ALINE GOMES BITTENCOURT
Projetos de Pesquisa
Unidades Organizacionais
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
- Auditory Brainstem Implants in Children: Results Based on a Review of the Literature(2014) MONSANTO, Rafael da Costa; BITTENCOURT, Aline Gomes; BOBATO NETO, Natal Jose; BEILKE, Silvia Carolina Almeida; LIMA, Nelson Fabricio Goetten de; LORENZETTI, Fabio Tadeu Moura; SALOMONE, RaquelThe objective of this study is to review the literature regarding Auditory Brainstem Implant (ABI) indications, surgical techniques, activation methods, and post-surgery follow-up in children. A search was performed in the LILACS, MEDLINE, SciELO, and PubMed databases in June 2014, and the key words used in the search were ((""auditory brain stem implant"" OR ""auditory brainstem implants"") OR (""auditory"" AND ""brainstem"" AND (""implants"" OR ""implant"")). Forty-two studies that met the criteria described in ""Study Selection"" were read in full; 24 studies referred to the ABI fitting process in children, and were selected for appraisal. The studies showed 120 children (younger than 18 years old) fitted with ABIs. Evaluation after surgery showed that 112 (93.3%) of the patients improved in their ability to recognize environmental sounds and speech perception. Patients with tumors or those with cochlear or cochlear nerve malformations had good outcomes as well. Two of the children did not achieve any sound perception upon ABI activation. The results obtained in 120 children fitted with an ABI showed that the patients globally improved in their ability to detect sounds and communication skills. The phenomenon could be seen both in patients with tumoral diseases of the inner ear and those with malformations of the cochlea or cochlear nerve, although patients with non-tumoral issues achieved better results than patients with schwannomas. We propose that the Food and Drug Administration (FDA) ABI indications should be extended to patients younger than 12 years old with NT diseases of the cochlea and cochlear nerve.
- Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review(2013) BITTENCOURT, Aline Gomes; TSUJI, Robinson Koji; CABRAL JUNIOR, Francisco; PEREIRA, Larissa Vilela; FONSECA, Anna Carolina de Oliveira; ALVES, Venâncio; BENTO, Ricardo FerreiraINTRODUCTION: Adenomas with neuroendocrine differentiation are defined as neuroendocrine neoplasms, and they are rarely found in the head and neck. OBJECTIVE: To describe two cases of a middle ear adenoma with neuroendocrine differentiation, with a literature review. CASE REPORT: Patient 1 was a 41-year-old woman who presented with a 3-year history of left aural fullness associated with ipsilateral ""hammer beating"" tinnitus. Patient 2 was a 41-year-old male who presented with unilateral conductive hearing loss. CONCLUSION: Adenoma with neuroendocrine differentiation of the middle ear is a rare entity, but it should be considered in patients with tinnitus, aural fullness, and a retrotympanic mass and remembered as a diferential diagnosis of tympanic paraganglioma.
bookPart 0 Citação(ões) na Scopus Post-meningitis deafness and cochlear implantation(2014) BITTENCOURT, A. G.; MONSANTO, R. C.; BURKE, P. R.Objective: The objective of this paper is to review and discuss the role, indications, beneficial effects and outcomes of cochlear implantation in patients with post-meningitis deafness. Methods: A search in the PubMed, Lilacs and SciELO databases was performed. The keywords used were (""Cochlear implant"" OR ""Cochlear implants"" OR ""Cochlear implantation"") AND (""meningitis""). Results: The complications of hearing impairment following bacterial meningitis are many, and not only regarding to the deafness itself. There is a risk of cochlear fibrosis and subsequent obliteration of the cochlear lumen, which may occur within weeks after the onset of meningitis. The streptococcus pneumoniae is the commonest identified organism and the one that more commonly leads to labyrinthitis ossificans. The prompt administration of dexamethasone, even prior to the antibiotics, reduces the neurologic complications and risk of hearing loss. All children recovering from meningitis should have a hearing assessment before and 4 to 6 weeks after hospital discharge to allow early identification of hearing impairment. Early implantation is essential before obliteration has occurred, and if imaging shows that it is developing, there is a very high degree of urgency. For all implant candidates, the imaging evaluation of the cochlea and inner ear is mandatory, and it should include a high-resolution computerized tomography and a magnetic resonance imaging regarding cochlear patency. Patients with cochlear ossification achieved worse auditory results than patients without ossification, and implantees with other causes of deafness achieved best performances than the ones deafened by bacterial meningitis Discussion: Early identification of hearing disorders in patients with meningitis is essential to prevent future complications. All patients should have a reliable assessment of their hearing as soon as the patient is capable or at the discharge. Several studies show that the performance of implantees deafened by meningitis is directly related to the duration of deafness, and children implanted within 6 months after the meningitis achieve best results. The cochlear osteoneogenesis should be soon recognized, and early implantation is essential before obliteration has occurred. The surgical options for patients with cochlear ossification varies accordingly to the degree of ossification; if the obliteration is partial and does not extend further than the anterior end of the basal turn, it is possible to drill past it to a clear lumen and insert an implant to its full extent; if the cochlea is completely obstructed, the auditory brainstem implant is an option. The reasons why post-meningitis deafened patients usually achieve worse results than patients with other causes of deafness is because meningitis may damage parts of the central auditory pathways and compromise the patient's cognitive abilities. Conclusion: Post-meningitis deafness should be soon recognized and treated in order to prevent cochlear ossification and to allow a safe surgery for cochlear implantation. © 2015 by Nova Science Publishers, Inc. All rights reserved.- IgG4-Related Sclerosing Disease of the Temporal Bone(2013) BITTENCOURT, Aline Gomes; PEREIRA, Larissa Vilela; CABRAL JUNIOR, Francisco; HALANG, Felipe de Santes; GONCALVES, Marianne de Castro; BENTO, Ricardo Ferreira
bookPart Implante Coclear em Multiplas Deficiências(2014) BITTENCOURT, Aline Gomes; BENTO, Ricardo Ferreira- Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation(2013) BENTO, Ricardo Ferreira; MONTEIRO, Tatiana Alves; BITTENCOURT, Aline Gomes; GOFFI-GOMEZ, Maria Valeria Schmidt; BRITO, Rubens deINTRODUCTION: Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. OBJECTIVES: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. RESUMED REPORT: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. CONCLUSION: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients.
- Surdez pré-lingual: benefícios do implante coclear versus prótese auditiva convencional(2012) BITTENCOURT, Aline Gomes; TORRE, Ana Adelina Giantomassi Della; BENTO, Ricardo Ferreira; TSUJI, Robinson Koji; BRITO, Rubens deINTRODUCTION: The majority of patients with hearing loss, including those with severe hearing loss, benefits from the use of hearing aids. The cochlear implant is believed to achieve better results in a child with hearing loss in cases where the severity of disability renders hearing aids incapable of providing adequate sound information, as they require sufficient cochlear reserve so that acoustic detention occurs. OBJECTIVE: To assess if cochlear implants provide more benefit than conventional hearing aids in prelingually deaf patients. SUMMARY OF THE FINDINGS : The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies. CONCLUSION: Based on several studies, cochlear implants were demonstrated to be the best current alternative for bilateral severe or profound hearing loss, achieving better results in speech perception and development in prelingual children when compared to conventional hearing aids.
- Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature(2016) MONSANTO, Rafael da Costa; BITTENCOURT, Aline Gomes; BOBATO NETO, Natal José; BEILKE, Silvia Carolina Almeida; LORENZETTI, Fabio Tadeu Moura; SALOMONE, RaquelAbstract Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction. Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature. Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4%) achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI), 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone. Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.
- Carina (R) and Esteem (R): A Systematic Review of Fully Implantable Hearing Devices(2014) PULCHERIO, Janaina Oliveira Bentivi; BITTENCOURT, Aline Gomes; BURKE, Patrick Rademaker; MONSANTO, Rafael da Costa; BRITO, Rubens de; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraObjective: To review the outcomes of the fully implantable middle ear devices Carina and Esteem regarding the treatment of hearing loss. Data Sources: PubMed, Embase, Scielo, and Cochrane Library databases were searched. Study Selection: Abstracts of 77 citations were screened, and 43 articles were selected for full review. From those, 22 studies and two literature reviews in English directly demonstrating the results of Carina and Esteem were included. Data Extraction: There were a total of 244 patients ranging from 18 to 88 years. One hundred and 10 patients were implanted with Carina and with 134 Esteem. There were registered 92 males and 67 females. Five studies provided no information about patients' age or gender. From the data available, the follow-up ranged from 2 to 29.4 months. Data Synthesis: The comparison of the results about word recognition is difficult as there was no standardization of measurement. The results were obtained from various sound intensities and different frequencies. The outcomes comparing to conventional HAs were conflicting. Nevertheless, all results comparing to unaided condition showed improvement and showed a subjective improvement of quality of life. Conclusion: There are still some problems to be solved, mainly related to device functioning and price. Due to the relatively few publications available and small sample sizes, we must be careful in extrapolating these results to a broader population. Additionally, none of all these studies represented level high levels of evidence (i.e. randomized controlled trials).
- Cochleovestibular nerve involvement in multifocal fibrosclerosis(2012) TSUJI, R. K.; BITTENCOURT, A. G.; ARAI, M. H.; GEBRIM, E. M. SantiagoObjectives: To report a case of multifocal fibrosclerosis with a nine-year follow up, and to discuss this disease's radiological appearance and management. The disease is a rare systemic disorder of unknown cause characterised by fibrous proliferation involving multiple anatomical sites. Case report: A 50-year-old woman presented with histological findings characterised by similar inflammatory processes involving the meninges, pituitary gland, peritoneum, retroperitoneum and orbits, prompting a search for a common pathophysiology. A diagnosis of multifocal fibrosclerosis was postulated. Symptom improvement was noted after treatment with prednisone and azathioprine. Conclusion: This is the first documented case of involvement of the cochleovestibular nerve in a patient with multifocal fibrosclerosis. The rare association between fibrotic diseases and masses showing various clinical patterns should be kept in mind by otolaryngologists, and imaging performed to investigate for multifocal fibrosclerosis. However, diagnosis can only be confirmed with tissue biopsy and histopathological examination.
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