SUELLY CECILIA OLIVAN LIMONGI

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Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina

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  • article 7 Citação(ões) na Scopus
    Caracterização eletrofisiológica da audição em indivíduos com Síndrome de Down
    (2016) KAZAN, Hellen Medeiros; SAMELLI, Alessandra Giannella; NEVES-LOBO, Ivone Ferreira; MAGLIARO, Fernanda Cristina Leite; LIMONGI, Suelly Cecília Olivan; MATAS, Carla Gentile
    ABSTRACT Introduction Few studies have performed Brainstem (BAEP) and P300 Auditory Evoked Potentials simultaneously to assess central auditory pathways in normal hearing individuals with Down syndrome (DS), mainly because of the difficulty in applying these procedures to this population. Previous studies have suggested that individuals with DS might present different patterns of response compared with those of individuals with typical development; nevertheless, the identification of these potentials would be crucial for the establishment of an accurate audiological diagnosis. Purpose To characterize BAEP and P300 in normal-hearing individuals with DS. Methods BAEP and P300 were analyzed in 17 individuals with DS and in 21 individuals with typical development aged 7 to 15 years. The results were quantitatively and qualitatively analyzed using descriptive measures and hypothesis tests. Results In the quantitative analysis, latency values were lower in the BAEP for the DS group, with statistically significant difference for wave V and interpeaks III-V and I-V; there were no significant differences in the P300 latency values. In the qualitative analysis, there were a larger number of individuals with early values for BAEP latencies and late latencies for P300 in the DS group; both comparisons showed statistically significant differences. Conclusion Children and adolescents with DS can present early responses to the components of BAEP, suggesting that their auditory pathway requires less time for the neural transmission of acoustic stimuli to the brainstem. Concerning P300, individuals with DS may present increased latencies, suggesting impairment in the central auditory pathway for the cortical processing of auditory information.
  • article 19 Citação(ões) na Scopus
    Comparison between clinical and videofluoroscopic evaluation of swallowing in children with suspected dysphagia
    (2015) SILVA-MUNHOZ, Lenice de Fatima da; BüHLER, Karina Elena Bernardis; LIMONGI, Suelly Cecilia Olivan
    Purpose: To verify the accuracy of clinical evaluation compared with videofluoroscopic swallowing studies in the detection of isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia; to identify clinical signs and symptoms associated with isolated laryngeal penetration and laryngeal aspiration; and to determine the sensitivity and specificity of the clinical signs and symptoms identified. Methods: Retrospective analysis of data from clinical and videofluoroscopic evaluations carried out in 55 children from 1 month to 7 years and 11 months old. For clinical assessment, the Protocol for Clinical Assessment of Pediatric Dysphagia was used. The sensitivity, specificity, and positive and negative predictive values of clinical evaluation were analyzed. For statistical analysis, the Fisher's exact and χ2 tests were used. Results: Clinical evaluation showed, in general, a sensitivity of 86% and a specificity of 32%. For isolated laryngeal penetration, clinical evaluation showed a sensitivity of 88%. For laryngeal aspiration, clinical evaluation showed a sensitivity of 86%. However, the specificity values were low for both alterations. There was no association between clinical evaluation and videofluoroscopic findings. Choking was the only clinical sign associated with isolated laryngeal penetration thin fluid and showed a sensitivity of 53% and a specificity of 77%. Conclusions: Clinical evaluation was sensible to detect isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia. However, it showed a low specificity. Choking was the only clinical sign associated with isolated laryngeal penetration of thin fluid. More prospective studies are needed to confirm these findings in this population.
  • article 3 Citação(ões) na Scopus
    Mean length utterance in Brazilian children: a comparative study between Down syndrome, specific language impairment, and typical language development
    (2014) CARVALHO, Angela Maria de Amorim; BEFI-LOPES, Debora Maria; LIMONGI, Suelly Cecília Olivan
    PURPOSE: To describe the linguistic performance of Brazilian Portuguese-speaking children with Down syndrome by analyzing their Mean Length Utterance; to compare their performance to that of children with Specific Language Impairment and Typical Development; and to verify whether children with Down syndrome present developmental language delay or disorder. METHOD: Participants were 25 children with Down syndrome (Research Group), matched by mental age to a Control Group of typically developing children, and to a Control Group of children with Specific Language Impairment. Participants were divided into subgroups, according to age range (three, four and five years). Speech samples were collected for the Research Group, and the Mean Length Utterance was analyzed for morphemes and words. RESULTS: Differences were observed between the performance of the Research Group and both Control Groups, and the former presented inferior Mean Length Utterance values for all age ranges, characterizing a delay in grammar and general language development. CONCLUSION: The description of the linguistic abilities of Brazilian Portuguese-speaking children with Down syndrome indicated important grammatical deficits, especially regarding the use of functional words.
  • article
    O uso da comunicação suplementar e/ou alternativa no trabalho com a morfossintaxe em adolescentes com Síndrome de Down
    (2014) ANDRADE, Rosangela Viana; SILVA-MUNHOZ, Lenice de Fatima da; LIMONGI, Suelly Cecilia Olivan
    Purpose to present and to discuss the use of augmentative and alternative communication as a therapeutic tool with the morphosyntax with adolescents with Down syndrome. Methods this pilot study monitored during 12 months four adolescents chronologically aged between 13 and 15 years and mentally aged between 5 and 6 years. It were analyzed the initial and the final assessments, situations of free interaction between the participant and the caregiver videotaped during 30 minutes. The speech samples were analyzed as MLU values considering morphemes and words, comparing both the two situations. All of the participants were submitted to the same procedures during the therapeutic interventions. Picture Communication Symbols (PCS) has been used and the symbols were organized according to a simple syntactic structure (substantive + verb + complement) with a gradual extension, and the elements were rated at the following order: articles, prepositions, pronouns (personals, possessives and demonstratives), and conjunctions. Each therapeutic session was recorded in specific protocol. It was used the Wilcoxon test and the p value considered was 5%. Results spites there were no statistical significant differences, increase in number of morphemes and words used between the both assessments was observed. This improve was represented by the worked elements, including prepositions and conjunctions beyond substantives and verbs. For personal pronouns there was tendency to significance (p=0,068). Conclusion the communication system showed to be a therapeutic tool to improve the use of syntactic elements in statement structures, as articles, prepositions and conjunctions, which use for individuals with Down syndrome are difficult.
  • article
    Deglutição e consistências alimentares pastosas e sólidas: revisão crítica de literatura
    (2012) PANSARINI, Amanda Checchinato; SASSI, Fernanda Chiarion; MANGILLI, Laura Davison; FORTUNATO-TAVARES, Talita; LIMONGI, Suelly Cecília Olivan; ANDRADE, Claudia Regina Furquim de
    PURPOSE: To analyze published international scientific papers on the physiology of deglutition in oral and pharyngeal phases, considering different food consistencies: nectar, honey, pudding, pasty heterogeneous, semi-solid, and solid. METHODS: This is a qualitative literature reviews. The studies considered were selected on PubMed, using the keywords ""Swallowing and consistency"", ""Swallowing and solid"", and ""Swallowing and pasty"", limiting the search to manuscripts published in English in the period between 2005 and 2010, and conducted with human beings over 18 years old. The methodology involved question formulation, location and selection of studies, and critical analyses of the manuscripts, according to the concepts of the Cochrane Handbook. RESULTS: Two hundred and eleven studies were identified, out of which only 18 allowed access to the full text and were directly related to the theme. CONCLUSION: The studies presented very few similarities between the applied methodologies, especially when considering assessment methods. Overall, the studies were conducted with healthy individuals or with a specific pathology, without presenting the comparison with control cases. The heterogeneity of studies allows the investigation of different swallowing disorders. However, methodological variability makes it difficult to define and generalize the identified swallowing patterns. For this reason, it is not possible to identify parameters on which to base the clinical practice of speech-language therapists, especially when considering the normal or altered physiology of swallowing different food consistencies.
  • book
    Disfagia: prática baseada em evidências
    (2012) ANDRADE, Claudia Regina Furquim de; LIMONGI, Suelly Cecilia Olivan
  • article 4 Citação(ões) na Scopus
    Wideband reflectance in Down syndrome
    (2016) SOARES, Jordana Costa; UROSAS, Juliana Granja; CALARGA, Karenina Santos; PICHELLI, Tathiany Silva; LIMONGI, Suelly Cecilia Olivan; SHAHNAZ, Navid; CARVALLO, Renata Mota Mamede
    Objective: Children with Down syndrome (DS) have a high incidence of middle ear disorders and congenital abnormalities of the external, middle and inner ear. Energy reflectance (ER), a wideband acoustic immittance (WAI) measurement parameter, can measure the sound energy reflected or absorbed in the ear canal over a wider range of frequencies more efficiently and faster than conventional single-tone 226 Hz tympanometry. The aim of the present study was to compare the WAI measurements of children with DS with those of typically developing, normal-hearing children according to their tympanometric findings. Methods: Four groups of children with Down syndrome (age range: 2 years and 4 months to 16 years and 3 months; mean age: 8.5 yr) with normal tympanograms (19 ears), flat tympanograms (13 ears), mild negative pressure tympanograms (6 ears between -100 and -199 daPa at the admittance peak) and severe negative pressure tympanograms (4 ears at -200 daPa or lower at the admittance peak) were assessed. All findings were compared with data obtained from 21 ears of a healthy control group (age range: 3 years and 1 month to 13 years and 11 months; mean age: 7.9 yr). The subjects underwent tympanometry with a 226-Hz probe tone frequency and ER measurements along the 200-6,000 Hz range with a chirp stimulus using the Middle-Ear Power Analyzer (MEPA3 - HearID) by Mimosa Acoustics (Champaign, IL), software, version 3.3 [38]. Results: Statistically significant differences were observed in the ER curves for some comparisons between the studied groups. There was also a negative correlation between the static acoustic admittance at the tympanic membrane level and ER measured with a chirp stimulus at 500 and 1,000 Hz. The discriminant analysis technique, which used a chirp stimulus at 1,000 and 1,600 Hz to classify the participants' data based on ER values, achieved a correct classification rate of 59.52% for participants with DS. Conclusion: While groups with abnormal middle ear status, as indicated by tympanometry, showed higher ER values compared to the DS tymp A group and the control group, similar reflectance curves were observed between control group and the DS tymp A group. WAI shows promise as a clinical diagnostic tool in investigating the impact of middle ear disorders in DS group. However, further research is required to investigate this issue in narrower age range group and a larger sample size.
  • bookPart
    Higiene Oral como Fator de Risco para Pneumonia Aspirativa
    (2012) BUENO, Adriana Costa; ANDRADE, Claudia Regina Furquim de; LIMONGI, Suelly Cecilia Olivan
  • article 4 Citação(ões) na Scopus
    Laryngeal cleft type I in neonate: case report
    (2014) ROSSI, Mirella Spinoso; BUHLER, Karina Elena Bernardis; VENTURA, Gabriel Alberto Brasil; OTOCH, José Pinhata; LIMONGI, Suelly Cecilia Olivan
    Laryngeal cleft (LC) is a congenital malformation that leads to the unusual communication between the esophagus and the laryngotracheal complex. It is a rare disease, mostly prevalent among male individuals. The goal of this study was to describe the evaluation and intervention by the speech language pathologist of a female newborn diagnosed with LC type I, admitted on the University Hospital of Universidade de São Paulo, in her second hospitalization due to small weight gain and pneumonia. She was submitted to a bedside clinical evaluation of the swallowing and the most important occurrence was frequent gagging. The videofluoroscopy swallowing study showed laryngotracheal aspiration level 8 for thin liquid and level 1 for thickened liquid, according to the Penetration-Aspiration Scale. The newborn was submitted to a microlaryngoscopy, in which the presence of LC type I was found. After the diagnosis, the speech language pathologist offered thickened liquid at 6% and, in 8 days, the newborn was discharged with exclusive oral diet without gagging. Eight outpatient consultations were carried out for 11 months, with emphasis on reintroduction of thin liquids. The treatment was discontinued and the patient was put on general diet for the age without modifications. Throughout follow-up, the patient remained asymptomatic and showed no respiratory complications.
  • article
    Ultrassonografia e deglutição: revisão crítica da literatura
    (2014) LEITE, Karoline Kussik de Almeida; MANGILLI, Laura Davison; SASSI, Fernanda Chiarion; LIMONGI, Suelly Cecília Olivan; ANDRADE, Claudia Regina Furquim de
    Purpose To identify how the deglutition function has been evaluated using ultrasound (US). Research strategy This literature review used the PubMed database to survey international scientific publications about US and its use to evaluate deglutition. Studies were located and selected by surveying relevant articles published between January 2002 and August 2013. The survey was limited to studies on humans published in English. Selection criteria Repeated studies (determined by overlapping keywords), case studies, literature reviews, letters to the editor and studies not directly related to the topic were excluded. Results A total of 17 studies matching the inclusion criteria were identified. More than half of the studies evaluated the deglutition of healthy adults with no preference for gender. The parameters adopted for image analysis were not unanimous, and there was considerable variation among studies. Conclusion US proved to be a fast, non-invasive, low-cost method for evaluating objective parameters of deglutition. As a further advantage, US may be performed at bedside because the equipment is typically easy to handle and transport.