Departamento de Otorrinolaringologia e Oftalmologia - FM/MOF

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O Departamento de Otorrinolaringologia e Oftalmologia da Faculdade de Medicina da Universidade de São Paulo vincula-se à disciplina de mesmo nome que está presente na grade da Faculdade de Medicina da USP desde a sua fundação (1912). Contribui para a formação técnica, científica e profissional dos alunos da FMUSP e de profissionais oriundos desta e outras faculdades do país e do exterior, nos seus cursos de graduação em Medicina, residência médica, programa de complementação especializada (fellowship), programa de capacitação profissional para médicos estrangeiros, programa de prática profissionalizante, programa de pesquisador e cursos de pós graduação stricto-sensu (Mestrado e Doutorado). Contribui igualmente com a formação técnica, científica e profissional de alunos do curso de graduação em fonoaudiologia, fisioterapia e terapia ocupacional, bem como em cursos de especialização a profissionais já formados destas áreas (Fonoaudiologia, Fisioterapia e Psicologia).

A área de oftalmologia tem como subespecialidades: catarata, córnea, ecografia, estrabismo, glaucoma, glaucoma congênito, neuroftalmologia, plástica ocular, retina, uveíte e visão subnormal.

Site: http://www.otorrinousp.org.br/

http://www.oftalmologiausp.com.br/

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article 0 Citação(ões) na Scopus
Complications and audiological results of percutaneous bone-anchored hearing devices
(2024) SUCCAR, Ana Carolina Soares; SASSI, Tyuana Sandim da Silveira; BRITO NETO, Rubens Vuono de; LOURENCONE, Luiz Fernando Manzoni
Objective. To describe the post-operative complications and audiological results related to percutaneous bone-anchored hearing devices. Methods. A retrospective review was conducted of 44 patients with bilateral conductive or mixed hearing loss who were implanted with unilateral Baha Connect or Ponto devices. A generalised linear model for repeated measurements was used. Results. Twenty patients were Baha Connect users, and 24 were implanted with Ponto devices. Twenty-seven patients experienced complications. No fewer complications were found in the group of patients using longer abutments. When we compared the frequency of complications between Ponto and Baha Connect users, there was no statistically significant difference (p = 0.90). Free-field hearing thresholds were statistically significantly improved when we compared pre- and post-operative results (p < 0.001). Average speech perception also improved (p < 0.001). Conclusion. Despite percutaneous bone-anchored hearing devices having a high rate of complications, they provide significant audiological benefits.
article 1 Citação(ões) na Scopus
Effects of Mucosal Decongestion on Nasal Aerodynamics: A Pilot Study
(2024) HAMDAN, Ahmad T.; CHEROBIN, Giancarlo B.; VOEGELS, Richard L.; RHEE, John S.; GARCIA, Guilherme J. M.
ObjectiveMucosal decongestion with nasal sprays is a common treatment for nasal airway obstruction. However, the impact of mucosal decongestion on nasal aerodynamics and the physiological mechanism of nasal airflow sensation are incompletely understood. The objective of this study is to compare nasal airflow patterns in nasal airway obstruction (NAO) patients with and without mucosal decongestion and nondecongested healthy subjects.Study DesignCross-sectional study of a convenience sample.SettingAcademic tertiary medical center.MethodsForty-five subjects were studied (15 nondecongested healthy subjects, 15 nondecongested NAO patients, and 15 decongested NAO patients). Three-dimensional models of the nasal anatomy were created from computed tomography scans. Steady-state simulations of airflow and heat transfer were conducted at 15 L/min inhalation rate using computational fluid dynamics.ResultsIn the narrow side of the nose, unilateral nasal resistance was similar in decongested NAO patients and nondecongested healthy subjects, but substantially higher in nondecongested NAO patients. The vertical airflow distribution within the nasal cavity (inferior vs middle vs superior) was also similar in decongested NAO patients and nondecongested healthy subjects, but nondecongested NAO patients had substantially less middle airflow. Mucosal cooling, quantified by the surface area where heat flux exceeds 50 W/m2, was significantly higher in decongested NAO patients than in nondecongested NAO patients.ConclusionThis pilot study suggests that mucosal decongestion improves objective measures of nasal airflow, which is consistent with improved subjective sensation of nasal patency after decongestion.
article 0 Citação(ões) na Scopus
White-line ptosis repair with complications
(2024) MATAYOSHI, Suzana; ALMEIDA, Alice Carvalho Gouveia de; SCHELLINI, Silvana Artioli
article
Combined Endoscopic Cyclophotocoagulation and Phacoemulsification Versus Phacoemulsification Alone in the Glaucoma Treatment: A Systematic Review and Meta-Analysis
(2024) AMARAL, Dillan Cunha; LOUZADA, Ricardo Noguera; MOREIRA, Pedro Henrique Santana; OLIVEIRA, Lucas Neves de; YUATI, Thais Tiemi; GUEDES, Jaime; ALVES, Milton Ruiz; MORA-PAEZ, Denisse Josefina; MONTEIRO, Mario Luiz Ribeiro
The complete safety and efficacy of endoscopic cyclophotocoagulation (ECP) remain unclear in the literature and, to our knowledge, there are no current meta -analyses on phaco-ECP versus phacoemulsification alone to date. Thus, we conducted a systematic review and meta -analysis comparing these two strategies through studies, assessing the effectiveness and safety of outcomes in a population with glaucoma. The protocol for this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023482376). We systematically searched PubMed, Embase, and Web of Science from inception to December 2023. A random -effects model was used for all analyses due to heterogeneity. Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) was used for statistical analysis. Finally, nine studies were included in this comprehensive review and a total of 5389 eyes were analyzed in our study. In comparison to the ECP and phacoemulsification group, those receiving phacoemulsification alone showed better results in best -corrected visual acuity (MD 0.09; CI 95% 0.03 to 0.16; I2=0%), but worse outcomes in intraocular pressure (IOP) (MD -1.49; 95% CI -2.29 to -0.68; I2=29%) and use medications (MD -0.75; 95% CI -0.94 to -0.56; I2=0%) in the last visit. Complication rates, both general and serious, were significantly different between the groups, indicating the potential impact of combined procedures on patient outcomes. Thus, combining ECP with phacoemulsification for glaucoma treatment showed sustained IOP reduction and decreased medication dependence. However, higher complication rates suggest careful consideration of risks. More extensive research with larger trials and longer follow-ups is needed to validate findings and address limitations, providing valuable insights into this treatment approach.
article 1 Citação(ões) na Scopus
Morphofunctional evaluation of peripapillary retinoschisis associated with myopic posterior staphyloma and hyaloid traction: does it cause peripapillary vitreoretinal traction?
(2024) BORGES, Fillipe B.; ZACHARIAS, Leandro Cabral; PIMENTEL, Sergio Luis Gianotti; CUNHA, Leonardo Provetti; MONTEIRO, Mario Luis Ribeiro; PRETI, Rony Carlos
This case report presents the details of a 33 -year -old female patient who was referred to a specialized retina service because of mild vision loss in her right eye). The patient's visual acuity was 20/25 in right eye and 20/50 in the left eye (; amblyopic); the spherical equivalent was -12.75 diopters (right eye) and -14.75 diopters (left eye). Multimodal retinal imaging showed peripapillary schisis in both the inner and outer retinal layers, grade II posterior vitreous detachment, and a tessellated fundus. Using Humphrey perimetry and MP -3 microperimetry, the functional evaluation indicated macular sensitivity within normal limits and decreased sensitivity in the peripapillary region, especially in right eye. The pattern-re versal visual evoked potential was measured. The N75 and P100 latency and amplitude in right eye were within normal values for checks of 1(o) . However, the amplitude was low for checks of 15 ' . Highly myopic patients who have posterior staphyloma that involves the optic nerve are susceptible to posterior hyaloid traction, and the resulting peripapillary vitreous traction may compromise vision.
article
Hearing Performance in Cochlear Implant Users Who Have Facial Nerve Stimulation
(2024) ROCHA, Larissa Veloso; GOFFI-GOMEZ, Maria Valeria Schmidt; HOSHINO, Ana Cristina; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira
Introduction Facial nerve stimulation (FNS) is a complication in cochlear implant (CI) when the electrical current escapes from the cochlea to the nearby facial nerve. Different management to reduce its effects are available, although changes might result in a less-than-ideal fitting for the CI user, eventually reducing speech perception.Objective To verify the etiologies that cause FNS, to identify strategies in managing FNS, and to evaluate speech recognition in patients who present FNS.Methods Retrospective study approved by the Ethical Board of the Institution. From the files of a CI group, patients who were identified with FNS either during surgery or at any time postoperatively were selected. Data collection included: CI manufacturer, electrode array type, age at implantation, etiology of hearing loss, FNS identification date, number of electrodes that generated FNS, FNS management actions, and speech recognition in quiet and in noise.Results Data were collected from 7 children and 25 adults. Etiologies that cause FNS were cochlear malformation, head trauma, meningitis, and otosclerosis; the main actions included decrease in the stimulation levels followed by the deactivation of electrodes. Average speech recognition in quiet before FNS was 86% and 80% after in patients who were able to accomplish the test. However, there was great variability, ranging from 0% in quiet to 90% of speech recognition in noise.Conclusion Etiologies that cause FNS are related to cochlear morphology alterations. Facial nerve stimulation can be solved using speech processor programming parameters; however, it is not possible to predict outcomes, since results depend on other variables.
article 0 Citação(ões) na Scopus
Effects of aflibercept and bevacizumab on cell viability, cell metabolism and inflammation in hypoxic human Müller cells
(2024) MATSUDA, Monique; SILVA, Rafael Andre da; RODA, Vinicius Moraes de Paiva; MARQUEZINI, Monica Valeria; MONTEIRO, Mario Luiz Ribeiro; HAMASSAKI, Dania Emi
Anti-VEGF (vascular endothelial growth factor) drugs such as aflibercept (AFL) and bevacizumab (BVZ) inhibit pathological neo-angiogenesis and vascular permeability in retinal vascular diseases. As cytokines and growth factors are produced by Muller glial cells under stressful and pathological conditions, we evaluated the in vitro effect of AFL (Eylea (R), 0.5 mg/mL) and BVZ (Avastin (R), 0.5 mg/mL) on cell viability/metabolism, and cytokine/growth factor production by Muller cells (MIO-M1) under cobalt chloride (CoCl2)-induced hypoxia after 24h, 48h and 72h. Cell viability/metabolism were analyzed by Trypan Blue and MTT assays and cytokine/growth factors in supernatants by Luminex xMAP-based multiplex bead-based immunoassay. Cell viability increased with AFL at 48h and 72h and decreased with BVZ or hypoxia at 24h. BVZ-treated cells showed lower cell viability than AFL at all exposure times. Cell metabolism increased with AFL but decreased with BVZ (72h) and hypoxia (48h and72h). As expected, AFL and BVZ decreased VEGF levels. AFL increased PDGF-BB, IL-6 and TNF-alpha (24h) and BVZ increased PDGF-BB (72h). Hypoxia reduced IL-1 beta, -6, -8, TNF-alpha and PDGF-BB at 24h, and its suppressive effect was more prominent than AFL (EGF, PDGF-BB, IL-1 beta, IL-6, IL-8, and TNF-alpha) and BVZ (PDGF-BB and IL-6) effects. Hypoxia increased bFGF levels at 48h and 72h, even when combined with anti-VEGFs. However, the stimulatory effect of BVZ predominated over hypoxia for IL-8 and TNF-alpha (24h), as well as for IL-1 beta (72h). Thus, AFL and BVZ exhibit distinct exposure times effects on MIO-M1 cells viability, metabolism, and cytokines/growth factors. Hypoxia and BVZ decreased MIO-M1 cell viability/metabolism, whereas AFL likely induced gliosis. Hypoxia resulted in immunosuppression, and BVZ stimulated inflammation in hypoxic MIO-M1 cells. These findings highlight the complexity of the cellular response as well as the interplay between anti-VEGF treatments and the hypoxic microenvironment.
article 1 Citação(ões) na Scopus
Source and Filter Acoustic Measures of Young, Middle-Aged and Elderly Adults for Application in Vowel Synthesis
(2024) DAVATZ, Giovanna Castilho; YAMASAKI, Rosiane; HACHIYA, Adriana; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo Neto
Introduction: The output sound has important changes throughout life due to anatomical and physiological modifications in the larynx and vocal tract. Understanding the young adult to the elderly speech acoustic characteristics may assist in the synthesis of representative voices of men and women of different age groups. Objective: To obtain the fundamental frequency (f(0)), formant frequencies (F-1, F-2, F-3, F-4), and bandwidth (B-1, B-2, B-3, B-4) values extracted from the sustained vowel /a/ of young, middle-aged, and elderly adults who are Brazilian Portuguese speakers; to present the application of these parameters in vowel synthesis. Study Design Prospective study. Methods: The acoustic analysis of tokens of the 162 sustained vowel /a/ produced by vocally healthy adults, men, and women, between 18 and 80 years old, was performed. The adults were divided into three groups: young adults (18 to 44 years old); middle-aged adults (45 to 59 years old) and, elderly adults (60 to 80 years old). The f(0), F-1, F-2, F-3, F-4, B-1, B-2, B-3, B-4 were extracted from the audio signals. Their average values were applied to a source-filter mathematical model to perform vowel synthesis in each age group both men and woman. Results: Young women had higher f(0) than middle-aged and elderly women. Elderly women had lower F-1 than middle-aged women. Young women had higher F-2 than elderly women. For the men's output sound, the source-filter acoustic measures were statistically equivalent among the age groups. Average values of the f(0), F-1, F-2, F-3, F-4, B-1, and B-2 were higher in women. The sound waves distance in signals, the position of formant frequencies and the dimension of the bandwidths visible in spectra of the synthesized sounds represent the average values extracted from the volunteers' emissions for the sustained vowel /a/ in Brazilian Portuguese. Conclusion: Sustained vowel /a/ produced by women presented different values of f(0,) F-1 and F-2 between age groups, which was not observed for men. In addition to the f(0) and the formant frequencies, the bandwidths were also different between women and men. The synthetic vowels available represent the acoustic changes found for each sex as a function of age.
article 0 Citação(ões) na Scopus
Discrimination ability of central visual field testing using stimulus size I, II, and III and relationship between VF findings and macular ganglion cell thickness in chiasmal compression
(2024) ROCHA, Arthur Andrade do Nascimento; BENASSI, Thais de Souza Andrade; MELLO, Luiz Guilherme Marchesi; PRETI, Rony Carlos; ZACHARIAS, Leandro C.; CUNHA, Leonardo P.; MONTEIRO, Mario L. R.
Purpose To compare the relationship between macular ganglion cell layer (mGCL) thickness and 10-2 visual field (VF) sensitivity using different stimulus sizes in patients with temporal hemianopia from chiasmal compression.Methods A cross-sectional study was conducted involving 30 eyes from 25 patients with temporal VF loss on 24-2 SITA standard automated perimetry due to previous chiasmal compression and 30 healthy eyes (23 controls). Optical coherence tomography (OCT) of the macular area and 10-2 VF testing using Goldmann stimulus size I (GI), II (GII), and III (GIII) were performed in the Octopus 900 perimeter. For the sake of analysis, mGCL thickness and VF data were segregated into four quadrants (two temporal and two nasal) and two halves (temporal and nasal) centered on the fovea, in order to evaluate separately both the severely affected nasal hemi-retina corresponding to the temporal VF sectors and the subclinically affected temporal hemi-retina corresponding to the nasal VF sectors. Data from patients and controls were compared using generalized estimated equations. The discrimination ability of GI, GII, and GIII was evaluated, as was the correlation between mGCL and 10-2 VF sensitivity using GI, GII, and GIII.Results All mGCL parameters in the nasal and temporal halves of the retina were significantly reduced in patients compared to controls. 10-2 VF test sensitivity using GI, GII, and GIII was significantly lower in patients than in controls (p <= 0.008) for all parameters, except the three nasal divisions when using GI (p = 0.41, 0.07 and 0.18) Significant correlations were found between temporal VF sectors (all stimulus sizes) and the corresponding nasal mGCL measurements, with similar discrimination ability. Significant correlations were also observed between all three nasal VF divisions and the corresponding temporal mGCL thickness when using stimulus sizes I and II, but not stimulus size III.Conclusions On 10-2 VF testing, GII outperformed GI and GIII with regard to discrimination ability and structure-function correlation with mGCL thickness in the subclinically affected nasal part of the VF in patients with chiasmal compression. Our findings suggest that the use of GII can enhance the diagnostic power of 10-2 VF testing in early cases of chiasmal compression, although further studies are necessary to support this conclusion.
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Otite média crônica
(2021) RAPOPORT, Priscila Bogar; MARONE, Silvio Antonio Monteiro