Letícia Petersen Schmidt Rosito

Hospital de Clínicas de Porto Alegre

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Sady Selaimen da Costa

Universidade Federal do Rio Grande do Sul

Adriane Ribeiro Teixeira

Universidade Federal do Rio Grande do Sul

Celso Dall’Igna

Universidade Federal do Rio Grande do Sul

Fábio André Selaimen

Hospital de Clínicas de Porto Alegre

Cristina Dornelles

Hospital de Clínicas de Porto Alegre

Luiza Alexi Freitas

Hospital de Clínicas de Porto Alegre

Alexandre Hundertmarck Lessa

Universidade Federal do Rio Grande do Sul

Konrado Massing Deutsch

University of Toronto

Celso Dall Igna

Sabrina Lima Alves

Faculdade Ruy Barbosa

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Universidade Federal do Rio Grande do Sul

105

Hospital de Clínicas de Porto Alegre

Universidade de São Paulo

Universidade Federal de São Paulo

Universidade Federal do Rio Grande

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

University of Rio Grande and Rio Grande Community College

Pontifícia Universidade Católica do Rio Grande do Sul

Hospital Mãe de Deus

Hospital de Clínicas

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The Role of Tympanic Membrane Retractions in Cholesteatoma Pathogenesis

BioMed Research International (2018)

Letícia Petersen Schmidt Rosito Neil M. Sperling Adriane Ribeiro Teixeira Fábio André Selaimen Sady Selaimen da Costa

Objective . To analyze the contralateral ear (CLE) of patients with cholesteatoma and to correlate the cholesteatoma growth pattern in the affected ear with the findings in the CLE. Methods . Videotoscopy of both ears in 432 patients with cholesteatomas classified as posterior epitympanic (PEC), posterior mesotympanic (PMC), two routes, or undetermined. Tympanic membrane (TM) retractions were classified by location and severity and TM perforations according to signs of previous TM retraction. Results . TM retraction was the most prevalent alteration in the CLE (42.6%). Cholesteatoma was observed in 17.4%. In patients with PEC, the retraction in the CLE was more frequent in the PF (66.7%) than in the PT (1.4%), and in those with two-route cholesteatoma, the retraction in the CLE most frequently involved both the PT and PF (65.6%;p<0.0001). Conclusion . Our results confirm the essential role of TM retraction at least in the earlier phases of cholesteatoma pathogenesis.

Pathogenesis

10.1155/2018/9817123

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Cholesteatoma labyrinthine fistula: prevalence and impact

Figshare (2019)

Letícia Petersen Schmidt Rosito Inesângela Canali Adriane Ribeiro Teixeira Maurício Noschang Lopes da Silva Fábio André Selaimen

Abstract Introduction: Labyrinthine fistula is one of the most common complications associated with cholesteatoma. It represents an erosive loss of the endochondral bone overlying the labyrinth. Reasons for cholesteatoma-induced labyrinthine fistula are still poorly understood. Objective: Evaluate patients with cholesteatoma, in order to identify possible risk factors or clinical findings associated with labyrinthine fistula. Secondary objectives were to determine the prevalence of labyrinthine fistula in the study cohort, to analyze the role of computed tomography and to describe the hearing results after surgery. Methods: This retrospective cohort study included patients with an acquired middle ear cholesteatoma in at least one ear with no prior surgery, who underwent audiometry and tomographic examination of the ears or surgery at our institution. Hearing results after surgery were analyzed according to the labyrinthine fistula classification and the employed technique. Results: We analyzed a total of 333 patients, of which 9 (2.7%) had labyrinthine fistula in the lateral semicircular canal. In 8 patients, the fistula was first identified on image studies and confirmed at surgery. In patients with posterior epitympanic and two-route cholesteatomas, the prevalence was 5.0%; and in cases with remaining cholesteatoma growth patterns, the prevalence was 0.6% (p = 0.16). In addition, the prevalence ratio for labyrinthine fistula between patients with and without vertigo was 2.1. Of patients without sensorineural hearing loss before surgery, 80.0% remained with the same bone conduction thresholds, whereas 20.0% progressed to profound hearing loss. Of patients with sensorineural hearing loss before surgery, 33.33% remained with the same hearing impairment, whereas 33.33% showed improvement of the bone conduction thresholds' Pure Tone Average. Conclusion: Labyrinthine fistula must be ruled out prior to ear surgery, particularly in cases of posterior epitympanic or two-route cholesteatoma. Computed tomography is a good diagnostic modality for lateral semicircular canal fistula. Sensorineural hearing loss can occur post-surgically, even in previously unaffected patients despite the technique employed.

Labyrinth Diseases

10.6084/m9.figshare.8092667

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Incômodo provocado pelo zumbido em pacientes atendidos em hospital universitário : avaliação por meio do Tinnitus Handicap Inventory

Ícaro da Silva Walbrohel Adriane Ribeiro Teixeira Letícia Petersen Schmidt Rosito Alexandre Hundertmarck Lessa Lílian Benin

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Investigação de mutações associadas à perda auditiva não sindrômica nos genes GJB2 e GJB6

Caroline Rodrigues da Silveira Jéssica Tonin Ferrari Liliane Todeschini de Souza Marina Faistauer Letícia Petersen Schmidt Rosito

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Relação entre a causa e o pitch do zumbido

Fernando A. N. Santos Letícia Petersen Schmidt Rosito Adriane Ribeiro Teixeira Sabrina Nuñes Gonçalves Alexandre Hundertmarck Lessa

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Characteristics of 419 patients with acquired middle ear cholesteatoma

Brazilian Journal of Otorhinolaryngology (2016)

Letícia Petersen Schmidt Rosito Maurício Noschang Lopes da Silva Fábio André Selaimen Yuri Petermann Jung Marcos Guilherme Tibes Pauletti

Cholesteatoma is a destructive lesion that can result in life-threatening complications. Typically, it presents with hypoacusis and continuous otorrhea as symptoms. Because it is a rare disease, there are few studies in Brazil describing the characteristics of patients with the disease.This study aimed to determine the prevalence of cholesteatoma in patients with chronic otitis media and describe clinical, audiological and surgical characteristics of patients with acquired middle ear cholesteatoma treated at a referral hospital in the public health system.Cross-sectional and prospective cohort study, including 1710 patients with chronic otitis media, treated between August 2000 and June 2015, without prior surgery. Detailed clinical history, videotoscopy, and audiometry were performed, in addition to review of medical records to search for surgical data. Cholesteatomas were classified according to their route of formation.Of the patients with chronic otitis media, 419 (24.5%) had cholesteatoma; mean age of 34.49 years; 53.5% female and 63.8% adults. Bilateral cholesteatoma was observed in 17.1%. Anterior epitympanic cholesteatoma corresponded to 1.9%; posterior epitympanic, 32.9%; posterior mesotympanic, 33.7%; two routes, 14.8%; and indeterminate, 16.7%. The mean air-bone gap was 29.84dB and did not differ between routes of formation. There were no correlations between gap size and patient age or duration of symptoms. Of the surgical cases, 16.8% underwent closed tympanomastoidectomy and 75.2% open tympanomastoidectomy.The prevalence of cholesteatoma in patients with chronic otitis media was 24.5% and it was more common in adults than in children. Posterior mesotympanic cholesteatoma was more frequent, with no difference in mean air-bone gap between the different routes of formation. In patients undergoing surgery, open tympanomastoidectomy was the procedure most frequently chosen.

10.1016/j.bjorl.2016.02.013

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Zumbido crônico : análise do tempo de percepção do sintoma e grau de incômodo em adultos e idosos

Glória Maria Irineu Ferreira Letícia Petersen Schmidt Rosito Adriane Ribeiro Teixeira Sabrina Nuñes Gonçalves Alexandre Hundertmarck Lessa

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LIMIARES AUDITIVOS EM FREQUÊNCIAS CONVENCIONAIS E ALTAS FREQUÊNCIAS EM PACIENTES COM E SEM ZUMBIDO

Editora Conhecimento Livre eBooks (2021)

Helena Jacques Letícia Petersen Schmidt Rosito Nathany Lima Ruschel Mariane Farias Pinto Amanda Somensi Bonatto

10.37423/210804669

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Assessment of Eustachian tube function in patients with tympanic membrane retraction and in normal subjects

Brazilian Journal of Otorhinolaryngology (2016)

Inesângela Canali Letícia Petersen Schmidt Rosito Bruno Siliprandi Cláudia Giugno Sady Selaimen da Costa

The diagnosis of Eustachian tube dysfunctions is essential for better understanding of the pathogenesis of chronic otitis media. A series of tests to assess tube function are described in the literature; however, they are methodologically heterogeneous, with differences ranging from application protocols to standardization of tests and their results. To evaluate the variation in middle ear pressure in patients with tympanic membrane retraction and in normal patients during tube function tests, as well as to evaluate intra-individual variation between these tests. An observational, contemporary, cross-sectional study was conducted, in which the factor under study was the variation in middle ear pressure during tube function tests (Valsalva maneuver, sniff test, Toynbee maneuver) in healthy patients and in patients with mild and moderate/severe tympanic retraction. A total of 38 patients (76 ears) were included in the study. Patients underwent tube function tests at two different time points to determine pressure measurements after each maneuver. Statistical analysis was performed using SPSS software, version 18.0, considering p-values <0.05 as statistically significant. Mean (standard deviation) age was 11 (2.72) years; 55.3% of patients were male and 44.7% female. The prevalence of type A tympanogram was higher among participants with healthy ears and those with mild retraction, whereas type C tympanograms were more frequent in the moderate/severe retraction group. An increase in middle ear pressure was observed during the Valsalva maneuver at the first time point evaluated in all three groups of ears (p = 0.012). The variation in pressure was not significant either for the sniff test or for the Toynbee maneuver at the two time points evaluated (p ≥ 0.05). Agreement between measurements obtained at the two different time points was weak to moderate for all tests in all three groups of ears, and the variations in discrepancy between measurements were higher in ears with moderate/severe tympanic retraction. In this study population, the mean pressure in the middle ear showed significant variation only during the Valsalva maneuver at the first time point evaluated in the three groups of ears. Normal ears and those with mild retraction behaved similarly in all tests. The tested maneuvers exhibited weak to moderate intra-individual variation, with the greatest variation occurring in ears with moderate/severe retraction. O diagnóstico das disfunções da tuba auditiva é essencial para o melhor entendimento da patogênese da otite média crônica. A literatura descreve uma série de testes que avaliam a função tubária; contudo, tais exames são metodologicamente heterogêneos, com diferenças que variam desde os protocolos de aplicação até a padronização dos exames e seus resultados. Avaliar a variação na pressão na orelha média em pacientes com retração da membrana timpânica e em indivíduos normais durante a realização dos testes de função tubária, e também avaliar a variação intraindividual desses testes. Estudo observacional do tipo transversal e contemporâneo, no qual o fator em estudo foi a variação na pressão na orelha média durante a realização dos testes de função tubária (manobra de Valsalva, Sniff Test e manobra de Toynbee) em indivíduos normais e em pacientes com retrações timpânicas leves e moderadas/graves. Foram incluídos 38 pacientes (76 orelhas). Os pacientes foram submetidos, em dois momentos diferentes, a testes de função tubária para determinar as medidas de pressão após cada manobra. A análise estatística foi realizada com o uso do programa SPSS, versão 18.0, e consideramos como estatisticamente significativos os valores de p < 0,05. A média ± desvio padrão da idade foi de 11 ± 2,72 anos; 55,3% dos pacientes eram do gênero masculino e 44,7% pertenciam ao gênero feminino. A prevalência de curvas timpanométricas do tipo A foi mais alta entre os participantes com orelhas normais e naqueles com retrações leves, enquanto as curvas timpanométricas do tipo C foram mais frequentes no grupo com retrações moderadas/graves. Observamos pressões aumentadas na orelha média durante a realização da manobra de Valsalva no primeiro momento da avaliação nos três grupos de orelhas (p = 0,012). A variação na pressão não foi significativa para o Sniff Test, nem para a manobra de Toynbee nos dois momentos de avaliação (p ≥ 0,05). Consideramos que a concordância entre as determinações obtidas nos dois momentos diferentes foi fraca a moderada para todos os testes nos três grupos de orelhas, e as variações em termos de discrepância entre as medidas foram maiores nas orelhas com retrações timpânicas moderadas/graves. Na população estudada, a média das pressões na orelha média apresentou variação significante apenas durante a manobra de Valsalva no primeiro momento de avaliação, nos três grupos de orelhas. As orelhas normais e aquelas apresentando retração leve se comportaram de maneira similar nos testes realizados. As manobras testadas exibiram uma variação intraindividual fraca a moderada, e a maior variação ocorreu nas orelhas com retrações moderadas/graves.

Valsalva maneuver

Eustachian tube

10.1016/j.bjorl.2016.01.010

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Diferenças na acufenometria e no incômodo causado pelo zumbido entre pacientes com presbiacusia e Doença de Ménière

Celso Dall Igna Letícia Petersen Schmidt Rosito Konrado Massing Deutsch Luiza Birck Klein Ricardo Brandão Kliemann

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