ELOISA MARIA MELLO SANTIAGO GEBRIM
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
18 resultados
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- Tongue size matters: revisiting the Mallampati classification system in patients with obstructive sleep apnea(2023) ATHAYDE, Rodolfo Augusto Bacelar de; COLONNA, Leonardo Luiz Igreja; SCHORR, Fabiola; GEBRIM, Eloisa Maria Mello Santiago; LORENZI-FILHO, Geraldo; GENTA, Pedro RodriguesObjective: The Mallampati classification system has been used to predict obstructive sleep apnea (OSA). Upper airway soft tissue structures are prone to fat deposition, and the tongue is the largest of these structures. Given that a higher Mallampati score is associated with a crowded oropharynx, we hypothesized that the Mallampati score is associated with tongue volume and an imbalance between tongue and mandible volumes. Methods: Adult males underwent clinical evaluation, polysomnography, and upper airway CT scans. Tongue and mandible volumes were calculated and compared by Mallampati class. Results: Eighty patients were included (mean age, 46.8 years). On average, the study participants were overweight (BMI, 29.3 +/- 4.0 kg/m(2)) and had moderate OSA (an apnea-hypopnea index of 26.2 +/- 26.7 events/h). Mallampati class IV patients were older than Mallampati class II patients ( 53 +/- 9 years vs. 40 +/- 12 years; p < 0.01), had a larger neck circumference (43 +/- 3 cm vs. 40 +/- 3 cm; p < 0.05), had more severe OSA (51 +/- 27 events/h vs. 24 +/- 23 events/h; p < 0.01), and had a larger tongue volume (152 +/- 19 cm(3) v s. 135 +/- 18 cm3; p < 0.01). Mallampati class IV patients also had a larger tongue volume than did Mallampati class III patients (152 +/- 19 cm(3) vs. 135 +/- 13 cm(3); p < 0.05), as well as having a higher tongue to mandible volume ratio (2.5 +/- 0.5 cm(3) vs. 2.1 +/- 0.4 cm(3); p < 0.05). The Mallampati score was associated with the apnea-hypopnea index (r = 0.431, p < 0.001), BMI (r = 0.405, p < 0.001), neck and waist circumference (r = 0.393, p < 0.001), tongue volume (r = 0.283, p < 0.001), and tongue/ mandible volume (r = 0.280, p = 0.012). Conclusions: The Mallampati score appears to be influenced by obesity, tongue enlargement, and upper airway crowding.
- Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis(2014) CAMARGO, Raphael Abegao de; NICODEMO, Antonio C.; SUMI, Daniel Vaccaro; GEBRIM, Eloisa Maria Mello Santiago; TUON, Felipe Francisco; CAMARGO, Lazaro Manoel de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground/Objectives: Mucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group. Methodology/Principal Findings: We evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay >= 4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score >= 4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis. Conclusion/Significance: CT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).
- Minimally Invasive Surgery for Intracochlear Schwannoma Removal and Simultaneous Cochlear Implantation(2016) BENTO, Ricardo Ferreira; GEBRIM, Eloisa Maria Mello Santiago; MAGALHÃES, Ana Tereza de Matos; PEREIRA, Larissa Vilela; FONSECA, Anna Carolina de OliveiraAbstract Introduction Hearing preservation has not yet been reported in patients undergoing resection of intracochlear schwannomas. This study describes a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation that resulted in good hearing. Objective This study aims to describe a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation. Data Synthesis The technique described in this study was developed for a 55-year-old male with a 20-year history of bilateral progressive hearing loss and tinnitus that had a mass in the left apical turn of the cochleameasuring 0.3 cm. Surgery accessed the apical turn of the cochlea. We performed mastoidectomy and posterior tympanotomy and removed incus and tensor tympani muscle to expose the cochlear apex. The tumor was identified and completely resected. After the cochleawas anatomically preserved, it was implanted with a straight electrode via round window insertion. The histopathological examination confirmed intracochlear schwannoma. Speech perception test revealed 100% speech recognition with closed sentences and the average audiometric threshold (500 to 2000 Hz) was 23 dB. Conclusion Our technique led to rehabilitation of the patient and improved hearing without damaging the intracochlear structure, making it possible to perform CI in the same procedure with good results.
- Characteristics related to TMJ arthralgia, visualized by magnetic resonance imaging (3.0 Tesla)(2013) GALHARDO, Alessandra Pucci Mantelli; BARACAT, Edmund Chada; LEITE, Claudia da Costa; GEBRIM, Eloisa Maria Mello Santiago; GOMES, Regina Lucia Elia; MUKAI, Marcio Katsuyoshi; MORI, Matsuyoshi; GIL, CarlosPatients: Six women, with ages ranging from 52 to 64 years old, clinically evaluated (Research Diagnostic Criteria for Temporomandibular Disorders) by a single examiner were submitted to MRI (3.0 T). They had only arthralgia diagnosis. The images were evaluated by two radiologists who were not informed about the patients' clinical conditions, in which discs displacements, osteophytes and morphological irregularities, as well as completely normal images, i.e., without any characteristics were identified. Discussion: TMJ arthralgia can be caused by various conditions, few of which are objectively observed when investigating its causes or diagnose temporomandibular disorders (TMD). In some cases, imaging exams can detect some conditions and magnetic resonance imaging (MRI) is commonly used for this purpose. Here, the MRI (3.0 T) enabled a detailed visualization of the structures of the TMJ, allowing the characterization of the symptomology in some cases. Despite, some images were completely normal. Conclusion: This case report detected some features seen on the MRI that justified a clinical diagnosis arthralgia, not associated with other clinical diagnosis. However, the detailed clinical examination should be sovereign even in the face of equipment with advanced technology.
- The influence of the subarcuate artery in the superior semicircular canal dehiscence and its frequency on stillbirths: illustrative cases and systematic review(2018) BRAGA, Gabriela Pereira Bom; NOBLE, Jack H.; GEBRIM, Eloisa Maria Mello Santiago; LABADIE, Robert F.; BENTO, Ricardo FerreiraLiterature describes that on the 25th gestational week the labyrinth is fully formed and with adult size. However, recent studies have shown that the cranial and labyrinth development continues until 3 years of age. Objectives: To demonstrate through tomographic study the frequency of semicircular canal dehiscence on nine specimens of stillbirths between 32 and 40 weeks and, through literature review, present another possible etiology for its cause. Methods: Tomographic study of the temporal bone of 9 specimens of stillbirths between 32 and 40 weeks. Results: A frequency of 88.89% of alterations were found in our study, with 44% presenting bilateral alterations and 44% unilateral alteration; 11.11% had no dehiscence. Conclusion: The tomographic study showed superior semicircular canal dehiscence (SSCD) in 88% of the specimens studied, protrusion of the superior semicircular canal (SSC) in all fetuses, and an enlarged SSC that may be caused by the expansion process provoked by the subarcuate artery entering the subarcuate canaliculus, leading to SSCD.
- The correlation of research diagnostic criteria for temporomandibular disorders and magnetic resonance imaging: a study of diagnostic accuracy(2013) GALHARDO, Alessandra Pucci Mantelli; LEITE, Claudia da Costa; GEBRIM, Eloisa Maria Mello Santiago; GOMES, Regina Lucia Elia; MUKAI, Marcio Katsuyoshi; YAMAGUCHI, Claudio Akira; BERNARDO, Wanderley Marques; SOARES JR., Jose Maria; BARACAT, Edmund Chada; GIL, CarlosObjective. The aim of this study was to evaluate the performance of research diagnostic criteria for temporomandibular disorders (RDC/TMD) as a diagnostic test for temporomandibular joint problems using magnetic resonance imaging (MRI) as the gold standard. Study Design. Sixty-seven women were assessed with RDC/TMD (2 examiners) and underwent MRI examination (3.0 T). Images were evaluated by 2 independent radiologists blinded to the clinical diagnoses. Results were analyzed by the Catmaker system. Results. Of the 67 patients, 44 were diagnosed with temporomandibular disorders (TMD) according to RDC/TMD, but 21 (32%) of the diagnoses were not confirmed by MRI. The RDC/TMD sensitivity was 83.0%, specificity was 53.0%, and the positive likelihood ratio was 1.77, whereas the negative likelihood ratio was 0.32 (P = 0.16). Conclusions. Our data suggest that RDC/TMD is a good research tool, but the high rate of false-positive results limits its use in clinical practice. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:277-284)
- Cervical Lymph Node Metastases from Central Nervous System Tumors: A Systematic Review(2022) COCA-PELAZ, Andres; BISHOP, Justin A.; ZIDAR, Nina; AGAIMY, Abbas; GEBRIM, Eloisa Maria Mello Santiago; MONDIN, Vanni; COHEN, Oded; STROJAN, Primoz; RINALDO, Alessandra; SHAHA, Ashok R.; BREE, Remco de; HAMOIR, Marc; MAKITIE, Antti A.; KOWALSKI, Luiz P.; SABA, Nabil F.; FERLITO, AlfioIntroduction: Lymph node metastasis (LNM) from primary tumors of the central nervous system (CNS) is an infrequent condition, and classically it was thought that CNS tumors could not spread via the lymphatic route. Recent discoveries about this route of dissemination make its knowledge necessary for surgeons and pathologists to avoid delays in diagnosis and unnecessary treatments. The aim of this paper is to review the literature and to discuss the relevant pathogenetic mechanism and the cytologic features along with recommendations for surgical treatment of these cervical LNM. Materials and Methods: Using PRISMA guidelines, we conducted a systematic review of the literature published from 1944 to 2021, updating the comprehensive review published in 2010 by our group. Results: Our review includes data of 143 articles obtaining 174 patients with LNM from a primary CNS tumor. The mean age of the patients was 31.9 years (range, 0.1-87) and there were 61 females (35.1%) and 103 males (59.2%), and in 10 cases (5.7%) the gender was not specified. The more frequent sites of distant metastasis were bones (23%), lungs (11.5%) and non-cervical lymph nodes (11%). Conclusion: Cervical LNM from CNS tumors is infrequent. Pathologic diagnosis can be obtained by fine-needle aspiration cytology in most cases, giving surgeons the option to plan the appropriate surgical treatment. Given the poor prognosis of these cases, the most conservative possible cervical dissection is usually the treatment of choice.
bookPart Imagine(2019) CHAMMAS, Maria Cristina; GEBRIM, Eloisa Maria Mello Santiago; LEITE, Claudia da Costa- State-dependent changes in the upper airway assessed by multidetector CT in healthy individuals and during obstructive events in patients with sleep apnea(2019) PASSOS, Ula Lindoso; GENTA, Pedro Rodrigues; MARCONDES, Bianca Fernandes; LORENZI-FILHO, Geraldo; GEBRIM, Eloisa Maria Mello SantiagoObjective: To determine whether airway narrowing during obstructive events occurs predominantly at the retropalatal level and results from dynamic changes in the lateral pharyngeal walls and in tongue position. Methods: We evaluated 11 patients with severe obstructive sleep apnea (OSA) and 7 healthy controls without OSA during wakefulness and during natural sleep (documented by full polysomnography). Using fast multidetector CT, we obtained images of the upper airway in the waking and sleep states. Results: Upper airway narrowing during sleep was significantly greater at the retropalatal level than at the retroglossal level in the OSA group (p < 0.001) and in the control group (p < 0.05). The retropalatal airway volume was smaller in the OSA group than in the control group during wakefulness (p < 0.05) and decreased significantly from wakefulness to sleep only among the OSA group subjects. Retropalatal pharyngeal narrowing was attributed to reductions in the anteroposterior diameter (p = 0.001) and lateral diameter (p = 0.006), which correlated with an increase in lateral pharyngeal wall volume (p = 0.001) and posterior displacement of the tongue (p = 0.001), respectively. Retroglossal pharyngeal narrowing during sleep did not occur in the OSA group subjects. Conclusions: In patients with OSA, upper airway narrowing during sleep occurs predominantly at the retropalatal level, affecting the anteroposterior and lateral dimensions, being associated with lateral pharyngeal wall enlargement and posterior tongue displacement.
- Regurgitation of Undigested Food: What is Your Diagnosis?(2016) IMAMURA, Rui; MARCELO, Agatha Mol; GEBRIM, Eloisa Maria Mello Santiago; TSUJI, Domingos Hiroshi