sistrunk procedure still varied from 0 to 15.8 %, indicating the... more
Although Sistrunk operation is the standard method to treat thyroglossal duct cyst, the reported recurrence rates after a "classic" or "modified" Sistrunk procedure still varied from 0 to 15.8 %, indicating the existence of some technical uncertainties. While simple cystectomy has been recognized as the most important prognostic factor predicting thyroglossal duct cyst recurrence, whether other clinico-pathological parameters also affect disease recurrence has not been well studied. We retrospectively reviewed the medical records of all patients who underwent thyroglossal duct cyst surgery between June 1998 and June 2014 at our institution. Among the 180 primary patients, 160 patients received a "conservative" Sistrunk operation, while the remaining 20 patients received simple cystectomy only. Five patients (2.8 %, 5/180) had recurrence. Four of them received simple cystectomy while 1 had "conservative" Sistrunk operation. In univariable analy...
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ABSTRACT The assistive hearing devices are the only aids to help subjects with hearing loss to use their residual hearing. However, the performance of those devices is closely dependent on auditory training. To develop handheld devices... more
ABSTRACT The assistive hearing devices are the only aids to help subjects with hearing loss to use their residual hearing. However, the performance of those devices is closely dependent on auditory training. To develop handheld devices based personal auditory training system with perceptional discrimination analysis and automatic test item generation is very helpful for subjects with hearing loss. Besides, it would ease the burden of speech-language pathologists in developing a personal auditory training. In this study, the mel-frequency cepstrum coefficients and automatic speech recognition are applied to objectively estimate the phonemic confusions. For reducing computational complex, multidimensional scaling is then used to transfer the phonemic confusions into a Euclidean space. Thus, a suitable training material could be automatically generated by simple random process. Finally, the Android based mobile phones are selected as a platform for auditory training. It is convenient for subjects to use the auditory training system. The experimental results show that the average score of mean opinion score is 3.73, which means that the system is very useful.
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Objectives: Noise-induced hearing loss (NIHL) has become more common among adolescents due to increased exposure to personal music players. Many adolescents listen to music on headphones. We aimed to assess whether the use of earphones... more
Objectives: Noise-induced hearing loss (NIHL) has become more common among adolescents due to increased exposure to personal music players. Many adolescents listen to music on headphones. We aimed to assess whether the use of earphones has a significant effect on music-induced hearing impairment among teenage students. Methods: This cross-sectional study recruited students who habitually listen to music in a quiet environment. Listeners with the use of earphone and desktop speaker were included. Pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE), and questionnaires were obtained. Cumulative noise exposure (CNE) was calculated by listening time and volume of using portable players. Results: A total of 105 subjects were analyzed. Mean age was 17.03 years. Sixty-eight subjects (67.76%) used earphones, and the others used desktop speakers. Mean of PTA at high frequency (average of 3000, 4000 and 6000 Hz) was 8.97 dB HL (SD = 5.71). DPOAE amplitude level at high ...
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Multimedia data is a popular communication medium, but requires substantial storage space and network bandwidth. Vector quantization (VQ) is suitable for multimedia data applications because of its simple architecture, fast decoding... more
Multimedia data is a popular communication medium, but requires substantial storage space and network bandwidth. Vector quantization (VQ) is suitable for multimedia data applications because of its simple architecture, fast decoding ability, and high compression rate. Full-search VQ can typically be used to determine optimal codewords, but requires considerable computational time and resources. In this study, a hybrid VQ combining a tree structure and a Voronoi diagram is proposed to improve VQ efficiency. To efficiently reduce the search space, a tree structure integrated with principal component analysis is proposed, to rapidly determine an initial codeword in low-dimensional space. To increase accuracy, a Voronoi diagram is applied to precisely enlarge the search space by modeling relations between each codeword. This enables an optimal codeword to be efficiently identified by rippling an optimal neighbor from parts of neighboring Voronoi regions. The experimental results demonst...
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To facilitate the process of developing speech perception, speech-language pathologists have to teach a subject with hearing loss the differences between two syllables by manually enhancing acoustic cues of speech. However, this process... more
To facilitate the process of developing speech perception, speech-language pathologists have to teach a subject with hearing loss the differences between two syllables by manually enhancing acoustic cues of speech. However, this process is time consuming and difficult. Thus, this study proposes an objective approach to automatically identify the regions of spectral distinctiveness between two syllables, which is used for speech-perception training. To accurately represent the characteristics of speech, mel-frequency cepstrum coefficients are selected as analytical parameters. The mismatch between two syllables in time domain is handled by dynamic time warping. Further, a filter bank is adopted to estimate the components in different frequency bands, which are also represented as mel-frequency cepstrum coefficients. The spectral distinctiveness in different frequency bands is then easily estimated by using Euclidean metrics. Finally, a morphological gradient operator is applied to au...
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In human, salicylate-induced tinnitus sometimes occurs a few days after its administration, but the chronic effects of salicylate in animal models are not fully known. In this study, we revealed the distribution of active cells in the rat... more
In human, salicylate-induced tinnitus sometimes occurs a few days after its administration, but the chronic effects of salicylate in animal models are not fully known. In this study, we revealed the distribution of active cells in the rat auditory brainstem by staining an activity marker Fos-protein after multiple daily injections of salicylate. Experimental animals were first given five daily doses of sodium salicylate (250 mg/kg, i.p.). On day 6 they were placed inside a sound room for 8 h before sacrifice. Immunohistochemistry showed a significant increase in the number of Fos-positive cells at the inferior colliculus (IC), particularly its central division. At the cochlear nucleus (CN), only a few Fos-stains were found at the dorsal nucleus while no Fos-stain appeared at the ventral nucleus. The scarcity of Fos-stains at the CN reflected more a lack of external sound inputs than an adaptation in Fos-expression. Since Fos-stains in CN could still be induced on day 6 following brief tonal stimulation. Results are consistent with the hypothesis that salicylate-induced tinnitus is a phantom sound perception related to overactivity of cells at the IC.
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Auditory neuropathy (AN) is a hearing disorder characterized by the preservation of outer hair cell function despite the absence of auditory brainstem responses. The pathophysiology and etiology of this condition remain unknown. Recent... more
Auditory neuropathy (AN) is a hearing disorder characterized by the preservation of outer hair cell function despite the absence of auditory brainstem responses. The pathophysiology and etiology of this condition remain unknown. Recent studies have shown that some patients with AN benefit significantly from cochlear implantation. These patients have all been native speakers of Western languages. A 3-year-old Mandarin-speaking boy was referred to our center because of speech delay. After a series of audiological surveys, retro-cochlear lesion was impressed. During the 2-year period of rehabilitation, poor speech discrimination out of proportion to aided hearing thresholds led to the diagnosis of auditory neuropathy. Because of the limited benefit from amplification, he received a cochlear implant. Significant improvement of speech perception skills assessed by a Mandarin auditory perception test was noted shortly after implantation. The post-implantation performance in this Mandarin-speaking child was consistent with that of reports for implantees speaking Western languages. For Mandarin-speaking children with AN who fail to benefit from conventional treatment, cochlear implantation may be a good alternative choice.
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Ear piercing (EP) is increasing in popularity among teenagers. Techniques for EP should be selected carefully to prevent possible complications. The purpose of this study is to compare the clinical outcomes of EP techniques between CO(2)... more
Ear piercing (EP) is increasing in popularity among teenagers. Techniques for EP should be selected carefully to prevent possible complications. The purpose of this study is to compare the clinical outcomes of EP techniques between CO(2) laser and spring-loaded gun. This is a prospective and comparative clinical trial. Under local anesthesia, EP was performed on left ear with CO(2) laser (20 watt/single mode) and on right ear with spring-loaded gun. With visual analog scale (VAS, 0-10) and questionnaire, post-operative pain and wound healing status were assessed immediately, 1, 2, 4 and 8 weeks after EP procedure. Fourteen subjects (14/17, 82.4%) completed the whole study. Immediately after the procedure, the level of post-operative pain (VAS) was 3.2 for CO(2) laser and 1.5 for spring-loaded gun (p &amp;amp;lt; 0.05). In CO(2) laser group, pain severity decreased to 0.4, 0.1, 0, and 0, while in spring-loaded gun group, the decrease was only to 0.7, 0.6, 0.3 and 0 at 1, 2, 4, and 8 weeks, respectively. Duration of post-operative pain was 3.8 and 17.5 days for CO(2) laser and spring-loaded gun, respectively (p &amp;amp;lt; 0.05). There was no major complication like infection, bleeding or hypertrophic scar. Our study suggests that CO(2) laser is a precise, simple, safe and aseptic technique for EP. It has a lower level and shorter duration of post-operative pain, when compared with spring-loaded gun. Therefore, CO(2) assisted EP is an alternative and feasible technique in our daily clinical practice. The level of evidence: 2b.
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Functional dyspepsia (FD) is considered a bio-psychosocial disorder. The role of psychosocial factors in FD pathogenesis remains unclear. This study evaluated sleep quality and mood symptoms in patients with FD, assessing the associations... more
Functional dyspepsia (FD) is considered a bio-psychosocial disorder. The role of psychosocial factors in FD pathogenesis remains unclear. This study evaluated sleep quality and mood symptoms in patients with FD, assessing the associations of FD severity, disordered sleep, and psychological symptoms. One-hundred-and-fifteen adult patients with typical FD symptoms were enrolled alongside 61 healthy volunteers. Rome III criteria were used to evaluate FD symptoms; sleep disorder was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist-90-Revised (SCL-90R) was utilized to determine the status of depression, anxiety and other psychological symptoms. PSQI scores and nine symptomatic dimensions of SCL-90R were significantly higher in FD patients than in controls. Multiple logistic regression indicated that lower BMI, lower level of education, and sleep disturbance were independently associated with FD and FD subgroups. Hostility and phobic anxiety were independent ...
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Objective: The purposes of this study were to examine (1) whether the benefit of cochlear implants in Mandarin-speaking congenitally deaf children persists over a 2-year follow-up period, and (2) whether the age of the child at... more
Objective: The purposes of this study were to examine (1) whether the benefit of cochlear implants in Mandarin-speaking congenitally deaf children persists over a 2-year follow-up period, and (2) whether the age of the child at implantation affects the acquisition of ...
Research Interests: Auditory Perception, Language, Humans, Child, Cochlear Implant, and 15 moreFemale, Male, Regression Analysis, Infant, Cochlear Implants, Mandarin Chinese, Deafness, Clinical Sciences, Age Factors, Asian Continental Ancestry Group, Cochlear Implantation, Hearing Aid, Recovery of Function, Child preschool, and Paediatrics and reproductive medicine
Based on imaging findings, large vestibular aqueduct syndrome (LVAS) in early childhood is the most common cause of sensorineural hearing loss. Children with LVAS are at a high risk of suffering sudden deteriorations in hearing. This... more
Based on imaging findings, large vestibular aqueduct syndrome (LVAS) in early childhood is the most common cause of sensorineural hearing loss. Children with LVAS are at a high risk of suffering sudden deteriorations in hearing. This study was to review treatment of sudden hearing deterioration in children with LVAS who underwent corticosteroid therapy. We conducted a retrospective study of patients presenting to an academic tertiary medical center. Sixteen children of LVAS were evaluated. Corticosteroid therapy (prednisolone 1-2 mg/(kg day) or equal titer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s dexamethasone) was administered as soon as sudden hearing loss developed. The pure tone audiometric result improved more than 10dB at two or more consecutive frequencies and was regarded as a significant response to corticosteroid therapy. Sixteen cases comprising 12 boys and 4 girls were retrospectively analyzed in this study. The mean age at which LVAS was diagnosed was 2.3 years. Mean follow-up for the 16 cases from the first clinic visit to November 2003 was 4.2 years. The initial audiograms varied from down-sloping, valve or rising patterns. In addition, bilateral enlargement of the vestibular aqueduct was found to all children and the mean diameter of right and left ears were 7.23 and 6.83 mm, respectively. Seven children had totally experienced 13 episodes of sudden hearing deterioration. After receiving corticosteroid therapy in time, 11 of 13 episodes had indicated significant responses to treatment, a response rate of 85%. Early detection of LVAS and the timing of treatment are crucial for preventing the residual hearing from deteriorating. As soon as the hearing deterioration of a child with LVAS is recognized, aggressive intervention such as corticosteroid therapy should be performed in no time.
Research Interests: Treatment Outcome, Early Childhood, Dexamethasone, Humans, Sensorineural Hearing Loss, and 14 moreFemale, Male, Infant, Prednisolone, Hearing Loss, Clinical Sciences, Early Detection, Retrospective Studies, X ray Computed Tomography, Retrospective Study, Glucocorticoids, Vestibular aqueduct, Child preschool, and High risk
Cochlear implantation is regarded as a safe surgery for young children with minimal complications. However, inner ear malformations and aberrant course of facial nerves may impede electrode insertion via the round window approach and... more
Cochlear implantation is regarded as a safe surgery for young children with minimal complications. However, inner ear malformations and aberrant course of facial nerves may impede electrode insertion via the round window approach and increase the risk of iatrogenic facial nerve injury. We report a case of cochlear incomplete partition in a patient with anomalous facial nerve anatomy. The anterior and inferior displacement of the facial nerve obscured the round window. A retrofacial approach was used to expose the round window and the electrode was inserted successfully. No surgical complications were found postoperatively, and the child showed significant improvement in speech perception. As the course of the aberrant facial nerve is difficult to track preoperatively, surgeons should proceed with caution to reduce the risk of facial nerve injury during the operation.
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Exactly how speech perception and tinnitus perception are related remains unclear. This study investigated how tinnitus alone affects speech perception and the relationship between speech perception, tinnitus loudness, and tinnitus... more
Exactly how speech perception and tinnitus perception are related remains unclear. This study investigated how tinnitus alone affects speech perception and the relationship between speech perception, tinnitus loudness, and tinnitus disability. The Mandarin Speech Perception in Noise Test (MSPIN), Tinnitus Loudness Scaling (TLS), and Tinnitus Handicap Inventory (THI) were utilized to assess 20 tinnitus patients with normal hearing. The tinnitus group had a significantly lower MSPIN score than the control group (p &amp;amp;amp;amp;lt; 0.01). TLS and THI scores were strongly correlated (r(2): 0.534 approximately 0.627, p &amp;amp;amp;amp;lt; 0.05). Correlations between MSPIN and TLS or THI scores were not significant. Tinnitus loudness correlated well with tinnitus-related disability. Neither tinnitus loudness nor disability was strongly correlated with speech perception. In noisy environments, tinnitus sufferers had significantly poorer ability to recognize speech than control subjects.