ROBINSON KOJI TSUJI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Speech Perception Performance of Double Array Multichannel Cochlear Implant Users With Standard and Duplicated Maps in Each of the Arrays
    (2013) BENTO, Ricardo Ferreira; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; FONSECA, Anna Carolina de Oliveira; IKARI, Liliane Satomi; BRITO NETO, Rubens Vuono de
    Objective: The present investigation evaluated the speech perception performance of patients with ossified cochlea implanted with the 24M Double Array cochlear implant, using standard and duplicated maps in each of the arrays. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Sixteen subjects received a Double Array cochlear implant. Among these, 9 fulfilled the following inclusion criteria: bilateral severe-to- profound postlingual deafness; bilateral obliterated cochlea, as shown by a computed tomographic scan; and a minimum age of 14 years to ensure reliable responses in the behavioral tests with the 3 tested maps. Intervention: Rehabilitative. Main Outcome Measures: The speech perception performance with the 2 arrays was compared with that with a basal array duplicated map and an apical array duplicated map. Three maps were fitted: the default map with both arrays activated, a double channel map using only the electrodes of the basal array, and a double channel map programmed only with the electrodes of the apical array. The test battery was composed of a vowel test, a 4-choice word test, and sentence recognition in quiet. Results: Statistical significance was reached in comparison the all tests in all programming conditions. Speech recognition in the standard map with both electrode arrays activated showed the highest scores. Conclusion: Performance with the 2 split electrode arrays was superior to those with the single arrays, regardless of the duplication of channels.
  • article 5 Citação(ões) na Scopus
    Microangiopathy of the inner ear, deafness, and cochlear implantation in a patient with Susac syndrome
    (2011) BITTENCOURT, Aline Gomes; SANTOS, Andrea Felice Dos; GOFFI-GOMEZ, Maria Valeria Schmidt; KUTSCHER, Kellen; TSUJI, Robinson Koji; BRITO, Rubens De; BENTO, Ricardo Ferreira
    Conclusion: The cochlear implant was beneficial as an attempt to restore hearing and improve communication abilities in this patient with profound sensorineural hearing loss secondary to Susac syndrome. Objective: To report the audiological outcomes of cochlear implantation (CI) in a young woman with Susac syndrome after a 6-month follow-up period. Susac syndrome is a rare disorder. It is clinically characterized by a typical triad of sensorineural deafness, encephalopathy, and visual defect, due to microangiopathy involving the brain, inner ear, and retina. Methods: This was a retrospective review of a case at a tertiary referral center. After diagnosis, the patient was evaluated by a multidisciplinary team and received a cochlear implant in her right ear. Results: The patient achieved 100% open-set sentence recognition in noise conditions and 92% monosyllable and 68% medial consonant recognition in quiet conditions after 6 months of implant use. She reported the use of the telephone 3 months after activation.
  • article 15 Citação(ões) na Scopus
    Hearing preservation using topical dexamethasone alone and associated with hyaluronic acid in cochlear implantation
    (2015) RAMOS, Bernardo Faria; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; GOFFI-GOMEZ, Maria Valeria Schmidt; RAMOS, Henrique Faria; SAMUEL, Paola Angelica; BRITO, Rubens
    Conclusion: Topical dexamethasone associated with hyaluronic acid in cochlear implant surgery demonstrated a statistically significant difference in the preservation of low-frequency thresholds when compared with topical dexamethasone alone and a control group. Topical dexamethasone alone was not superior in hearing preservation when compared to the control group. Objective: To compare the effects of topical dexamethasone alone and associated with hyaluronic acid intraoperatively in hearing preservation in cochlear implantation. Methods: Eighteen severely to profoundly hearing-impaired adult patients with measurable hearing were divided into three groups preoperatively: cochlear implantation as a control group (group 1), cochlear implantation using topical dexamethasone intraoperatively (group 2), and cochlear implantation using topical dexamethasone associated with hyaluronic acid intraoperatively (group 3). Preimplant and postimplant low-frequency pure-tone averages (PTAs) were calculated from unaided audiograms at 125, 250, and 500 Hz. Results: The mean changes in the low-frequency PTA comparing postoperative against preoperative thresholds were 28.03 +/- 6.77 dB in group 1, 30 +/- 14.53 dB in group 2, and 7.23 +/- 6.12 dB in group 3. There was statistical difference when comparing group 3 with groups 1 and 2 using one-way ANOVA (p = 0.002) followed by Scheffe post hoc test.
  • article 0 Citação(ões) na Scopus
    Is There Any Correlation between Spread of Excitation Width and the Refractory Properties of the Auditory Nerve in Cochlear Implant Users?
    (2021) SILVA, Juliana Coutinho da; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; BENTO, Ricardo; BRITO NETO, Rubens
    Background: The spread of excitation (SOE) and auditory nerve recovery function (REC) are objective measures recorded by neural response telemetry and may interfere in cochlear implant (CI) stimulation. Objective: To analyze and correlate SOE with the refractory periods in subjects with pre- and postlingual deafness implanted with different electrode arrays. Methods: This was a retrospective study of 323 ears separated by perimodiolar or straight arrays and by pre- or postlingually deaf recipients. Measures were collected intraoperatively on electrode 11. The SOE width was measured in millimeters at the 0.75 point of the curve, and the relative (tau) and absolute (t0) refractory periods were measured in microseconds. Results: There was a statistical correlation between the SOE and the t0 in the patients with postlingual deafness implanted with the perimodiolar array. The SOE width was statistically different between the straight and perimodiolar arrays and between the pre- and postlingual groups in the perimodiolar array. Tau was statistically different between the pre- and postlingual groups with the straight array and the t0, between the pre- and postlingual groups with the perimodiolar array. Neural response threshold and amplitude of the neural response were not statistically different among groups. Conclusion: There was a correlation between SOE width and t0 only in patients with acquired deafness. The findings suggest that different factors influence SOE and REC, considering SOE is different according to the electrode array and REC being different according the onset of deafness.
  • article 9 Citação(ões) na Scopus
    Are Auditory Steady-State Responses Useful to Evaluate Severe-to-Profound Hearing Loss in Children?
    (2015) GRASEL, Signe Schuster; ALMEIDA, Edigar Rezende de; BECK, Roberto Miquelino de Oliveira; GOFFI-GOMEZ, Maria Valeria Schmidt; RAMOS, Henrique Faria; ROSSI, Amanda Costa; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; BRITO, Rubens de
    Objective. To evaluate Auditory Steady-State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral tests responses. Methods. This prospective study evaluated 42 children with suspected severe-to-profound hearing loss, aged from 3 to 72 months. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dB HL with a 10 dB down-seeking procedure. ASSR and behavioral test results were compared. Results. Forty-two subjects completed both ASSR and behavioral evaluation. Eleven children (26.2%) had bilateral responses. Four (9.5%) showed unilateral responses in at least two frequencies, all confirmed by behavioral results. Overall 61 ASSR responses were obtained, most (37.7%) in 500 Hz. Mean thresholds were between 101.3 and 104.2 dB HL. Among 27 subjects with absent ASSR, fifteen had no behavioral responses. Seven subjects showed behavioral responses with absent ASSR responses. No spurious ASSR responses were observed at 100 or 110 dB HL. Conclusion. ASSR is a valuable tool to detect residual hearing. No false-positive ASSR results were observed among 42 children, but in seven cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.
  • article 13 Citação(ões) na Scopus
    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 de
    INTRODUCTION: 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.
  • article 6 Citação(ões) na Scopus
    Longitudinal Analysis of the Absence of Intraoperative Neural Response Telemetry in Children using Cochlear Implants
    (2014) MOURA, Amanda Christina Gomes de; GOFFI-GOMEZ, Maria Valéria Schmidt; COUTO, Maria Ines Vieira; BRITO, Rubens; TSUJI, Robinson Koji; BEFI-LOPES, Debora Maria; MATAS, Carla Gentile; BENTO, Ricardo Ferreira
    Introduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.
  • article 8 Citação(ões) na Scopus
    Satisfação e qualidade de vida em usuários de implante auditivo de tronco cerebral
    (2017) FERNANDES, Nayara Freitas; GOFFI-GOMEZ, Maria Valéria Schmidt; MAGALHÃES, Ana Tereza De Matos; TSUJI, Robinson Koji; DE BRITO, Rubens Vuono; BENTO, Ricardo Ferreira
    ABSTRACT Purpose To evaluate satisfaction and quality of life of users of Auditory Implant Brainstem. Methods This is a cross-sectional and descriptive study conducted at Divisão de Clínica Otorrinolaringológica of Hospital das Clínicas of Faculdade de Medicina da Universidade de São Paulo, Brazil. For the research, 19 users of an Auditory Brainstem Implant answered the following questionnaires: KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents), for children and adolescents, their parents and/or caregivers; WHOQOL-BREF questionnaire, for adult participants; and the Satisfaction with Amplification in Daily Life (SADL) questionnaire culturally adapted to Brazilian Portuguese. Results The quality of life of children using Auditory Brainstem Implant from the perspective of their parents showed global results above average, as for most domains, except for the emotional well-being domain. Adults showed results above average for all domains. Regarding satisfaction with the device, the adult users of auditory brainstem implant were satisfied in general, except with regard to personal image. The parents of the children showed dissatisfaction in all subscales, except for the subscale of services and cost. Conclusion The results indicated that although patients are dissatisfied with the device in some aspects, overall the quality of life was rated as good for most of the aspects assessed.
  • article 41 Citação(ões) na Scopus
    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 Ferreira
    Objective: 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).
  • article 7 Citação(ões) na Scopus
    Are auditory steady-state responses a good tool prior to pediatric cochlear implantation?
    (2015) BECK, Roberto Miquelino de Oliveira; GRASEL, Signe Schuster; RAMOS, Henrique Faria; ALMEIDA, Edigar Rezende de; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; BRITO, Rubens de
    Introduction: ASSR allow frequency-specific evaluation in intensities up to 120 dB HL and detection of residual hearing in patients with severe-to-profound hearing loss. Aim: to compare ASSR thresholds and behavioral test results in children with suspected severe-to-profound hearing loss. Methods: Cross sectional study to compare ASSR and behavioral responses (VRA or audiometry) in 63 pediatric cochlear implant candidates (126 ears) aged between 6 and 72 months. We included children with normal otomicroscopy, absent responses to click-ABR and otoaccoustic emissions. We excluded children with inner ear malformations, auditory neuropathy spectrum disorder or who did not complete VRA or achieve EEG noise < 30 nV during the ASSR test. Air-conduction ASSR stimuli were continuous sinusoidal tones presented at 0.5, 1, 2 and 4 kHz starting at 110 dB HL Behavioral thresholds were acquired with warble tones presented at 0.5, 1, 2 and 4 kHz in each ear through insert or head phones at maximum presentation level of 120 dB HL Results: Behavioral thresholds were obtained in 36.7% (185/504) of all frequencies in all subjects, 9% in intensities >110 dB HL. Among 504 ASSR measurements, 53 thresholds were obtained (10.5%). Overall 89.5% of the tested frequencies did not show any response at 110 dB HL Most responses were at 500 Hz. Mean differences between behavioral and ASSR thresholds varied from 0.09 to 8.94 dB. Twenty-seven comparisons of behavioral and ASSR thresholds were obtained: 12 at 0.5 kHz, 9 at 1 kHz, Sat 2 kHz and 1 at 4 kHz. Absent responses were observed in both tests in 38.1% at 0.5 kHz, 52.4% at 1 kHz, 74.6% at 2 kHz and 81.0% at 4 kHz. Specificity was > 90% at 1,2 and 4 kHz. In ears with no behavioral response at 120 dB HL all ASSR thresholds were in the profound hearing loss range, 90% of them were >110 dB HL Conclusion: Among 63 pediatric CI candidates, absent responses to high-intensity ASSR was the major finding (specificity > 90%) predicting behavioral thresholds in the profound hearing loss range. These findings can be helpful to confirm the decision for cochlear implantation.