Browsing by Author "Liu, Ching-Feng"

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Comparison between open partial laryngectomy with tube-free tracheostomy and total laryngectomy for hypopharyngeal cancer with cartilage invasion
(2018-10-01)
Lien, Ching-Feng
;
Wang, Chih-Chun
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Hwang, Tzer-Zen
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Liu, Ching-Feng
;
Lin, Bor-Shyh
The present study aimed to identify a feasible treatment strategy for hypopharyngeal cancer (HPC) with non-extensive invasion of the thyroid and/or cricoid cartilage. Between June 2008 and December 2014, patients with previously untreated HPC invading cartilage who had received either open partial laryngectomy (OPL) with tube-free tracheostomy or total laryngectomy (TL) with permanent tracheostomy and an artificial larynx (pneumatic tube) were retrospectively reviewed. The patients with extensive cartilage invasion and those with inoperable or T4b disease were excluded for OPL. Outcomes and quality of life were compared between the two treatment modalities. A total of 44 patients were included. The survival rates, complications, and Dysphagia Score were compared between the two treatment modalities. The outcome of the Voice Handicap Index (P=0.032), understandability of speech (P<0.001), normalcy of diet (P=0.041), senses (P=0.006), speech (P<0.001) and social contact (P=0.004) were significantly improved in the group receiving OPL compared with the group receiving TL. Therefore, OPL with tube-free tracheostomy may be a feasible option to treat patients with HPC with non-extensive invasion of the thyroid and/or cricoid cartilage.
Design of Novel Field Programmable Gate Array-Based Hearing Aid
(2019-01-01)
Lin, Bor-Shing
;
Yang, Po-Yu
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Liu, Ching-Feng
;
Huang, Yi-Chia
;
Liu, Chengyu
Hearing loss is one of the most common chronic diseases. For people with hearing loss, communicating with other people, particularly in an environment with considerable background noise, is difficult. Recently, several hearing aids have been developed to improve speech comprehension in a noisy environment. The use of an adaptive beamformer is one of the alternative methods for improving speech intelligibility. However, the adaptive beamformer requires the location of the desired speaker to estimate the time differences of arrival (TDOAs) of speech sources to numerous spatially separated sensors in acoustics. In general, the technique of steered response power source localization was used to estimate the TDOA; however, this technique was easily affected by environmental reverberation. To overcome the aforementioned concern, a novel hearing aid is proposed in this paper. By using an image processing technology, the location of the desired speaker could be manually selected to provide precise information on the TDOA. Moreover, adaptive signal enhancements were implemented in a field-programmable gate array to enhance the speech of interest in real time. The experimental results indicate that the proposed system could improve speech intelligibility in various noisy environments. Therefore, the proposed system may be employed to improve the daily lives of people with hearing the loss in the future.
Development of Novel Hearing Aids by Using Image Recognition Technology
(2019-05-01)
Lin, Bor-Shing
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Liu, Ching-Feng
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Cheng, Chih-Jen
;
Wang, Jhi-Joung
;
Liu, Chengyu
Speech is easily affected by different background noise in real environment to reduce the speech intelligibility, in particular, for hearing impaired listeners. In order to improve the above issue, several hearing aids have been developed to enhance the speech signal in noisy environment. Most of current hearing aids were designed to enhance the component of speech and suppress the component of noise. However, it is difficult to separate other speech sources. Adaptive signal enhancement with the beamforming technique might improve the above issue. However, how to distinguish the location of the desired speaker effectively is still a difficult challenge for adaptive beamforming method. A novel concept of hearing aid was proposed in this study. Different from the beamforming-based hearing aids, which use the cross-correlation-coefficient method to estimate time difference of arrival (TDOA), an image recognition technology was used to estimate the location of the desired speaker to obtain the more precise TDOA. An adaptive signal enhancement was also used to enhance the noisy speech sound. From the experimental results, the proposed system could provide a smaller absolute error of TDOA less than 1.25 x 10(-4) ms, and a clear speech sound from the target speaker who the user wants to listen to.
Development of Novel Lip-Reading Recognition Algorithm
(2017-01-01)
Lin, Bor-Shing
;
Yao, Yu-Hsien
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Liu, Ching-Feng
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Lien, Ching-Feng
;
Lin, Bor-Shyh
Total laryngectomy is a common treatment for patients with advanced laryngeal and hypopharyngeal cancer, but it is also a result from the loss of the natural voice and directly affects the basic communication functions in daily life. Reconstructing the basic communication function is an important issue for these patients after total laryngectomy surgery. Recently, the image processing technique for lip-reading recognition has been widely developed and applied in various kinds of applications. It is also one of the possibly alternative approaches to reconstructing the basic communication function for these patients after total laryngectomy surgery. Although many human lip-reading recognition methods have been developed to detect lip contour precisely, detecting pronouncing lip contour effectively is still a difficult challenge. In this paper, a novel lip-reading recognition algorithm was proposed to recognize English vowels from the lip contour when speaking. Here, several criteria for detecting the mouth region of interest (ROI) were designed to reduce the error rate of detecting the mouth ROI and lip contour. Moreover, several lip parameters, including the width, height, contour points, area, and the ratio (width/height) of lips, were used to recognize the lip contour and English vowels when speaking. The advantages of the proposed method are that it could detect the mouth ROI automatically, reduce the influence of individual differences, such as the individual lip shape or makeup effect, and it also could perform a good performance without pretraining. Finally, the performance of lip-reading recognition under different backgrounds and individual differences was also tested, and the accuracy of the proposed algorithm on lip-reading recognition was over 80%.
Effect of carotid artery aberrancy on the distance between the vessel and nasopharyngeal subsites
(2014-05-01)
Lien, Ching-Feng
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Weng, Hsu-Huei
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Lin, Bor-Shyh
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Liu, Ching-Feng
;
Wu, Tai-Ching
Background: Life-threatening hemorrhaging due to nasopharyngeal internal carotid artery (ICA) aberrancy may occur during routine nasopharyngeal surgery. To understand better the potential adverse effect of nasopharyngeal ICA aberrancy on routine nasopharyngeal surgery, we classified aberrant nasopharyngeal ICAs and analyzed the differences in mean distances from the ICA to nasopharyngeal subsites between aberrant and nonaberrant vessels. Methods: The courses of nasopharyngeal ICAs were examined and classified for an aberrant pathway. Various distances were measured on magnetic resonance brain scans. The mean values of the measured variables were compared using an unpaired two-sample t test. Results: The mean distances to the torus tubarius, the opening of Rosenmuller\'s fossa, and the posterior nasopharyngeal wall were 19.6 mm, 15.8 mm, and 16.7 mm, respectively, in the aberrant case group, and 23.1 mm (p < 0.001), 19.8 mm (p < 0.001), and 20.7 mm (p < 0.001) in the nonaberrant control group. Conclusion: The mean distances between the ICA and nasopharyngeal subsites were significantly shortened (by 15-21%) in the presence of aberrant nasopharyngeal segments, which may increase the risk of severe complications in common and uncomplicated nasopharyngeal surgery, such as adenoidectomy, eustachian tuboplasty, and nasopharyngeal biopsies. However, the mean distances were not shortened by the severity (kinking and coiling) of the aberrant nasopharyngeal carotid arteries. Copyright (C) 2014 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.
Increased risk of deep neck infection among HIV-infected patients in the era of highly active antiretroviral therapy-a population-based follow-up study
(2013-04-22)
Liu, Ching-Feng
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Weng, Shih-Feng
;
Lin, Yung-Song
;
Lin, Chih-Sheng
;
Lien, Ching-Feng
Background: Deep neck infections (DNIs) in HIV-infected patients often produce severe complications, even death. Data on the incidence rates and risks of DNI among HIV-infected patients are scarce, particularly with the widespread use of highly active antiretroviral therapy (HAART). We evaluated the incidence rates and risks for DNI among HIV-infected patients and observed the long-term trends. Methods: A total of 9888 new HIV-infected patients diagnosed in 2001-2007 were included and matched with 49440 randomly selected subjects. The HIV-infected subjects were offered free access to HAART. All subjects were traced until December 2009. A Kaplan-Meier analysis generated the cumulative DNI incidence rate. The adjusted hazard ratio was computed using Cox proportional hazard regressions. Results: From the HIV-infected and comparison cohorts, 222 individuals (57.01 cases per 10000 person-years) and 735 individuals (35.54 cases per 10000 person-years) developed DNI, respectively. The log rank test indicated that patients with HIV had a significantly higher 8-year incidence rate of DNI than the control group (P < 0.0001). The adjusted hazard ratio for developing DNI after an HIV attack during the mean 3.94 years follow-up period was 1.59. The incidence rate and relative risk of DNI were 74.58 (per 10000 person-years) and 2.05 (P < 0.0001). Both figures were highest in the first follow-up year and decreased year-by-year thereafter. Conclusion: The risk of developing DNI is significantly elevated among HIV-infected patients, even with free access to HAART. Additional research is needed to examine the role of HAART in reducing the risk.
Radial forearm and forehead flap reconstruction following resection of a nasal arteriovenous malformation: A case report
(2016-10)
Lin, Chih-Shin
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Lin, Yung-Song
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Lin, Bor-Shyh
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Lien, Ching-Feng
;
Liu, Ching-Feng
Arteriovenous malformation (AVM) is a structural vascular abnormality in which the arterial vasculature connects with the venous vasculature without capillary connections. AVM confined to the nasal cavity is considerably rare. Blurred vision can be one of the associated symptoms. A combined approach of complete surgical resection with prior superselective embolization is the treatment of choice. Following resection, the reconstruction of facial defects, particularly in the nasal area, is challenging. The present study reports the rare case of a patient with an AVM in the nasal cavity, in which embolization, resection and flap reconstruction were performed. Embolization and complete surgical resection were used to avoid recurrence. Subsequently, a combination of free radial forearm and forehead flaps was used for the reconstruction of the nasal defect, without prosthesis. To the best of our knowledge, this is the first report of AVM confined to the nasal cavity, managed by a combination of free radial forearm and forehead flap reconstruction following complete resection. The cosmetic results of the procedure were acceptable.
Risk factors for internal carotid artery injury in adults during simple nasopharyngeal surgeries
(2014-06-01)
Lien, Ching-Feng
;
Weng, Hsu-Huei
;
Liu, Ching-Feng
;
Lin, Bor-Shyh
;
Wu, Tai-Ching
The purpose of this study attempted to analyze the potential risk factors for internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid. One hundred and seventy magnetic resonance imaging scans (340 halves) of the brain were retrospectively reviewed and studied. Anatomic variations of carotid arteries were classified, and various distances from the internal carotid arteries to the nasopharyngeal subsites were directly measured on the scans. The mean distances between the internal carotid arteries and nasopharyngeal subsites were significantly shortened in patients with nasopharyngeal internal carotid artery aberrancy, female gender, and lower body weight. The distance to the posterior nasopharyngeal wall was also shortened with age. However, the severity of nasopharyngeal carotid artery variations (kinking and coiling) did not reflect the shortening of mean distances to nasopharyngeal subsites. In conclusion, from multiple linear regression analysis, we found that the risk of an internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid is greatest in adult patients with nasopharyngeal carotid artery aberrancy, followed by female gender, lower body weight, and increasing age.