Miguel Coutinho - Academia.edu (original) (raw)
Papers by Miguel Coutinho
O BAHA (Bone Anchored Hearing Aid - prótese auditiva ancorada no osso) é utilizado em malformaçõe... more O BAHA (Bone Anchored Hearing Aid - prótese auditiva ancorada no osso) é utilizado em malformações do ouvido externo e médio, otorreia crónica, doença ossicular inoperável e como alternativa à prótese auditiva convencional por inadaptação/ impossibilidade. Este artigo descreve a experiência de colocação de BAHA no Hospital Maria Pia – Centro Hospitalar do Porto na última década, por estudo retrospectivo de 47 pacientes. O ganho audiométrico médio foi de 33,9 dB em relação aos valores base e de 14,4 dB em relação ao uso de próteses auditivas convencionais, com limiar auditivo médio com BAHA de 17,8 dB. Não houve qualquer complicação intra-operatória. No pós-operatório, quatro casos exigiram cirurgia para revisão da pele, em dois casos não houve integração óssea do implante e em três casos houve extrusão do implante por traumatismo directo. Este estudo conclui que os BAHA são um método eficaz e seguro de aparelhamento auditivo em crianças.
Foram estudadas 135 criancas com Sindroma de Down, das quais 62,2% apresentavam uma surdez de tra... more Foram estudadas 135 criancas com Sindroma de Down, das quais 62,2% apresentavam uma surdez de transmissao bilateral, e 4,4%, uma surdez sensorio-neural. A alta prevalencia de surdez encontrada exige uma avaliacao precoce de todas estas criancas e um seguimento rigoroso, e e fundamental um tratamento agressivo para maximizar o desenvolvimento da linguagem receptiva e da aprendizagem cognitiva.
Introducao: A traqueostomia na crianca esta indicada em situacoes de obstrucao respiratoria alta,... more Introducao: A traqueostomia na crianca esta indicada em situacoes de obstrucao respiratoria alta, necessidade de ventilacao mecânica prolongada e toilette pulmonar. Material e Metodos: Os autores apresentam o estudo retrospectivo dos doentes submetidos a traqueostomia no Hospital Maria Pia entre 1994-1997. Foram analisados os seguintes parâmetros: idade, sexo, patologia de base, idade de realizacao da traqueostomia, intervencoes anteriores, indicacao e tipo de traqueostomia, complicacoes e data de descanulacao. Resultados: Foram submetidos a traqueostomia seis criancas, quatro do sexo masculino e duas do sexo feminino. A idade de execucao da traqueostomia variou entre dois meses e sete anos. As indicacoes foram: em quatro criancas patologia congenita obstrutiva da via aerea superior e necessidade de ventilacao mecânica prolongada nas outras duas. Foi efectuada entubacao endotraqueal previa em cinco criancas, duas das quais com necessidade de ventilacao mecânica. A traqueostomia foi ...
Introducao: A mastoidite aguda e a principal complicacao da otite media aguda (OMA).Varios estudo... more Introducao: A mastoidite aguda e a principal complicacao da otite media aguda (OMA).Varios estudos recentes revelam uma incidencia crescente, frequentemente com complicacoes associadas. Objectivos: Descrever os casos de mastoidite aguda e detetar factores associados a uma maior morbilidade clinica. Metodos: Revisao dos processos clinicos referentes aos internamentos por mastoidite aguda no Servico de Pediatria, entre Janeiro de 1998 e Dezembro de 2010. Foram incluidos os casos definidos pela presenca de sinais inflamatorios retroauriculares, protrusao auricular e coexistencia de OMA. Resultados: Registaram-se 59 casos, maioritariamente no ano de 2010 (18.6%). A mediana de idades foi de cinco anos. A data do internamento 36 criancas (61.0%) tinham tido o diagnostico recente de OMA e estavam medicadas com antibiotico. Os sintomas mais frequentes foram: otalgia (61.0%) e febre (42.4%). A maioria melhorou com tratamento conservador, com excepcao das criancas com mastoidite complicada: 1...
NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 2020
The main aims of this observational study were to describe a poorly characterized malformation of... more The main aims of this observational study were to describe a poorly characterized malformation of the inner ear termed bilateral congenital semicircular canal malformation; determine if the degree and pattern of semicircular canal dysmorphology and the presence or absence of a well-formed cochlea predict audiological outcomes, type, and severity of congenital hearing loss; and investigate its relationship with known syndromic forms of hearing loss. Review of eight cases of hearing loss with radiographic evidence of congenital semicircular canal malformation was performed. Information was collected on clinical history, physical examination, computed tomography study and serial audiograms for all patients. Analyzed features included other syndrome-characteristic phenotypic dysmorphologies, audiometric configuration, severity and type of hearing loss, type of audiological rehabilitation, and presence of associated inner ear abnormalities besides those in the vestibular system. Among th...
Minerva Pediatrics, 2021
BACKGROUND The increase in resistance of the respiratory nasal caused by adenoid hypertrophy can ... more BACKGROUND The increase in resistance of the respiratory nasal caused by adenoid hypertrophy can condition changes in pulmonary ventilation and translate into a risk of cardiopulmonary diseases. The mean platelet volume is a marker of platelet function, associated with indicators of platelet activity - a greater volume indicates the presence of larger platelets and greater hemostatic reactivity, associated with a propensity for thrombosis. METHODS Retrospective study of 200 patients who presented to the otolaryngology outpatient clinic of our hospital, divided in two group-s : chAil dren with adenoid hypertrophy, B - children without adenoid hypertrophy. The age, hemoglobin levels, platelet counts were compared between the two groups. RESULTS The Mean Platelet Volume levels in patients with Adenoid Hypertrophy were significantly higher than those in the control group (p<0.001). White blood cells, hemoglobin, and platelet levels were not significantly different between the 2 groups (P > 0.05). CONCLUSIONS Adenoid hypertrophy is associated with higher mean platelet volume in children. Measurement of mean platelet volume and platelet count can be considered as quick, safe, and reliable guide for the assessment of clinical consequences of adenoid hypertrophy.
Journal of Otology, 2021
Objective: To assess hyperacusis after stapedotomy and its possible influencing factors. Study de... more Objective: To assess hyperacusis after stapedotomy and its possible influencing factors. Study design: Prospective, interventional, and longitudinal study. Setting: A tertiary referral center. Patients: Fifty consecutive patients (35 females, mean age ¼ 46.8 years). Intervention: All patients underwent stapedotomy. The validated Portuguese version of the "Hyperacusis Questionnaire" (HQ) was administered before and two weeks and one month after surgery. Results: No hyperacusis was reported by any patient before surgery. At two weeks after surgery, all patients experienced hyperacusis, with a mean HQ at 16.88 ± 6.54 (range 4e25). One month after surgery, hyperacusis had already resolved in most patients. Gender, preoperative presentation or surgeon had no influence on HQ scores (p > 0.05). Patients with previous contralateral stapedotomy showed lower HQ scores (p ¼ 0.001). Audiological parameters improvement measured at one month after surgery (PTA, SRT and contralateral SRT) were associated with HQ higher scores. Conclusion: This study confirms that hyperacusis is a common complaint after stapedotomy that usually resolves in one month after surgery. The HQ highest scores were registered among patients with the highest audiological gain after surgery. This suggests that hyperacusis may be a positive prognostic factor for audiological success after stapedotomy.
The Laryngoscope, 2019
Objective: Assess the aesthetic and functional outcomes of the first 100 patients who underwent r... more Objective: Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT). Methods: Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides. Results: The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides. Conclusion: This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty.
International Journal of Pediatric Otorhinolaryngology, 2018
Compliance with Ethical Standards: Ethical approval: All procedures performed in studies involvin... more Compliance with Ethical Standards: Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from the parents of the patient.
Journal of voice : official journal of the Voice Foundation, Jan 20, 2018
The aim of this case-control study was to evaluate the overall behavior of children with vocal fo... more The aim of this case-control study was to evaluate the overall behavior of children with vocal fold nodules (VNs). The study group included children with VNs between 4 and 15 years old diagnosed using fiberoptic video laryngoscopy with stroboscopy in a tertiary university hospital. As a control group, children between 4 and 13 years old without VNs, routinely followed up in a primary care facility, were included in the study. Parents of the participants completed the parent-proxy strengths and difficulties questionnaire (SDQ), a brief behavioral screening questionnaire designed for children. The SDQ evaluates emotional, conduct, and peer problems, and also focuses on hyperactivity and prosocial behavior. Children are classified into "normal," "borderline," or "abnormal" according to the total SDQ score. Twenty-seven children (24 boys and 3 girls) with VNs and 41 controls (33 boys and 8 girls) were enrolled in the study. The two groups did not differ sig...
Autism research : official journal of the International Society for Autism Research, 2017
To determine whether children with autism spectrum disorders (ASDs) have an increased number of w... more To determine whether children with autism spectrum disorders (ASDs) have an increased number of wave I abnormal amplitudes in auditory brainstem responses (ABRs) than age- and sex-matched typically developing children. This analytical case-control study compared patients with ASDs between the ages of 2 and 6 years and children who had a language delay not associated with any other pathology. Amplitudes of ABR waves I and V; absolute latencies (ALs) of waves I, III, and V; and interpeak latencies (IPLs) I-III, III-IV, and I-V at 90 dB were compared between ASD patients and normally developing children. The study enrolled 40 children with documented ASDs and 40 age- and sex-matched control subjects. Analyses of the ABR showed that children with ASDs exhibited higher amplitudes of wave 1 than wave V (35%) more frequently than the control group (10%), and this difference between groups reached statistical significance by Chi-squared analysis. There were no significant differences in ALs...
Acta otorrinolaringologica espanola, Jan 21, 2016
The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of... more The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of the placement of BAHA in children. The authors performed a retrospective analysis of all children for whom hearing rehabilitation with BAHA was indicated at a central hospital, between January 2003 and December 2014. 53 children were included. The most common indications for placement of BAHA were external and middle ear malformations (n=34, 64%) and chronic otitis media with difficult to control otorrhea (n=9, 17%). The average age for BAHA placement was 10.66±3.44 years. The average audiometric gain was 31.5±7.20dB compared to baseline values, with average hearing threshold with BAHA of 19.6±5.79dB. The most frequent postoperative complications were related to the skin (n=15, 28%). There were no major complications. This study concludes that BAHA is an effective and safe method of hearing rehabilitation in children.
O BAHA (Bone Anchored Hearing Aid - prótese auditiva ancorada no osso) é utilizado em malformaçõe... more O BAHA (Bone Anchored Hearing Aid - prótese auditiva ancorada no osso) é utilizado em malformações do ouvido externo e médio, otorreia crónica, doença ossicular inoperável e como alternativa à prótese auditiva convencional por inadaptação/ impossibilidade. Este artigo descreve a experiência de colocação de BAHA no Hospital Maria Pia – Centro Hospitalar do Porto na última década, por estudo retrospectivo de 47 pacientes. O ganho audiométrico médio foi de 33,9 dB em relação aos valores base e de 14,4 dB em relação ao uso de próteses auditivas convencionais, com limiar auditivo médio com BAHA de 17,8 dB. Não houve qualquer complicação intra-operatória. No pós-operatório, quatro casos exigiram cirurgia para revisão da pele, em dois casos não houve integração óssea do implante e em três casos houve extrusão do implante por traumatismo directo. Este estudo conclui que os BAHA são um método eficaz e seguro de aparelhamento auditivo em crianças.
Foram estudadas 135 criancas com Sindroma de Down, das quais 62,2% apresentavam uma surdez de tra... more Foram estudadas 135 criancas com Sindroma de Down, das quais 62,2% apresentavam uma surdez de transmissao bilateral, e 4,4%, uma surdez sensorio-neural. A alta prevalencia de surdez encontrada exige uma avaliacao precoce de todas estas criancas e um seguimento rigoroso, e e fundamental um tratamento agressivo para maximizar o desenvolvimento da linguagem receptiva e da aprendizagem cognitiva.
Introducao: A traqueostomia na crianca esta indicada em situacoes de obstrucao respiratoria alta,... more Introducao: A traqueostomia na crianca esta indicada em situacoes de obstrucao respiratoria alta, necessidade de ventilacao mecânica prolongada e toilette pulmonar. Material e Metodos: Os autores apresentam o estudo retrospectivo dos doentes submetidos a traqueostomia no Hospital Maria Pia entre 1994-1997. Foram analisados os seguintes parâmetros: idade, sexo, patologia de base, idade de realizacao da traqueostomia, intervencoes anteriores, indicacao e tipo de traqueostomia, complicacoes e data de descanulacao. Resultados: Foram submetidos a traqueostomia seis criancas, quatro do sexo masculino e duas do sexo feminino. A idade de execucao da traqueostomia variou entre dois meses e sete anos. As indicacoes foram: em quatro criancas patologia congenita obstrutiva da via aerea superior e necessidade de ventilacao mecânica prolongada nas outras duas. Foi efectuada entubacao endotraqueal previa em cinco criancas, duas das quais com necessidade de ventilacao mecânica. A traqueostomia foi ...
Introducao: A mastoidite aguda e a principal complicacao da otite media aguda (OMA).Varios estudo... more Introducao: A mastoidite aguda e a principal complicacao da otite media aguda (OMA).Varios estudos recentes revelam uma incidencia crescente, frequentemente com complicacoes associadas. Objectivos: Descrever os casos de mastoidite aguda e detetar factores associados a uma maior morbilidade clinica. Metodos: Revisao dos processos clinicos referentes aos internamentos por mastoidite aguda no Servico de Pediatria, entre Janeiro de 1998 e Dezembro de 2010. Foram incluidos os casos definidos pela presenca de sinais inflamatorios retroauriculares, protrusao auricular e coexistencia de OMA. Resultados: Registaram-se 59 casos, maioritariamente no ano de 2010 (18.6%). A mediana de idades foi de cinco anos. A data do internamento 36 criancas (61.0%) tinham tido o diagnostico recente de OMA e estavam medicadas com antibiotico. Os sintomas mais frequentes foram: otalgia (61.0%) e febre (42.4%). A maioria melhorou com tratamento conservador, com excepcao das criancas com mastoidite complicada: 1...
NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 2020
The main aims of this observational study were to describe a poorly characterized malformation of... more The main aims of this observational study were to describe a poorly characterized malformation of the inner ear termed bilateral congenital semicircular canal malformation; determine if the degree and pattern of semicircular canal dysmorphology and the presence or absence of a well-formed cochlea predict audiological outcomes, type, and severity of congenital hearing loss; and investigate its relationship with known syndromic forms of hearing loss. Review of eight cases of hearing loss with radiographic evidence of congenital semicircular canal malformation was performed. Information was collected on clinical history, physical examination, computed tomography study and serial audiograms for all patients. Analyzed features included other syndrome-characteristic phenotypic dysmorphologies, audiometric configuration, severity and type of hearing loss, type of audiological rehabilitation, and presence of associated inner ear abnormalities besides those in the vestibular system. Among th...
Minerva Pediatrics, 2021
BACKGROUND The increase in resistance of the respiratory nasal caused by adenoid hypertrophy can ... more BACKGROUND The increase in resistance of the respiratory nasal caused by adenoid hypertrophy can condition changes in pulmonary ventilation and translate into a risk of cardiopulmonary diseases. The mean platelet volume is a marker of platelet function, associated with indicators of platelet activity - a greater volume indicates the presence of larger platelets and greater hemostatic reactivity, associated with a propensity for thrombosis. METHODS Retrospective study of 200 patients who presented to the otolaryngology outpatient clinic of our hospital, divided in two group-s : chAil dren with adenoid hypertrophy, B - children without adenoid hypertrophy. The age, hemoglobin levels, platelet counts were compared between the two groups. RESULTS The Mean Platelet Volume levels in patients with Adenoid Hypertrophy were significantly higher than those in the control group (p<0.001). White blood cells, hemoglobin, and platelet levels were not significantly different between the 2 groups (P > 0.05). CONCLUSIONS Adenoid hypertrophy is associated with higher mean platelet volume in children. Measurement of mean platelet volume and platelet count can be considered as quick, safe, and reliable guide for the assessment of clinical consequences of adenoid hypertrophy.
Journal of Otology, 2021
Objective: To assess hyperacusis after stapedotomy and its possible influencing factors. Study de... more Objective: To assess hyperacusis after stapedotomy and its possible influencing factors. Study design: Prospective, interventional, and longitudinal study. Setting: A tertiary referral center. Patients: Fifty consecutive patients (35 females, mean age ¼ 46.8 years). Intervention: All patients underwent stapedotomy. The validated Portuguese version of the "Hyperacusis Questionnaire" (HQ) was administered before and two weeks and one month after surgery. Results: No hyperacusis was reported by any patient before surgery. At two weeks after surgery, all patients experienced hyperacusis, with a mean HQ at 16.88 ± 6.54 (range 4e25). One month after surgery, hyperacusis had already resolved in most patients. Gender, preoperative presentation or surgeon had no influence on HQ scores (p > 0.05). Patients with previous contralateral stapedotomy showed lower HQ scores (p ¼ 0.001). Audiological parameters improvement measured at one month after surgery (PTA, SRT and contralateral SRT) were associated with HQ higher scores. Conclusion: This study confirms that hyperacusis is a common complaint after stapedotomy that usually resolves in one month after surgery. The HQ highest scores were registered among patients with the highest audiological gain after surgery. This suggests that hyperacusis may be a positive prognostic factor for audiological success after stapedotomy.
The Laryngoscope, 2019
Objective: Assess the aesthetic and functional outcomes of the first 100 patients who underwent r... more Objective: Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT). Methods: Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides. Results: The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides. Conclusion: This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty.
International Journal of Pediatric Otorhinolaryngology, 2018
Compliance with Ethical Standards: Ethical approval: All procedures performed in studies involvin... more Compliance with Ethical Standards: Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from the parents of the patient.
Journal of voice : official journal of the Voice Foundation, Jan 20, 2018
The aim of this case-control study was to evaluate the overall behavior of children with vocal fo... more The aim of this case-control study was to evaluate the overall behavior of children with vocal fold nodules (VNs). The study group included children with VNs between 4 and 15 years old diagnosed using fiberoptic video laryngoscopy with stroboscopy in a tertiary university hospital. As a control group, children between 4 and 13 years old without VNs, routinely followed up in a primary care facility, were included in the study. Parents of the participants completed the parent-proxy strengths and difficulties questionnaire (SDQ), a brief behavioral screening questionnaire designed for children. The SDQ evaluates emotional, conduct, and peer problems, and also focuses on hyperactivity and prosocial behavior. Children are classified into "normal," "borderline," or "abnormal" according to the total SDQ score. Twenty-seven children (24 boys and 3 girls) with VNs and 41 controls (33 boys and 8 girls) were enrolled in the study. The two groups did not differ sig...
Autism research : official journal of the International Society for Autism Research, 2017
To determine whether children with autism spectrum disorders (ASDs) have an increased number of w... more To determine whether children with autism spectrum disorders (ASDs) have an increased number of wave I abnormal amplitudes in auditory brainstem responses (ABRs) than age- and sex-matched typically developing children. This analytical case-control study compared patients with ASDs between the ages of 2 and 6 years and children who had a language delay not associated with any other pathology. Amplitudes of ABR waves I and V; absolute latencies (ALs) of waves I, III, and V; and interpeak latencies (IPLs) I-III, III-IV, and I-V at 90 dB were compared between ASD patients and normally developing children. The study enrolled 40 children with documented ASDs and 40 age- and sex-matched control subjects. Analyses of the ABR showed that children with ASDs exhibited higher amplitudes of wave 1 than wave V (35%) more frequently than the control group (10%), and this difference between groups reached statistical significance by Chi-squared analysis. There were no significant differences in ALs...
Acta otorrinolaringologica espanola, Jan 21, 2016
The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of... more The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of the placement of BAHA in children. The authors performed a retrospective analysis of all children for whom hearing rehabilitation with BAHA was indicated at a central hospital, between January 2003 and December 2014. 53 children were included. The most common indications for placement of BAHA were external and middle ear malformations (n=34, 64%) and chronic otitis media with difficult to control otorrhea (n=9, 17%). The average age for BAHA placement was 10.66±3.44 years. The average audiometric gain was 31.5±7.20dB compared to baseline values, with average hearing threshold with BAHA of 19.6±5.79dB. The most frequent postoperative complications were related to the skin (n=15, 28%). There were no major complications. This study concludes that BAHA is an effective and safe method of hearing rehabilitation in children.