ALINE GOMES BITTENCOURT
Projetos de Pesquisa
Unidades Organizacionais
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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- 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.
- 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).
- Cochlear implantation trough the middle cranial fossa: a novel approach to access the basal turn of the cochlea(2013) BITTENCOURT, Aline Gomes; TSUJI, Robinson Koji; TEMPESTINI, Joao Paulo Ratto; JACOMO, Alfredo Luiz; BENTO, Ricardo Ferreira; BRITO, Rubens deThe classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. Objective: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. Method: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy. Results: Only the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani. Conclusion: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.
- Remote programming of cochlear implants(2014) SAMUEL, Paola Angelica; GOFFI-GOMEZ, Maria Valéria Schmidt; BITTENCOURT, Aline Gomes; TSUJI, Robinson Koji; BRITO, Rubens dePURPOSE: To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests. METHODS: Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones. Speech perception tests were applied using 65 dBSPL (recorded open context sentences and monosyllables). The patients were submitted to free-field audiometry at 250-8,000 Hz frequencies. The results for the RP and LP were compared. RESULTS: Differences in mean of the T levels for three electrodes and the C levels for one electrode were found. No difference between the results was obtained in the speech perception tests and audiometric thresholds in the RP and LP. CONCLUSION: The RP is a simple and effective procedure for programming cochlear implant devices and, although there were differences in the stimulation levels of some electrodes, it did not interfere in the speech perception outcomes.
- Cochlear implants and bacterial meningitis: a speech recognition study in paired samples(2013) BRITO, Rubens de; BITTENCOURT, Aline Gomes; GOFFI-GOMEZ, Maria Valéria; MAGALHÃES, Ana Tereza; SAMUEL, Paola; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraINTRODUCTION: Cochlear implants may guarantee sound perception and the ability to detect speech at a close-to-normal hearing intensity; however, differences have been observed among implantees in terms of performance on discrimination tests and speech recognition. OBJECTIVE: To identify whether patients with post-meningitis deafness perform similarly to patients with hearing loss due to other causes. METHOD: A retrospective clinical study involving post-lingual patients who had been using Nucleus-22 or Nucleus-24 cochlear implants for at least 1 year. These patients were matched with respect to age (± 2 years), time since the onset of deafness (± 1 year), and the duration of implant use with implant users who had hearing loss due to other causes. Speech perception was assessed using the Portuguese version of the Latin-American Protocol for the Evaluation of Cochlear Implants. RESULTS: The sample consisted of 52 individuals (26 in each of the 2 groups). The post-meningitic group had a median of 18.5 active electrodes. The group with hearing loss due to other causes had a median of 21, but no significant statistical difference was observed (p = 0.07). The results of closed- and open-set speech recognition tests showed great variability in speech recognition between the studied groups. These differences were more pronounced for the most difficult listening tasks, such as the medial consonant task (in the vowel-consonant-vowel format). CONCLUSION: Cochlear implant recipients with hearing loss due to bacterial meningitis, who had been using the device for 1 year performed more poorly on closed- and open-set speech recognition tests than did implant recipients with hearing loss due to other causes.
- Implantable and Semi-Implantable Hearing Aids: A Review of History, Indications, and Surgery(2014) BITTENCOURT, Aline Gomes; BURKE, Patrick Rademaker; JARDIM, Isabela de Souza; BRITO, Rubens de; TSUJI, Robinson Koji; FONSECA, Anna Carolina de Oliveira; BENTO, Ricardo FerreiraIntroduction The complaints associated with the use of conventional amplifying hearing aids prompted research at several centers worldwide that ultimately led to the development of implantable devices for aural rehabilitation. Objectives To review the history, indications, and surgical aspects of the implantable middle ear hearing devices. Data Synthesis Implantable hearing aids, such as the Vibrant Soundbridge system (Med-El Corporation, Innsbruck, Austria), the Maxum system (Ototronix LLC, Houston, Texas, United States), the fourth-generation of Carina prosthesis (Otologics LLC, Boulder, Colorado, United States), and the Esteem device (Envoy Medical Corporation - Minnesota, United States), have their own peculiarities on candidacy and surgical procedure. Conclusion Implantable hearing aids, which are currently in the early stages of development, will unquestionably be the major drivers of advancement in otologic practice in the 21st century, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.
- Intracochlear Schwannoma: Diagnosis and Management(2014) BITTENCOURT, Aline Gomes; ALVES, Ricardo Dourado; IKARI, Liliane Satomi; BURKE, Patrick Rademaker; GEBRIM, Eloisa Maria Santiago; BENTO, Ricardo FerreiraIntroduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions.