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Master's Dissertation
DOI
https://doi.org/10.11606/D.61.2022.tde-14102022-094627
Document
Author
Full name
Luiz Paulo Gomes
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Tonello, Cristiano (President)
Brabo, Alexandre Minetto
Fernandes, Adriano Yacubian
Volpi, Mauro dos Santos
Title in Portuguese
Instabilidade craniocervical no espectro oculoauriculovertebral
Keywords in Portuguese
Coluna vertebral
Instabilidade articular
Síndrome oculoauriculovertebral
Abstract in Portuguese
Introdução: O espectro oculoauriculovertebral (OAVS) são anomalias do primeiro e segundo arcos faríngeos, causando alterações craniofaciais, principalmente assimetria facial, assim como anomalias na coluna vertebral, que podem ser causa de instabilidade do junção craniocervical - a manipulação de uma coluna instável pode resultar em compressão da medula espinhal, resultando em morbimortalidade. No entanto, poucos relacionaram a EOAV com estudos de instabilidade craniocervical. Objetivos: Para correlacionar pacientes com EOAV através de radiografia com craniocervical instabilidade e previsão de sua ocorrência. Métodos: Através de um estudo radiográfico da coluna cervical, avaliação da malformações e a presença de instabilidade craniocervical, e avaliação clínica usando o escore OMES como critério fenotípico para pacientes com a OAVS, por uma equipe multidisciplinar especializada. Foram realizados o teste t de Student, Kolmogorov-Smirnova e qui-quadrado. Resultados: 26 pacientes com EOAV foram avaliados, sendo que, destes, 7 (26,9%) apresentavam instabilidade craniocervical. Escore OMENS abaixo de 5: nenhum dos 6 pacientes apresentou instabilidade craniocervical; escore entre 5 e 9 - frequência significativamente maior de instabilidade (5 de 15 indivíduos, ou 33,3%); escore igual ou superior a 10 - maior frequência (2 de 5, ou 40%), porém sem significância estatística. Todos os pacientes com instabilidade também apresentavam malformações da coluna, e daqueles sem instabilidade craniocervical (19 pacientes), 57,8% tiveram malformações. As anomalias de coluna foram semelhantes naqueles com e sem instabilidade, sendo a mais comum a escoliose. Não houve significância estatística na presença ou ausência de malformações da coluna vertebral com a presença ou ausência de instabilidade craniocervical. 71,4% dos indivíduos com instabilidade tiveram anomalias extracraniofaciais, sendo a principal a radial. Conclusões: pacientes com escores OMENS mais altos tiveram mais instabilidade craniocervical, mas sem significância estatística. Também não mostram relevância estatística entre a presença de malformações craniocervicais e instabilidade. Atribuímos os resultados ao pequeno tamanho da amostra.
Title in English
Craniocervical instability in the hemifacial microsomia
Keywords in English
Articular instability
Oculo-auriculo-vertebral spectrum
Vertebral neck
Abstract in English
Introduction: The oculoauriculovertebral spectrum (OAVS) are anomalies of the first and second pharyngeal arches, causing craniofacial changes, principally facial asymmetry, as well as anomalies in spine, that can be a cause of instability of the craniocervical junction - manipulation of an unstable spine can result in compression of the spinal cord, resulting in morbimortality. However, few studies have related OAVS to craniocervical instability. Objectives: To correlate patients with OAVS through radiography with craniocervical instability, and prediction of its occurrence. Methods: Through a radiographic study of the cervical spine, the assessment of vertebral malformations and the presence of craniocervical instability was performed, and clinical assessment using the OMENS score as a phenotypic criteria for patients with OAVS, by a specialized multidisciplinary team. Student's t test, KolmogorovSmirnova and chi-square were performed. Results: 26 patients with OAVS were evaluated, 7 (26.9%) had craniocervical instability, that OMENS score was three times higher, but without statistical significance. OMENS score below 5: none of 6 patients had craniocervical instability; score between 5 and 9 - significantly higher frequency of instability (5 of 15 individuals, or 33.3%); score equal to or greater than 10 - higher frequency (2 of 5, or 40%). All patients with instability also had spinal malformations, and of those without craniocervical instability (19 patients), 57.8% had spinal malformations. Vertebral malformations had a similar incidence in those with and without instability, the most common being scoliosis. There was no statistical significance in the presence or absence of spinal malformations with the presence or absence of craniocervical instability. Extracraniofacial findings were found in all patients with instability, 71.4% of them were radial. Conclusions: patients with higher OMENS scores had more craniocervical instability, but without statistical significance. It also did not show statistical relevance between the presence of malformations and craniocervical instability. We attribute the results to the small sample size.
 
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Release Date
2024-07-05
Publishing Date
2022-12-12
 
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