Khoo Teck Puat Hospital (Abbreviation: KTPH) is a 795-bed general and acute care hospital located at Yishun in Singapore. Named after Singaporean hotelier, Khoo Teck Puat, the hospital is part of an integrated development together with the adjoining Yishun Community Hospital. The hospital was officially opened by Minister Mentor Lee Kuan Yew on 15 November 2010, but began seeing outpatients and day surgery patients on 28 March that year. Spanning over 3.5 hectares (8.6 acres) in the Yishun Central Area overlooking the scenic Yishun Pond. The hospital offers an extensive range of medical services and healthcare options for residents living in the north. As of October 2017, KTPH merged with the National Healthcare Group and is now known as Yishun Health, together with Yishun Community Hospital and Admiralty Medical Centre.
Accurate detection of ocular signs is essential for early diagnosis of eye diseases, but current AI approaches using facial or external ocular images include non-essential information, compromising performance and patient privacy. We conducted a multinational retrospective study of 2360 eyes from 1180 half-face images of thyroid eye disease patients across five racial groups from five hospitals in three countries. We developed a Dense Squeeze-and-Excitation Network (DSE-Net) to segment eyelid, conjunctiva, lacrimal caruncle, and eyeball, minimizing exposure and enhancing privacy. DSE-Net achieved Dice coefficient of 84.7%, 84.8%, 92.7%, and 95.1%, outperforming seven segmentation models. We then built SegmenView, employing LeNet, AlexNet, ResNet50, and VGGNet16 to detect eyelid edema, conjunctival erythema, caruncle or plica edema, and exophthalmos. SegmenView achieved internal Area Under the Curve (AUCs) of 71.09%, 80.81%, 90.07%, and 82.86%; external AUCs ranging 55.58%-84.29% across two test datasets, outperforming half-face and periocular models. We also compared SegmenView with four privacy-preserving methods, showing its superior ability to balance privacy protection with diagnostic accuracy. Additionally, visualizations based on Gradient-weighted Class Activation Mapping (Grad-CAM) further enhanced the model's interpretability. Our approach demonstrates high accuracy, generalizability, and potential for lightweight, privacy-preserving ocular sign detection.
Rapid advances in the diagnosis and treatment of thyroid eye disease (TED) have led to the development of three patient care guidelines by regional professional societies: the European Group on Graves’ Orbitopathy, the Oculoplastics and Orbital Diseases Group of the Chinese Medical Association Ophthalmology Branch/Thyroid Group of the Chinese Medical Association Endocrinology Branch, and the American Thyroid Association/European Thyroid Association. Although broad consensus can be found across the three guidelines, important differences could affect patient management. This review examines and compares the recommendations of these guidelines across 11 dimensions, from disease diagnosis to treatment strategies. We explore the possible root sources of these variations. The review also suggests future directions and potential implications, thus providing a comprehensive perspective of current and future management of TED.
Tracheostomal stenosis is a recognized complication following total laryngectomy, with most cases occurring within the first post-operative year. We report a case of late-onset tracheostomal stenosis in a 67-year old male, presenting 10 years after total laryngectomy, bilateral neck dissection and adjuvant radiotherapy for laryngeal squamous cell carcinoma. The patient developed progressive breathlessness on neck flexion and examination revealed a stenotic tracheostoma measuring 7 × 10mm. The patient underwent stomaplasty using bilateral advancement flaps with lateral tracheal division and flap interposition, preserving the posterior tracheal wall for potential tracheoesophageal voice rehabilitation. At 2 months follow-up, the stoma remained patient at 18 × 20 mm, with resolution of symptoms. This report highlights the potential for delayed tracheostomal stenosis years after laryngectomy and describes a straightforward and effective method for its management.
