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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  • article 1776 Citação(ões) na Scopus
    European Position Paper on Rhinosinusitis and Nasal Polyps 2020
    (2020) FOKKENS, Wytske J.; LUND, Valerie J.; HOPKINS, Claire; HELLINGS, Peter W.; KERN, Robert; REITSMA, Sietze; TOPPILA-SALMI, Sanna; BERNAL-SPREKELSEN, Manuel; MULLOL, Joaquim; ALOBID, Isam; ANSELMO-LIMA, Wilma Terezinha; BEDOYA, Juan David; BEULE, Achim; BOFARES, Khaled M.; BRAVERMAN, Itzhak; BROZEK-MADRY, Eliza; BYARUHANGA, Richard; CALLEJAS, Claudio; CARRIE, Sean; HAMIZAN, Aneeza W.; MAHDJOUBI, Abdelhak; OZKAN, Muge; CAULLEY, Lisa; CHUSSI, Desderius; CORSO, Eugenio de; COSTE, Andre; HADI, Usama El; ELFAROUK, Ahmed; ELOY, Philippe H.; FARROKHI, Shokrollah; FELISATI, Giovanni; HEINICHEN, Julio V.; PERIC, Aleksandar; FERRARI, Michel D.; MESBAHI, Alireza; FISHCHUK, Roman; GRAYSON, Jessica W.; HUSAIN, Salina; PING, Tang Ing; IVASKA, Justinas; NETKOVSKI, Jane; JAKIMOVSKA, Frodita; KOSAK, Tanja Soklic; PLZAK, Jan; JOVANCEVIC, Ljiljana; KAKANDE, Emily; KAMEL, Reda; KARPISCHENKO, Sergei; KARIYAWASAM, Harsha H.; KAWAUCHI, Hideyuki; KJELDSEN, Anette; KLIMEK, Ludger; KRZESKI, Antoni; TSHIPUKANE, Dieudonne Nyenbue; PROKOPAKIS, Emmanuel; STJARNE, Par; BARSOVA, Gabriela Kopacheva; KIM, Sung Wam; LAL, Devyani; LETORT, Jose J.; OBANDO-VALVERDE, Andres; OKANO, Mitsuhiro; ONERCI, Metin; ONG, Yew Kwang; ORLANDI, Richard; PREPAGERAN, Nerayanan; BACHERT, Claus; SUTIKNO, Budi; OTORI, Nobuyoshi; OUENNOUGHY, Kheir; PSALTIS, Alkis; PUGIN, Benoit; RAFTOPULOS, Marco; STEINSVAG, Sverre; BAROODY, Fuad; JOOS, Guy F.; ROMBAUX, Philippe; RIECHELMANN, Herbert; SAHTOUT, Semia; SARAFOLEANU, Caius-Codrut; SEARYOH, Kafui; RHEE, Chae-Seo; SHI, Jianbo; SHKOUKANI, Mahdi; SHUKURYAN, Arthur K.; TANTILIPIKORN, Pongsakorn; KALOGJERA, Livije; SICAK, Marian; BUCHWALD, Christian von; SMYTH, David; SNIDVONGS, Kornkiat; THANAVIRATANANICH, Sanguansak; Thuy Tran; URBANCIC, Jure; CERVIN, Anders; VALIULIS, Arunas; AHLSTROM-EMANUELSSON, Cecilia; KNILL, Andrew; APARICIO, Carolina Vasquez de; VICHEVA, Dilyana; VIRKKULA, Paula M.; VICENTE, Gil; VOEGELS, Richard; WAGENMANN, Martin; WARDANI, Retno S.; WELGE-LUSSEN, Antje; WITTERICK, Ian; COHEN, Noam; KOCKS, Janwillem H.; ALABRI, Rashid; WRIGHT, Erin; ZABOLOTNIY, Dmytro; ZSOLT, Bella; ZWETSLOOT, Casper P.; CONSTANTINIDIS, Jannis; GABORY, Ludovic De; DESROSIERS, Martin; DIAMANT, Zuzana; DOUGLAS, Richard G.; LANDIS, Basile N.; GEVAERT, Philippe H.; ALBU, Silviu; HAFNER, Anita; HARVEY, Richard J.; LIMPENS, Jacqueline; LEBEER, Sarah; LOURENCO, Olga; ALHABASH, Saied; MATRICARDI, Paolo M.; GONCALVES, Paulo M.; MECO, Cem; O'MAHONY, Liam; PHILPOTT, Carl M.; RYAN, Dermot; SCHLOSSER, Rodney; SENIOR, Brent; SMITH, Timothy L.; TEELING, Thijs; TOMAZIC, Peter Valentin; ALEKSIC, Aleksandra; GRDINIC, Boris; WANG, De Yun; WANG, Dehui; ZHANG, Luo; AGIUS, Adrian M.; ALOULAH, Mohammad; AL-QUDAH, Mohannad; ALSALEH, Saad; BABAN, Muaid Aziz; BAUDOIN, Tomislav; LOPATIN, Andrey; GRGIC, Velimir; BALVERS, Tijmen; BATTAGLIA, Paolo
    The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.
  • article 3 Citação(ões) na Scopus
    Fire simulator exposure alters the innate epithelial response and inflammatory status in the airways of firefighters
    (2021) CORDEIRO, Telma Gomes; AMARAL, Jonatas Bussador do; PAVAO, Valdir; CARDOSO, Ricardo Galesso; VOEGELS, Richard Louis; PEZATO, Pedro Michaluat; PAIXAO, Vitoria; ALMEIDA, Ewin Barbosa de; BACHI, Andre Luis Lacerda; PEZATO, Rogerio
    Background: Firefighters are often exposed to high temperatures and by-products of combustion, which can compromise their health. We aimed to evaluate the effect of fire exposure in fire simulators on the airways of firefighters at different time-points. Methodology: Thirty-seven male firefighters exposed to fire simulators were evaluated in three phases: pre-exposure, at the end of the first week, and 4 weeks after. Pulmonary function by spirometry, nasal mucociliary clearance; peripheral oxygen saturation, inflammatory markers in the nasal lavage and CC16 in the sputum, nasal obstruction, and quality of life (using the questionnaires NOSE and SNOT-22) were assessed. Results: Higher levels of IL-8, IL-10, and exhaled carbon monoxide were found more in phase 2 than in phase 1. Higher CC16 levels and lower peripheral oxygen saturation were observed in phase 3 as compared to phase 1. Lower levels of IL-2 and peripheral oxygen saturation were found in phase 3 than in phase 2. Higher nasal mucociliary clearance, as well as the worst quality of life and nasal obstruction, were observed in phases 2 and 3 as compared to phase 1. Conclusions: The firefighters' exposures to high temperatures and by-products of combustion in the fire simulators elicit an inflammatory process in the airways with impairment in the innate epithelial response of the upper airway lining. Furthermore, changes in O2 transport affected the professionals' quality of life negatively.
  • article 19 Citação(ões) na Scopus
    Juvenile angiofibroma: major and minor complications of preoperative embolization
    (2012) OGAWA, Alex Itar; FORNAZIERI, Marco Aurelio; SILVA, Leonardo Victor Espana Rueda da; PINNA, Fabio de Rezende; VOEGELS, Richard Louis; SENNES, Luis Ubirajara; PUGLIA JUNIOR, Paulo; CALDAS, Jose Guilherme Mendes Pereira
    Introduction: Juvenile angiofibromas (JA) are highly vascular, benign tumours for which surgery is the treatment of choice. In most services, embolisation is performed prior to resection. Nevertheless, there are few data on the complications of preoperative embolisation for JA. Aim: To describe major and minor complications of preoperative embolisation in a 32-year experience of patients undergoing surgical resection of JA at a tertiary hospital. Methods: Retrospective chart review study of 170 patients who underwent surgical resection of JA at a tertiary hospital between September 1976 and July 2008. Results: All patients were male. Age ranged from 9 to 26 years. Ninety-one patients had no complications after embolisation. Overall, 105 complication events occurred of which four major and 101 minor. Conclusion: In our series, preoperative embolisation for JA produced no irreversible complications and no aesthetic or functional sequelae. The vast majority of complications were transient and amenable to clinical management.
  • article 1575 Citação(ões) na Scopus
    European position paper on rhinosinusitis and nasal polyps 2012
    (2012) FOKKENS, W. J.; LUND, V. J.; MULLOL, J.; BACHERT, C.; ALOBID, I.; BAROODY, F.; COHEN, N.; CERVIN, A.; DOUGLAS, R.; GEVAERT, Ph.; GEORGALAS, Ch.; GOOSSENS, H.; HARVEY, R.; HELLINGS, P.; HOPKINS, C.; JONES, N.; JOOS, G.; KALOGJERA, L.; KERN, B.; KOWALSKI, M.; PRICE, D.; RIECHELMANN, H.; SCHLOSSER, R.; SENIOR, B.; THOMAS, M.; TOSKALA, E.; VOEGELS, R.; WANG, D. -Y.; WORMALD, P. J.
  • article 51 Citação(ões) na Scopus
    Cross-cultural adaptation and validation of a Quality of Life questionnaire: The Nasal Obstruction Symptom Evaluation questionnaire
    (2011) BEZERRA, Thiago F. P.; PADUA, Francini G. M.; PILAN, Renata R. de M.; STEWART, Michael G.; VOEGELS, Richard L.
    Background:The Nasal Obstruction Symptom Evaluation (NOSE) instrument is a disease-specific questionnaire for assessing the outcome of an intervention in nasal obstruction in trials. This instrument is only available in the English language and cross-culturally valid questionnaires are very important for all research, including nasal obstruction. The aim of the current study was to reproduce the cross-cultural adaptation process for the NOSE questionnaire in the Portuguese language (NOSE-p). Methodology: Cross-cultural adaptation and validation of the instrument were divided into two stages. Stage I involved four bilingual professionals, an expert committee and the author of the original instrument. In Stage 2, the NOSE-p was tested on 33 patients undergoing septoplasty for internal consistency, test-retest reliability, construct validity. discriminant validity, criterion validity, and response sensitivity. Results: The cross-cultural adaptation process was completed and the NOSE-p was demonstrated to be a valid instrument with satisfactory construct validity. It showed an adequate internal consistency reliability and adequate test-retest reliability. It could discriminate between patients with and without nasal obstruction and it has a high response sensitivity to change. Conclusions: The cross-cultural adaptation and validation process demonstrated to be valid and the NOSE-p proved to be applicable in Brazil.
  • article 1514 Citação(ões) na Scopus
    EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists
    (2012) FOKKENS, Wytske J.; LUND, Valerie J.; MULLOL, Joachim; BACHERT, Claus; ALOBID, Isam; BAROODY, Fuad; COHEN, Noam; CERVIN, Anders; DOUGLAS, Richard; GEVAERT, Philippe; GEORGALAS, Christos; GOOSSENS, Herman; HARVEY, Richard; HELLINGS, Peter; HOPKINS, Claire; JONES, Nick; JOOS, Guy; KALOGJERA, Livije; KERN, Bob; KOWALSKI, Marek; PRICE, David; RIECHELMANN, Herbert; SCHLOSSER, Rodney; SENIOR, Brent; THOMAS, Mike; TOSKALA, Elina; VOEGELS, Richard; WANG, De Yun; WORMALD, Peter John
    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also propose definitions for 'difficult to treat' rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between the upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists.
  • article 39 Citação(ões) na Scopus
    Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps
    (2017) SOTER, Ana Carolina Pinto Bezerra; BEZERRA, Thiago Freire Pinto; PEZATO, Rogerio; ABDO, Tatiana Regina Teles; PILAN, Renata Mendonca; PINNA, Fabio de Rezende; GEVAERT, Philippe; ZELE, Thibaut van; BACHERT, Claus; VOEGELS, Richard Louis
    Background: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). Methods: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation. The main outcome measure was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Other outcome measures were the SNOT-20, NOSE, and Lund-Kennedy scores. The following parameters were also analyzed: asthma, rhinitis, non-steroidal-exacerbated respiratory disease (NERD), and baseline serum IgG, IgA, IgE, IgM, ANCA, and eosinophil count. Results:There was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Patients who received doxycycline also had significantly better outcomes regarding SNOT-20, NOSE, and Lund-Kennedy scores. There was a negative association among a clinically significant improvement of SNOT-20 and presence of asthma, NERD, and elevated serum IgE levels before treatment. Conclusion:These findings suggest that doxycycline may have a beneficial role for CRSwNP patients, especially for patients without asthma, NERD or high levels of serum IgE before treatment.
  • article 13 Citação(ões) na Scopus
    Prevalence of chronic rhinosinusitis in Sao Paulo
    (2012) PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; BEZERRA, Thiago Freire Pinto; MORI, Renata Lopes; PADUA, Francini Grecco de Melo; BENTO, Ricardo Ferreira; PEREZ-NOVO, Claudina; BACHERT, Claus; VOEGELS, Richard Louis
    Introduction: Studies designed to investigate chronic rhinosinusitis (CRS) epidemiology play an important role to assess population's distribution and risk factors to result in the development and promotion of public health policies. Method: This study design is a survey carried out with a complex two-stage cluster sampling plan. Personal interviews were carried out with 2,003 individuals. The questionnaire included the epidemiological criteria for CRS. Demographic data, history of physician-diagnosed respiratory diseases (asthma, sinusitis, rhinitis), smoking, family income, educational attainment, and household characteristics were also evaluated. Results: The overall response rate was 93.9% of the households. Mean age was 39.8 +/- 21 years; 45.33% were male. The overall prevalence of CRS in the city of Sao Paulo was 5.51%. We found a significant association between diagnosis of CRS and diagnosis of asthma and CRS and diagnosis of rhinitis and a significant association between presence of CRS and belonging to the low-income subgroup. Conclusion: The municipality of Sao Paulo has an urban population of 11 million. According to the present study, the prevalence of CRS is 5.51%, which represents more than 500,000 individuals affected by this condition in the city.
  • article 18 Citação(ões) na Scopus
    Mechanical dysfunction in the mucosal oedema formation of patients with nasal polyps
    (2014) PEZATO, Rogerio; VOEGELS, Richard Louis; BEZERRA, Thiago Freire Pinto; PEREZ-NOVO, Claudina; STAMM, Aldo Cassol; GREGORIO, Luis Carlos
    Background: Nasal polyposis (NP) is characterized by an anomalous tissue growth with oedema and a lack of extracellular matrix. In this study, we investigated whether a mechanical disfunction of the forces that act in oedema formation is present in NP. Methods: We compared the interstitial hydrostatic pressure behaviour during a saline solution infusion between healthy nasal mucosa (inferior and middle turbinate from 10 patients) and inflamed nasal mucosa from NP patients (inferior, middle turbinate and a nasal polyp from 6 patients). We used Controlled Disc Stimulation equipment to compare the curve Pressure/Volume created during the saline solution infusion. Results:The pressure at 0.2 ml infusion was lower in the middle turbinate of NP patients than in the middle turbinate of control patients. The lowest P/V mean assessed was in the polypoid tissue. Conclusions: The interstitial hydrostatic pressure showed different behaviour during liquid infusion in nasal mucosa from NP patients when compared with healthy nasal mucosa. This study allows us to cogitate on a new pathophysiological mechanism contributing to the development of the NP.