LUCIANO HENRIQUE LOPES FORONI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Elective amputation of the upper limb is an option in the treatment of traumatic injuries of the brachial plexus?(2017) SIQUEIRA, Mario Gilberto; MARTINS, Roberto Sergio; HEISE, Carlos Otto; FORONI, LucianoThe treatment of complete post-traumatic brachial plexus palsy resulting in a flail shoulder and upper extremity remains a challenge to peripheral nerve surgeons. The option of upper limb amputation is controversial and scarcely discussed in the literature. We believe that elective amputation still has a role in the treatment of select cases. The pros and cons of the procedure should be intensely discussed with the patient by a multidisciplinary team. Better outcomes are usually achieved in active patients who strongly advocate for the procedure.
- Prognostic value of thumb pain sensation in birth brachial plexopathy(2012) HEISE, Carlos O.; MARTINS, Roberto S.; FORONI, Luciano H.; SIQUEIRA, Mario G.Objective: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. Methods: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6). The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. Results: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. Conclusion: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.
- Expanded endonasal approach to skull base meningiomas(2013) MONACO, Bernardo Assumpcao de; RAMOS, Henrique Faria; GOMES, Marcos Queiroz Telles; SANTO, Marcelo Prudente do Espirito; FORONI, Luciano; SENNES, Luiz Ubirajara; TEIXEIRA, Manoel Jacobsen
- Perineurioma of the posterior interosseous nerve: surgical treatment(2013) MENENDEZ, Djalma Felipe da Silva; MARTINS, Roberto Sergio; SIQUEIRA, Mario Gilberto; SILVA, Igor Araujo Ferreira da; CAVALCANTE, Livia Barreiro; FALZONI, Roberto; FORONI, Luciano Henrique Lopes; TEIXEIRA, Manoel Jacobsen
article 2 Citação(ões) na Scopus Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus(2011) MARTINS, Roberto Sergio; MONACO, Bernardo Assumpcao; SIQUEIRA, Mario Gilberto; FORONI, Luciano; HEISE, Carlos Otto; TEIXEIRA, Manoel JacobsenLesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. Method: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. Results: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. Conclusion: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage.- The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation(2017) FORONI, Luciano; SIQUEIRA, Mario Gilberto; MARTINS, Roberto Sergio; OLIVEIRA, Gabriela PintarObjective: Few donors are available for restoration of sensibility in patients with complete brachial plexus injuries.The objective of our study was to evaluate the anatomical feasibility of using the intercostobrachial nerve (ICBN) as an axon donor to the lateral cord contribution to the median nerve (LCMN). Methods: Thirty cadavers were dissected. Data of the ICBN and the LCMN were collected, including diameters, branches and distances. Results:The diameters of the ICBN and the LCMN at their point of coaptation were 2.7mm and 3.7mm, respectively. The ICBN originated as a single trunk in 93.3% of the specimens and bifurcated in 73.3%.The distance between the ICBN origin and its point of coaptation to the LCMN was 54mm. All ICBNs had enough extension to reach the LCMN. Conclusion: Transfer of the ICBN to the LCMN is anatomically feasible and may be useful for restoring sensation in patients with complete brachial plexus injuries.
- Management of desmoid-type fibromatosis involving peripheral nerves(2012) SIQUEIRA, Mario G.; TAVARES, Paulo L.; MARTINS, Roberto S.; HEISE, Carlos O.; FORONI, Luciano H. L.; BORDALO, Marcelo; FALZONI, RobertoDesmoid-type fibromatosis is an uncommon and aggressive neoplasia, associated with a high rate of recurrence. It is characterized by an infiltrative but benign fibroblastic proliferation occurring within the deep soft tissues. There is no consensus about the treatment of those tumors. We present a surgical series of four cases, involving the brachial plexus (two cases), the median nerve and the medial brachial cutaneous nerve. Except for the last case, they were submitted to multiple surgical procedures and showed repeated recurrences. The diagnosis, the different ways of treatment and the prognosis of these tumoral lesions are discussed. Our results support the indication of radical surgery followed by radiotherapy as probably one of the best ways to treat those controversial lesions.
- Functional outcome of spinal accessory nerve transfer to the suprascapular nerve to restore shoulder function: Results in upper and complete traumatic brachial plexus palsy in adults(2019) SIQUEIRA, Mario G.; MARTINS, Roberto S.; SOLLA, Davi; FAGLIONI, Wilson; FORONI, Luciano; HEISE, Carlos O.Background: Shoulder stability, abduction and external rotation are vital for the performance of usual daily tasks. Aims: To compare the functional outcomes in the shoulder following spinal accessory to suprascapular nerve transfer (SASNT). Patients and Methods: Comparison of the outcome of adult patients with upper traumatic brachial plexus palsy undergoing SASNT with patients with complete palsy submitted to the same procedure. Statistical Analysis: Ranges of motion were compared via the Mann-Whitney U test. The percentages of patients with a favorable outcome were compared by the chi-square test. All tests were two-tailed and P values <0.05 were considered statistically significant. Results: SASNT was performed in 76 patients: 23 cases (30.2%) of upper-plexus injuries and 53 cases (69.7%) of complete brachial plexus palsy. Good shoulder abduction was achieved in 15 patients (65.2%) with upper plexus palsy and a good external rotation in 5 (21.7%). In those patients with a good recovery, the average range of motion (ROM) was 53 degrees for shoulder abduction and 71.2 degrees for external rotation. Thirty-six patients (67.9%) with complete palsy had a good shoulder abduction recovery with 30.7 degrees of average ROM, but only 3 patients (5.6%) recovered a good shoulder external rotation with 68.3 degrees of average ROM. There was no statistical difference for the abduction outcome, but the external rotation outcome was superior in the upper plexus palsy group. Conclusion: SASNT is a consistent procedure to achieve functional recovery of shoulder abduction after a partial or complete plexus injury, but the outcomes of external rotation were quite disappointing in both the groups.
- Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor(2017) FORONI, Luciano; SIQUEIRA, Mario Gilberto; MARTINS, Roberto Sergio; HEISE, Carlos Otto; STERMAN NETO, Hugo; IMAMURA, Adriana YorikoObjective: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor. Methods: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed. Results: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient. Conclusion: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.