FABIO DE REZENDE PINNA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Assessment of quality of life after endoscopic sinus surgery for chronic rhinosinusitis(2012) BEZERRA, Thiago Freire Pinto; PICCIRILLO, Jay F.; FORNAZIERI, Marco Aurelio; PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; PADUA, Francini Grecco de Melo; VOEGELS, Richard LouisChronic rhinosinusitis is a disease of undefined etiology that significantly impacts the quality of life of its patients. Various studies carried out in countries other than Brazil have shown endoscopic sinus surgery as an effective means of treating this condition. Objective: This study aims to analyze, with the aid of SNOT-20, the association between endoscopic sinus surgery and disease-specific quality of life of Brazilian patients treated for chronic rhinosinusitis accompanied or not by nasal polyps. Materials and Methods: This prospective study enrolled patients submitted to endoscopic sinus surgery after drug therapy failed to improve their symptoms. They were assessed based on questionnaire SNOT-20p before and 12 months after surgery. Improvement on total scores and on the five items deemed more important by each patient were assessed. The study also looked into the correlation between preoperative scores and postoperative improvement and if there were any gender-related improvement differences. Results: Forty-three patients aged 44 (19), md (IQR), 65% of whom (26/43) were males. Statistically significant improvement was seen on SNOT-20 and SNOT-20(5+) and a correlation was established between preoperative scores and postoperative improved scores (p<0.001). No gender-related differences were observed in quality of life. Conclusion: Endoscopic sinus surgery in patients with chronic rhinosinusitis is associated with statistically significant improvements in disease-specific quality of life.
- Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa(2014) ORDONES, Alexandre Beraldo; FORNAZIERI, Marco Aurélio; PINNA, Fábio de Rezende; BEZERRA, Thiago Freire Pinto; VOEGELS, Richard Louis; SENNES, Luiz UbirajaraObjective To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and developed a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1 year postoperatively. Conclusion This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.
- Quality of life assessment septoplasty in patients with nasal obstruction(2012) BEZERRA, Thiago Freire Pinto; STEWART, Michael G.; FORNAZIERI, Marco Aurelio; PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; PADUA, Francini Grecco de Melo; VOEGELS, Richard LouisNaasal obstruction is a common complaint in the population. When caused by a deviated nasal septum, septoplasty is the procedure of choice for treating these patients. NOSE is a tool for assessing the disease-specific quality of life related to nasal obstruction. Aim: To assess the impact of septoplasty on patients with nasal obstruction secondary to deviated nasal septum based on the disease-specific quality-of-life questionnaire. Design: Prospective. Methods: Patients undergoing septoplasty with/without turbinectomy after no clinical improvement with medical treatment were assessed by the NOSE questionnaire before and 3 months after surgery. We evaluated the surgical improvement based on total score, the magnitude of the surgery in the disease-specific quality of life and the correlation between the preoperative score and postoperatively improvement. Results: Fourty-six patients were included in the study. There was a statistically significant improvement in the preoperative NOSE score (md = 75, IQR = 26) and after three months (md = 10, IQR = 20) (p < 0.001.T-Wilcoxon). The standardized response mean was 3.07. We found a strong correlation between the preoperative score in the NOSE questionnaire and improvements in the postoperative period (r = -0.789, p < 0.001, Spearman). No difference was found in improvement scores by gender. (p = 0.668, U-Mann-Whitney). Conclusion: Septoplasty resulted in a statistically significant improvement in the disease-specific QOL questionnaire.
- Anatomical terminology of the internal nose and paranasal sinuses: cross-cultural adaptation to Portuguese(2018) BEZERRA, Thiago Freire Pinto; STAMM, Aldo; ANSELMO-LIMA, Wilma Teresinha; FORNAZIERI, Marco Aurelio; MELO, Nelson D'Avila; BALSALOBRE, Leonardo; JOTZ, Geraldo Pereira; LEAO, Henrique Zaquia; NUNES, Andre Alencar Araripe; FELIPPU, Alexandre; CEDIN, Antonio Carlos; PINHEIRO-NETO, Carlos D.; OLIVEIRA, Diego Lima; SAKANO, Eulalia; KOSUGI, Eduardo Macoto; ARAUJO, Elizabeth; VALERA, Fabiana Cardoso Pereira; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francine Grecco de Melo; RAMOS, Henrique Faria; TELLES JR., Joao; SA, Leonardo Conrado Barbosa de; D'ASSUNCAO FILHO, Leopoldo Marques; SENNES, Luiz Ubirajara; GREGORIO, Luis Carlos; SAMPAIO, Marcelo H.; SANTOS, Marco Cesar Jorge dos; FRANCA, Marco; MOCELLIN, Marcos; LESSA, Marcus Miranda; AVELINO, Melissa Ameloti G.; TEPEDINO, Miguel; ANDRADE, Nilvano Alves de; PILTCHER, Otavio B.; ROITHMANN, Renato; PILAN, Renata Mendonca; MEIRELES, Roberto Campos; GUIMARAES, Roberto Eustaquio; SANTOS, Rodrigo de Paula; PEZATO, Rogerio; PIGNATARI, Shirley; ABDO, Tatiana Telles; NAKAJIMA, Victor; ALMEIDA, Washington; VOEGELS, Richard L.Introduction: Functional endonasal endoscopic surgery is a frequent surgical procedure among otorhinolaryngologists. In 2014, the European Society of Rhinology published the ""European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses"", aiming to unify the terms in the English language. We do not yet have a unified terminology in the Portuguese language. Objective: Transcultural adaptation of the anatomical terms of the nose and paranasal cavities of the ""European Anatomical Terminology of the Internal Nose and Paranasal Sinuses"" to Portuguese. Methods: A group of rhinologists from diverse parts of Brazil, all experienced in endoscopic endonasal surgery, was invited to participate in the creation of this position paper on the anatomical terms of the nose and paranasal sinuses in the Portuguese language according to the methodology adapted from that previously described by Rudmik and Smith. Results: The results of this document were generated based on the agreement of the majority of the participants according to the most popular suggestions among the rhinologists. A cross-cultural adaptation of the sinonasal anatomical terminology was consolidated. We suggest the terms ""inferior turbinate"", ""nasal septum"", ""(bone/cartilaginous) part of the nasal septum"", ""(middle/inferior) nasal meatus"", ""frontal sinus drainage pathway"", ""frontal recess"" and ""uncinate process"" be standardized. Conclusion: We have consolidated a Portuguese version of the European Anatomical Terminology of the Internal Nose and Paranasal Sinuses, which will help in the publication of technical announcements, scientific publications and the teaching of the internal anatomical terms of the nose and paranasal sinuses in Brazil. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps(2017) SOTER, Ana Carolina Pinto Bezerra; BEZERRA, Thiago Freire Pinto; PEZATO, Rogerio; ABDO, Tatiana Regina Teles; PILAN, Renata Mendonca; PINNA, Fabio de Rezende; GEVAERT, Philippe; ZELE, Thibaut van; BACHERT, Claus; VOEGELS, Richard LouisBackground: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). Methods: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation. The main outcome measure was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Other outcome measures were the SNOT-20, NOSE, and Lund-Kennedy scores. The following parameters were also analyzed: asthma, rhinitis, non-steroidal-exacerbated respiratory disease (NERD), and baseline serum IgG, IgA, IgE, IgM, ANCA, and eosinophil count. Results:There was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Patients who received doxycycline also had significantly better outcomes regarding SNOT-20, NOSE, and Lund-Kennedy scores. There was a negative association among a clinically significant improvement of SNOT-20 and presence of asthma, NERD, and elevated serum IgE levels before treatment. Conclusion:These findings suggest that doxycycline may have a beneficial role for CRSwNP patients, especially for patients without asthma, NERD or high levels of serum IgE before treatment.
- Prevalence of chronic rhinosinusitis in Sao Paulo(2012) PILAN, Renata Ribeiro de Mendonca; PINNA, Fabio de Rezende; BEZERRA, Thiago Freire Pinto; MORI, Renata Lopes; PADUA, Francini Grecco de Melo; BENTO, Ricardo Ferreira; PEREZ-NOVO, Claudina; BACHERT, Claus; VOEGELS, Richard LouisIntroduction: Studies designed to investigate chronic rhinosinusitis (CRS) epidemiology play an important role to assess population's distribution and risk factors to result in the development and promotion of public health policies. Method: This study design is a survey carried out with a complex two-stage cluster sampling plan. Personal interviews were carried out with 2,003 individuals. The questionnaire included the epidemiological criteria for CRS. Demographic data, history of physician-diagnosed respiratory diseases (asthma, sinusitis, rhinitis), smoking, family income, educational attainment, and household characteristics were also evaluated. Results: The overall response rate was 93.9% of the households. Mean age was 39.8 +/- 21 years; 45.33% were male. The overall prevalence of CRS in the city of Sao Paulo was 5.51%. We found a significant association between diagnosis of CRS and diagnosis of asthma and CRS and diagnosis of rhinitis and a significant association between presence of CRS and belonging to the low-income subgroup. Conclusion: The municipality of Sao Paulo has an urban population of 11 million. According to the present study, the prevalence of CRS is 5.51%, which represents more than 500,000 individuals affected by this condition in the city.
- Relationship of socioeconomic status to olfactory function(2019) FORNAZIERI, Marco Aurelio; DOTY, Richard L.; BEZERRA, Thiago Freire Pinto; PINNA, Fabio de Rezende; COSTA, Fernando Oliveira; VOEGELS, Richard Louis; SILVEIRA-MORIYAMA, LauraSocioeconomic status can significantly impact health. To what degree education and other socioeconomic factors influence the chemical sense of olfaction is not clear. Most studies that have assessed such influences come from countries lacking large disparities in education and income and generally view such measures as nuisance variables to be controlled for statistically. In this study, we evaluated the influences of education and income on odor identification in a diverse sample of subjects from Brazil, a society where large disparities in both income and education are present. The 40-item University of Pennsylvania Smell Identification Test (UPSIT) was administered to 1572 healthy Brazilian citizens with no self-reported olfactory or gustatory deficits and for whom detailed socioeconomic and educational status data were obtained. Univariate and multivariate models were employed to examine the influence of socioeconomic status on the test scores. After controlling for age, sex, ethnicity, and smoking behavior, income and educational level were positively and independently related to the olfactory test scores (respective ps < 0.001 & 0.01). Both linear and quadratic functions described the relationship between the UPSIT scores and the levels of education and socioeconomic status. Individuals of lower socioeconomic status performed significantly worse than those of higher socioeconomic status on 20 of the 40 odorant items. This study demonstrates socioeconomic status is significantly associated with influence the ability to identify odors. The degree to which this reflects differential exposures to xenobiotic agents, cultural differences, familiarity with odors or their names, cognitive development, or other factors requires further investigation.
- A new cultural adaptation of the University of Pennsylvania Smell Identification Test(2013) FORNAZIERI, Marco Aurelio; DOTY, Richard L.; SANTOS, Clayson Alan dos; PINNA, Fabio de Rezende; BEZERRA, Thiago Freire Pinto; VOEGELS, Richard LouisOBJECTIVES: The University of Pennsylvania Smell Identification Test, a test of olfactory function that is widely used by otolaryngologists, geriatricians, and neurologists, has been translated into more than a dozen languages. In some instances, cultural and socioeconomic factors have necessitated changes in the odorant items or the response alternatives to make the test scores congruent with North American norms. The objective of this study was to compare the performance of Brazilian subjects on a new Portuguese language version of the University of Pennsylvania Smell Identification Test with their performance on an earlier Portuguese language version of the test, as well as to assess the influences of gender, age, ethnicity, and economic status on the test scores. METHODS: Based on pilot data, several response alternatives of the earlier Portuguese language version of the test were altered in an effort to improve test performance. Forty-nine healthy Brazilian volunteers, who represented several economic classes, were tested. The test scores of the study cohort who received the newer version of the test were compared with those of a group of 25 subjects who received the earlier version of the test. RESULTS: The mean score for the new version [35 (2.1)] was significantly (p = 0.002) higher than that for the earlier version [32.5 (3.5)]. Although no apparent influence of socioeconomic status was observed, the female participants outperformed the male participants in the current subject cohort. CONCLUSION: The changes made in the new cultural adaptation of the Portuguese version of the University of Pennsylvania Smell Identification Test were effective in increasing the average test scores of the participants. Overall, the female subjects outperformed the male subjects on the test.
- Development of Normative Data for the Brazilian Adaptation of the University of Pennsylvania Smell Identification Test(2015) FORNAZIERI, Marco Aurelio; SANTOS, Clayson Alan dos; BEZERRA, Thiago Freire Pinto; PINNA, Fabio de Rezende; VOEGELS, Richard Louis; DOTY, Richard L.It is well established that olfactory dysfunction has significant implications for safety, nutrition, and quality of life. The more reliable standardized tests of olfactory function, such as the University of Pennsylvania Smell Identification Test (UPSIT), assess odor identification ability. Unfortunately, cultural factors can influence such tests, as a number of odors are not universally recognized. In this study, a Portuguese language version of the UPSIT was administered to an age-and sex-stratified prospective sample of 1820 Brazilian subjects. Normative data were developed for a subset of 1578 subjects who reported having no difficulties smelling or tasting. Individuals with a history of head trauma or, in the case of those over the age of 64 years, Mini-Mental State Examination Scores <24, were excluded from analysis. As in other populations, the test scores were significantly influenced by age and sex. The median overall difference between the North American and Brazilian UPSIT scores was 2.2 points for men and 0.8 points for women, although subtle age-related differences were also apparent. This research represents that largest clinical study of olfaction ever performed in South America. Correction factors based upon age and sex are provided to allow for direct comparisons of Brazilian test scores to those based upon North American norms.
- Cross-cultural adaptation and validation of the Sinus and Nasal Quality of Life Survey (SN-5) into Brazilian Portuguese(2016) UCHOA, Priscila Regina Candido Espinola; BEZERRA, Thiago Freire Pinto; LIMA, Elcio Duarte; FORNAZIERI, Marco Aurelio; PINNA, Fabio de Rezende; SPERANDIO, Fabiana de Araujo; VOEGELS, Richard LouisIntroduction: The concept of quality of life is subjective and variable definition, which depends on the individual's perception of their state of health. Quality of life questionnaires are instruments designed to measure quality of life, but most are developed in a language other than Portuguese. Questionnaires can identify the most important symptoms, focus on consultation, and assist in defining the goals of treatment. Some of these have been validated for the Portuguese language, but none in children. Objective: To validate the translation with cross-cultural adaptation and validation of the Sinus and Nasal Quality of Life Survey (SN-5) into Portuguese. Methods: Prospective study of children aged 2-12 years with sinonasal symptoms of over 30 days. The study comprised two stages: (I) translation and cross-cultural adaptation of the SN-5 into Portuguese (SN-5p); and (II) validation of the SN5-p. Statistical analysis was performed to assess internal consistency, test-retest reliability, and sensitivity, as well as construct and discriminant validity and standardization. Results: The SN-5 was translated and adapted into Portuguese (SN-5p) and the author of the original version approved the process. Validation was carried out by administration of the SN-5p to 51 pediatric patients with sinonasal complaints (mean age, 5.8 +/- 2.5 years; range, 2-12 years). The questionnaire exhibited adequate construct validity (0.62, p<0.01), internal consistency (Cronbach's alpha = 0.73), and discriminant validity (p<0.01), as well as good test-retest reproducibility (Goodman-Kruskal gamma = 0.957, p < 0.001), good correlation with a visual analog scale (r = 0.62, p<0.01), and sensitivity to change. Conclusion: This study reports the successful translation and cross-cultural adaptation of the SN-5 instrument into Brazilian Portuguese. The translated version exhibited adequate psychometric properties for assessment of disease-specific quality of life in pediatric patients with sinonasal complaints. (C) 2016 Associacdo Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.