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
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Reduced Three-Dimensional Nasal Airway Volume in Treacher Collins Syndrome and Its Association with Craniofacial Morphology(2015) MA, Xiaoyang; FORTE, Antonio Jorge; BERLIN, Nicholas Lee; ALONSO, Nivaldo; PERSING, John A.; STEINBACHER, Dereck MatthewBackground: Airway insufficiency decreases quality of life and may be life threatening in patients with Treacher Collins syndrome. The authors calculated the three-dimensional nasal airway volume in patients with Treacher Collins syndrome to identify correlations between nasal airway volume and craniofacial morphology and provide guidance for surgical planning. Methods: Thirty nonoperated patients with Treacher Collins syndrome were compared with 35 unaffected age-and gender-matched controls. Anatomic variables of the cranial base, the maxilla complex, and internal diameters of nasal airway were compared between patients and control subjects using three-dimensional craniometric analyses. In the Treacher Collins group, the relation of craniofacial morphology to nasal airway volume was assessed separately. Statistical analyses were performed using independent sample t tests and Pearson correlation coefficient analyses. Results: Nasal airway volume was decreased 38.6 percent in patients with Treacher Collins syndrome relative to controls (p = 0.001). A positive correlation of maxillary position and nasal airway volume was shown in Treacher Collins patients (r = +0.463, p = 0.013). Maxillary, nasal bone, and orbitale width were also positively correlated with nasal airway volume (r = +0.582, p = 0.001; r = +0.408, p = 0.035; and r = +0.677, p < 0.001, respectively). Shortened internal diameters of the nasal airway all positively correlated with nasal airway volume. Conclusions: Nasal airway volume is reduced in patients with Treacher Collins syndrome. Reduced projection of the maxilla and transverse maxillary deficiency are correlated with reduced nasal airway volume and are primarily responsible for obstruction of the nasal airway.
- Orbital Dysmorphology in Untreated Children with Crouzon and Apert Syndromes(2015) FORTE, Antonio Jorge; STEINBACHER, Derek M.; PERSING, John A.; BROOKS, Eric D.; ANDREW, Tom W.; ALONSO, NivaldoBackground: Orbital dysmorphology and midface retrusion are the hallmarks of Crouzon and Apert syndromes. The precise nature of this deficiency is not known. Methods: Untreated Crouzon and Apert syndrome patients and age- and sex-matched controls were included. Computed tomographic scans were digitized and reconstructed. Craniometric and volumetric data relating to the orbit were collected. Results: Thirty-one scans were included (control, n = 12; Crouzon; n = 9; Apert, n = 10). The mean age of the Apert group was 5.31 5 years; Crouzon, 5.77 +/- 2.7 years; and control, 6.4 +/- 3.6 years. The bony orbit length was 12 percent shorter in Apert (p = 0.004) and 17 percent shorter in the Crouzon group when compared to controls (p < 0.0001). The bony orbital volume was 21 percent smaller in the Apert children (p = 0.0006) and 23 percent smaller in Crouzon when compared to controls (p = 0.003). Globe volume was 15 percent larger in Apert (p = 0.008) and 36 percent larger in the Crouzon group when compared to controls (p < 0.0001). Orbital soft-tissue volume was 19 percent less in the Apert group (p = 0.004) and 29 percent less in the Crouzon group (p = 0.001) when compared to controls. Conclusions: A shortened bony orbit, decreased orbital and orbital soft-tissue volumes, and an increased volume of the globe were found in both conditions. Despite normal volume of the overall orbital contents, the contents are altered, and the bony orbit is shorter and holds less volume.
- Reduced Three-Dimensional Airway Volume Is a Function of Skeletal Dysmorphology in Treacher Collins Syndrome(2015) MA, Xiaoyang; FORTE, Antonio J.; PERSING, John A.; ALONSO, Nivaldo; BERLIN, Nicholas L.; STEINBACHER, Derek M.Background: Children with Treacher Collins syndrome frequently present with obstructive sleep apnea and respiratory insufficiency. The purpose of this study was to three-dimensionally calculate upper airway volume in these patients. The authors also assessed the correlation between bony craniofacial morphology and spatial position with airway volume. Methods: Thirty Treacher Collins syndrome patients who have not been operated on were compared with a sample of 35 age-and sex-matched unaffected controls. Upper airway volume was stratified into retropalatal and retroglossal aspects. Three-dimensional craniometric findings were compared between patients and controls. Among Treacher Collins syndrome patients, the authors assessed the relationship of craniofacial morphology and spatial positioning to airway volume. Statistical analyses included independent sample t tests and Pearson correlation coefficient analyses. Results: Decreased total upper airway volume (p = 0.034) was found in the Treacher Collins syndrome group, attributable primarily to a decrease in retroglossal airway volume (p = 0.009). Regarding three-dimensional craniometric variables, maxillary and mandibular length (r = 0.76, p < 0.001; and r = 0.68, p < 0.001), and the anterior and posterior cranial base (r = 0.61, p < 0.001; and r = 0.77, p < 0.001) were positively correlated with airway volume in Treacher Collins syndrome patients. Transverse internal diameters of the upper airway were also positively correlated with airway volume (r = 0.635, p = 0.001; and r = 0.511, p = 0.006); however, no correlation was shown for the anteroposterior airway diameters. Conclusions: Three-dimensional analysis revealed diminished upper airway volume in Treacher Collins syndrome, with the retroglossal region being the most severely constricted. Maxillomandibular dysmorphologies, and their relationship to the cranial base, correlated significantly with airway findings.
- Cadaveric Study of Breast Measurements during Augmentation with Implants(2015) FORTE, Antonio Jorge; BARBOSA, Marco Polo; PERSING, John Arthur; ALONSO, Nivaldo; BERLIN, Nicholas; BROER, Niclas; NARAYAN, Deepak; KWEI, StephanieBackground: The goal of this study was to compare immediate changes in breast shape and nipple position using different implant shapes and volumes, with variable release of the pectoralis major muscle in fresh cadavers. Methods: Seventeen fresh cadaveric breasts were analyzed. Six different augmentation procedures were performed, including pocket dissection in the sub-muscular and subglandular planes, and partial and full release of the pectoralis major muscle insertion. Round and contoured implant volumes of 200, 300, 400, 500, and 600 ml were used, resulting in a total of 30 procedures per breast. Results: Projection was greater when subjects received contoured implants versus round implants in all volumes both in submuscular and in subglandular pockets (p < 0.001). For implants larger than 200 ml, projection was greater when a subglandular pocket was chosen (p < 0.02), for both round and contoured implants. Nipple-to-inframammary fold distance was increased with contoured implants compared with round implants in both subglandular and submuscular pockets for all implant volumes (p < 0.05). Conclusions: Implant shape, volume, and pocket location influence projection, causing it to increase in a linear fashion. Partial pectoralis major release seems to affect projection only for small volumes, but does not influence nipple position in the immediate setting. As projection increases with augmentation volume, cephalad movement of the nipple is produced by a relative increase in nipple-to-inframammary fold distance compared with the midclavicular point-to-nipple distance in our cadaveric sample.