ALINE GOMES BITTENCOURT
Projetos de Pesquisa
Unidades Organizacionais
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- 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.
- 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
- 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.
- 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.
- Cochlear Implantation Via the Middle Fossa Approach: Surgical and Programming Considerations(2012) BENTO, Ricardo Ferreira; BITTENCOURT, Aline Gomes; GOFFI-GOMEZ, Maria Valeria Schmidt; SAMUEL, Paola; TSUJI, Robinson Koji; BRITO, Rubens deObjectives: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases. Study Design: Retrospective case review. Setting: Tertiary-care referral center with a well-established cochlear implant program. Patients: Four patients with bilateral canal wall down mastoid cavities who underwent the middle fossa approach for cochlear implantation. Interventions: Cochlear implantation and subsequent rehabilitation. A middle fossa approach with cochleostomy was successfully performed on the most superficial part of the apical turn in 4 patients. A Nucleus 24 cochlear implant system was used in 3 patients and a MED-EL Sonata Medium device in 1 patient. The single electrode array was inserted through a cochleostomy from the cochlear apex and occupied the apical, middle, and basal turns. Telemetry and intraoperative impedance recordings were performed at the end of surgery. A CT scan of the temporal bones was performed to document electrode insertion for all of the patients. Main Outcome Measures: Complications, hearing thresholds, and speech perception outcomes were evaluated. Results: Neural response telemetry showed present responses in all but 1 patient, who demonstrated facial nerve stimulation during the test. Open-set speech perception varied from 30% to 100%, despite the frequency allocation order of the MAP. Conclusion: Cochlear implantation via the middle cranial fossa is a safe approach, although it is a challenging procedure, even for experienced surgeons.
- Radiology Quiz Case 2 - Diagnosis: Middle ear hemangioma(2012) BITTENCOURT, Aline Gomes; BRITO, Rubens de; BENTO, Ricardo Ferreira; TOYAMA, Carlos
- 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.
- 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.