Leopoldo Pfeilsticker - Academia.edu (original) (raw)
Papers by Leopoldo Pfeilsticker
Acta Otorrinolaringologica Espanola, Nov 20, 2014
Head Neck Oncology, Jun 10, 2014
ABSTRACT Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the in... more ABSTRACT Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and prompt treatment to prevent loss of visual function in patients with carotid cavernous fistula.Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and prompt treatment to prevent loss of visual function in patients with carotid cavernous fistula.
Iranian journal of otorhinolaryngology, 2013
A keratocystic odontogenic tumor is a benign intra-bone mass originating from dental lamina or it... more A keratocystic odontogenic tumor is a benign intra-bone mass originating from dental lamina or its residue. It represents 2-11% of jaw cysts, and has a slow but aggressive growth. The evaluation of molecular characteristics, immunohistochemistry, and genetic expression currently have no established classification regarding the evolution and pathophysiologic pattern of these lesions. This is a clinical retrospective study with a full analysis of patient history regarding physical evaluation, radiologic images, pathology results, and surgical resection. We performed a major literature review concerning current concepts relating to its biological characterization. Three cases of keratocystic odontogenic tumor were identified. Two of the cases were large, with aggressive behavior and significant bone destruction and recurrence, which had been overlooked for more than a decade. The third case had an early diagnosis, and the treatment led to full recovery and complete healing. The keratoc...
O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportam... more O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportamento variado e potencialmente destrutivo e, na face, atinge principalmente a região de mandíbula. Discute-se o melhor método para seu tratamento, buscando-se obter baixo índice de recorrência, com a menor agressão possível. A ostectomia periférica complementar à ressecção das lesões pode diminuir o índice de recorrência e, ao mesmo tempo, minimizar a morbidade associada. A cirurgia videoassistida permite exploração acurada do campo operatório em área de difícil acesso e remoção completa de lesões. Preconizamos a utilização da ostectomia periférica em cirurgia videoassistida descrita em dois casos de GCG de maxila e mandíbula.
Revista Brasileira de Otorrinolaringologia, 2004
... A investigação genética na surdez hereditária não-sindrômica. Genetic investigation of non-sy... more ... A investigação genética na surdez hereditária não-sindrômica. Genetic investigation of non-syndromic hereditary deafness. Leopoldo N. Pfeilsticker I ; Guita Stole II ; Edi Lucia Sartorato III ; Denise Delfino IV ; Andréa Trevas Maciel Guerra V. ... 10. Bruzzone R, White TW, Paul DL. ...
Case Reports in Oncological Medicine, 2016
Revista Brasileira De Otorrinolaringologia, 2003
O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportam... more O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportamento variado e potencialmente destrutivo e, na face, atinge principalmente a região de mandíbula. Discute-se o melhor método para seu tratamento, buscando-se obter baixo índice de recorrência, com a menor agressão possível. A ostectomia periférica complementar à ressecção das lesões pode diminuir o índice de recorrência e, ao mesmo tempo, minimizar a morbidade associada. A cirurgia videoassistida permite exploração acurada do campo operatório em área de difícil acesso e remoção completa de lesões. Preconizamos a utilização da ostectomia periférica em cirurgia videoassistida descrita em dois casos de GCG de maxila e mandíbula.
Head & Neck Oncology
Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal ca... more Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and pro...
Revista Española de Cirugía Oral y Maxilofacial, 2014
Background: Temporomandibular-ankylosis brings extensive limitations on the patient quality of li... more Background: Temporomandibular-ankylosis brings extensive limitations on the patient quality of life. Surgical treatment is frequently necessary associated with a continuous rehabilitation. The anatomy of this region and potential complications of this surgery must be thoroughly known to avoid iatrogenic injuries.
Acta Otorrinolaringológica Española, 2014
Revista Brasileira de Otorrinolaringologia, 2003
Revista CEFAC, 2013
ABSTRACT PURPOSE: to assess the use of the digital caliper in the measurement of the facial mimic... more ABSTRACT PURPOSE: to assess the use of the digital caliper in the measurement of the facial mimic movements in different moments of the speech therapy. METHOD: prospective longitudinal study, with 20 subjects between 7 and 70 years-old, 13 females and 7 males, all diagnosed with Bell's Palsy, attended in the Facial Paralysis Ambulatory, of the otorhinolaryngology subject of a University Public Hospital. The use of a Digimess 100,174BL digital measuring caliper was adopted for this study. The measurements were carried out in the facial mimic movement, always starting from a fixed point to a mobile point in the structures: the tragus and the labial commissure, external corner of the eye and labial commissure and also internal corner of the eye and the nasal ala. All measurements were carried out both prior and after the treatment. The quantification of the incompetence of the movement was measured by simple percentage. The Wilcoxon signed rank test was applied to check for possible differences between both moments considered (with and without movements), as the study variables. RESULTS: the measurements had a statistically significant result (p<0.05) in all the proposed measured structures (tragus and labial commissure, external corner of the eye and labial commissure, and internal corner of the eye and nasal ala), showing that there are possibilities of measuring of movement and absence of movement using a digital caliper. CONCLUSION: the caliper has demonstrated to be a useful device which has permitted to objectively compare the evolution of the rehabilitation of facial mimic in Bell's Palsy in the sample studied here.
Neurosurgical FOCUS, 2004
Neurosurgery, 2005
OBJECTIVE: Jugular foramen tumors are rare cranial base lesions that present diagnostic and manag... more OBJECTIVE: Jugular foramen tumors are rare cranial base lesions that present diagnostic and management difficulties. With the availability of new diagnostic procedures these tumors have been more precisely studied and questions of whether, when, and how these lesions should be treated often arise. Data from 106 consecutive patients surgically treated in the past 17 years were retrospectively analyzed to identify surgical outcomes. METHODS: The tumors were approached by a multidisciplinary team composed of neurosurgeons, ear, nose, and throat surgeons, and neuroradiologists. Hypervascular lesions were embolized 3 to 5 days before surgery. The same surgical technique was used to resect all tumors. The surgical defect was covered with vascularized myofascial flaps. The internal carotid artery was infiltrated in two patients, and a saphenous graft bypass was carried out before removal of the lesions. The facial nerve was reconstructed with nerve grafts (great auricular nerve) or XII/VII anastomosis in five cases. Postoperative radiotherapy was carried out for malignant and invasive tumors. RESULTS: Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. Complete excision was possible in 89% of benign tumors and 80% of paragangliomas. Lower cranial nerve deficit was the most frequent complication (10 patients, 9.4%), transient in 4 patients. Facial and cochlear nerve paralysis occurred in 8 patients (7.5%). The function of the facial nerve recovered spontaneously in 3 patients. Four patients (3.7%) developed postoperative cerebrospinal fluid leakage. Four patients (3.7%) died after surgery. CONCLUSION: Radical removal of benign jugular foramen tumors is the treatment of choice and may be curative. Large lesions can be radically excised in one surgical procedure with preservation of lower cranial nerves. Cranial base reconstruction with vascularized myofascial flaps reduces the incidence of postoperative cerebrospinal fluid leakage. Damage of the lower cranial nerves is the most serious surgical complication.
Allergy & Rhinology, 2016
Nasal obstruction is an important condition that can lead to severe respiratory distress in newbo... more Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases. We report two cases of infants diagnosed with CNPAS. The patients in the first case had no concomitant comorbidities, and the outcome was successful after surgical correction of stenosis. The patient in the second case had an associated holoprosencephaly, and although surgical correction and nasal cavity patency, the patient remains dependent on tracheostomy due to dysphagia and neurologic impairment. Airway obstruction affects 1 in 5000 children, and CNPAS is a diagnosis frequently forgotten and even unknown to neonatal and pediatric intensivists. Newborns are obligate nasal breathers, and, nasal obstruction, therefore, can lead to severe respiratory distress. CNPAS is not only rare but, many times, is not easily recognized. It is important to bear in mind the diagnostic criteria when evaluating infants with nasal obstruction. Conservative treatment should be prioritized, but surgical treatment is required in severe cases with failure to thrive and persistent respiratory distress. Respiratory distress and dysphagia may persist to some degree despite correction of the stenotic pyriform aperture due to associated narrowing of the entire nasal cavity and association with other anomalies. Final Comments: CNPAS is a rare condition and may be lethal in newborns. Differential diagnosis of nasal obstruction must be remembered to recognize this anomaly, and the otolaryngologist must be familiarized with this condition and its diagnosis. Precise surgical treatment in severe cases have high rates of success in children without other comorbidities.
Acta Otorrinolaringologica Espanola, Nov 20, 2014
Head Neck Oncology, Jun 10, 2014
ABSTRACT Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the in... more ABSTRACT Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and prompt treatment to prevent loss of visual function in patients with carotid cavernous fistula.Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and prompt treatment to prevent loss of visual function in patients with carotid cavernous fistula.
Iranian journal of otorhinolaryngology, 2013
A keratocystic odontogenic tumor is a benign intra-bone mass originating from dental lamina or it... more A keratocystic odontogenic tumor is a benign intra-bone mass originating from dental lamina or its residue. It represents 2-11% of jaw cysts, and has a slow but aggressive growth. The evaluation of molecular characteristics, immunohistochemistry, and genetic expression currently have no established classification regarding the evolution and pathophysiologic pattern of these lesions. This is a clinical retrospective study with a full analysis of patient history regarding physical evaluation, radiologic images, pathology results, and surgical resection. We performed a major literature review concerning current concepts relating to its biological characterization. Three cases of keratocystic odontogenic tumor were identified. Two of the cases were large, with aggressive behavior and significant bone destruction and recurrence, which had been overlooked for more than a decade. The third case had an early diagnosis, and the treatment led to full recovery and complete healing. The keratoc...
O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportam... more O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportamento variado e potencialmente destrutivo e, na face, atinge principalmente a região de mandíbula. Discute-se o melhor método para seu tratamento, buscando-se obter baixo índice de recorrência, com a menor agressão possível. A ostectomia periférica complementar à ressecção das lesões pode diminuir o índice de recorrência e, ao mesmo tempo, minimizar a morbidade associada. A cirurgia videoassistida permite exploração acurada do campo operatório em área de difícil acesso e remoção completa de lesões. Preconizamos a utilização da ostectomia periférica em cirurgia videoassistida descrita em dois casos de GCG de maxila e mandíbula.
Revista Brasileira de Otorrinolaringologia, 2004
... A investigação genética na surdez hereditária não-sindrômica. Genetic investigation of non-sy... more ... A investigação genética na surdez hereditária não-sindrômica. Genetic investigation of non-syndromic hereditary deafness. Leopoldo N. Pfeilsticker I ; Guita Stole II ; Edi Lucia Sartorato III ; Denise Delfino IV ; Andréa Trevas Maciel Guerra V. ... 10. Bruzzone R, White TW, Paul DL. ...
Case Reports in Oncological Medicine, 2016
Revista Brasileira De Otorrinolaringologia, 2003
O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportam... more O granuloma de células gigantes (GCG) é uma doença incomum, de etiologia indeterminada, comportamento variado e potencialmente destrutivo e, na face, atinge principalmente a região de mandíbula. Discute-se o melhor método para seu tratamento, buscando-se obter baixo índice de recorrência, com a menor agressão possível. A ostectomia periférica complementar à ressecção das lesões pode diminuir o índice de recorrência e, ao mesmo tempo, minimizar a morbidade associada. A cirurgia videoassistida permite exploração acurada do campo operatório em área de difícil acesso e remoção completa de lesões. Preconizamos a utilização da ostectomia periférica em cirurgia videoassistida descrita em dois casos de GCG de maxila e mandíbula.
Head & Neck Oncology
Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal ca... more Introduction Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. It is a rare complication caused by maxillofacial trauma and can lead to amaurosis. This paper describes two cases of young men with late CCF diagnosis. Case report The first patient was 23 years old and had a basilar skull and he also had paralysis on the right side of his face. The diagnosis of CCF for this patient occurred three weeks after the onset of symptoms through an arteriography. Embolization treatment was then performed. The second patient was 21 years old and had a LeFort ll fracture on the right side of his face. He showed symptoms of CCF and was also treated by embolization. The classical clinical symptoms of chemosis, paralytic mydriasis, absence of consensus and photomotor reflex, restriction of eye mobility, proptosis, thrill and murmur were present in both cases. Conclusion This paper emphasizes the need for early diagnosis and pro...
Revista Española de Cirugía Oral y Maxilofacial, 2014
Background: Temporomandibular-ankylosis brings extensive limitations on the patient quality of li... more Background: Temporomandibular-ankylosis brings extensive limitations on the patient quality of life. Surgical treatment is frequently necessary associated with a continuous rehabilitation. The anatomy of this region and potential complications of this surgery must be thoroughly known to avoid iatrogenic injuries.
Acta Otorrinolaringológica Española, 2014
Revista Brasileira de Otorrinolaringologia, 2003
Revista CEFAC, 2013
ABSTRACT PURPOSE: to assess the use of the digital caliper in the measurement of the facial mimic... more ABSTRACT PURPOSE: to assess the use of the digital caliper in the measurement of the facial mimic movements in different moments of the speech therapy. METHOD: prospective longitudinal study, with 20 subjects between 7 and 70 years-old, 13 females and 7 males, all diagnosed with Bell's Palsy, attended in the Facial Paralysis Ambulatory, of the otorhinolaryngology subject of a University Public Hospital. The use of a Digimess 100,174BL digital measuring caliper was adopted for this study. The measurements were carried out in the facial mimic movement, always starting from a fixed point to a mobile point in the structures: the tragus and the labial commissure, external corner of the eye and labial commissure and also internal corner of the eye and the nasal ala. All measurements were carried out both prior and after the treatment. The quantification of the incompetence of the movement was measured by simple percentage. The Wilcoxon signed rank test was applied to check for possible differences between both moments considered (with and without movements), as the study variables. RESULTS: the measurements had a statistically significant result (p<0.05) in all the proposed measured structures (tragus and labial commissure, external corner of the eye and labial commissure, and internal corner of the eye and nasal ala), showing that there are possibilities of measuring of movement and absence of movement using a digital caliper. CONCLUSION: the caliper has demonstrated to be a useful device which has permitted to objectively compare the evolution of the rehabilitation of facial mimic in Bell's Palsy in the sample studied here.
Neurosurgical FOCUS, 2004
Neurosurgery, 2005
OBJECTIVE: Jugular foramen tumors are rare cranial base lesions that present diagnostic and manag... more OBJECTIVE: Jugular foramen tumors are rare cranial base lesions that present diagnostic and management difficulties. With the availability of new diagnostic procedures these tumors have been more precisely studied and questions of whether, when, and how these lesions should be treated often arise. Data from 106 consecutive patients surgically treated in the past 17 years were retrospectively analyzed to identify surgical outcomes. METHODS: The tumors were approached by a multidisciplinary team composed of neurosurgeons, ear, nose, and throat surgeons, and neuroradiologists. Hypervascular lesions were embolized 3 to 5 days before surgery. The same surgical technique was used to resect all tumors. The surgical defect was covered with vascularized myofascial flaps. The internal carotid artery was infiltrated in two patients, and a saphenous graft bypass was carried out before removal of the lesions. The facial nerve was reconstructed with nerve grafts (great auricular nerve) or XII/VII anastomosis in five cases. Postoperative radiotherapy was carried out for malignant and invasive tumors. RESULTS: Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. Complete excision was possible in 89% of benign tumors and 80% of paragangliomas. Lower cranial nerve deficit was the most frequent complication (10 patients, 9.4%), transient in 4 patients. Facial and cochlear nerve paralysis occurred in 8 patients (7.5%). The function of the facial nerve recovered spontaneously in 3 patients. Four patients (3.7%) developed postoperative cerebrospinal fluid leakage. Four patients (3.7%) died after surgery. CONCLUSION: Radical removal of benign jugular foramen tumors is the treatment of choice and may be curative. Large lesions can be radically excised in one surgical procedure with preservation of lower cranial nerves. Cranial base reconstruction with vascularized myofascial flaps reduces the incidence of postoperative cerebrospinal fluid leakage. Damage of the lower cranial nerves is the most serious surgical complication.
Allergy & Rhinology, 2016
Nasal obstruction is an important condition that can lead to severe respiratory distress in newbo... more Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases. We report two cases of infants diagnosed with CNPAS. The patients in the first case had no concomitant comorbidities, and the outcome was successful after surgical correction of stenosis. The patient in the second case had an associated holoprosencephaly, and although surgical correction and nasal cavity patency, the patient remains dependent on tracheostomy due to dysphagia and neurologic impairment. Airway obstruction affects 1 in 5000 children, and CNPAS is a diagnosis frequently forgotten and even unknown to neonatal and pediatric intensivists. Newborns are obligate nasal breathers, and, nasal obstruction, therefore, can lead to severe respiratory distress. CNPAS is not only rare but, many times, is not easily recognized. It is important to bear in mind the diagnostic criteria when evaluating infants with nasal obstruction. Conservative treatment should be prioritized, but surgical treatment is required in severe cases with failure to thrive and persistent respiratory distress. Respiratory distress and dysphagia may persist to some degree despite correction of the stenotic pyriform aperture due to associated narrowing of the entire nasal cavity and association with other anomalies. Final Comments: CNPAS is a rare condition and may be lethal in newborns. Differential diagnosis of nasal obstruction must be remembered to recognize this anomaly, and the otolaryngologist must be familiarized with this condition and its diagnosis. Precise surgical treatment in severe cases have high rates of success in children without other comorbidities.