DOMINGOS HIROSHI TSUJI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
bookPart Tireoplastias: princípios e técnicas(2022) TSUJI, Domingos Hiroshi; IMAMURA, Rui; SENNES, Luiz Ubirajara- Bipedicled Vocal Fold Mucosal Flap Use in Phonomicrosurgery: Case Series(2021) TSUJI, Domingos Hiroshi; KINCHOKU, Vanessa Mika; IMAMURA, Rui; HACHIYA, Adriana; YAMASAKI, Rosiane; MARINHO, Guilherme Rodrigues; SENNES, Luiz UbirajaraObjectives. The objective of this study was to present a novel surgical technique involving the use of a ""bipedicled vocal fold mucosal flap"" to repair a mucosal defect and to evaluate the outcomes of patients in whom it was used. Material and methods. This was a retrospective study of 6 clinical cases. All patients underwent surgery between November 2000 and July 2018, and all procedures were performed by the same surgeon. For the auditory-perceptual assessment, the Grade-Roughness-Breathiness-Asthenia-Strain hoarseness scale was used. We based the stroboscopic evaluation on the European Laryngological Society protocol, analyzing the parameters glottal closure, mucosal wave, and phase symmetry. Results. Ages at the time of surgery ranged from 10 to 52 years, and all of the patients were male. Preexisting vocal fold lesions included polyps, cysts, a sulcus, and mucosal bridges. Among the stroboscopic parameters, only the mucosal wave differed significantly between the preoperative and postoperative periods (P = 0.046). There were also significant postoperative improvements in the overall grade of dysphonia (P = 0.025) and in the degree of breathiness (P = 0.025). Conclusions. The use of a bipedicled vocal fold mucosal flap appears to promote significant improvements in the mucosal wave and in voice quality. In the patients evaluated here, the technique was used without preoperative planning. However, it proved to be a safe and appropriate means of repairing mucosal defects in the vocal folds, with the potential to preserve rheological properties and promote healing with less chance of fibrosis.
bookPart Princípios básicos da fonomicrocirurgia(2022) TSUJI, Domingos Hiroshi; D´AVILLA, Jeferson; SENNES, Luiz UbirajarabookPart Injeção intralaríngea de substâncias para medialização de prega vocal(2022) HACHIYA, Adriana; TSUJI, Domingos Hiroshi; SENNES, Luiz Ubirajaraarticle 6 Citação(ões) na Scopus Effect of Fibrin Glue on Collagen Deposition After Autologous Fascia Grafting in Rabbit Vocal Folds(2011) SCAPINI, Fabricio; SILVA, Luiz Fernando Ferraz da; TSUJI, Domingos Hiroshi; DOLHNIKOFF, Marisa; SENNES, Luiz UbirajaraObjectives: Fibrin glue (FG) is a reaction product of fibrinogen and thrombin that forms a fibrin clot responsible for tissue adhesion. However, FG and its components may interfere with wound healing by interacting with cytokines such as transforming growth factor-beta (TGF-beta). The objective of this study was to investigate the effect of FG on collagen deposition after fascia grafting in the vocal folds of rabbits. Methods: Eighteen rabbits underwent autologous fascia grafting in both vocal folds, and the left side was fixed with FG. Each animal was painlessly sacrificed after 7,30, or 90 clays. The larynx was removed, and the vocal folds were prepared for histomorphometric analysis by picrosirius red staining to evaluate collagen deposition around the graft. Results: There was a significant increase in collagen density around the grafts at 90 days in the vocal folds that were fixed with FG (p = 0.0102) compared with the control vocal folds. Conclusions: Application of FG altered collagen deposition around the fascia grafts, leading to significantly increased collagen density after 90 days. Differences found in the composition of the extracellular matrix in later stages of the healing process are a result of changes that occur in the beginning of this process. Therapeutic interventions, such as the use of FG and/or its components, performed in the early stages of wound healing may interfere with the complex interactions of fibroblasts, inflammatory cells, and cytokines (especially TGF-beta), thereby modulating the healing process.article 12 Citação(ões) na Scopus Collagen Type I, Collagen Type III, and Versican in Vocal Fold Lamina Propria(2011) BUEHLER, Rogerio B.; SENNES, Luiz U.; TSUJI, Domingos H.; MAUAD, Thais; SILVA, Luiz Ferraz da; SALDIVA, Paulo N.Objective: To analyze the distributions of collagen type I, collagen type III, and versican in the lamina propria of the human vocal fold. Design: Cross-sectional analysis of cadaveric vocal folds of adult human larynges. Setting: Academic tertiary referral center. Subjects: Larynges harvested at autopsy from 10 adult men and 10 adult women. Main Outcome Measures: Immunohistochemical reactions were performed using antihuman monoclonal antibodies to analyze the expression of collagen type I, collagen type III, and versican. Results: Collagen type I density was lower in the intermediate layer compared with the superficial and deep layers of vocal folds. Collagen type III density was lower in the intermediate layer compared with the deep layer. Versican density was lower in the superficial layer compared with the intermediate and deep layers. Versican density was lower in the lamina propria of women compared with men; this difference was noted in the superficial layer only. There was a positive correlation between collagen type III and versican densities within the lamina propria. Conclusion: Collagen type I, collagen type III, and versican are distributed differently within the lamina propria layers of the adult vocal folds.bookPart Microlaringoscopia de suspensão (princípios básicos, instrumentais e técnica)(2022) SENNES, Luiz Ubirajara; TSUJI, Domingos Hiroshi; IMAMURA, Rui- Endoscopic Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia: A Pilot Study on Long-Term Outcome on Voice Quality(2012) TSUJI, Domingos Hiroshi; TAKAHASHI, Marystella Tomoe; IMAMURA, Rui; HACHIYA, Adriana; SENNES, Luiz UbirajaraObjectives. Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Study Design. Prospective study. Methods. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). Results. A significant improvement in VHI was observed after surgery, as compared with baseline values (P = 0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Conclusions. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.
- Diffusion of aniline blue injected into the thyroarytenoid muscle as a proxy for botulinum toxin injection: an experimental study in cadaver larynges(2013) ALONSO, Valéria Maria de Oliveira; CHAGURY, Azis Arruda; HACHIYA, Adriana; IMAMURA, Rui; TSUJI, Domingos Hiroshi; SENNES, Luiz UbirajaraINTRODUCTION: Endolaryngeal injection of botulinum toxin into the thyroarytenoid (TA) muscle is one of the methods for treatment of focal laryngeal dystonia. However, after treatment, there is variation in laryngeal configuration as well as the side effects reported by patients. As a consequence of the functional variability of results, it was hypothesized that botulinum toxin diffuses beyond the limits of the muscle into which it is injected. OBJECTIVES: After injection of botulinum toxin into the TA muscle for the treatment of focal laryngeal dystonia, patients differ in terms of laryngeal configuration and side effects. We hypothesized that this toxin diffuses from the target muscle to adjacent muscles. METHOD: The TA muscles of 18 cadaver larynges were injected with aniline blue (0.2 mL). After fixation in formaldehyde and nitric acid decalcification, the larynges were sectioned in the coronal plane and the intrinsic muscles were analyzed. RESULTS: We found diffusion of aniline blue to the lateral cricoarytenoid muscle, cricothyroid muscle, and posterior cricoarytenoid muscle in 94.3%, 42.9%, and 8.6% of the cases, respectively. In terms of the degree of diffusion to adjacent muscles, we found no differences related to the size (height and width) of the TA muscle or to gender. CONCLUSIONS: Our findings suggest that diffusion of botulinum toxin from its injection site in the TA muscle to the lateral cricoarytenoid muscle is likely in most cases. On the other hand, diffusion to the cricothyroid muscle occurs in approximately half of cases and diffusion to the posterior cricoarytenoid muscle occurs in very few cases.
- Individually Customized Implants for Laryngoplasty-Are They Possible?(2012) FRIZZARINI, Ronaldo; GEBRIM, Eloisa M. M. S.; IMAMURA, Rui; TSUJI, Domingos H.; MOYSES, Raquel A.; SENNES, Luiz U.Objective. To standardize the design of individually fitted implants based on computed tomographic (CT) images for use in medialization laryngoplasty without intraoperative voice monitoring. Study Design. Prospective tomographic and anatomical experimental study of 10 human cadaveric larynges. Methods. CT scans of 10 excised human larynges were analyzed to define the shape and size of ideal implants for medialization laryngoplasty. Silicone implants were designed according to CT parameters and used in simulated laryngoplasties in the laryngeal specimens. The efficacy of each implant in providing adequate medialization of the vocal fold was evaluated. Results. Diverse shapes and sizes of implants were obtained, reflecting variations in laryngeal anatomy. The implants enabled regular medialization of the entire extent of the free border of the vocal fold, including its posterior aspect. Medialization was considered adequate in all cases. Conclusions. This method proved to be a simple and efficient way to design individualized implants for medialization laryngoplasty, regardless of the size and shape of the larynx.