RICHARD LOUIS VOEGELS

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Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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Revista / Livro: Brazilian Journal of Otorhinolaryngology ×

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Agora exibindo 1 - 10 de 17
  • article 8 Citação(ões) na Scopus
    Assessment of quality of life after endoscopic sinus surgery for chronic rhinosinusitis
    (2012) BEZERRA, Thiago Freire Pinto; PICCIRILLO, Jay F.; FORNAZIERI, Marco Aurelio; PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; PADUA, Francini Grecco de Melo; VOEGELS, Richard Louis
    Chronic rhinosinusitis is a disease of undefined etiology that significantly impacts the quality of life of its patients. Various studies carried out in countries other than Brazil have shown endoscopic sinus surgery as an effective means of treating this condition. Objective: This study aims to analyze, with the aid of SNOT-20, the association between endoscopic sinus surgery and disease-specific quality of life of Brazilian patients treated for chronic rhinosinusitis accompanied or not by nasal polyps. Materials and Methods: This prospective study enrolled patients submitted to endoscopic sinus surgery after drug therapy failed to improve their symptoms. They were assessed based on questionnaire SNOT-20p before and 12 months after surgery. Improvement on total scores and on the five items deemed more important by each patient were assessed. The study also looked into the correlation between preoperative scores and postoperative improvement and if there were any gender-related improvement differences. Results: Forty-three patients aged 44 (19), md (IQR), 65% of whom (26/43) were males. Statistically significant improvement was seen on SNOT-20 and SNOT-20(5+) and a correlation was established between preoperative scores and postoperative improved scores (p<0.001). No gender-related differences were observed in quality of life. Conclusion: Endoscopic sinus surgery in patients with chronic rhinosinusitis is associated with statistically significant improvements in disease-specific quality of life.
  • article 12 Citação(ões) na Scopus
    Endoscopic ligation of the anterior ethmoidal artery: a cadaver dissection study
    (2011) ARAUJO FILHO, Bernardo Cunha; PINHEIRO-NETO, Carlos Diogenes; RAMOS, Henrique Faria; VOEGELS, Richard Louis; SENNES, Luiz Ubirajara
    Anterior ethmoidal artery (AEA) ligation may be necessary in cases of severe epistaxis not controllable with traditional therapy. Endoscopic endonasal ligation of the AEA is not used frequently; there are few studies in the literature for standardization of the endoscopic technique for this vessel. Aim: To demonstrate the feasibility of periorbital AEA ligation in a transethmoidal endoscopic approach. Methods: A prospective study where 50 nasal cavities were dissected. After anterior ethmoidectomy and partial removal of lamina papyracea, the periorbital area was carefully dissected along a subperiosteal plane to identify the AEA. The vessel was exposed within the orbit and dissected. Results: Data on technical difficulties, complications, the learning curve and anatomical variations were gathered. Conclusion: An endonasal endoscopic approach to the AEA within the orbit was shown to be feasible. Identifying the artery is not difficult, and this technique avoids external incisions. This approach appears to be an excellent alternative for approaching the AEA. Further clinical studies are needed to demonstarte the benefits of this technique.
  • article 8 Citação(ões) na Scopus
    Prospective evaluation of clarithromycin in recurrent chronic rhinosinusitis with nasal polyps
    (2021) BEZERRA, Thiago Freire Pinto; PEZATO, Rogerio; BARROS, Pamella Marletti de; COUTINHO, Larissa Leal; COSTA, Leidianny Firmino; PINNA, Fabio; VOEGELS, Richard
    Introduction: The antiinflammatory effects of macrolides, especially clarithromycin, have been described in patients with chronic rhinosinusitis without polyps and also other chronic inflammatory airway diseases. There is no consensus in the literature regarding the effectiveness of clarithromycin in patients with chronic rhinosinusitis with sinonasal polyposis and the national literature does not report any prospective studies on the efficacy of clarithromycin in chronic rhinosinusitis in our population. Objective: To evaluate the effect of clarithromycin in the adjunctive treatment of recurrent chronic rhinosinusitis with sinonasal polyposis refractory to clinical and surgical treatment. Methods: Open prospective study with 52 patients with chronic rhinosinusitis and recurrent sinonasal polyposis. All subjects received nasal lavage with 20 mL 0.9% SS and fluticasone nasal spray, 200 mcg / day, 12/12 h for 12 weeks; and clarithromycin 250 mg 8/8 h for 2 weeks and, thereafter, 12/12 h for 10 weeks. The patients were assessed by SNOT 20, NOSE and Lund-Kennedy scales before, immediately after treatment and 12 weeks after treatment. The patients were also evaluated before treatment with paranasal cavity computed tomography (Lund-Mackay) and serum IgG, IgM, IgA, IgE and eosinophil levels. The outcomes evaluated were: SNOT-20, NOSE and Lund-Kennedy. Results: Most patients were women, aged 47 (15) years (median / interquartile range), and 61.5% (32/52) had asthma. All patients completed the follow-up after 12 weeks and 42.3% (22/52) after 24 weeks. Treatment resulted in a quantitative decrease in the SNOT-20 [2.3 (1.6) vs. 1.4 (1.6); Delta = -0.9 (1.1); p < 0.01]; NOSE [65 (64) vs. 20 (63); Delta = -28 (38), p < 0.01] and Lund-Kennedy [11 (05) vs. 07 (05); Delta = -2 (05); p < 0.01] scores. SNOT-20 showed a qualitative improvement (>0.8) in 54% (28/52, p < 0.04) of patients, a group that showed lower IgE level [108 (147) vs. 289 (355), p < 0.01]. The group of patients who completed follow-up 12 weeks after the end of treatment (n = 22) showed no worsening of outcomes. Conclusion: Long-term adjuvant use of low-dose clarithromycin for chronic rhinosinusitis patients with recurrent sinonasal polyposis refractory to clinical and surgical treatment has resulted in improved quality of life and nasal endoscopy findings, especially in patients with normal IgE levels. This improvement persisted in the patient group evaluated 12 weeks after the end of the treatment. (C) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 0 Citação(ões) na Scopus
    Biopsy of the olfactory epithelium from the superior nasal septum: is it possible to obtain neurons without damaging olfaction?
    (2022) GARCIA, Ellen Cristine Duarte; LUZ, Lucas de Almeida; ANZOLIN, Lucas Kanieski; SILVA, Jose Lucas Barbosa da; DOTY, Richard L.; PINNA, Fabio de Rezende; VOEGELS, Richard Louis; FORNAZIERI, Marco Aurelio
    Introduction: Olfactory epithelium biopsy has been useful for studying diverse otorhinolaryngological and neurological diseases, including the potential to better understand the pathophysiology behind COVID-19 olfactory manifestations. However, the safety and efficacy of the technique for obtaining human olfactory epithelium are still not fully established. Objective: This study aimed to determine the safety and efficacy of harvesting olfactory epithelium cells, nerve bundles, and olfactory epithelium proper for morphological analysis from the superior nasal septum. Methods: During nasal surgery, 22 individuals without olfactory complaints underwent olfactory epithelium biopsies from the superior nasal septum. The efficacy of obtaining olfactory epithelium, verification of intact olfactory epithelium and the presence of nerve bundles in biopsies were assessed using immunofluorescence. Safety for the olfactory function was tested psychophysically using both unilateral and bilateral tests before and 1 month after the operative procedure. Results: Olfactory epithelium was found in 59.1% of the subjects. Of the samples, 50% were of the quality necessary for morphological characterization and 90.9% had nerve bundles. There was no difference in the psychophysical scores obtained in the bilateral olfactory test (University of Pennsylvania Smell Identification Test [UPSIT (R)]) between means before biopsy: 32.3 vs. postoperative: 32.5, p = 0.81. Also, no significant decrease occurred in unilateral testing (mean unilateral test scores 6 vs. 6.2, p = 0.46). None out of the 56 different odorant identification significantly diminished (p > 0.05). Conclusion: The technique depicted for olfactory epithelium biopsy is highly effective in obtaining neuronal olfactory tissue, but it has moderate efficacy in achieving samples useful for morphological analysis. Olfactory sensitivity remained intact. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 39 Citação(ões) na Scopus
    Quality of life assessment septoplasty in patients with nasal obstruction
    (2012) BEZERRA, Thiago Freire Pinto; STEWART, Michael G.; FORNAZIERI, Marco Aurelio; PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; PADUA, Francini Grecco de Melo; VOEGELS, Richard Louis
    Naasal obstruction is a common complaint in the population. When caused by a deviated nasal septum, septoplasty is the procedure of choice for treating these patients. NOSE is a tool for assessing the disease-specific quality of life related to nasal obstruction. Aim: To assess the impact of septoplasty on patients with nasal obstruction secondary to deviated nasal septum based on the disease-specific quality-of-life questionnaire. Design: Prospective. Methods: Patients undergoing septoplasty with/without turbinectomy after no clinical improvement with medical treatment were assessed by the NOSE questionnaire before and 3 months after surgery. We evaluated the surgical improvement based on total score, the magnitude of the surgery in the disease-specific quality of life and the correlation between the preoperative score and postoperatively improvement. Results: Fourty-six patients were included in the study. There was a statistically significant improvement in the preoperative NOSE score (md = 75, IQR = 26) and after three months (md = 10, IQR = 20) (p < 0.001.T-Wilcoxon). The standardized response mean was 3.07. We found a strong correlation between the preoperative score in the NOSE questionnaire and improvements in the postoperative period (r = -0.789, p < 0.001, Spearman). No difference was found in improvement scores by gender. (p = 0.668, U-Mann-Whitney). Conclusion: Septoplasty resulted in a statistically significant improvement in the disease-specific QOL questionnaire.
  • article 7 Citação(ões) na Scopus
    Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (RSCwPN) in Brazil
    (2022) ANSELMO-LIMA, Wilma T.; TAMASHIRO, Edwin; ROMANO, Fabrizio R.; MIYAKE, Marcel M.; ROITHMANN, Renato; KOSUGI, Eduardo M.; NAKANISHI, Marcio; FORNAZIERI, Marco A.; BEZERRA, Thiago F. P.; MELLO, Joao F.; LESSA, Marcus M.; VOEGELS, Richard L.; PILTCHER, Otavio B.; SAKANO, Eulalia; VALERA, Fabiana C. P.
    Introduction: Severe uncontrolled chronic rhinosinusitis with nasal polyps has a negative impact on an individual's quality of life. Therefore, new biologics have emerged for use in specific phenotypes of chronic rhinosinusitis, changing the paradigms of its treatment. Objective: To review the current status of biologic treatment indications in chronic rhinosinusitis. Methods: The Brazilian Academy of Rhinology brought together different specialists to suggest a course of action, considering its particularities and aspects related to the national reality. Results: Of particular interest for decision making will be the identification of subgroups of patients refractory to pre-existing treatment options and the construction of a strategy that improves their quality of life, with the best cost-benefit ratio. Conclusion: The use of biologics is a valid option for treatment in more severe cases. This strategy must be better understood and improved in the future, with more studies and greater clinical experience.
  • article 0 Citação(ões) na Scopus
    Anatomical terminology of the internal nose and paranasal sinuses: cross-cultural adaptation to Portuguese
    (2018) BEZERRA, Thiago Freire Pinto; STAMM, Aldo; ANSELMO-LIMA, Wilma Teresinha; FORNAZIERI, Marco Aurelio; MELO, Nelson D'Avila; BALSALOBRE, Leonardo; JOTZ, Geraldo Pereira; LEAO, Henrique Zaquia; NUNES, Andre Alencar Araripe; FELIPPU, Alexandre; CEDIN, Antonio Carlos; PINHEIRO-NETO, Carlos D.; OLIVEIRA, Diego Lima; SAKANO, Eulalia; KOSUGI, Eduardo Macoto; ARAUJO, Elizabeth; VALERA, Fabiana Cardoso Pereira; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francine Grecco de Melo; RAMOS, Henrique Faria; TELLES JR., Joao; SA, Leonardo Conrado Barbosa de; D'ASSUNCAO FILHO, Leopoldo Marques; SENNES, Luiz Ubirajara; GREGORIO, Luis Carlos; SAMPAIO, Marcelo H.; SANTOS, Marco Cesar Jorge dos; FRANCA, Marco; MOCELLIN, Marcos; LESSA, Marcus Miranda; AVELINO, Melissa Ameloti G.; TEPEDINO, Miguel; ANDRADE, Nilvano Alves de; PILTCHER, Otavio B.; ROITHMANN, Renato; PILAN, Renata Mendonca; MEIRELES, Roberto Campos; GUIMARAES, Roberto Eustaquio; SANTOS, Rodrigo de Paula; PEZATO, Rogerio; PIGNATARI, Shirley; ABDO, Tatiana Telles; NAKAJIMA, Victor; ALMEIDA, Washington; VOEGELS, Richard L.
    Introduction: Functional endonasal endoscopic surgery is a frequent surgical procedure among otorhinolaryngologists. In 2014, the European Society of Rhinology published the ""European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses"", aiming to unify the terms in the English language. We do not yet have a unified terminology in the Portuguese language. Objective: Transcultural adaptation of the anatomical terms of the nose and paranasal cavities of the ""European Anatomical Terminology of the Internal Nose and Paranasal Sinuses"" to Portuguese. Methods: A group of rhinologists from diverse parts of Brazil, all experienced in endoscopic endonasal surgery, was invited to participate in the creation of this position paper on the anatomical terms of the nose and paranasal sinuses in the Portuguese language according to the methodology adapted from that previously described by Rudmik and Smith. Results: The results of this document were generated based on the agreement of the majority of the participants according to the most popular suggestions among the rhinologists. A cross-cultural adaptation of the sinonasal anatomical terminology was consolidated. We suggest the terms ""inferior turbinate"", ""nasal septum"", ""(bone/cartilaginous) part of the nasal septum"", ""(middle/inferior) nasal meatus"", ""frontal sinus drainage pathway"", ""frontal recess"" and ""uncinate process"" be standardized. Conclusion: We have consolidated a Portuguese version of the European Anatomical Terminology of the Internal Nose and Paranasal Sinuses, which will help in the publication of technical announcements, scientific publications and the teaching of the internal anatomical terms of the nose and paranasal sinuses in Brazil. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 0 Citação(ões) na Scopus
    Anatomical terminology of the internal nose and paranasal sinuses: cross-cultural adaptation to Portuguese (vol 85, pg 130, 2019)
    (2019) BEZERRA, Thiago Freire Pinto; STAMM, Aldo; ANSELMO-LIMA, Wilma Teresinha; FORNAZIERI, Marco Aurelio; MELO, Nelson D'Avila; BALSALOBRE, Leonardo; JOTZ, Geraldo Pereira; LEAO, Henrique Zaquia; NUNES, Andre Alencar Araripe; FELIPPU, Alexandre; CEDIN, Antonio Carlos; PINHEIRO-NETO, Carlos D.; OLIVEIRA, Diego Lima; SAKANO, Eulalia; KOSUGI, Eduardo Macoto; ARAUJO, Elizabeth; VALERA, Fabiana Cardoso Pereira; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francine Grecco de Melo; RAMOS, Henrique Faria; TELLES JR., Joao; SA, Leonardo Conrado Barbosa de; D'ASSUNCAO FILHO, Leopoldo Marques; SENNES, Luiz Ubirajara; GREGORIO, Luis Carlos; SAMPAIO, Marcelo H.; SANTOS, Marco Cesar Jorge dos; FRANCA, Marco; MOCELLIN, Marcos; LESSA, Marcus Miranda; AVELINO, Melissa Ameloti G.; TEPEDINO, Miguel; ANDRADE, Nilvano Alves de; PILTCHER, Otavio B.; ROITHMANN, Renato; PILAN, Renata Mendonca; MEIRELES, Roberto Campos; GUIMARAES, Roberto Eustaquio; SANTOS, Rodrigo de Paula; PEZATO, Rogerio; PIGNATARI, Shirley; ABDO, Tatiana Telles; NAKAJIMA, Victor; ALMEIDA, Washington; NAKANISHI, Marcio; VOEGELS, Richard L.
  • article 5 Citação(ões) na Scopus
    Rhinosinusitis: evidence and experience. A summary
    (2015) ANSELMO-LIMA, Wilma T.; SAKANO, Eulalia; TAMASHIRO, Edwin; NUNES, Andre Alencar Araripe; FERNANDES, Atilio Maximino; PEREIRA, Elizabeth Araujo; ORTIZ, Erica; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francini Grecco de Melo; MELLO JUNIOR, Joao Ferreira; TELES JUNIOR, Joao; DOLCI, Jose Eduardo Lutaif; BALSALOBRE FILHO, Leonardo Lopes; KOSUGI, Eduardo Macoto; SAMPAIO, Marcelo Hamilton; NAKANISHI, Marcio; SANTOS, Marco Cesar Jorge dos; ANDRADE, Nilvano Alves de; MION, Olavo de Godoy; PILTCHER, Otavio Bejzman; FUJITA, Reginaldo Raimundo; ROITHMANN, Renato; VOEGELS, Richard Louis; GUIMARAES, Roberto Eustaquio Santos; MEIRELES, Roberto Campos; NAKAJIMA, Victor; VALERA, Fabiana Cardoso Pereira; PIGNATARI, Shirley Shizue Nagata
  • article 0 Citação(ões) na Scopus
    Brazilian academy of rhinology position paper on topical intranasal therapy (vol 79, pg 391, 2013)
    (2013) MELLO JUNIOR, Joao Ferreira de; MION, Olavo de Godoy; ANDRADE, Nilvano Alves de; ANSELMO-LIMA, Wilma Terezinha; STAMM, Aldo Eden Cassol; ALMEIDA, Washingthon Luiz de Cerqueira; CAVALCANTE FILHO, Pedro Oliveira; CASTRO, Fair de Carvalho e; PADUA, Francini Grecco de Melo; ROMANO, Fabrizio Ricci; SANTOS, Rodrigo de Paulo; ROITMANN, Renato; VOEGELS, Richard Louis; MEIRELLES, Roberto Campos; SA, Leonardo Conrado Barbosa; MOACYR, Moacyr Tabasnik; SANTOS, Marco Cesar Jorge dos; GUIMARAES, Roberto Eustaquio Santos