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Francisco Zuma e Maia

Francisco Zuma e Maia
Clinica Maia · Otoneurology

MD, PhD

About

42
Publications
14,065
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173
Citations
Citations since 2016
34 Research Items
157 Citations
201620172018201920202021202201020304050
201620172018201920202021202201020304050
201620172018201920202021202201020304050
201620172018201920202021202201020304050
Introduction
Skills and Expertise

Publications

Publications (42)
Article
Benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal is a well-recognized condition, even though there are controversies about the repositioning maneuvers and their efficacy. In recent decades, several maneuvers have been proposed for treating both apogeotropic and geotropic variants of lateral canal BPPV. Our purpose is to...
Article
Introduction The geotropic variant of lateral canal BPPV occurs due to free floating otoconia in the non ampullary arm of this canal. Several repositioning maneuvers were effective to treat patients with this variant. We have previously proposed that the Zuma maneuver, first described for apogeotropic lateral canal BPPV, could also be effective for...
Article
Full-text available
In clinical practice, the head impulse test paradigm (HIMP) and the suppression head impulse paradigm (SHIMP) stimulate high-frequency head movements so that the visual system is temporarily suppressed. The two tests could also be useful tools for vestibular assessment at low frequencies: VVOR (visually enhanced vestibulo-ocular reflex) and VORS (v...
Article
Background and objectives: Horizontal canal BPPV is the second most common variant of BPPV after posterior canal BPPV.Various liberatory maneuvers are recommended for the treatment of horizontal canal BPPV canalithiasis (hc-BPPV-ca). The aim of this study was to show how 3D dynamic simulation models visualize the movement of the clot of otoconia w...
Article
Full-text available
A 34-year old men presented with 2-days history of quick episodes of vertigo caused by changes in the position of the head, mainly when turning over in the supine position. Video-Frenzel examination revealed a mild spontaneous downbeating nystagmus only with visual fixation removed that robustly increased in the bow test. The lean test and the Dix...
Article
Full-text available
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular vertigo. It is caused by free-floating otoconia moving freely in one of the semicircular canals (canalolithiasis) or by otoliths adhered to the cupula (cupulolithiasis). The posterior canal is the most common canal affected, followed by the lateral canal....
Article
Full-text available
Introduction Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder, resulting from detached otoliths that migrate to one of the semicircular canals – canalolithiasis – or one of the cupulas – cupulolithiasis. The present study is related to lateral canal BPPVs, which may be either geotropic or apogeotropic. The geotropi...
Article
Full-text available
The bedside examination associated with their clinical history remains the most critical means to accurately diagnose the cause for most of the signs and symptoms related to pathology of the cerebellum and vestibular system in patients presenting with dizziness and imbalance. This paper focuses on those critical bedside examinations, suggests when...
Article
Full-text available
Introduction: Neurotology is a rapidly expanding field of knowledge. The study of the vestibular system has advanced so much that even basic definitions, such as the meaning of vestibular symptoms, have only recently been standardized. Objective: To present a review of the main subjects of neurotology, including concepts, diagnosis and treatment...
Article
Full-text available
The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to free floating particles in the anterior arm of the lateral semicircular canal, particles attached to the cupula facing the canal or particles attached to the cupula facing the utricule. Zuma e Maia described a new treatment to b...
Article
Full-text available
Background: Several studies have shown that the incidence of benign paroxysmal positional vertigo (BPPV) presents seasonal variations and there is evidence that the variation in time is dependent on the patient’s amount of vitamin D. Objectives: This is a retrospective study to verify if there is a correlation between the incidence of BPPV and the...
Chapter
This chapter discusses the anatomy and physiology of the inner ear, with emphasis on the vestibular organs and functions, and the vestibular pathways in the central nervous system. An operational model of the vestibular system is included, exploring the mechanisms that are particularly relevant to its clinical evaluation. It must be taken into cons...
Chapter
Benign paroxysmal positional vertigo (BPPV) (otolith disease) is the most common cause of vertigo. Overall, its prevalence ranges from 10.7 to 64 per 100,000 individuals; it is more frequent in women and has a peak incidence in the 50–60-year age group. The labyrinthine mechanical disorder which causes BPPV is due to the presence of otoconial debri...
Chapter
Surgery is infrequently indicated for patients with vestibular diseases, being limited to those in whom all attempts of clinical treatment result in failure. This chapter reviews the diseases that may need surgical treatment, as well as the techniques available.
Chapter
This chapter reviews the clinical data related to vestibular migraine, benign paroxysmal vertigo of childhood, benign paroxysmal torticollis of childhood, and motion sickness.
Chapter
The video head impulse test (vHIT) is presently an essential part of the laboratory vestibular examination for patients with a suspected acute or chronic vestibular disorder. This chapter reviews its neurophysiology, interpretation, and clinical applications. A comparison with the caloric tests is included.
Chapter
This chapter discusses the classical audiological dimensions – thresholds, discrimination, recruitment, and adaptation – as well as air and bone conduction tests, immittance tests, otoacoustic emissions, and electrical response audiometry. The patterns for different types of hearing loss are also presented, taking into consideration the neurotologi...
Chapter
The inner ear has highly complex metabolic mechanisms. The maintenance of the endocochlear potential and of the chemical composition of endolymph is highly dependent on oxygen and glucose. This chapter discusses two mechanisms of reactive hypoglycemia that cause cochlear and vestibular symptoms. The inner ears are very sensitive organs and in many...
Chapter
In spite of having been described in 1861, and of generating an enormous number of clinical and research studies, Menière’s disease still constitutes a challenge to the neurotologist. This chapter discusses the clinical history, pathology, and etiology of the disease, as well as its symptoms, unilateral and bilateral incidence, and treatment.
Chapter
This chapter reviews the clinical data relative to bilateral loss of vestibular function, including symptomatology, differential diagnosis, and diagnostic criteria.
Chapter
This chapter describes the tests of vestibular function that are conducted in a laboratory dedicated to the evaluation of the vestibular system. These tests are useful to confirm the preliminary diagnosis derived from the clinical history, the physical examination, and the bedside tests, to identify oculomotor abnormalities by means of a sensitive...
Chapter
The subject of this chapter are the key strategies to the diagnosis of vestibular and ocular motor disorders that include the understanding of the six eye movements, an essential knowledge of the anatomy and physiology of the vestibular and oculomotor systems, a detailed patient’s history, and a systematic clinical bedside examination. Each of thes...
Chapter
This chapter details the most important peripheral and central vestibular disorders, as well as their clinical characteristics, following the Bárány Society classification and the TiTrATE protocol.
Chapter
This chapter describes the disorders of vestibular function in relation to their anatomical origin, describing structural defects, the perilymphatic and endolymphatic spaces, the receptor cells, the cupulae and semicircular ducts, the maculae and otolithic membranes, the vestibular nerves, and the central vestibular system.
Chapter
Clinical history is important in all areas of medicine, but it is particularly important in neurotology, since it suggests the diagnosis that will be afterward confirmed by the specific examinations. This chapter reviews the need to identify the patient’s symptoms and suggests the pathways to obtain the most important information regarding the pati...
Book
Neurotology is a branch of medicine that focuses on diagnosing and treating neurological conditions of the inner ear and related structures. There have been many recent advances in neurotology that have been published in general medicine, otolaryngology and neurology journals. This comprehensive book will aggregate this information to provide a mor...
Article
Full-text available
Introduction and objective: In recent years, significant progress has been made in the diagnosis of vestibular pathologies, especially in the use of alterations in eye movements for diagnosis. An orderly way of evaluating ocular motor function in patients with vestibular system involvement is presented in this review. Method: Narrative review. Resu...
Article
Full-text available
Tilt suppression refers to both tilting the head away from an Earth vertical axis and a reduction of an induced horizontal nystagmus. This phenomenon of reducing an induced horizontal nystagmus involves a circuitry of neurons within the vestibular nuclei and the cerebellum (collectively referred to as velocity storage) and signals from the otolith...
Article
Full-text available
The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to canalithiasis of the anterior arm or cupulolithiasis. Despite some therapeutic maneuvers, I propose a new treatment strategy for apogeotropic HCBPPV that is designed to detach both the otoconial debris from the anterior arm of t...
Article
Full-text available
The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular...
Article
Full-text available
Evaluation of the Labyrinthine Operation Function in Ears with Acquired Cholesteatoma - Volume 130 Issue S3 - Leticia Rosito, Bruna Seimetz, Cristiane Affeld, Adriane Teixeira, Francisco Zuma e Maia, Sady Selaimen da Costa
Article
Differentiating central from peripheral origins of vestibulo-ocular reflex (VOR) lesions can be challenging. A 36-year old man presented with a 1-year history of progressive unsteadiness. The video-Head Impulse Test revealed a significantly reduced VOR gain in both horizontal and posterior canals (0.49 ± 0.05 and 0.38 ± 0.06) but normal VOR respons...
Article
Full-text available
There were no changes in the function of the six semicircular canals in active fighter pilots, through the use of the video head impulse test (vHIT). These results suggest that the vestibuloocular reflex (VOR) works well at the high frequencies related to the natural head movements in this population. The vestibular function in pilots has been repo...
Article
Full-text available
Conclusion: Additional research is needed to validate the importance of the video head impulse tests (vHIT), but it provides an important contribution to the evaluation of anterior and posterior semicircular canal disorders. Objectives: To share observations of the vHIT test in clinical neurotology and to discuss the significance of the study fi...
Article
Full-text available
Utriculostomy is a new surgical alternative for Ménière's disease. The basis of this procedure is that the outcome of an electrocautery-induced utricular trauma does not affect cochlear function. However, a demonstration of the hypothesis that this approach to the utricle would preserve hearing is still pending. To determine whether any changes wou...
Article
Full-text available
INTRODUÇÃO: As cirurgias dos shunts endolinfáticos empregadas para o tratamento da vertigem na doença de Ménière incapacitante permanece um tópico controverso. Portmann, em 1926, foi o primeiro a executar a cirurgia, incisando o saco endolinfático com o objetivo de diminuir a pressão endolinfática da orelha interna. Planejadas para criar uma fístul...
Article
Full-text available
As emissões otoacústicas transientes evocadas e as emissões otoacústicas por produtos de distorção vêm assumindo importância significativa na identificação de alterações cocleares. OBJETIVO: Através da monitorização das emissões otoacústicas, registrar os limiares dos produtos de distorção em condições normais e na presença de modificações eletrofi...
Article
Full-text available
Transient evoked otoacoustic emissions and distortion product otoacoustic emissions have gained significant importance in the identification of cochlear alterations. To record distortion product thresholds through the monitoring of otoacoustic emissions in normal conditions and in the presence of electrophysiologic changes in cochlear outer hair ce...
Article
The existence of a relationship between abnormal insulin levels and the occurrence of labyrinth disorders has been demonstrated in several works. Among many metabolic alterations, such studies indicate that hyperinsulinemia is one of the most frequent causes of cochlear and vestibular syndromes. In this study, we monitored distortion product evoked...

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Projects (3)
Project
Benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal is a well-recognized condition, even though there are controversies about the repositioning maneuvers and their efficacy. In recent decades, several maneuvers have been proposed for treating both apogeotropic and geotropic variants of lateral canal BPPV. Our purpose is to discuss an approach to this pathology with the Zuma maneuver.