LUIZ UBIRAJARA SENNES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/63, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/63, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
32 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 32
- Extracellular Matrix Composition of the Cricopharyngeus Muscle(2012) TAVARES, Raquel Aguiar; SENNES, Luiz Ubirajara; MAUAD, Thais; IMAMURA, Rui; SILVA, Luiz Fernando Ferraz da; CARRAU, Ricardo LuisThe aim of this study was to analyze the presence and distribution of total collagen, type I and type III collagen, elastic fibers, fibronectin, and versican in the endomysium of cricopharyngeus muscles from adults of various ages. The study was a cross-sectional analysis of human cricopharyngeus muscles. Twenty-seven muscles obtained from autopsies of men and women ranging in age from 28 to 92 years were analyzed with the Picrosirius method, oxidized Weigert resorcin-fuchsin, immunohistochemistry, and image analysis. Collagen had the highest density among the analyzed components. Elastic fibers surrounded each muscle cell; they were aligned longitudinally by their long axis and associated with traversing fibers, thereby forming a fiber network with embedded muscle cells. The fibronectin and versican contents varied widely among the specimens. We found no statistically significant differences between the proportion of extracellular matrix (ECM) components and factors such as gender and race. We conclude that the higher proportion of type I and type III collagen is compatible with the cricopharyngeus muscle's sphincteric behavior, and the arrangement of the elastic fibers may also contribute to the muscle's elasticity. We found no statistically significant correlation between the ECM components and age.
- Influence of international authorship on citations in Brazilian medical journals: a bibliometric analysis(2019) MONTEFUSCO, Adilson Marcos; NASCIMENTO, Felipe Parra do; SENNES, Luiz Ubirajara; BENTO, Ricardo Ferreira; IMAMURA, RuiThe challenge of increasing the impact of regional journals has received much attention. While funding and research agencies require the acceptance of papers from foreign authors as a means of increasing citations, Brazilian journal editors dispute the impact of this measure. This study aimed to evaluate, for Brazilian medical journals, whether the number of citations a document received was influenced by the authors' institutional affiliations or other predictive factors related to the paper or the journal. Sixty-one medical journals published in Brazil in 2012 were selected for analysis. SCImago and Scopus were used to extract the articles and their data. The number of citations a document received in 5years was analyzed according to the authors' affiliations, language, document type, SCImago Cites per Document, and journal subject category. After adjusting for covariates by multivariate analysis, documents with collaborative international affiliations showed a citation increase of 0.17 (95% CI: 0.084-0.216) over documents by Brazilian authors. Significant increases in citations were also observed for bilingual documents (0.329; 95% CI: 0.236-0.380), English-only documents (0.159; 95% CI: 0.078-0.203), articles (1.590; 95% CI: 1.363-1.714), reviews (2.752; 95% CI: 2.355-2.972), and those under the subject category of hematology (1.280; 95% CI: 0.756-1.604). In summary, while collaborative international authorship increased citations in the investigated journals, language, type of document, and subject category had a stronger impact on the number of citations.
- Designer Receptors Exclusively Activated by Designer Drugs Approach to Treatment of Sleep-disordered Breathing(2021) CURADO, Thomaz Fleury; PHO, Huy; FREIRE, Carla; AMORIM, Mateus R.; BONAVENTURA, Jordi; KIM, Lenise J.; LEE, Rachel; CABASSA, Meaghan E.; STREETER, Stone R.; BRANCO, Luiz G.; SENNES, Luiz U.; FISHBEIN, Kenneth; SPENCER, Richard G.; SCHWARTZ, Alan R.; BRENNICK, Michael J.; MICHAELIDES, Michael; FULLER, David D.; POLOTSKY, Vsevolod Y.Rationale: Obstructive sleep apnea is recurrent upper airway obstruction caused by a loss of upper airway muscle tone during sleep. The main goal of our study was to determine if designer receptors exclusively activated by designer drugs (DREADD) could be used to activate the genioglossus muscle as a potential novel treatment strategy for sleep apnea. We have previously shown that the prototypical DREADD ligand clozapine-N-oxide increased pharyngeal diameter in mice expressing DREADD in the hypoglossal nucleus. However, the need for direct brainstem viral injections and clozapine-N-oxide toxicity diminished translational potential of this approach, and breathing during sleep was not examined. Objectives: Here, we took advantage of our model of sleep-disordered breathing in diet-induced obese mice, retrograde properties of the adeno-associated virus serotype 9 (AAV9) viral vector, and the novel DREADD ligand J60. Methods: We administered AAV9-hSyn-hM3(Gq)-mCherry or control AAV9 into the genioglossus muscle of diet-induced obese mice and examined the effect of J60 on genioglossus activity, pharyngeal patency, and breathing during sleep. Measurements and Main Results: Compared with control, J60 increased genioglossus tonic activity by greater than sixfold and tongue uptake of 2-deoxy-2-[F-18]fluoro-D-glucose by 1.5-fold. J60 increased pharyngeal patency and relieved upper airway obstruction during non-REM sleep. Conclusions: We conclude that following intralingual administration of AAV9-DREADD, J60 can activate the genioglossus muscle and improve pharyngeal patency and breathing during sleep.
- 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 PereiraIntroduction: 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.
- Bipedicled Vocal Fold Mucosal Flap Use in Phonomicrosurgery: Case Series(2021) TSUJI, Domingos Hiroshi; KINCHOKU, Vanessa Mika; IMAMURA, Rui; HACHIYA, Adriana; YAMASAKI, Rosiane; MARINHO, Guilherme Rodrigues; SENNES, Luiz UbirajaraObjectives. The objective of this study was to present a novel surgical technique involving the use of a ""bipedicled vocal fold mucosal flap"" to repair a mucosal defect and to evaluate the outcomes of patients in whom it was used. Material and methods. This was a retrospective study of 6 clinical cases. All patients underwent surgery between November 2000 and July 2018, and all procedures were performed by the same surgeon. For the auditory-perceptual assessment, the Grade-Roughness-Breathiness-Asthenia-Strain hoarseness scale was used. We based the stroboscopic evaluation on the European Laryngological Society protocol, analyzing the parameters glottal closure, mucosal wave, and phase symmetry. Results. Ages at the time of surgery ranged from 10 to 52 years, and all of the patients were male. Preexisting vocal fold lesions included polyps, cysts, a sulcus, and mucosal bridges. Among the stroboscopic parameters, only the mucosal wave differed significantly between the preoperative and postoperative periods (P = 0.046). There were also significant postoperative improvements in the overall grade of dysphonia (P = 0.025) and in the degree of breathiness (P = 0.025). Conclusions. The use of a bipedicled vocal fold mucosal flap appears to promote significant improvements in the mucosal wave and in voice quality. In the patients evaluated here, the technique was used without preoperative planning. However, it proved to be a safe and appropriate means of repairing mucosal defects in the vocal folds, with the potential to preserve rheological properties and promote healing with less chance of fibrosis.
- Study of the relation between medial orbitofrontal artery and anterior skull base performed by computed tomography angiography(2018) PATRICIO, Henrique C.; FELIPPU, Alexandre; PINHEIRO-NETO, Carlos D.; SENNES, Luiz U.Badcground: The aims of this study were to analyze the relationships between the medial orbitofrontal artery (MOFA) and the anterior skull base (ASB) including anatomical endonasal landmarks using computed tomography angiography (CTA). Methods: We studied 52 CTAs using OsiriX (R) software. All CTAs were placed in the same anatomical position. MOFA was identified in the sagittal and coronal plane and its correlation with ASB was analyzed.The distance between the MOFA and landmarks for endonasal surgery were obtained, determining the high risk areas for its injury. Results: After arising from the anterior cerebral artery, the MOFA dives inferiorly towards the ASB, close to the midline (average distance of 1.5 mm), approaching the planum sphenoidale (average distance of 1.8 mm) and then ascends away from the ASB as it runs anteriorly, with an average distance of 4.4 mm in the region of the anterior wall of the sphenoid sinus and 12 mm in the region of the anterior ethmoid artery. Conclusions: The MOFA has an intimate relationship with the ASB and nasal cavity; the regions with the highest risk of surgical trauma are between the posterior ethmoid and the planum sphenoidale.
article 3 Citação(ões) na Scopus Endoscopic anatomy of the approaches to the sellar area and planum sphenoidale(2011) RAMOS, Henrique Faria; MONTEIRO, Tatiana Alves; PINHEIRO NETO, Carlos Diogenes; MARIANI, Pedro Paulo; FORTES, Felipe Sartor Guimaraes; SENNES, Luiz UbirajaraThe productive work between otolaryngologists and neurosurgeons has resulted in the emergence of endoscopic endonasal skull base surgery. The goal of the present study is to describe the endoscopic anatomy of the endonasal approach to the sellar region and planum sphenoidale, highlighting the key points of the surgical approach and the neurovascular landmarks. Method: Descriptive study of the endoscopic endonasal dissection of 9 fresh cadavers with exposure of the anatomic structures. Results: The endoscopic endonasal ethmoidectomy and sphenoidotomy allows an expanded access to the sellar area and planum sphenoidale. The surface anatomy of the sphenoid sinus is easily identifiable and provides safe landmarks, guiding the intracranial dissection. Conclusion: The endoscopic endonasal approach to the skull base by the ENT and neurosurgeon is feasible, but it requires adequate anatomical knowledge and endoscopic skills for its realization, which can be obtained by practicing in cadavers.- Endoscopic anatomy of the palatovaginal canal (palatosphenoidal canal)(2012) PINHEIRO-NETO, Carlos D.; FERNANDEZ-MIRANDA, Juan C.; RIVERA-SERRANO, Carlos M.; PALUZZI, Alessandro; SNYDERMAN, Carl H.; GARDNER, Paul A.; SENNES, Luiz U.Objectives/Hypothesis: Demonstrate the endoscopic anatomy of the palatovaginal (PV) canal and artery for identification and dissection of the vidian nerve during endoscopic transpterygoid approaches. Evaluate the length of the PV canal and its relation with the vidian nerve. Show that the traditionally known PV canal is a misnomer and should be renamed. Study Design: Experimental study: anatomical and radiological. Methods: Dissection of eight cadaveric heads was performed to demonstrate the endoscopic anatomy of the PV canal. Computed tomography scan analysis of 20 patients was used to evaluate the length of the PV canal, the angle formed between this canal and the vidian nerve, and the distance between the vidian canal and the PV canal. Study of 10 dry skull bases was performed to verify the structures involved in the formation of the PV canal. Results: Anatomic steps and foundations for dissection of the vidian nerve using the PV canal as a landmark were described. The mean length of the PV canal was 7.15 mm. The mean proximal distance between the vidian and the PV canal was 1.95 mm, and the mean distal distance was 4.14 mm. The mean angle between those canals was 48 degrees. The osteology study showed the vaginal process of the sphenoid bone did not contribute to the formation of the PV canal. Conclusions: Our anatomic investigations, radiologic studies, and surgical experience demonstrate the important anatomic relationship of the PV canal with the vidian canal and the relevance of the PV canal as a surgical landmark in endoscopic endonasal transpterygoid approaches. Anatomically, PV canal is a misnomer and should be replaced with palatosphenoidal canal.
- Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa(2014) ORDONES, Alexandre Beraldo; FORNAZIERI, Marco Aurélio; PINNA, Fábio de Rezende; BEZERRA, Thiago Freire Pinto; VOEGELS, Richard Louis; SENNES, Luiz UbirajaraObjective To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and developed a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1 year postoperatively. Conclusion This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.
- Master Regulators of Epithelial-Mesenchymal Transition and WNT Signaling Pathways in Juvenile Nasopharyngeal Angiofibromas(2021) CALANCA, Naiade; BINATO, Sara Martoreli Silveira; SILVA, Sabrina Daniela da; BRENTANI, Helena Paula; SENNES, Luiz Ubirajara; PINTO, Clovis Antonio Lopes; DOMINGUES, Maria Aparecida Custodio; FONSECA-ALVES, Carlos Eduardo; RAINHO, Claudia Aparecida; ROGATTO, Silvia ReginaJuvenile nasopharyngeal angiofibroma (JNA) is a rare fibrovascular benign tumor showing an invasive growth pattern and affecting mainly male adolescents. We investigated the role of epithelial-mesenchymal transition (EMT) and WNT signaling pathways in JNA. Gene expression profiles using nine JNA paired with four inferior nasal turbinate samples were interrogated using a customized 2.3K microarray platform containing genes mainly involved in EMT and WNT/PI3K pathways. The expression of selected genes (BCL2, CAV1, CD74, COL4A2, FZD7, ING1, LAMB1, and RAC2) and proteins (BCL2, CAV1, CD74, FZD7, RAF1, WNT5A, and WNT5B) was investigated by RT-qPCR (28 cases) and immunohistochemistry (40 cases), respectively. Among 104 differentially expressed genes, we found a significantly increased expression of COL4A2 and LAMB1 and a decreased expression of BCL2 and RAC2 by RT-qPCR. The immunohistochemistry analysis revealed a low expression of BCL2 and a negative to moderate expression of FZD7 in most samples, while increased CAV1 and RAF1 expression were detected. Moderate to strong CD74 protein expression was observed in endothelial and inflammatory cells. A significant number of JNAs (78%) presented reduced WNT5A and increased WNT5B expression. Overall, the transcript and protein profile indicated the involvement of EMT and WNT pathways in JNA. These candidates are promising druggable targets for treating JNA.