ROSELI SARAIVA MOREIRA BITTAR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Glucose metabolism disorders and vestibular manifestations: evaluation through computerized dynamic posturography(2016) BITTAR, Roseli Saraiva Moreira; SANTOS, Maruska D'Aparecida; MEZZALIRA, RaquelIntroduction: Global sugar consumption has increased in the past 50 years; its abusive intake is responsible for peripheral insulin resistance, which causes the metabolic syndrome - obesity, diabetes mellitus, hypertension, and coronary heart disease. Objective: To evaluate the effect of a fractionated diet without glucose as treatment for labyrinthine disorders associated with glucose-insulin index. Methods: The study design was a prospective randomized controlled trial. Fifty-one patients were divided into two groups: the diet group (DG), which comprised subjects treated with a fractionated diet with glucose restriction, and the control group (CG), in which individuals were not counseled regarding diet. Patients underwent computerized dynamic posturography (CDP) and visual analog scale (VAS) on the first and 30th days of the study. Results: There was improvement in the assessed posturographic conditions and VAS self assessment in the DG group after 30 days when compared to the control group. Conclusion: The fractionated diet with glucose restriction was effective for the treatment of vestibular dysfunction associated with glucose metabolism disorders. (C) 2015 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Neurotology: definitions and evidence-based therapies - Results of the I Brazilian Forum of Neurotology(2020) SALMITO, Marcio Cavalcante; MAIA, Francisco Carlos Zuma e; GRETES, Mario Edvin; VENOSA, Alessandra; GANANCA, Fernando Freitas; GANANCA, Mauricio Malavasi; MEZZALIRA, Raquel; BITTAR, Roseli Saraiva Moreira; GASPERIN, Alexandre Camilotti; PIRES, Anna Paula Batista de Avila; RAMOS, Bernardo Faria; BERTOLDO, Cesar; JR, Cicero Ferreira; REAL, Danilo; GUIMARAES, Humberto Afonso; OITICICA, Jeanne; LAVINSKY, Joel; LOPES, Karen Carvalho; DUARTE, Juliana Antoniolli; MORGANTI, Ligia Oliveira Goncalves; SANTOS, Lisandra Megumi Arima dos; JOFFILY, Lucia; LAVINSKY, Luiz; SANTOS, Monica Alcantara de Oliveira; MANO, Patricia Mauro; ARAUJO, Pedro Ivo Machado Pires de; ALBERNAZ, Pedro Luis Mangabeira; CAL, Renato; DORIGUETO, Ricardo Schaffeln; GUIMARAES, Rita de Cassia Cassou; CARVALHO, Rogerio Castro Borges deIntroduction: Neurotology is a rapidly expanding field of knowledge. The study of the vestibular system has advanced so much that even basic definitions, such as the meaning of vestibular symptoms, have only recently been standardized. Objective: To present a review of the main subjects of neurotology, including concepts, diagnosis and treatment of Neurotology, defining current scientific evidence to facilitate decision-making and to point out the most evidence-lacking areas to stimulate further new research. Methods: This text is the result of the I Brazilian Forum of Neurotology, which brought together the foremost Brazilian researchers in this area for a literature review. In all, there will be three review papers to be published. This first review will address definitions and therapies, the second one will address diagnostic tools, and the third will define the main diseases diagnoses. Each author performed a bibliographic search in the LILACS, Sci ELO, PubMed and MEDLINE databases on a given subject. The text was then submitted to the other Forum participants for a period of 30 days for analysis. A special chapter, on the definition of vestibular symptoms, was translated by an official translation service, and equally submitted to the other stages of the process. There was then a in-person meeting in which all the texts were orally presented, and there was a discussion among the participants to define a consensual text for each chapter. The consensual texts were then submitted to a final review by four professors of neurotology disciplines from three Brazilian universities and finally concluded. Based on the full text, available on the website of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery, this summary version was written as a review article. Result: The text presents the official translation into Portuguese of the definition of vestibular symptoms proposed by the Barany Society and brings together the main scientific evidence for each of the main existing therapies for neurotological diseases. Conclusion: This text rationally grouped the main topics of knowledge regarding the definitions and therapies of Neurotology, allowing the reader a broad view of the approach of neurotological patients based on scientific evidence and national experience, which should assist them in clinical decision-making, and show the most evidence-lacking topics to stimulate further study. (C) 2019 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Otoneurological evaluation: current good practice(2014) GONCALVES, Denise Utsch; GANANCA, Fernando Freitas; BOTTINO, Marco Aurelio; GRETERS, Mario Edvin; GANANCA, Mauricio Malavasi; MEZZALIRA, Raquel; BITTAR, Roseli Saraiva Moreira; ALBERTINO, Sergio
- Air caloric test reference values(2012) ALBERTINO, Sergio; BITTAR, Roseli Saraiva Moreira; BOTTINO, Marco Aurelio; GANANCA, Mauricio Malavasi; GONCALVES, Denise Utsch; GRETERS, Mario Edvin; MEZZALIRA, Raquel; GANANCA, Fernando Freitas
- Video head impulse test relevance in the early postoperative period after cochlear implantation(2019) BITTAR, Roseli Saraiva Moreira; SATO, Eduardo; RIBEIRO, Douglas Josimo Silva; OITICICA, Jeanne; GRASEL, Signe Schuster; MEZZALIRA, Raquel; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraBackground: Cochlear implantation (CI) is the gold standard therapy for profound or severe sensorineural hearing loss. It is a safe surgical procedure but, because of the proximity of the cochlea and vestibule, postoperative vestibular disorder may occur. Our hypothesis is that the video head impulse test (vHIT) may be a good tool to achieve a topographic diagnosis of dizziness in the early postoperative period after CI. Aims/Objectives: To evaluate patients with instability, imbalance and vertigo between 7 and 14 days after CI procedure. Material and methods: A total of 31patients scheduled for unilateral CI were included in this study. vHIT for horizontal semicircular canal was performed before CI and between days 7 to 14 after the surgery. Results: Six subjects had dizziness complaints after CI: instability (N = 2), imbalance (N = 2) and vertigo (N = 2). The postoperative vHIT test turned abnormal only in subjects with vertigo as compared to the preoperative vHIT test results. Conclusion and significance: vHIT is a good vestibular function test during the first 2 weeks after CI surgery when vertigo is the main complaint
- Dizziness profile and clinical features: a population based survey in São Paulo City, Brazil(2015) BITTAR, Roseli Saraiva Moreira; MEZZALIRA, Raquel; GRASEL, Signe Schuster; OITICICA, JeanneOBJECTIVE: This is a cross-sectional epidemiological survey designed to estimate the prevalence of dizziness among the adult population of the city of São Paulo, Brazil, and to describe the clinical features and level of discomfort. METHOD: This population based study was conductedin the city of São Paulo, Brazil, between April and October 2012. A total of 1,960 household interviews were completed. The following variables were assessed: gender, age, clinical characteristics of dizziness, and dizziness disability index. Chi-square test, Student's t-test,Tukey test and logistic regression were used for statistical analysis. RESULTS: The dizziness prevalence in São Paulo was 42%. Peaks of dizziness were observed in two age groups: 49% among the 46 to 55 year-old, and 44% among the elderly subjects(> 65 years-old). Vestibular vertigo was detected in 8.3% of patients, with a strong female preponderance (p < 0.001). Symptoms caused disability in 27% of the affected respondents and were more frequent among women (p < 0.001). These sought medical care more frequently (p < 0.001). The dizziness disability index was significantly higher (p = 0.0165) among subjects with a lower educational level. There was no correlation between dizziness discomfort and the type of job. CONCLUSION: The prevalence of dizziness in São Paulo, Brazil, was established at 42%. Among the symptomatic subjects, 67% reported interruption of daily activities, but only 46% of them sought medical attention.
- Caloric test and video head impulse test sensitivity as vestibular impairment predictors before cochlear implant surgery(2019) BITTAR, Roseli Saraiva Moreira; SATO, Eduardo Setsuo; SILVA-RIBEIRO, Douglas Josimo; OITICICA, Jeanne; MEZZALIRA, Raquel; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraOBJECTIVES: Currently, cochlear implant procedures are becoming increasingly broad and have greatly expanded. Bilateral cochlear implants and cochlear implants are more frequently applied in children. Our hypothesis is that the video head impulse test may be more sensitive than the caloric test in detecting abnormal vestibular function before cochlear implant surgery. The objective of this study was to compare the video head impulse test and caloric test results of patients selected for cochlear implant procedures before surgery. METHODS: The patients selected for cochlear implant surgery were submitted to a bithermal caloric test and video head impulse test. RESULTS: By comparing angular slow phase velocity values below 5 degrees in the bithermal caloric test (hypofunction) and video head impulse test with a gain lower than 0.8, we identified 37 (64.9%) patients with vestibular hypofunction or canal paresis and 21 (36.8%) patients with abnormal video head impulse test gain before the cochlear implant procedure. Of the 37 patients with caloric test vestibular hypofunction, 20 (54%) patients exhibited an abnormal gain in the video head impulse test. CONCLUSION: The caloric test is more sensitive than the video head impulse test (Fisher's exact test, p=0.0002) in detecting the impaired ear before cochlear implant delivery. The proportion of caloric test/video head impulse test positive identification of abnormal vestibular function or caloric test/video head impulse test sensitivity was 1.8:1.
- Vestibular recruitment: new application for an old concept(2022) BITTAR, Roseli Saraiva Moreira; MEZZALIRA, Raquel; RAMOS, Alice Carolina Mataruco; RISSO, Gabriel Henrique; REAL, Danilo Martin; GRASEL, Signe SchusterAbstract Introduction Vestibular recruitment is a sign of hyperexcitability of central vestibular neurons and may be characteristic of peripheral vestibular damage. Objective To define the post-caloric recruitment index and its ability to predict the stage of vestibular compensation and peripheral lesion. Methods First of all, we demonstrated that larger values in the cold post-caloric stimulation compared to warm stimulation were equivalent to vestibular recruitment observed during the sinusoidal harmonic acceleration test. In the next step, patients with vestibular complaints and asymptomatic controls were submitted to the caloric test. We calculated post-caloric recruitment index for the control group. Among the study group, we analyzed the relation between post-caloric recruitment and unilateral weakness as well as the types of vestibular diagnoses. Results Mean post-caloric recruitment was 17.06% and 33.37% among the control and study group, respectively. The ratio between post-caloric recruitment and unilateral weakness was 1.3 in the study group. Among recruiting subjects, no significant difference of unilateral weakness from the lesioned or healthy side was observed. We found no differences in vestibular diagnoses between recruiting and non-recruiting subjects. Conclusion Post-caloric recruitment index identified asymmetric vestibular tonus and central compensation. The normal value was established at 17.06%.
- Sensitivity of caloric test and video head impulse as screening test for chronic vestibular complaints(2017) MEZZALIRA, Raquel; BITTAR, Roseli Saraiva Moreira; BILECKI-STIPSKY, Marcia Maria do Carmo; BRUGNERA, Cibele; GRASEL, Signe SchusterOBJECTIVE: This study compared the results of the caloric test with those of the video head impulse test obtained during the same session and evaluated whether the former can be used to screen for non-acute vestibular dysfunction. METHODS: A total of 157 participants complaining of dizziness with vestibular characteristics of varying durations and clinical courses completed the caloric test and video head impulse test. RESULTS: Significantly more caloric test results than video head impulse test results were abnormal. CONCLUSIONS: The results of the caloric test and video head impulse test are distinct but complement each other. Within our sample, the caloric test was more sensitive for vestibular dysfunction. Therefore, the video head impulse test is not a suitable screening tool of the vestibular system in patients with chronic complaints.
- Does the video head impulse test replace caloric testing?(2020) VENOSA, Alessandra Ramos; GANANCA, Mauricio Malavasi; MEZZALIRA, Raquel; BITTAR, Roseli Saraiva Moreira; GANANCA, Fernando Freitas