FLAVIO CARNEIRO HOJAIJ
Projetos de Pesquisa
Unidades Organizacionais
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
19 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 19
- Left Nonrecurrent Laryngeal Nerve: A Very Unusual Finding during Thyroid Surgery(2022) AHUMADA, Nicolas Galat; HOJAIJ, Flavio Carneiro; CUNICO, Caroline; AKAHANE, Hugo Genki Kagawa; LEITAO, Cleverson Alex; MATIAS, Jorge Eduardo FoutoBackground. Identifying the inferior laryngeal nerve is one of the main concerns in thyroid surgery. The typical recurrent position occurs due the relative position between the vagus nerve and the larynx during the last 3 branchial arches development. In rare cases, this nerve does not loop under the right subclavian artery or the aortic arch. This abnormality is present in 0.7% of patients and is associated with the presence of anatomical vascular anomalies. The left non-recurrent inferior laryngeal nerve is an even rarer abnormality, with only six cases described in the literature to date. Method. A 46- years old female patient referred to total thyroidectomy for symptomatic multinodular benign goiter. Results. A left non-recurrent inferior laryngeal nerve was found with difficulty and then a partial thyroidectomy was performed. CT scan showed dextroposition of the vessels of the base of the heart and an aberrant left subclavian artery. Conclusion. An association of a right-sided aortic arch and aberrant left subclavian artery, or the presence of situs inversus, although rare anatomical variations, are associated to a non-recurrent inferior left laryngeal nerve. Proper identifying these abnormalities may help to properly identify and salvage this structure.
- Anatomical Study of the Innervation of the Masseter Muscle and Its Correlation with Myofascial Trigger Points(2020) PINHEIRO, Roberto Procopio; GAUBEUR, Matheus Aquesta; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz; AKAMATSU, Flavia EmiBackground and Purpose: Myofascial pain syndrome (MPS) is widely prevalent in the general population; some reports estimate its prevalence ranges from 9 to 85%. Among the different locations where MPS may arise, pain related to the masseter muscle is referred as masticatory myofascial pain. MPS is characterized by myofascial trigger points (MTPs), which represent tender anatomical areas of a muscle where painful symptoms are elicited whenever stimulated. Previous publications have found MTPs to coincide with neuromuscular junctions at the motor end plate, at the innervation zone (IZ). Our study aimed to describe the innervation of the masseter muscle and relate it to clinically described myofascial trigger points (MTPs). Materials and Methods: We mapped the nerve fiber distribution into the masseter muscles from 16 cadavers by anatomical dissection. We divided the muscle into six regions, three superior (I-III) and three inferior (IV-VI), and classified the nerve's branches distribution according to these predetermined areas. Statistical analyses was made by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons (P<0.05). Results: All six areas received branches from the masseteric nerve. Areas I and II (upper posterior and upper intermediate, respectively) had a significant higher number of nerve entries as compared to the remaining areas. Conclusion: The penetration areas of the masseteric nerve have been established and MTPs are found in the innervation zones, clinicians should focus initially on the regions of the penetration points, for diagnostics and therapeutic measures, such as injections, dry needling and soft tissue interventions. Anatomical study of nerve supply to the masseter muscle can provide useful additional knowledge to further understanding masticatory myofascial pain and to direct therapeutic interventions and diagnostic studies of temporomandibular junction dysfunction.
- Conventional thyroidectomy: what is the impact of the scar on the lives of operated patients?(2021) BOOG, Gustavo Henrique Pereira; KASMIRSKI, Julia Adriana; HOJAIJ, Flavio CarneiroObjective: This study was aimed at investigating the aesthetic impact of scars on the lives of patients who undergo conventional thyroidectomy. Materials and methods: This cross-sectional study was based on a retrospective analysis of 98 electronic medical records of patients who underwent conventional thyroidectomy performed by the same surgeon. The impact was determined through a qualitative question and categorized into three levels of dissatisfaction. Results: Among the 98 patients, 96 (97.95%) reported experiencing no functional or visual discomfort with their scars. The two unsatisfied individuals were women, and both classified their discomfort as moderate. Although the diseases that indicated surgery varied, papillary thyroid carcinoma predominated. Conclusion: The sample's satisfaction level indicates that, in line with the current literature, the decision to opt for cosmetically appealing methods is not justified by aesthetic complaints about scars. The benefits of lower cost and fewer complications make conventional thyroidectomy an old but reliable option for afflictions of the thyroid gland that require surgery.
- Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle(2017) AKAMATSU, Flavia Emi; YENDO, Tatiana Mina; RHODE, Ciro; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; HSING, Wu Tu; JACOMO, Alfredo LuizMyofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs). We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females). We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Students f-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.
- Syntopy of vagus nerve in the carotid sheath: A dissectional study of 50 cadavers(2019) HOJAIJ, Flavio; REBELO, Gabriela; AKAMATSU, Flavia; ANDRADE, Mauro; CAMARGO, Cristina; CERNEA, Claudio; JACOMO, AlfredoBackground Vagus nerve anatomical position inside the carotid sheath is not clear in the literature. Nevertheless, monitoring laryngeal nerves during thyroid surgeries may damage big vessels in the carotid sheath (jugular vein; carotid artery). This gap led to an unprecedent cross sectional study of vagus syntopy using the carotid artery as anatomical mark. Methods Fifty cadavers less than 24 hours postmortem were studied. The vagus nerve was spotted, reproducing the patterns performed in thyroidectomies. Results On the right side, vagus nerve was posterior to the common carotid artery in 64% of the cases. On the left side, it was anterior, in 68% of the dissections. Comparing both sides, there was no symmetry in this syntopy. No influence of ethnic or anthropometric characteristics was observed. Conclusion The vagus nerve is more frequently posterior to the common carotid artery on the right side and, anterior, on the left side. Level of Evidence 4
- Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic facial paralysis(2018) SALOMONE, Raquel; JACOMO, Alfredo Luiz; NASCIMENTO, Silvia Bona do; LEZIROVITZ, Karina; HOJAIJ, Flavio Carneiro; COSTA, Heloisa Juliana Zabeu Rossi; BENTO, Ricardo FerreiraBackground: Recent studies in invertebrates have taught us that early cell membrane regeneration is determinant for axonal recovery and survival after trauma. Many authors obtained extraordinary results in neural regeneration using polyethylene glycol fusion protocols, which also involved microsutures and antioxidants. Methods: Sixty rats were evaluated with functional and histological protocol after facial nerve neurotmesis. Groups A and B had their stumps coapted with microsuture after 24 hours of neurotmesis and groups C and D after 72 hours. In addition to the microstructure, groups B and D used the polyethylene glycol-fusion protocol for the modulation of the Ca12. Results: At the sixth week, the latency of group D and duration of group B was lower than groups A and C (P 5.011). The axonal diameter of the groups that used polyethylene glycol-fusion was higher than those who did not use polyethylene glycol-fusion (P 001). Conclusion: Although not providing a functional improvement, polyethylene glycolfusion slowed down demyelination.
article 2 Citação(ões) na Scopus Radiofrequency preserves histoarchitecture and enhances collagen synthesis in experimental tendon injury(2016) AKAMATSU, Flavia Emi; SALEH, Samir Omar; HOJAIJ, Flavio; AUGUSTO, Carlos; MARTINEZ, Real; ANDRADE, Mauro; TEODORO, Walcy Rosolia; JACOMO, Alfredo LuizWe investigated the action of radiofrequency (RF) on the healing process after inducing experimental lesions of the Achilles tendon in rats. Wistar rats were surgically subjected to bilateral partial transverse sectioning of the Achilles tendon. The right tendon was treated with radiofrequency (RFT), whereas the left tendon served as a control (CT). On the third postoperative day, the rats were divided into three experimental groups consisting of ten rats each, which were treated with monopolar radiofrequency (Tonederm (TM)) until they were sacrificed on the 7th, 14th or 28th days. The histological specimens were studied for inflammatory cell content, collagen types I and III, immunostaining and morphometry. Total collagen were biochemically analyzed and to evalute fibroblast and myofibroblast proliferation by vimentin and a-actin smooth muscle immunohistochemistry methods. Statistical analysis was performed using the Student's t-test, the sign test and the Kruskal-Wallis test to compare tendons treated with radiofrequency with the non-treated tendons (alpha=5%; alpha=10%). Larger amounts of collagen I with hydroxyproline content and myofibroblast cells were clearly evident within 7 days (p<0.05). No difference was observed in the inflammatory cell content between the groups. We found better collagen arrangement with RF administration across the entire time studied. Radiofrequency administration preserves histoarchitecture and enhances collagen synthesis during the initial phases of cicatrization, suggesting that the treatment can provide improved stiffness during the most vulnerable phases of tendon healing. Clinical studies may include RF among the therapeutic tools in tendinous lesion management.- Is the colon mucosa affected by ten days of gastric restriction in an animal model?(2019) AKAMATSU, Flavia Emi; FONTES, Luiz Gustavo; ITEZEROTE, Ana Maria; SALEH, Samir; TEODORO, Walcy Paganelli Rosolia; ARTIFON, Everson; HOJAIJ, Flavio; ANDRADE, Mauro; PEREIRA, Jose Aires; MARTINEZ, Carlos Augusto Real; JACOMO, Alfredo LuizPurpose: To identify whether the colon mucosa is affected by ten days of gastric restriction in an animal model. Methods: An experimental model of gastric restriction was devised using rats. The animals were submitted to surgical gastrostomy, and a cylindrical loofah was inserted into the stomach. We studied 30 adult male Wistar rats divided into three groups: the stomach restriction group (R10); the sham group (S10), which underwent the same procedure except for the loofah insertion; and the control group (C10). The expression of neutral and acid mucins was evaluated using histochemical techniques. Goblet cells and protein content were compared between groups using generalized estimation equations (GEEs). Bonferroni's multiple comparison was applied to identify differences between the groups. All tests considered a 5% significance level. Results: There was an increased expression of neutral mucins, acid mucins and goblet cells in the R10 group. Collagen was also enhanced in the R10 group. Conclusion: The colon mucosa is affected by ten days of gastric restriction in an animal model, increasing neutral mucins, acid mucins and collagen content with trophic maintenance.
- Linfonodos do nível VI: estudo anatômico dos linfonodos localizados entre o nervo laríngeo recorrente e a artéria carótida comum direita.(2018) SALEH, Samir Omar; HOJAIJ, Flávio Carneiro; ITEZEROTI, Ana Maria; CAMARGO, Cristina Pires; SALEH, Kassem Samir; ANDRADE, Mauro Figueiredo Carvalho de; AKAMATSU, Flávia Emi; JACOMO, Alfredo LuizABSTRACT Objective: to describe the presence of lymph nodes and their relationships with demographic and anthropometric characteristics in a specific region, not yet described in anatomy compendiums, called by us Recurrent Carotid Recess (RCR) and located among the right recurrent laryngeal nerve, the right common carotid artery, and the right inferior thyroid artery. Methods: 32 right cervical regions were harvested from cadavers within 24 hours post-mortem. The fibro-fatty tissue of the RCR was resected and prepared with formalin fixation. It was then subjected to an increasing sequence of alcohols (70%, 80%, and 90%), subsequently to a solution of Xylol, and finally to a solution of Methyl Salicylate, respecting the time required for each step. The macroscopic study was carried out on the diaphanized piece, observing the presence or not of lymph nodes. When present, they were photographed and their measurements were gauged with a digital caliper. In the microscopic study, hematoxylin-eosin staining was used to confirm the lymph node. Results: the presence of lymph nodes was observed in 22 (68.75%) of the 32 specimens. The number of lymph nodes ranged from zero to six (mean of 1.56±0.29), per cadaver, and their mean size was 7.82mmx3.86mm (longitudinal x transversal diameters). Conclusion: the relationship between anthropometric data and presence of lymph nodes in the RCR (Fisher’s exact test) was significant for medium-height individuals (p=0.03) and also white ones (p=0.04).
- Trigger Points: An Anatomical Substratum(2015) AKAMATSU, Flavia Emi; AYRES, Bernardo Rodrigues; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; HSING, Wu Tu; JACOMO, Alfredo LuizThis study aimed to bring the trapezius muscle knowledge of the locations where the accessory nerve branches enter the muscle belly to reach the motor endplates and find myofascial trigger points (MTrPs). Although anatomoclinical correlations represent a major feature of MTrP, no previous reports describing the distribution of the accessory nerve branches and their anatomical relationship with MTrP are found in the literature. Both trapezius muscles from twelve adult cadavers were carefully dissected by the authors (anatomy professors and medical graduate students) to observe the exact point where the branches of the spinal accessory nerve entered the muscle belly. Dissection was performed through stratigraphic layers to preserve the motor innervation of the trapezius muscle, which is located deep in the muscle. Seven points are described, four of which are motor points: in all cases, these locations corresponded to clinically described MTrPs. The four points were common in these twelve cadavers. This type of clinical correlation between spinal accessory nerve branching and MTrP is useful to achieve a better understanding of the anatomical correlation of MTrP and the physiopathology of these disorders and may provide a scientific basis for their treatment, rendering useful additional information to therapists to achieve better diagnoses and improve therapeutic approaches.