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
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Distracção osteogênica mandibular: experiência do INTO-RJ(2014) MARICEVICH, PABLO; CRUZ, RICARDO LOPES DA; ALONSO, NIVALDO; FREITAS, RENATO DA SILVA; BASÍLIO, GABRIEL DUARTE; BRAUNE, ANDRÉ; LESSA, EDMAR SOARES; COSTA, MAYRA JOAN MARINS DA; SILVA, LEIZI REGINA BARRETOABSTRACT Introduction: The introduction of distraction of the craniofacial skeleton represented a great advancement in the practice of craniofacial surgery. Distraction is a less invasive technique that is faster and with an apparently lower morbidity than the traditional craniofacial reconstruction techniques. In 2013, the craniomaxillofacial surgery service of the Institute of Traumatology and Orthopaedics performed a series of mandibular distraction surgeries. In this article, we aim to present our experience. Methods: From January to March 2013, seven patients underwent mandibular distraction surgery. All patients exhibited unilateral or bilateral mandibular hypoplasia due to ankylosis of the temporomandibular joint (TMJ), or craniofacial microsomia. In some patients with ankylosis of the TMJ, resection of the anlylotic block was also performed concomitantly with the distraction. Results: Postoperative improvement was noted in all the stomatognathic functions: weight gain, decannulation of a tracheostomized patient, and improved quality of sleep. There was an improvement in facial profiles: the laterognathism was eased and the mouth opening increased in most patients. The mouth opening increased more significantly in patients in whom ankylosis surgery was done in conjunction with the distraction. The most common complication was pain upon distraction, reported by five patients (71%). Conclusion: Mandibular distraction osteogenesis is a good alternative for the treatment of mandibular hypoplasia, often being the first indication in some clinical situations. It apparently has a lower morbidity than the classic mandible reconstructions and has the added benefit of also lengthening the soft tissues.
- Uso de malhas tridimensionais em cirurgia plástica(2016) DORNELLES, RODRIGO DE FARIA VALLE; ALONSO, NIVALDO; TISSIANI, LUIZ ALEXANDRE LORICO; SOUZA, ANDERSON RODRIGO; CARDIM, VERA LÚCIA NOCCHIABSTRACT Introduction: Image recording as we know it today has evolved considerably from the beginning of photography by means of light printing directly onto a photosensitive material, up to the mathematical algorithms that constitute three-dimensional (3-D) meshes in stereophotogrammetry. The 3-D technology to capture and extract reliable information in plastic surgery has evolved considerably in recent years. However, the procedure for which the applicability potential can be exploited directly by the surgeon in their routine work should be fully understood. The objective of this work was to address the conceptual aspects and the accuracy of the image capture, and to illustrate clinical applications of 3-D meshes, with emphasis on their importance in clinical use. Methods: Literature on the principles of image capture and formation of tridimensional models was reviewed, as well as the description of the application of the tests of accuracy with the use of a structuredlight scanner. Clinical indications of 3-D meshes were evaluated both in the preoperative planning and postsurgical follow-up. Results: The principles of the image capture technologies were established, and the reproducibility of the validation of the tool to capture meshes was confirmed. The clinical applicability both in programming and monitoring was exemplified. Conclusion: The conceptual difference between photography and the 3-D mesh system was established, together with the introduction of the principles of 3-D technology. The clinical applications of the method were presented, evidencing the promising application of dimensional models in plastic surgery.
- Efeitos de diferentes pressões de aspiração do tecido adiposo na obtenção de células-tronco mesenquimais(2012) TISSIANI, Luiz Alexandre Lorico; AGUENA, Meire; PASSOS-BUENO, Maria Rita; ALONSO, NivaldoBACKGROUND: In recent years, fat grafts have become useful in plastic surgery. They are mainly used to fill soft tissues, refine breast reconstructions, and for volumetric facial rejuvenation. They are also a rich source of mesenchymal stem cells (i.e., adipose-derived stem cells [ADSCs]), which directly influence fat graft survival. Since ADSCs play an important role in angiogenesis and adipogenic differentiation, it is essential to optimize their isolation. Therefore, in this study, we evaluated and compared 2 procedures used to isolate viable cells from the stromal vascular fraction of abdominal adipose tissue and assess the expressions of surface markers. METHODS: We examined 9 female subjects who were scheduled to undergo liposuction. The adipose tissue was isolated from the abdominal infraumbilical region. Fat (20 mL) was collected from the right side by using a cannula attached to a syringe; the plunger was pulled back every 2 cm³ to create low-pressure suction (manual group). The same procedure was repeated on the left side, but the cannula was attached to a sterile and intermediate collector coupled to a vacuum pump that provided a constant negative pressure of 350 mmHg (pump group). The samples were centrifuged, and the adipocytes of the intermediate layer were counted, cultured, and immunophenotyped. RESULTS: The isolation of abdominal adipocytes with a pump providing a negative pressure of 350 mmHg yielded a higher concentration of cells in the stromal vascular fraction than that obtained using 10-mL syringes and low-pressure suction, although the difference was not significant. CONCLUSIONS: A negative pressure of 350 mmHg may be safely applied to isolate ADSCs. The cell yield did not indicate any statistically significant difference between the techniques.
- Abordagem cirúrgica no tratamento da displasia fibrosa craniofacialexperiência de 14 anos(2014) ALONSO, NIVALDO; MATUSHITA, HAMILTON; ALESSI, MARIANA SISTOABSTRACT Introduction: Fibrous dysplasia is benign tumor of the craniofacial skeleton that primarily affects young patients. It is characterized by the progressive growth of benign fibrous tumors with resulting functional and aesthetic deformities. This study assesses the clinical and prognostic features in patients with fibrous dysplasia who underwent surgical treatment at our institution. Methods: Retrospective analysis of 19 patients with craniofacial fibrous dysplasia, treated between January 1997 and December 2011 with bone remodeling and surgical resection. We also review the literature regarding fibrous dysplasia. Results: Patients ranged between 8-65 years old, with a mean age of 21.75 years. Ten patients (52.7%) were women. The polyostotic form was predominant and present in15 cases (78.9%). The sphenoid, ethmoid, and frontal bones were most commonly involved in the polyostotic form and the mandibular and zygomatic bones were most commonly involved in the monostotic form. The main complaint was asymmetry of the face. One patient developed decreased visual acuity. Treatment was based on surgical resection and graft reconstruction in the localized form of the disease, and bone abrasion and remodeling in the polyostotic form. Intracranial access was necessary in only one case (5.2%) where the optic nerve was compressed. Repeat surgical treatment due to recurrent tumor growth was necessary in three patients. The only complication occurred in a patient who developed lagophthalmos and epicanthus postoperatively after undergoing surgery using infraorbital access. No other complications occurred during shortand long-term follow-up. Functional preservation and facial contour recovery outcomes were satisfactory. Conclusion: Our experience, along with that of other investigators, demonstrates that surgery is effective in treating selected cases of craniofacial fibrous dysplasia.
- Análise morfométrica do lábio superior e da ação do envelhecimento(2013) LONGO, MARCO VINICIUS LOSSO; ISHIDA, LUIS HENRIQUE; FORTES, FERNANDO SARTOR GUIMARÃES; KASAI, KIRIL ENDO; ISHIDA, LUIS CARLOS; ALONSO, NIVALDO; FERREIRA, MARCUS CASTROABSTRACT Background: A pleasant smile depends on harmonious relationships between the teeth, gums, and lips. The present study measured upper lip changes related to ageing using a morphometric analysis. Methods: Fortysix Caucasian women at least 15 years of age were selected and divided into four groups: 15 - 30 years old, 31 - 45 years old, 46 - 60 years old, and > 60 years old. Frontal photographs with closed lips and parted lips were taken. The following measurements were performed: upper lip height, upper vermilion height in parted and closed lips positions, and exposure of the central upper incisors in the relaxed position. Results: Upper lip height increased with age. The average upper lip height in the closed lips position was 13.75 mm in the youngest age-range (15 - 30 years old). The upper lip height gradually increased with age until reaching an average of 19.24 mm was observed in the > 60 years old group. The opposite result was observed in upper vermilion height, which decreased with increasing age. The average vermilion height in the parted lips position was 7.09 mm in the youngest age-range (15-30 years old) and decreased to 4.58 mm in the oldest group (> 60 years old). Teeth exposure decreased with age. The average upper teeth exposure was 3.55 mm in the youngest group and decreased to 0.40 mm in the oldest group. Conclusion: The upper lip height increases, while the upper vermilion height and exposure of the upper teeth decrease with age.
- Fraca pressão aérea intraoral na fala após correção cirúrgica da fissura palatina(2012) BARBOSA, Daniela Aparecida; MANGILLI, Laura Davison; ANDRADE, Claudia Regina Furquim de; ALONSO, NivaldoBACKGROUND: Several anatomical and functional changes are observed in individuals with cleft lip and palate, including structural abnormalities of the oropharyngeal muscles, which can cause loss of velopharyngeal function and other functions such as sucking, swallowing, and speaking. The present study aimed to evaluate the presence of weak intraoral air pressure in the speech of individuals with cleft palate who underwent primary palatoplasty at the appropriate time or at a late stage and assess whether surgical timing may lead to a higher occurrence of the disorder. We hypothesized that individuals who undergo belated primary palatoplasty show a higher occurrence of weak intraoral air pressure compared to those who undergo primary palatoplasty at the appropriate time. METHODS: This study included 37 patients of both sexes with a diagnosis of cleft palate, with or without cleft lip, who were divided into 2 groups: 1) early group (GP), consisting of 22 patients who underwent primary palatoplasty during the second year of life, and 2) the late group (GT), comprising 15 patients who underwent primary palatoplasty at a later stage, after acquiring speech sounds. All participants underwent routine clinical assessment with an interval of at least 3 months after surgery. Among the parameters evaluated, weak intraoral air pressure was an important variable considered in this study. RESULTS: Data analysis revealed a higher frequency of weak intraoral air pressure in the GT group (33%) as compared to the GP group (18%). However, this difference was not statistically significant (P = 0.44). CONCLUSIONS: The study hypothesis was rejected. The presence of weak intraoral air pressure was observed in the speech of both groups, and the study findings showed that the timing at which primary palatoplasty was performed is not an influencing factor.
- Idade e indicações de osteotomias para avanço frontofacial em pacientes com craniossinostoses sindrômicas(2012) ALONSO, Nivaldo; MATUSHITA, Hamilton; GOLDENBERG, Dov Charles; BASTOS, Endrigo OliveiraBACKGROUND: Craniofacial surgery has overcome many challenges since its initiation into clinical practice. Several technical issues have been addressed and the basic infrastructure of the specialty has now been developed. At present, 25 years after the first publications on frontofacial advancement, questions still remain as to the appropriate age for surgery and the appropriate type of surgery that should be performed. The aim of this study was to evaluate patients surgically treated for syndromic craniosynostosis over the last 10 years at our institution. METHODS: All syndromic patients who underwent monobloc frontofacial advancement or only isolated facial advancement from 2001 to 2011were selected. Out of 70 patients in total, 56 underwent monobloc frontofacial advancement and 14 underwent facial advancement after fronto-orbital remodeling. All data concerning these patients were correlated with patient age and final result. Moreover, age at surgery, complications, and final results were correlated with the main preexisting problems. RESULTS: Final results for syndromic patients varied, depending on the syndrome and the age at which the procedure was performed. Monobloc frontofacial advancements had a low index of immediate postoperative complications, but there was a clear need for further procedures at the time of final facial growth. The index of positive outcome was higher in patients who underwent surgery at an older age. CONCLUSIONS: In cases of severe craniosynostosis with functional problems, monobloc frontofacial advancement is still the best therapeutic option.