NIVALDO ALONSO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
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article 8 Citação(ões) na Scopus Histological and radiological changes in cranial bone in the presence of bone wax(2011) RAPOSO-AMARAL, Cassio Eduardo; ALMEIDA, Ana Beatriz Albino de; PASCHOAL, Gustavo; BUENO, Daniela Franco; VULCANO, Luiz Carlos; PASSOS-BUENO, Maria Rita; ALONSO, NivaldoPurpose: To quantify the amount of bone formation in the calvarial region of Wistar rats after craniotomy using bone wax as a haemostatic agent. Methods: Surgery to produce bilateral, symmetric, full-thickness cranial defects (area: 18 mm(2)) was performed in eight animals. The right side of the cranium remained open and the edges of the left side osseous defect was covered with bone wax. Calvaria were imaged immediately after surgery and 12 weeks postoperatively by computerized tomography. The areas of the bone defects were measured in three-dimensional images using Magics 13.0 (Materialise-Belgic, software CAD). Results: The average amount of bone formation on the left and right side respectively was 4.85 mm(2) and 8.16 mm(2). Statistically significant differences between the amount of bone formation on the left and right sides were seen. Conclusion: Bone wax significantly diminishes the rate of bone formation in calvarial defects in a rat model.- Skull Base Cephalometric Changes in Cranial Expansion by Springs(2011) DORNELLES, Rodrigo de Faria Valle; CARDIM, Vera Lucia Nocchi; PINTO, Ana Carolina Brandao de Campos Fonseca; ALONSO, NivaldoBackground: The use of springs in cranial expansion has demonstrated to be effective for craniosynostosis treatment. The spring-exerted expansile action has been observed when springs are placed both in the sagittal and parasagittal regions, mainly in scaphocephaly. In this study, a variation in cephalometric measurements under expansible spring action on the skull base was analyzed. Methods: Thirteen 4-week-old New Zealand white rabbits were divided into 4 groups: group 1, in which only amalgam markers were used (control); group 2, in which amalgam markers were used, and a sagittal suturectomy was performed; group 3, in which amalgam markers were used, and a sagittal suturectomy was performed with placement of expansible springs in the interparietal region; and group 4, in which markers were used, and a linear parasagittal craniectomy was performed with spring placement. All animals were killed at weeks 2, 4, 8, and 12. Radiologic control with cephalometric study was performed. Results: Distraction of amalgam markers in the groups with springs was greater than in those without springs. A proportional change in the angles measured through craniometry was observed in these groups. Conclusions: The experimental rabbit model was shown to be adequate to the analysis proposed by the study. Under the action of springs, the groups with sagittal and parasagittal osteotomy were found to present a similar distraction of amalgam markers. A concomitant change in cephalometric measurements occurred, suggesting a change in the skull base mediated by expansible springs placed both in the sutural and nonsutural sites.
- The Sentinel Fat Pads: The Relationship of the ROOF and SOOF to the Temporal Nerve in Facial Rejuvenation(2011) SINGH, Devinder P.; FORTE, Antonio J. V.; APOSTOLIDES, John G.; STROMBERG, Jeffrey A.; ZAHIRI, Hamid R.; ALONSO, Nivaldo; PERSING, John A.Background: A great number of studies have reported on the temporal branch anatomy and its relationship to the fascial layers and various fat pads of the temporal region, but no article has included information on the relationship of the temporal nerve to the retro-orbicularis oculi fat (ROOF) and/or the suborbicularis oculi fat (SOOF). Objectives: The authors report the results of a series of human cadaver temporal nerve dissections, with particular attention paid to its relation to the ROOF and the SOOF. The results of a literature review and a subsequent open browlift are also reported to confirm the results of the cadaver study. Methods: Dissection was performed on 15 fresh human cadavers, for a total of 29 hemifaces. The course and relationships of the temporal nerve branch to the fascia, fat pads, and landmarks in the temporal region were noted and detailed. A thorough review was also performed for 23 articles, to compare the author's anatomical findings with data in the previous literature. Results: During cadaver dissection, the temporal branch was found to lie on the undersurface of the superficial temporal fascia. In the supraorbital area, the ROOF existed in the loose areolar plane or deep layer of the superficial temporal fascia, with the temporal nerve branch directly superficial to it. The temporal branch passed lateral to the SOOF in its superiomedial course at the level of the zygoma. These findings were later confirmed during an in vivo open browlift as well. Conclusions: The ROOF was formerly unrecognized as an important sentinel marker for possible injury to the temporal nerve branch during browlift. However, this cadaver study and its accompanying literature comparisons show that browlift dissection, whether endoscopic or open, should aim to keep the ROOF fat in the superficial plane, ensuring that the nerve branch is safe from iatrogenic injury.
- Reply: Myotomy of the Levator Labii Superioris Muscle and Lip Repositioning: A Combined Approach for the Correction of Gummy Smile(2011) ISHIDA, Luis Henrique; ALONSO, Nivaldo; ISHIDA, Luiz C.; FERRIERA, Marcus Castro
- The Role of Septal Cartilage in Rhinoplasty: Cadaveric Analysis and Assessment of Graft Selection(2011) POCHAT, Victor Diniz de; ALONSO, Nivaldo; FIGUEREDO, Adson; RIBEIRO, Emilie B.; MENDES, Rogerio Rafael da Silva; MENESES, Jose Valber LimaBackground: In addition to providing nearly 50% of total airway resistance via the internal valve, the nasal septum provides support for the cartilaginous portion of the nasal dorsum, and it is responsible for determining the projection of the nasal tip. In modern rhinoplasty, septal cartilage plays an important role as a donor graft material. Objectives: The authors evaluate the anatomy of nasal septal cartilage, identifying variations according to certain regions of the septum and proposing a correlation between the topography and morphology of septal cartilage and graft choice. Methods: An anatomical study was performed on 14 fresh adult cadavers. The excised septal cartilage was placed on grid paper; digital images were taken; all septal cartilage was divided into nine equivalent quadrants; and quantitative measurements for length, height, and area were calculated and compared. Statistical significance was set at P < .05. Results: The average length of the septum was 35.14 mm, while the average height was 32.5 mm. The average septal area was 933.11 mm(2). The septal thickness mean values were analyzed in nine quadrants, ranging from 1.04 to 1.71 mm. Statistically-significant differences in mean values were found in 13 of the 14 cadavers. Specifically, the central and cranial areas were thickest, and the area corresponding to the L-strut was thinnest. Conclusions: Anatomical variations of the thickness of septal cartilage excisions were found to be statistically significant, and these differences play an important role in the proper selection of the septal grafts.
- Genetic Contribution for Non-Syndromic Cleft Lip With or Without Cleft Palate (NS CL/P) in Different Regions of Brazil and Implications for Association Studies(2011) BRITO, Luciano A.; CRUZ, Lucas A.; ROCHA, Katia M.; BARBARA, Ligia K.; SILVA, Camila B. F.; BUENO, Daniela F.; AGUENA, Meire; BERTOLA, Debora R.; FRANCO, Diogo; COSTA, Andre M.; ALONSO, Nivaldo; OTTO, Paulo A.; PASSOS-BUENO, Maria RitaNon-syndromic cleft lip with or without cleft palate (NS CL/P) is a complex disease in which heritability estimates vary widely depending on the population studied. To evaluate the importance of genetic contribution to NS CL/P in the Brazilian population, we conducted a study with 1,042 families from five different locations (Santarem, Fortaleza, Barbalha, Maceio, and Rio de Janeiro). We also evaluated the role of consanguinity and ethnic background. The proportion of familial cases varied significantly across locations, with the highest values found in Santarem (44%) and the lowest in Maceio (23%). Heritability estimates showed a higher genetic contribution to NS CL/P in Barbalha (85%), followed by Santarem (71%), Rio de Janeiro (70%), Fortaleza (64%), and Maceio (45%). Ancestry was not correlated with the occurrence of NS CL/P or with the variability in heritability. Only in Rio de Janeiro was the coefficient of inbreeding significantly larger in NS CL/P families than in the local population. Recurrence risk for the total sample was approximately 1.5-1.6%, varying according to the location studied (0.6-0.7% in Maceio to 2.2-2.8% in Barbalha). Our findings show that the degree of genetic contribution to NS CL/P varies according to the geographic region studied, and this difference cannot be attributed to consanguinity or ancestry. These findings suggest that Barbalha is a promising region for genetic studies. The data presented here will be useful in interpreting results from molecular analyses and show that care must be taken when pooling samples from different populations for association studies. (C) 2011 Wiley-Liss, Inc.
- Eyebrow composite graft for eyelash reconstruction: A case report and review of the literature(2011) POCHAT, Victor Diniz de; COSTA, Thiago Vial; CASTRO, Manuela Perez; ANJOS NETO, Jorge Cabral dos; ALONSO, Nivaldo; MENESES, Jose Valber LimaReconstructing the eyelash margin is a challenge for plastic surgeons because eyelashes have specific characteristics. There is still no gold standard procedure for this type of reconstruction, which seeks to protect the eyeball and make the eyelid appear natural. The eyebrow composite graft can be a good option for reconstructing the eyelash margin because it is technically simple and safe, and takes advantage of the structural similarity between the eyelashes and eyebrow. The results presented showed the effectiveness of the technique by providing improved occlusion and a good aesthetic result.