LENINE GARCIA BRANDAO

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Lattes
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Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina - Líder

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Assunto: Otorhinolaryngology ×

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  • bookPart
    How to Avoid Injury of the External Branch of Superior Laryngeal Nerve
    (2012) CERNEA, Claudio R.; DEDIVITIS, Rogerio A.; FERRAZ, Alberto R.; BRANDAO, Lenine G.
  • article 5 Citação(ões) na Scopus
    Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth
    (2013) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia
    The presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. Objective: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. Method: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. Results: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. Conclusion: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.
  • article 30 Citação(ões) na Scopus
    Negative and positive predictive values of nerve monitoring in thyroidectomy
    (2012) CERNEA, Claudio R.; BRANDAO, Lenine G.; HOJAIJ, Flavio C.; CARLUCCI JR., Dorival De; BRANDAO, Jose; CAVALHEIRO, Beatriz; SONDERMANN, Adriana
    Background Recurrent nerve injury is 1 of the most important complications of thyroidectomy. During the last decade, nerve monitoring has gained increasing acceptance in several centers as a method to predict and to document nerve function at the end of the operation. We evaluated the efficacy of a nerve monitoring system in a series of patients who underwent thyroidectomy and critically analyzed the negative predictive value (NPV) and positive predictive value (PPV) of the method. Methods. NIM System efficacy was prospectively analyzed in 447 patients who underwent thyroidectomy between 2001 and 2008 (366 female/81 male; 420 white/47 nonwhite; 11 to 82 years of age; median, 43 years old). There were 421 total thyroidectomies and 26 partial thyroidectomies, leading to 868 nerves at risk. The gold standard to evaluate inferior laryngeal nerve function was early postoperative videolaryngoscopy, which was repeated after 4 to 6 months in all patients with abnormal endoscopic findings. Results. At the early evaluation, 858 nerves (98.8%) presented normal videolaryngoscopic features after surgery. Ten paretic/paralyzed nerves (1.2%) were detected (2 unexpected unilateral paresis, 2 unexpected bilateral paresis, 1 unexpected unilateral paralysis, 1 unexpected bilateral paralyses, and 1 expected unilateral paralysis). At the late videolaryngoscopy, only 2 permanent nerve paralyses were noted (0.2%), with an ultimate result of 99.8% functioning nerves. Nerve monitoring showed absent or markedly reduced electrical activity at the end of the operations in 25/868 nerves (2.9%), including all 10 endoscopically compromised nerves, with 15 false-positive results. There were no false-negative results. Therefore, the PPV was 40.0%, and the NPV was 100%. Conclusions. In the present series, nerve monitoring had a very high PPV but a low NPV for the detection of recurrent nerve injury. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 175-179, 2012
  • article 16 Citação(ões) na Scopus
    Anatomical study of jugular foramen in the neck
    (2020) FREITAS, Carlos Alberto Ferreira de; SANTOS, Luiz Roberto Medina dos; SANTOS, Andreza Negreli; AMARAL NETO, Augusto Barreto do; BRANDAO, Lenine Garcia
    Introduction: The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy. Objective: To study the anatomy of the jugular foramen, internal jugular vein and glossopharyngeal, vagus and accessory nerves, and to identify the anatomical relationships among these structures in the jugular foramen region and lateral-pharyngeal space. Methods: A total of 60 sides of 30 non-embalmed cadavers were examined few hours after death. The diameters of the jugular foramen and its anatomical relationships were analyzed. Results: The diameters of the jugular foramen and internal jugular vein were greater on the right side in most studied specimens. The inferior petrosal sinus ended in the internal jugular vein up to 40 mm below the jugular foramen; in 5% of cases. The glossopharyngeal nerve exhibited an intimate anatomical relationship with the styloglossus muscle after exiting the skull, and the vagal nerve had a similar relationship with the hypoglossal nerve. The accessory nerve passed around the internal jugular vein via its anterior wall in 71.7% of cadavers. Conclusion: Anatomical variations were found in the dimensions of the jugular foramen and the internal jugular vein, which were larger in size on the right side of most studied bodies; variations also occurred in the trajectory and anatomical relationships of the nerves. The petrosal sinus can join the internal jugular vein below the foramen. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 17 Citação(ões) na Scopus
    Lymph node distribution in the central compartment of the neck: An anatomic study
    (2014) TAVARES, Marcos Roberto; CRUZ, Jose Arnaldo Shiomi da; WAISBERG, Daniel Reis; TOLEDO, Sergio Pereira de Almeida; TAKEDA, Flavio Roberto; CERNEA, Claudio Roberto; CAPELOZZI, Vera Luiza; BRANDAO, Lenine Garcia
    Background. Dissection of the central compartment of the neck (CCN) is performed for proven or suspected lymph node metastases of thyroid carcinoma. During this procedure, the recurrent laryngeal nerves and the parathyroid glands are at risk. The purpose of this study was to determine the anatomic distribution of the lymph nodes in the CCN. Methods. The anatomic distribution of the lymph nodes in the CCN was studied by dissection of 30 fresh cadavers. The soft tissue between the cricoid cartilage and the innominate vein, carotid arteries, and prevertebral fascia was removed and divided according to CCN sublevels. Nodules were identified by palpation in the specimen and sent for pathological examination. Results. Three to 44 (18.5 +/- 10.29) nodules were identified macroscopically. Two to 42 nodules were confirmed as lymph nodes after microscopic examination. The lymph node distribution was as follows: precricoid: 0 to 2 (0.9 +/- 0.72); pretracheal: 1 of 35 (12.4 +/- 8.19); lateral to the right recurrent laryngeal nerve (RLN): 0 to 11 (3.4 +/- 2.34); and lateral to the left: 0 to 4 (1.7 +/- 1.30). Twenty-six parathyroid glands were removed by 14 dissections. The innominate vein was found at 15 mm above the superior border of the clavicles to 35 mm below on the left side of the neck and 5 to 45 mm on the right side. Conclusion. The number of confirmed lymph nodes in the central neck varied from 2 to 42. Sixty-seven percent of the lymph nodes were in the pretracheal sublevel. There was no division between level VI and VII lymph nodes. Additionally, the innominate vein was found to be from 15 mm above the superior border of the clavicles to 35 mm below on the left side of the neck and 5 to 45 mm on the right side. Parathyroid glands were identified to be far away from the thyroid gland. (C) 2014 Wiley Periodicals, Inc.
  • article 8 Citação(ões) na Scopus
    Cervical metastasis on level IV in laryngeal cancer
    (2014) ARAUJO NETO, V. J. Furtado De; CERNEA, C. R.; DEDIVITIS, R. Aparecido; PALAZZO, J. Fabiano; BRANDAO, L. Garcia
    The presence of cervical metastasis has substantial negative impact on survival of patients with laryngeal cancer. Bilateral elective selective neck dissection of levels II, II and IV is usually the chosen approach in these patients. However, there is significant morbidity associated with level IV dissection, such as phrenic nerve injury and lymphatic fistula. The objective of the present study was to evaluate the frequency of metastatic nodes in level IV in clinically T3/T4N0 patients with laryngeal cancer. The pathological reports of 77 patients with clinically T3/T4N0 laryngeal squamous cell carcinoma were reviewed. Patients underwent bilateral lateral neck dissection from January 2007 to November 2012. The surgical specimens were subdivided in levels before evaluation. There were 12 patients with neck metastasis (15.58%). In 3 cases (3.89%), there were metastatic lymph nodes in level IV, all T4 and with ipsilateral metastasis. In conclusion, the incidence of level IV metastasis was 3.89%, an in all patients was staged as T4.
  • article 29 Citação(ões) na Scopus
    Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review
    (2014) AIRES, Felipe T.; DEDIVITIS, Rogerio A.; CASTRO, Mario Augusto F.; BERNARDO, Wanderley Marques; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia
    Background Some primary studies compare manual and mechanical pharyngeal closures after total laryngectomy. The purpose of this study was to evaluate the advantages of the mechanical suture in pharyngeal closure. Methods The literature survey included research in MEDLINE, EMBASE, and LILACS. The intervention analyzed was stapler-assisted pharyngeal closure, whereas the control group was manual suture pharyngeal closure. Results The survey resulted in 319 studies. However, 4 studies were selected (417 patients). In the group of patients in whom the stapler was used, the incidence of pharyngocutaneous fistula was 8.7%, whereas in the other, it was 22.9%, with an absolute risk reduction of 15% (95% confidence interval [CI], 0.02-0.28; p = .02; I-2 = 66%). Regarding the surgical time, the average difference was 80 minutes in favor of the stapler group (95% CI, 23.16-136.58 minutes; p < .006). Conclusion The difference for starting oral feeding was 8 days in favor of the mechanical suture (95% CI, 4.01-11.73 days; p < .001). Patients who underwent mechanical suture had a shorter hospitalization period. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 739-742, 2014
  • article 7 Citação(ões) na Scopus
    Epidemiological assessment and therapeutic response in hypopharyngeal cancer
    (2013) AMAR, Ali; CURIONI, Otavio Alberto; PAIVA, Diogenes Lopes de; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia
    Despite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. Objective: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. Method: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. Results: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. Conclusion: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
  • article 1 Citação(ões) na Scopus
    Multifocal myositis ossificans in masticatory muscles 30 years after gunshot wound: case report and literature review
    (2019) CAVALHEIRO, Beatriz Godoi; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia
  • article 26 Citação(ões) na Scopus
    Pectoralis major myocutaneous flap for head and neck reconstruction: risk factors for fistula formation
    (2014) LEITE, A. K. N.; MATOS, L. L. De; BELLI, M.; KULCSAR, M. A. V.; CERNEA, C. R.; BRANDAO, L. Garcia; PINTO, F. R.
    The pectoralis major myocutaneous flap (PMMF) is a safe and versatile flap used widely for head and neck cancer reconstructions, but one of the major and most feared complications is oro- or pharyngocutaneous fistula. Herein, we attempt to establish risk factors for fistula formation in reconstructions of mucosal defects in the head and neck using PMMF through retrospective analysis of PMMF performed during 3 years at a single institution, with a total of 84 procedures. There were 69 men and 15 women, with a mean age of 59.5 years. There were 15 cases of partial flap loss, two total flap losses and 31 fistulas. The independent risk factors for fistula formation were preoperative serum hemoglobin <13 g/dl, preoperative serum albumin <3.4 g/dl and hypopharynx reconstruction. The PMMF is still a very useful flap and this is the first multivariate analysis analysing risk factors for fistula formation. These findings are helpful in selecting patients with elevated risk of fistula formation, and therefore preventive measures can be undertaken to avoid potentially serious complications.