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Oswaldo Cruz

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Arizona State University

Shiraz University Of Medical Sciences

José Francisco Pessanha

UERJ - Universidade do Estado do Rio de Janeiro / Rio de Janeiro State University

Ilka Afonso Reis

UFMG - The Federal University of Minas Gerais

Bharati Vidyapeeth college of pharmacy, kolhapur, maharashtra, India.

Marinalva Maciel

UFPA - Federal University of Pará

Sampath Chandra Prasad Rao

Manipal Academy of Higher Education

University of Cambridge

Syed umar farooq

Kakatiya University

University of Toronto

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Papers by Oswaldo Cruz

Magnetic resonance imaging in the evaluation of clinical trials in multiple sclerosis

Annals of Neurology, 1994

Magnetic resonance imaging (MRI) provides an objective method of evaluating multiple sclerosis cl... more Magnetic resonance imaging (MRI) provides an objective method of evaluating multiple sclerosis clinical trials and is at least five times more sensitive to disease activity. In a recent clinical trial, MRI was also approximately twice as sensitive as clinical measurements to the treatment effect of a drug.

Autopercepção do benefício auditivo e o reconhecimento de fala em usuários de implante coclear

Audiology - Communication Research, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more

Eficácia da avaliação audiométrica no tratamento medicamentoso da otospongiose

Brazilian Journal of Otorhinolaryngology, Apr 1, 2012

A otospongiose é uma osteodistrofia focal primária da cápsula ótica que acomete indivíduos geneti... more A otospongiose é uma osteodistrofia focal primária da cápsula ótica que acomete indivíduos geneticamente predispostos e promove perda auditiva progressiva. Objetivo: Verificar a aplicabilidade da avaliação audiométrica no tratamento medicamentoso da otospongiose. Material e Método: Estudo prospectivo, randomizado, controlado, duplo-cego, envolvendo 26 pacientes com diagnóstico clínico, audiométrico e tomográfico de otospongiose. Os pacientes elegíveis para o estudo foram alocados em três grupos (A, B e C) e receberam o tratamento com alendronato de sódio (B), fluoreto de sódio (C) e placebo (A) por 6 meses. Após este período, os mesmos realizaram nova avaliação audiométrica. Resultados: Na análise das diferenças entre as vias aérea e óssea (gap), não houve diferença estatisticamente significante. Também não foram encontradas diferenças em relação ao limiar de reconhecimento da fala (SRT) e a discriminação vocal (IRF) entre os períodos pré e pós-tratamento. Conclusão: Após seis meses de tratamento medicamentoso, a avaliação audiométrica evidenciou manutenção dos limiares auditivos, sugerindo estabilização da atividade da lesão otospongiótica.

Intracranial complications of otitis media: 15 years of experience in 33 patients

Otolaryngology-Head and Neck Surgery, 2005

Complications in the central nervous system (CNS) from acute otitis media (AOM) and chronic otiti... more Complications in the central nervous system (CNS) from acute otitis media (AOM) and chronic otitis media (COM) are becoming fewer, although they still represent a challenge for early recognition, adequate treatment, and satisfactory results. This retrospective study analyzed clinical data and therapeutic options in 33 patients with intracranial involvement resulting from otitis media. Important clinical features of intracranial complications and the sequence of the most efficient therapeutic maneuvers are discussed. METHODS: Charts of six patients with AOM and 27 patients with COM associated with CNS complications were analyzed for clinical presentation, imaging, and therapeutic approach. RESULTS: Ages ranged from 6 months to 79 years, with no gender predilection. Persistent fever, headache, and purulent otorrhea were the main symptoms. Proteus mirabilis, Enterococcus, and Pseudomonas aeruginosa were the most common microorganisms in COM, and Pneumococus and Haemophilus were the most common microorganisms in AOM. Nineteen patients (58%) presented with more than 1 CNS complication, resulting in a total of 56 complications, including 26 cases of otogenic brain abscess, 21 cases of meningitis, 5 cases of lateral sinus thromboses, two cases of subdural empyemas, 1 case of epidural empyema, and 1 case of meningocele. Surgical interventions included craniotomy and drainage of the abscess (n ‫؍‬ 17), open mastoidectomy with abscess drained through the mastoid (n ‫؍‬ 10), open mastoidectomy alone (n ‫؍‬ 8), and closed mastoidectomy (n ‫؍‬ 2). Twelve patients who underwent craniotomy had subsequent mastoidectomy for recurrent abscess. At the 6-month, 66% of patients presented without sequelae, 24% presented with sequelae, and 9% died. CONCLUSION: Early identification and prompt clinical and surgical intervention with mandatory drainage of the middle ear (primary disease), was essential for better outcome.

Clinical, etiological and progression factors of hearing in sudden deafness

Brazilian Journal of Otorhinolaryngology, Sep 1, 2005

Out of the many forms of therapy for sudden deafness, some require hospitalization and present si... more Out of the many forms of therapy for sudden deafness, some require hospitalization and present significant risks. Aim: This prospective study analyzes etiology and evolution in cases of sudden deafness (SD) where outpatient oral treatment was used. Study design: clinical with transversal cohort. Material and Method: Forty cases of sudden hearing loss were followed for at least one year. All were submitted to initial clinical evaluation, auditory tests, routine blood analysis, and magnetic resonance imaging. All received initial treatment with pentoxifylline and prednisone. Results: 45% (n=18) presented normal auditory thresholds, 40% (n=16) showed some improvement in hearing, 15% (n=6) maintained initial hearing level. Nine cases (22.5%) presented clinical conditions possibly implicated in hearing loss (viral infection, immunomediated hearing loss, vascular disorders, and so on); three (7.5%) had cerebellopontine tumors. Evolution of hearing in these 12 cases with presumed etiology presented no differences from hearing in the 28 cases without any known etiological factor. Clinical treatment within the first seven days was the only statistically significantly different condition in patients who improved hearing. Conclusions: An objective search for etiological bases should be conducted in any case of acute sensorineural hearing loss. The presence of cerebellopontine tumors in 7.5% of cases of SD, among other treated causes, justifies a thorough clinical investigation in these patients. Overall good evolution of hearing was observed in 67.5% of cases of SD, regardless of its etiology. Therapy within the first seven days of SD was significantly related to better outcomes in hearing.

R022: Sudden Deafness: Etiology and Evolution in 40 Cases

Otolaryngology-Head and Neck Surgery, Aug 1, 2003

Results: 45% of the patients (n = 18) showed normalization of auditory thresholds, 40% (n = 16) s... more

08:54 AM: Importance of Correct Classification of Acute Hearing Loss

Otolaryngology-Head and Neck Surgery, Aug 1, 2006

ated. Over three years after the second-stage operation, the microscopic otoscopy revealed no rec... more ated. Over three years after the second-stage operation, the microscopic otoscopy revealed no recurrence. A shallow pocket in 4 cases and a deep pocket with no debris in 2 cases were seen. CONCLUSIONS: This incidence of postoperative pocket (6/ 69: 8.7%) is statistically smaller than the team's previous data (41/134: 30.6%, pϽ0.05) in 1993. The conclusion is that the latest improvement of a SCUT is appropriate for prevention of cholesteatoma recurrence at the moment.

11:16 AM: Intracranial Complications of Otitis Media: 15 Years of Experience with 33 Patients

Otolaryngology-Head and Neck Surgery, Aug 1, 2003

Tinnitus Treatment with Trazodone

Brazilian Journal of Otorhinolaryngology, 2007

Ti nnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. Aim:... more Ti nnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. Aim: Evaluate if Trazodone, an antidepressant drug, which modulates serotonin at central neuronal pathways, is effective in controlling tinnitus. Study Design: Prospective, double blind, randomized, placebo-controlled. Materials and Methods: Study performed with patients presenting tinnitus. 85 patients were analyzed between February and June of 2005. 43 received trazodone and 42 placebo, for 60 days. The clinical criteria of analysis were tinnitus intensity, discomfort and life quality impact by tinnitus, using an analogue scale varying between 0 and 10, scored by patients before and after drug or placebo use. Results: There was a significant improvement in intensity, discomfort and life quality in both groups after treatment; however, there was no significant difference between the drug and placebo groups. Patients with age equal or over 60 years presented better results after treatment. Conclusion: Trazodone was not efficient in controlling tinnitus in the patients evaluated under the doses utilized.

National Campaign to Prevent Falls in the Elderly Population September 27

Brazilian Journal of Otorhinolaryngology, 2008

Epidemiology of Otitis Media Complication: 20 Year Study

Otolaryngology - Head and Neck Surgery, 2010

exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases ... more exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases of LF, 5(13.5%) and none (0%) of the control developed Early-onset SNHL (pϭ0.03). Forty percent of the cases studied had negative IgM. The audiograms ranged from 65-85dB and the speech discrimination 20-40%. Overall case fatality rate was 27%, and for Early-SNHL cases 60% (pϾ0.05). CONCLUSION: The incidence of sensorineural hearing loss in Lassa fever infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.

Clinical and histopathological changes of the nasal mucosa induced by sulfuric acid mists

Otolaryngology - Head and Neck Surgery, 1996

Sigmoid Sinus Thrombosis Associated to Chronic Otitis Media

Brazilian Journal of Otorhinolaryngology, 2007

Rinometria acústica em crianças submetidas à disjunção maxilar

by Alexandre Zanesco and Oswaldo Cruz

Revista Dental Press de Ortodontia e Ortopedia Facial, 2006

OBJETIVO: este estudo foi realizado na Disciplina de Otorrinolaringologia Pediátrica da Escola Pa... more OBJETIVO: este estudo foi realizado na Disciplina de Otorrinolaringologia Pediátrica da Escola Paulista de Medicina - UNIFESP, com o objetivo de verificar o comportamento da disjunção maxilar e sua influência na cavidade nasal em crianças de 7 a 8 anos de idade submetidas à rinometria acústica. METODOLOGIA: foram avaliadas 20 crianças respiradoras bucais, portadoras de atresia maxilar diagnosticada clinicamente e submetidas à avaliação objetiva da cavidade nasal pré-disjunção maxilar e pós-disjunção maxilar por meio de rinometria acústica, analisando-se os resultados das áreas transversais mínimas (MCA1 e MCA2) e volumes nasais (VOL1 e VOL2). RESULTADOS: os resultados de MCA1 e MCA2 pré-disjunção maxilar apresentaram-se menores que os valores de MCA1 e MCA2 pós-disjunção maxilar do lado esquerdo; à direita, a MCA1 pré-disjunção maxilar mostrou-se menor que a MCA1 pós-disjunção maxilar, aumentos estes estatisticamente significantes, já os VOL1 e VOL2 pré-disjunção foram menores que o...

The value of prognostic clinical data in Bell’s palsy

Brazilian Journal of Otorhinolaryngology, 2005

El ectroneurography (ENoG) and clinical staging are currently the methods of choice to indicate p... more El ectroneurography (ENoG) and clinical staging are currently the methods of choice to indicate prognosis in Bell's palsy, although ENoG is an electrophysiological test not universally available. Aim: Identify other options of prognostic evaluation based upon clinical aspects and minimal electrical stimulation test allowing prognostic measurement in almost any circumstances. Study design: historic cohort. Material and Method: Chart review of 1,521 cases of IPFP, analyzing the following clinical aspects: gender, age, paralyzed side, installation mode, previous symptoms, associated symptoms and minimal electrical stimulation test (Hilger test) and its statistical correlation to facial palsy evolution after 6 months. Results: Data indicated that patients above 60 years old had worse prognosis in comparison with patients under 30 years old. A progressive mode of paralysis installation, absence of previous symptoms, concomitant vertigo and response superior to 3.5 mA at minimum electrical stimulation test were also related to worse prognosis. On the other hand, the absence of concomitant symptoms, diminished tearing and sudden onset were related to better prognosis. Conclusion: Clinical factors and Hilger's test can accurately indicate the prognosis in cases of Bell's palsy when ENoG is not available.

Presentation, treatment, and clinical course of otogenic lateral sinus thrombosis

Acta Oto-laryngologica, 2009

Conclusions. Otogenic lateral sinus thrombosis (OLST) is almost always associated with other comp... more Conclusions. Otogenic lateral sinus thrombosis (OLST) is almost always associated with other complications of chronic otitis media (COM) and did not present a distinct clinical expression. In our experience, OLST exhibits a benign course if the underlying disease is controlled. Mastoidectomy in combination with broad-spectrum antibiotics provided effective treatment. Anticoagulation therapy is no longer used routinely. Recanalization is rare and is independent of the use of anticoagulants. Objectives. This study aimed to contribute to the understanding of the clinical aspects and evolution of OLST. Patients and methods. The study investigated a retrospective case series in a tertiary teaching hospital. From 1993 to 2007, eight cases of OLST were treated. The clinical and imaging data, treatments, and outcomes were analyzed. The follow-up period ranged from a minimum of 6 months to 5 years. Results. In all eight patients, the lateral sinus thrombosis was detected by imaging studies performed to evaluate complications and symptoms related to COM. Fever, headache, and cranial nerve paralysis were the main clinical manifestations associated with coexisting mastoiditis, meningitis, and cerebellar and epidural abscess. We could not identify features specific to lateral sinus thrombosis in any case. All patients underwent mastoidectomy and were given broad-spectrum antibiotics for 2 months. Four cases were anticoagulated and all eight cases experienced complete clinical recovery without sequelae.

Fatores clínicos, etiológicos e evolutivos da audição na surdez súbita

Revista Brasileira de Otorrinolaringologia, 2005

Existem várias terapias preconizadas para o tratamento da surdez súbita, algumas apresentam risco... more Existem várias terapias preconizadas para o tratamento da surdez súbita, algumas apresentam riscos significativos necessitando inclusive de internação hospitalar. OBJETIVO: Este estudo prospectivo analisa aspectos clínicos, etiológicos e evolutivos nos casos de surdez súbita (SS) em pacientes tratados ambulatorialmente com medicação oral. FORMA DE ESTUDO: clínico com coorte transversal. MATERIAL E MÉTODO: 40 pacientes com perda súbita da audição submeteram inicialmente a avaliação clínica otorrinolaringológica, testes audiométricos, análise hematológica e ressonância magnética. Confirmado o diagnóstico de SS, todos os pacientes receberam inicialmente prednisona e pentoxifilina sendo acompanhados por pelo menos um ano. RESULTADO: 45% (n=18) apresentaram normalização dos limiares auditivos, 40% (n=16) apresentaram melhoras auditivas, 15% (n=6) mantiveram os mesmos limiares iniciais. Nove casos (22,5%) apresentaram manifestações clínicas que justificaram a perda auditiva (infecção vira...

Patologia do canal auditivo interno

Rev Bras Med Otorrinolaringol, Mar 1, 1996

Comit� multiprofissional em sa�de auditiva: COMUSA

Brazilian Journal of Otorhinolaryngology, 2010

Fatores cl�nicos, etiol�gicos e evolutivos da audi��o na surdez s�bita

Revista Brasileira De Otorrinolaringologia, 2005

Magnetic resonance imaging in the evaluation of clinical trials in multiple sclerosis

Annals of Neurology, 1994

Magnetic resonance imaging (MRI) provides an objective method of evaluating multiple sclerosis cl... more Magnetic resonance imaging (MRI) provides an objective method of evaluating multiple sclerosis clinical trials and is at least five times more sensitive to disease activity. In a recent clinical trial, MRI was also approximately twice as sensitive as clinical measurements to the treatment effect of a drug.

Autopercepção do benefício auditivo e o reconhecimento de fala em usuários de implante coclear

Audiology - Communication Research, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more

Eficácia da avaliação audiométrica no tratamento medicamentoso da otospongiose

Brazilian Journal of Otorhinolaryngology, Apr 1, 2012

A otospongiose é uma osteodistrofia focal primária da cápsula ótica que acomete indivíduos geneti... more A otospongiose é uma osteodistrofia focal primária da cápsula ótica que acomete indivíduos geneticamente predispostos e promove perda auditiva progressiva. Objetivo: Verificar a aplicabilidade da avaliação audiométrica no tratamento medicamentoso da otospongiose. Material e Método: Estudo prospectivo, randomizado, controlado, duplo-cego, envolvendo 26 pacientes com diagnóstico clínico, audiométrico e tomográfico de otospongiose. Os pacientes elegíveis para o estudo foram alocados em três grupos (A, B e C) e receberam o tratamento com alendronato de sódio (B), fluoreto de sódio (C) e placebo (A) por 6 meses. Após este período, os mesmos realizaram nova avaliação audiométrica. Resultados: Na análise das diferenças entre as vias aérea e óssea (gap), não houve diferença estatisticamente significante. Também não foram encontradas diferenças em relação ao limiar de reconhecimento da fala (SRT) e a discriminação vocal (IRF) entre os períodos pré e pós-tratamento. Conclusão: Após seis meses de tratamento medicamentoso, a avaliação audiométrica evidenciou manutenção dos limiares auditivos, sugerindo estabilização da atividade da lesão otospongiótica.

Intracranial complications of otitis media: 15 years of experience in 33 patients

Otolaryngology-Head and Neck Surgery, 2005

Complications in the central nervous system (CNS) from acute otitis media (AOM) and chronic otiti... more Complications in the central nervous system (CNS) from acute otitis media (AOM) and chronic otitis media (COM) are becoming fewer, although they still represent a challenge for early recognition, adequate treatment, and satisfactory results. This retrospective study analyzed clinical data and therapeutic options in 33 patients with intracranial involvement resulting from otitis media. Important clinical features of intracranial complications and the sequence of the most efficient therapeutic maneuvers are discussed. METHODS: Charts of six patients with AOM and 27 patients with COM associated with CNS complications were analyzed for clinical presentation, imaging, and therapeutic approach. RESULTS: Ages ranged from 6 months to 79 years, with no gender predilection. Persistent fever, headache, and purulent otorrhea were the main symptoms. Proteus mirabilis, Enterococcus, and Pseudomonas aeruginosa were the most common microorganisms in COM, and Pneumococus and Haemophilus were the most common microorganisms in AOM. Nineteen patients (58%) presented with more than 1 CNS complication, resulting in a total of 56 complications, including 26 cases of otogenic brain abscess, 21 cases of meningitis, 5 cases of lateral sinus thromboses, two cases of subdural empyemas, 1 case of epidural empyema, and 1 case of meningocele. Surgical interventions included craniotomy and drainage of the abscess (n ‫؍‬ 17), open mastoidectomy with abscess drained through the mastoid (n ‫؍‬ 10), open mastoidectomy alone (n ‫؍‬ 8), and closed mastoidectomy (n ‫؍‬ 2). Twelve patients who underwent craniotomy had subsequent mastoidectomy for recurrent abscess. At the 6-month, 66% of patients presented without sequelae, 24% presented with sequelae, and 9% died. CONCLUSION: Early identification and prompt clinical and surgical intervention with mandatory drainage of the middle ear (primary disease), was essential for better outcome.

Clinical, etiological and progression factors of hearing in sudden deafness

Brazilian Journal of Otorhinolaryngology, Sep 1, 2005

Out of the many forms of therapy for sudden deafness, some require hospitalization and present si... more Out of the many forms of therapy for sudden deafness, some require hospitalization and present significant risks. Aim: This prospective study analyzes etiology and evolution in cases of sudden deafness (SD) where outpatient oral treatment was used. Study design: clinical with transversal cohort. Material and Method: Forty cases of sudden hearing loss were followed for at least one year. All were submitted to initial clinical evaluation, auditory tests, routine blood analysis, and magnetic resonance imaging. All received initial treatment with pentoxifylline and prednisone. Results: 45% (n=18) presented normal auditory thresholds, 40% (n=16) showed some improvement in hearing, 15% (n=6) maintained initial hearing level. Nine cases (22.5%) presented clinical conditions possibly implicated in hearing loss (viral infection, immunomediated hearing loss, vascular disorders, and so on); three (7.5%) had cerebellopontine tumors. Evolution of hearing in these 12 cases with presumed etiology presented no differences from hearing in the 28 cases without any known etiological factor. Clinical treatment within the first seven days was the only statistically significantly different condition in patients who improved hearing. Conclusions: An objective search for etiological bases should be conducted in any case of acute sensorineural hearing loss. The presence of cerebellopontine tumors in 7.5% of cases of SD, among other treated causes, justifies a thorough clinical investigation in these patients. Overall good evolution of hearing was observed in 67.5% of cases of SD, regardless of its etiology. Therapy within the first seven days of SD was significantly related to better outcomes in hearing.

R022: Sudden Deafness: Etiology and Evolution in 40 Cases

Otolaryngology-Head and Neck Surgery, Aug 1, 2003

Results: 45% of the patients (n = 18) showed normalization of auditory thresholds, 40% (n = 16) s... more

08:54 AM: Importance of Correct Classification of Acute Hearing Loss

Otolaryngology-Head and Neck Surgery, Aug 1, 2006

ated. Over three years after the second-stage operation, the microscopic otoscopy revealed no rec... more ated. Over three years after the second-stage operation, the microscopic otoscopy revealed no recurrence. A shallow pocket in 4 cases and a deep pocket with no debris in 2 cases were seen. CONCLUSIONS: This incidence of postoperative pocket (6/ 69: 8.7%) is statistically smaller than the team's previous data (41/134: 30.6%, pϽ0.05) in 1993. The conclusion is that the latest improvement of a SCUT is appropriate for prevention of cholesteatoma recurrence at the moment.

11:16 AM: Intracranial Complications of Otitis Media: 15 Years of Experience with 33 Patients

Otolaryngology-Head and Neck Surgery, Aug 1, 2003

Tinnitus Treatment with Trazodone

Brazilian Journal of Otorhinolaryngology, 2007

Ti nnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. Aim:... more Ti nnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. Aim: Evaluate if Trazodone, an antidepressant drug, which modulates serotonin at central neuronal pathways, is effective in controlling tinnitus. Study Design: Prospective, double blind, randomized, placebo-controlled. Materials and Methods: Study performed with patients presenting tinnitus. 85 patients were analyzed between February and June of 2005. 43 received trazodone and 42 placebo, for 60 days. The clinical criteria of analysis were tinnitus intensity, discomfort and life quality impact by tinnitus, using an analogue scale varying between 0 and 10, scored by patients before and after drug or placebo use. Results: There was a significant improvement in intensity, discomfort and life quality in both groups after treatment; however, there was no significant difference between the drug and placebo groups. Patients with age equal or over 60 years presented better results after treatment. Conclusion: Trazodone was not efficient in controlling tinnitus in the patients evaluated under the doses utilized.

National Campaign to Prevent Falls in the Elderly Population September 27

Brazilian Journal of Otorhinolaryngology, 2008

Epidemiology of Otitis Media Complication: 20 Year Study

Otolaryngology - Head and Neck Surgery, 2010

exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases ... more exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases of LF, 5(13.5%) and none (0%) of the control developed Early-onset SNHL (pϭ0.03). Forty percent of the cases studied had negative IgM. The audiograms ranged from 65-85dB and the speech discrimination 20-40%. Overall case fatality rate was 27%, and for Early-SNHL cases 60% (pϾ0.05). CONCLUSION: The incidence of sensorineural hearing loss in Lassa fever infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.

Clinical and histopathological changes of the nasal mucosa induced by sulfuric acid mists

Otolaryngology - Head and Neck Surgery, 1996

Sigmoid Sinus Thrombosis Associated to Chronic Otitis Media

Brazilian Journal of Otorhinolaryngology, 2007

Rinometria acústica em crianças submetidas à disjunção maxilar

by Alexandre Zanesco and Oswaldo Cruz

Revista Dental Press de Ortodontia e Ortopedia Facial, 2006

OBJETIVO: este estudo foi realizado na Disciplina de Otorrinolaringologia Pediátrica da Escola Pa... more OBJETIVO: este estudo foi realizado na Disciplina de Otorrinolaringologia Pediátrica da Escola Paulista de Medicina - UNIFESP, com o objetivo de verificar o comportamento da disjunção maxilar e sua influência na cavidade nasal em crianças de 7 a 8 anos de idade submetidas à rinometria acústica. METODOLOGIA: foram avaliadas 20 crianças respiradoras bucais, portadoras de atresia maxilar diagnosticada clinicamente e submetidas à avaliação objetiva da cavidade nasal pré-disjunção maxilar e pós-disjunção maxilar por meio de rinometria acústica, analisando-se os resultados das áreas transversais mínimas (MCA1 e MCA2) e volumes nasais (VOL1 e VOL2). RESULTADOS: os resultados de MCA1 e MCA2 pré-disjunção maxilar apresentaram-se menores que os valores de MCA1 e MCA2 pós-disjunção maxilar do lado esquerdo; à direita, a MCA1 pré-disjunção maxilar mostrou-se menor que a MCA1 pós-disjunção maxilar, aumentos estes estatisticamente significantes, já os VOL1 e VOL2 pré-disjunção foram menores que o...

The value of prognostic clinical data in Bell’s palsy

Brazilian Journal of Otorhinolaryngology, 2005

El ectroneurography (ENoG) and clinical staging are currently the methods of choice to indicate p... more El ectroneurography (ENoG) and clinical staging are currently the methods of choice to indicate prognosis in Bell's palsy, although ENoG is an electrophysiological test not universally available. Aim: Identify other options of prognostic evaluation based upon clinical aspects and minimal electrical stimulation test allowing prognostic measurement in almost any circumstances. Study design: historic cohort. Material and Method: Chart review of 1,521 cases of IPFP, analyzing the following clinical aspects: gender, age, paralyzed side, installation mode, previous symptoms, associated symptoms and minimal electrical stimulation test (Hilger test) and its statistical correlation to facial palsy evolution after 6 months. Results: Data indicated that patients above 60 years old had worse prognosis in comparison with patients under 30 years old. A progressive mode of paralysis installation, absence of previous symptoms, concomitant vertigo and response superior to 3.5 mA at minimum electrical stimulation test were also related to worse prognosis. On the other hand, the absence of concomitant symptoms, diminished tearing and sudden onset were related to better prognosis. Conclusion: Clinical factors and Hilger's test can accurately indicate the prognosis in cases of Bell's palsy when ENoG is not available.

Presentation, treatment, and clinical course of otogenic lateral sinus thrombosis

Acta Oto-laryngologica, 2009

Conclusions. Otogenic lateral sinus thrombosis (OLST) is almost always associated with other comp... more Conclusions. Otogenic lateral sinus thrombosis (OLST) is almost always associated with other complications of chronic otitis media (COM) and did not present a distinct clinical expression. In our experience, OLST exhibits a benign course if the underlying disease is controlled. Mastoidectomy in combination with broad-spectrum antibiotics provided effective treatment. Anticoagulation therapy is no longer used routinely. Recanalization is rare and is independent of the use of anticoagulants. Objectives. This study aimed to contribute to the understanding of the clinical aspects and evolution of OLST. Patients and methods. The study investigated a retrospective case series in a tertiary teaching hospital. From 1993 to 2007, eight cases of OLST were treated. The clinical and imaging data, treatments, and outcomes were analyzed. The follow-up period ranged from a minimum of 6 months to 5 years. Results. In all eight patients, the lateral sinus thrombosis was detected by imaging studies performed to evaluate complications and symptoms related to COM. Fever, headache, and cranial nerve paralysis were the main clinical manifestations associated with coexisting mastoiditis, meningitis, and cerebellar and epidural abscess. We could not identify features specific to lateral sinus thrombosis in any case. All patients underwent mastoidectomy and were given broad-spectrum antibiotics for 2 months. Four cases were anticoagulated and all eight cases experienced complete clinical recovery without sequelae.

Fatores clínicos, etiológicos e evolutivos da audição na surdez súbita

Revista Brasileira de Otorrinolaringologia, 2005

Existem várias terapias preconizadas para o tratamento da surdez súbita, algumas apresentam risco... more Existem várias terapias preconizadas para o tratamento da surdez súbita, algumas apresentam riscos significativos necessitando inclusive de internação hospitalar. OBJETIVO: Este estudo prospectivo analisa aspectos clínicos, etiológicos e evolutivos nos casos de surdez súbita (SS) em pacientes tratados ambulatorialmente com medicação oral. FORMA DE ESTUDO: clínico com coorte transversal. MATERIAL E MÉTODO: 40 pacientes com perda súbita da audição submeteram inicialmente a avaliação clínica otorrinolaringológica, testes audiométricos, análise hematológica e ressonância magnética. Confirmado o diagnóstico de SS, todos os pacientes receberam inicialmente prednisona e pentoxifilina sendo acompanhados por pelo menos um ano. RESULTADO: 45% (n=18) apresentaram normalização dos limiares auditivos, 40% (n=16) apresentaram melhoras auditivas, 15% (n=6) mantiveram os mesmos limiares iniciais. Nove casos (22,5%) apresentaram manifestações clínicas que justificaram a perda auditiva (infecção vira...

Patologia do canal auditivo interno

Rev Bras Med Otorrinolaringol, Mar 1, 1996

Comit� multiprofissional em sa�de auditiva: COMUSA

Brazilian Journal of Otorhinolaryngology, 2010

Fatores cl�nicos, etiol�gicos e evolutivos da audi��o na surdez s�bita

Revista Brasileira De Otorrinolaringologia, 2005