Biomedical subjects

Reginaldo Fujita

Publications and source records attributed to Reginaldo Fujita.

6 recordsLinked to original sources

PubMed2006

Endoscopic transeptal surgery for choanal atresia with a stentless folded-over-flap technique.

OBJECTIVE: To analyze long-term results of a new stentless surgical technique for choanal atresia that also used no packing. STUDY DESIGN: Prospective study. METHODS: Ten patients (3 bilateral and 7 unilateral), with ages ranging from 4 days to 30 years, were operated on. The follow-up was 6 months to 36 months. This approach allowed resection of the posterior portion of the vomer, atretic plate, and part of the medial pterygoid process. Flaps were fashioned from septal, nasal, and pharyngeal mucosa from the atretic plates and fixed with fibrin glue. Postoperative control included nasal endoscopy and computerized tomography (CT). RESULTS: Adequate functional nasal breathing was maintained during follow-up. CONCLUSIONS: This technique was satisfactory and safe, allowing fast recovery in a one-step surgery, using neither stents nor nasal packing. Long-term patency with no reduction in functional quality was also observed.

Adolescent↗

PubMed2005

Laryngeal assessment in rheumatic disease patients.

UNLABELLED: Rheumatic diseases usually promote several systemic disorders, which can affect blood vessels, mucosa and serosa of the aerodigestive tract. Scarce laryngeal involvement has been described in these patients and this study aims at investigating laryngeal alterations found in patients with rheumatic diseases. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: A transversal study was developed with systemic lupus erythematous, systemic sclerosis and mixed connective tissue disease's patients. They were evaluated by means of clinical examinations and videolaryngoestroboscopy. RESULTS: Twenty-seven patients were included in the study, 26 succeeded in completing the videolaryngoestroboscopy. Laryngeal abnormalities were seen in 11 of 12 patients with lupus, in all 11 patients with sclerodermia and in 3 patients with mixed connective tissue disease. Vocal fold bamboo node was observed in 5 patients and 92.3% of all patients presented laryngeal signs of gastroesophageal reflux disease. CONCLUSION: We noticed 5 vocal fold bamboo nodes and gastroesophageal reflux disease in almost all patients.

Adult↗

PubMed2005

[Treatment laryngomalacia: experience with 22 cases].

UNLABELLED: Laryngomalacia is the most frequent cause of stridor in childhood, and in most of the cases, spontaneous resolution occurs by the age of 2 years. Approximately 10% of the cases (severe laryngomalacia) require surgery. This condition is of unknown etiology and its diagnosis is made by fiberoptic laryngoscopy, which shows shortening of the aryepiglottic folds, and/or redundant arytenoid mucosa, and/or anterior-posterior epiglottic prolapse. AIM: Our objective was to verify the main clinical and anatomical affections and to highlight the clinical parameters for clinical follow-up and surgical indication in patients with laryngomalacia. STUDY DESIGN: Transversal cohort study. MATERIAL AND METHOD: Twenty-two children diagnosed with laryngomalacia in the Pediatric Otorhinolaryngology of UNIFESP-EPM, from January 2001 to December 2003, whose clinical and surgical follow-up were performed by the same examiner, were enrolled in this study. RESULTS: Out of twenty-two evaluated children, 2 (9.1%) presented with severe laryngomalacia and pectus excavatum (funnel chest). At polysomnography, no child presented any significant respiratory event during sleeping. Those two children with severe laryngomalacia were submitted to supraglottoplasty with resection of the aryepiglottic folds. CONCLUSION: We concluded that stridor and shortening of the aryepiglottic folds are preponderant in children with laryngomalacia. The polysomnographic exam did not prove to be a good parameter for clinical follow-up, neither for surgical indication. The most important parameters were pectus excavatum and failure to thrive. Supraglottoplasty is effective with low rate of morbidity.

Cohort Studies↗

PubMed2005

OSAS in children: correlation between endoscopic and polysomnographic findings.

OBJECTIVES: To correlate polysomnographic findings with clinical history of apnea, the degree of obstruction caused by tonsillar hypertrophy, and to age group. STUDY DESIGN AND SETTING: 267 children with a clinical diagnosis of obstructive sleep apnea (OSAS) were evaluated. Patients were divided into preschool- and school-age categories, and subdivided in 3 additional groups, according to tonsillar hypertrophy. Polysomnographic findings were compared within groups. RESULTS: 34% of children had history of OSAS and normal polysomnographic findings. Tonsillar hypertrophy was correlated to more severe apnea among preschool-age children, but not among school-age children. Among children with tonsillar hypertrophy, more severe apnea was observed in preschool-age children than in school-age children. CONCLUSIONS: There is little correlation between polysomnographic and clinical findings in children with OSAS. SIGNIFICANCE: Adenotonsillar hypertrophy leads to more severe polysomnographic patterns in preschool-age children. More severe apnea is observed in younger children with adenotonsillar hypertrophy than in older ones.

Adenoids↗

PubMedDate not supplied

Behavioral evaluation in children with obstructive sleep disorders.

AIM: The purpose of this study was to evaluate the behavior in children with obstructive sleep disorder. STUDY DESIGN: Prospective study. MATERIAL AND METHOD: Children's parents (4 to 18 years old) completed the CBCL4/18 (Child Behavior Checklist) in the period of January to July 2005. RESULTS: In the group, 12 (60%) were males and 8 (40%) females; the total problem score was abnormal in 5 children (25%); introversion was affected in 2 children (10%); extroversion in 5 children (25%). The scales of individual syndromes were abnormal in between 0 and 20% of patients. The individual scales most frequently affected were: total competency (20%), somatic complaints (10%), social problems (10%) and aggressive behavior (10%). DISCUSSION: This study demonstrates high prevalence (25%) of abnormal behavior. Although widely reported as a common complication of pediatric OSAS, behavioral and neurocognitive disorders have mostly been inferred in several cases and studies. There are few recent studies using standardized assessment to evaluate these alterations. Our study presents preliminary results of the behavior of children with obstructive sleep disorders.

Adolescent↗

PubMedDate not supplied

Correlation between fiberoptic nasal endoscopy and acoustic rhinometry in adults without nasal complaints.

BACKGROUND: Acoustic rhinometry indirectly calculates cross-sectional areas of the nose at various locations from the nostrils and the total volume of the nasal cavity. These parameters are calculated from an area-distance curve displayed by the device. METHODS: Seventy-seven adults between the ages of 20 and 40 years who had no nasal complaints were examined by acoustic rhinometry and fiberoptic nasal endoscopy in an attempt to compare and correlate areas of nasal narrowing detected by these two methods. RESULTS: The comparison between the distances to the various narrowed areas revealed a statistically significant correlation between the first three constrictions detected by acoustic rhinometry and the first three areas of anatomic narrowing measured by fiberoptic nasal endoscopy in both nares but no correlation between the fourth constriction and the fourth measurement on either side. CONCLUSION: The results confirm an anatomic correlation between the two examination methods, identifying the first constriction as the nasal valve, the second constriction as the head of the inferior nasal turbinate, and the third constriction as the head of the middle turbinate. The fourth constriction did not correspond to the choanal region.

Adult↗