J F Lubianca Neto

Publications (16)65.1 Total impact

• Article: Evaluation of inlay butterfly cartilage tympanoplasty: a randomized clinical trial.

  M Mauri, J F Lubianca Neto, S C Fuchs
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  ABSTRACT: In 1998 Eavey described a new inlay technique for tympanoplasty in the pediatric age group using a cartilage graft through a transcanal approach. This technique was found to be effective and comfortable (no external canal incisions or ear packing). This study evaluated the efficacy of modified-inlay cartilage tympanoplasty compared with the conventional underlay tympanoplasty. Randomized clinical trial. Patients were enrolled from December 1998 to March 2000. Seventy tympanoplasties were done in adults with medium-sized tympanic membrane (TM) perforations: 34 inlay tympanoplasties and 36 underlay tympanoplasties (control group). The main outcome measures were the "take rate" on the 30th postoperative day and the audiometric result at the second postoperative month. Secondary outcome measures include subjective postoperative hearing, postoperative pain, duration of surgery, and cost of the procedures. The "take rate" did not differ between groups on the 30th postoperative day (88.2% in the inlay tympanoplasty group vs 86.1% in the underlay tympanoplasty group; P =.8). After a mean follow-up of 7.5 +/- 3.8 months (range, 3-16 mo), the "take rate" was 85.3% in the inlay tympanoplasty group and 83.3% in the underlay tympanoplasty group (P =.8). In the inlay tympanoplasty group there was closure of the air-bone gap (ABG) to within 10 dB in 64.7% and to within 20 dB in 94.1%. The corresponding numbers to underlay tympanoplasty were 75% and 97.2%. In only 2 cases (5.9%) in the inlay tympanoplasty group and in 1 case (2.8%) in the underlay tympanoplasty group the ABG was greater than 20 dB. No audiometric difference was observed between groups (P =.6). Most patients in the inlay tympanoplasty group reported immediate improvement in their hearing (P <.0001). Pain was reported by 10 patients in the inlay tympanoplasty group and by 30 patients in the underlay tympanoplasty group on the first postoperative day (P <.0001). The duration of the surgery (mean +/- standard deviation) was 33.6 +/- 7.8 minutes for the inlay tympanoplasty group and 62.9 +/- 12.7 minutes for the underlay tympanoplasty group (P <.0001). The estimated charge for inlay tympanoplasty at our institution was 65% less expensive than underlay tympanoplasty. The "take rate" and audiometric results following inlay cartilage tympanoplasty or underlay tympanoplasty were similar. Inlay butterfly cartilage tympanoplasty did not require general anesthesia, was less expensive, and more comfortable to the patient.
  The Laryngoscope 08/2001; 111(8):1479-85. · 1.75 Impact Factor
• Article: Inlay butterfly cartilage tympanoplasty (Eavey technique) modified for adults.

  J F Lubianca-Neto
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  ABSTRACT: Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafts. In 1998, Eavey described an inlay tympanoplasty technique in children using a cartilage graft which resembled butterfly wings. This technique was effective for closure of tympanic membrane perforations, while being more rapid for the surgeon and more comfortable for the patient. The aim of this study was to describe our results with modification of this technique in adults under local anesthesia. Cartilage butterfly inlay tympanoplasty was carried out in 20 adult patients to close small-to-medium tympanic membrane perforations over a period of 11 months. Compared with the original description, 3 modifications are noted: (1) adult patients, (2) local anesthesia, and (3) no skin graft over the cartilage. We evaluated the success rate and postoperative hearing results. Two patients were not evaluated in terms of hearing gain because they had profound preoperative hearing loss. Fourteen patients had a postoperative 4 pure-tone average between 0 and 9 dB, 3 patients between 10 and 20 dB, and 1 patient greater than 20 dB. The graft "take rate" was 90% (18/20) at the end of the follow-up period (mean follow-up 7.25 months). Seventeen of 18 successful cases had cartilage grafts that were intact and dry at the last visit. The tympanoplasty technique described by Eavey is effective to close tympanic membrane perforation in adults as well as children. The technique modifications introduced here (abandonment of the skin graft and local anesthesia) reduced surgery time and postoperative morbidity. Postoperative results compared with those of the original technique were good.
  Otolaryngology Head and Neck Surgery 11/2000; 123(4):492-4. · 1.72 Impact Factor
• Article: Canal wall window tympanomastoidectomy.

  R D Eavey, J F Lubianca Neto
  The Laryngoscope 09/2000; 110(8):1410-4. · 1.75 Impact Factor
• Article: Evaluation of time of nasal packing after nasal surgery: a randomized trial.

  J F Lubianca-Neto, G D Sant'anna, M Mauri, J L Arrarte, C A Brinckmann
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  ABSTRACT: A randomized, prospective trial was carried out to compare the rate of hemorrhagic complications after removal of nasal packing left for 24 and 48 hours. A total of 104 patients underwent nasal surgery and were randomly assigned to 1 of 2 groups: group 1, 24 hours of nasal packing; group 2, 48 hours of nasal packing. No statistical difference was observed between the groups in terms of occurrence of hemorrhagic complications. Hypertension was the only prognostic factor for postoperative bleeding. The routine use of 48-hour postoperative nasal packing after nasal surgery is not justified because of the low incidence of bleeding and the potential associated morbidity. At the end of the procedure, surgeons should evaluate the risk of postoperative bleeding (ie, presence of hypertension) and decide whether 24-hour nasal packing is enough.
  Otolaryngology Head and Neck Surgery 07/2000; 122(6):899-901. · 1.72 Impact Factor
• Article: Air gun dart injury in paranasal sinuses left alone.

  J F Lubianca Neto, M Mauri, J R Machado, A Ceccon, C Paim da Cunha
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  ABSTRACT: Patients with paranasal sinus foreign body are not commonly seen in otolaryngological practice and papers dealing with this issue are rare in the English literature. One case of penetrating sinus injury due to air gun dart is presented to illustrate the potentially serious consequences of air gun injuries. The clinical presentation, diagnostic pitfalls and the treatment aspects are discussed.
  International Journal of Pediatric Otorhinolaryngology 05/2000; 52(2):173-6. · 1.17 Impact Factor
• Article: Passive smoking and nonrecurrent acute otitis media in children.

  J F Lubianca Neto, A G Burns, L Lu, R Mombach, M Saffer
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  ABSTRACT: It remains uncertain whether passive smoking is a risk factor (RF) for nonrecurrent acute otitis media (AOM). The aim of this study was to evaluate whether exposure to second-hand smoke at home increased the prevalence of an isolated single episode of nonrecurrent AOM in children. Methods And Material: We performed a cross-sectional study with 192 children younger than 3 years who were seen at a general pediatric clinic. A questionnaire was used to quantify the exposure to cigarette smoke at home and to assess other RFs for AOM. The diagnosis of AOM was made by pediatricians using otoscopy. The results of the associations were reported by prevalence ratios with 95% confidence intervals. Multiple logistic regression was used to investigate the role of confounding variables among other potential RFs and passive smoking. The prevalence ratio of an isolated single episode of nonrecurrent AOM between patients exposed and those not exposed to passive smoking was 0.82 (0.67 to 1.02). In logistic regression, any RF changed the main association significantly. Exposure to passive smoking did not change the prevalence of an isolated single episode of nonrecurrent AOM in children.
  Otolaryngology Head and Neck Surgery 01/2000; 121(6):805-8. · 1.72 Impact Factor
• Article: Is epistaxis evidence of end-organ damage in patients with hypertension?

  J F Lubianca Neto, F D Fuchs, S R Facco, M Gus, L Fasolo, R Mafessoni, A L Gleissner
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  ABSTRACT: To study the association between history of mild to severe epistaxis with different stages of hypertension and with other evidence of target organ damage in a sample of patients attending an outpatient hypertension clinic, controlling for potential confounding factors. A survey of adult patients with hypertension. A consecutive sample of 323 adults with hypertension was studied. The main outcome measures were history of adult epistaxis, high blood pressure, duration of hypertension, nasal abnormalities, and fundoscopic and electrocardiogram abnormalities. Ninety-four patients (29.1% of the whole sample) reported at least one episode of nosebleed after 18 years of age. Of these, 59 (62.8%) needed medical assistance to control at least one of the episodes. The history of epistaxis was not associated with blood pressure classified according to the World Health Organization/International Society of Hypertension paradigm or classified as severe or not severe. There was a trend of an association between history of epistaxis and duration of hypertension. The history of severe epistaxis (epistaxis that needed medical assistance) was not associated with blood pressure classified as severe or not severe and with duration of hypertension. More patients with left ventricular hypertrophy had a positive history of adult epistaxis. There was no association between history of epistaxis or history of severe epistaxis and fundoscopic abnormalities. Among the abnormalities detected at rhinoscopy, only the presence of enlarged septal vessels was associated with history of epistaxis. The presence of enlarged septal vessels was strongly and independently associated with history of epistaxis in the logistic regression model. Duration of hypertension and left ventricular hypertrophy showed a trend for an association with the history of epistaxis in the adult life. A definite association between blood pressure and history of adult epistaxis in hypertensive patients was not found. The evidence for an association of duration of hypertension and left ventricular hypertrophy with epistaxis suggests that epistaxis might be a consequence of long-lasting hypertension. The association between the presence of enlarged vessels at rhinoscopy with history of epistaxis in hypertensive patients is a novel observation that needs to be addressed in future observations.
  The Laryngoscope 08/1999; 109(7 Pt 1):1111-5. · 1.75 Impact Factor
• Source

  Available from: Nahid G Robertson

  Article: Mutations in a novel cochlear gene cause DFNA9, a human nonsyndromic deafness with vestibular dysfunction.

  N G Robertson, L Lu, S Heller, S N Merchant, R D Eavey, M McKenna, J B Nadol, R T Miyamoto, F H Linthicum, J F Lubianca Neto, A J Hudspeth, C E Seidman, C C Morton, J G Seidman
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  ABSTRACT: DFNA9 is an autosomal dominant, nonsyndromic, progressive sensorineural hearing loss with vestibular pathology. Here we report three missense mutations in human COCH (previously described as Coch5b2), a novel cochlear gene, in three unrelated kindreds with DFNA9. All three residues mutated in DFNA9 are conserved in mouse and chicken Coch, and are found in a region containing four conserved cysteines with homology to a domain in factor C, a lipopolysaccharide-binding coagulation factor in Limulus polyphemus. COCH message, found at high levels in human cochlear and vestibular organs, occurs in the chicken inner ear in the regions of the auditory and vestibular nerve fibres, the neural and abneural limbs adjacent to the cochlear sensory epithelium and the stroma of the crista ampullaris of the vestibular labyrinth. These areas correspond to human inner ear structures which show histopathological findings of acidophilic ground substance in DFNA9 patients.
  Nature Genetics 12/1998; 20(3):299-303. · 35.53 Impact Factor
• Source

  Available from: nih.gov

  Article: The Bjornstad syndrome (sensorineural hearing loss and pili torti) disease gene maps to chromosome 2q34-36.

  J F Lubianca Neto, L Lu, R D Eavey, M A Flores, R M Caldera, S Sangwatanaroj, J J Schott, B McDonough, J I Santos, C E Seidman, J G Seidman
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  ABSTRACT: We report that the Bjornstad syndrome gene maps to chromosome 2q34-36. The clinical association of sensorineural hearing loss with pili torti (broken, twisted hairs) was described >30 years ago by Bjornstad; subsequently, several small families have been studied. We evaluated a large kindred with Bjornstad syndrome in which eight members inherited pili torti and prelingual sensorineural hearing loss as autosomal recessive traits. A genomewide search using polymorphic loci demonstrated linkage between the disease gene segregating in this kindred and D2S434 (maximum two-point LOD score = 4.98 at theta = 0). Haplotype analysis of recombination events located the disease gene in a 3-cM region between loci D2S1371 and D2S163. We speculate that intermediate filament and intermediate filament-associated proteins are good candidate genes for causing Bjornstad syndrome.
  The American Journal of Human Genetics 05/1998; 62(5):1107-12. · 10.60 Impact Factor
• Article: Lateral sinus thrombosis and cervical abscess complicating cholesteatoma in children: case report and review.

  J F Lubianca Neto, M Saffer, F T Rotta, J L Arrarte, C A Brinckmann, P Ferreira
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  ABSTRACT: To call attention to complications of chronic otitis media, the case of a patient who simultaneously developed lateral sinus thrombosis and Bezold's abscess is reported. A 7 year old boy presented with fever, drowsiness, cervical mass and otorrhea not responding to medical management. Work-up revealed lateral sinus thrombosis and cervical abscess secondary to right ear cholesteatoma. After treatment with surgery and antibiotics, he had a favorable outcome. We review the literature regarding the diagnosis and management of these complications and concluded that although less frequent they remain a clinical challenge.
  International Journal of Pediatric Otorhinolaryngology 02/1998; 42(3):263-9. · 1.17 Impact Factor
• Article: Chronic secretory otitis media: negative bacteriology.

  M Saffer, J F Lubianca Neto, O B Piltcher, V F Petrillo
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  ABSTRACT: There is disagreement on the role of bacteria in the genesis and maintenance of chronic secretory otitis media (CSOM). Extensive studies from other countries report up to 40% of middle ear cultures with bacterial growth. For the present study, material was collected from 94 ears of children with both clinical and tympanometric diagnoses of CSOM. The samples were sent for bacteriological analysis, in there it was stained according to Gram's method and put into growing media: MacConkey (for gram-negative bacteria) and blood agar (for gram-positive bacteria) for 24 h, at 37 degrees C. If germs were identified by Gram's method, antibiograms would be carried out as well, with the Mueller Hington medium. No cultures were made for anaerobes. Only one ear had grown bacteria (Staphylococcus epidermidis), which was deemed contamination. No other ear studied bore bacteria. The possible causes for this disagreement between our study and the literature are discussed.
  Acta Oto-Laryngologica 12/1996; 116(6):836-9. · 1.08 Impact Factor
• Article: [Hypertensive urgencies and emergencies].

  F D Fuchs, J F Lubianca Neto, J M Neves
  Arquivos Brasileiros de Cardiologia 04/1991; 56(3):243-6. · 0.88 Impact Factor
• Article: [Evaluation of the diagnostic power of symptoms and signs in acute otitis media].

  M Saffer, J F Lubianca Neto
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  ABSTRACT: The diagnosis of acute otitis media (AOM) is made on clinical basis. The gold-standard tests are invasive. There are few studies quantifying the diagnostic power of the signs and symptoms. A sample of 300 children were analyzed to establish the diagnostic power of isolated and combinated signs and symptoms in AOM. The most important diagnostic signs were bulging, fluid level, acute perforation, and change in color of the tympanic membrane. Fever was the single symptom with statistical significance. We concluded that we can do an accurate and noninvasive AOM diagnosis using otomicroscopic findings.
  Jornal de Pediatria 72(2):93-7. · 1.01 Impact Factor
• Article: [Lateral sinus thrombophlebitis and cervical abscess as a complication of chronic otitis media].

  M Saffer, J F Lubianca Neto, J L Arrarte, C A Brinckmann, P Ferreira
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  ABSTRACT: To focus on two rare complications of cholesteatomatous chronic otitis media. A case of two simultaneous complications of cholesteatoma (lateral sinus thrombophlebitis and Bezold's cervical abscess) in a 7 year-old boy is reported. Thereafter, a review of the international literature about both complications is carried out. A 7 year-old white male patient was referred for assessment with high fever, obnubilation, cervical mass and otorrhea, being non-responsive to the clinic treatment, with the diagnostic hypothesis of infectious parotitis. The clinical examination and radiologic study demonstrated lateral sinus thrombophlebitis and cervical abscess due to cholesteatoma in the right ear. After being submitted to surgery and prolonged intravenous antibiotic therapy, the patient presented a favorable outcome, with little morbidity. Despite the incidence of complications of otitis had decreased in the last decades, they are still a challenge for the clinician, especially because of the insidious manner of presentation, usually hidden with the indiscriminate use of antibiotics.
  Jornal de Pediatria 73(4):269-72. · 1.01 Impact Factor
• Article: A study of the association between epistaxis and the severity of hypertension.

  J F Lubianca-Neto, M Bredemeier, E F Carvalhal, C A Arruda, E Estrella, A Pletsch, M Gus, L Lu, F D Fuchs
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  ABSTRACT: Hypertension (HTN) has frequently been cited as a general risk factor for epistaxis. However, studies dealing with this association have yielded equivocal results. In this study, a sample of 121 hypertensives (blood pressure > or = 140/90 mmHg) was selected to evaluate the association between the severity of HTN and a previous history of epistaxis. Patients with an average blood pressure > or = 160/100 mmHg were classified as suffering from a more severe form of HTN and were compared with those with a less severe form of the disease (160/100 mm Hg < or = blood pressure > or = 140/90 mm Hg). The frequency of epistaxis did not differ among patients categorized by the severity of HTN. Users of aspirin were found to be twice as likely to have a history of epistaxis. In addition, there was a statistical tendency for an association between a history of epistaxis and the duration of hypertension. We conclude that the severity of HTN and a history of epistaxis were not associated in a cohort of hypertensive patients. The identification of other risk factors for epistaxis, including the duration of HTN, deserves further study.
  American Journal of Rhinology 12(4):269-72. · 1.36 Impact Factor
• Article: Internal jugular phlebectasia in children.

  J F Lubianca-Neto, M Mauri, C Prati
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  ABSTRACT: Phlebectasia is an abnormal dilatation of an isolated vein, may affect any vein, and is usually asymptomatic. When the internal jugular vein is involved, it presents as a cervical swelling that can mimic the signs of either pharyngocele or a laryngocele and, because of its rarity, is frequently misdiagnosed. We describe 2 cases of phlebectasia of internal jugular vein in children with voice change in one of them. No treatment is necessary for this benign, self-limiting condition. Clinical features, diagnosis, treatment options, and a review of the literature about this rare venous lesion are presented.
  American Journal of Otolaryngology 20(6):415-8. · 0.87 Impact Factor