Sergio Henrique Kiemle Trindade

@usp.br

Medical Course
Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies- University of São Paulo

Sergio Henrique Kiemle Trindade


               Download Compact PDF  
https://researchid.co/sktrindadeusp.br

EDUCATION

MD PhD
Professor - Medical Course of Bauru School of Dentistry - University of São Paulo
Sleep Studies Unit - Hospital for Rehabilitation of Craniofacial Anomalies

RESEARCH INTERESTS

Obstructive Sleep Apnea, Craniofacial Anomalies, Upper Airways Morphology and Physiology
27

Scopus Publications

Scopus Publications

  • Evaluation of Upper Airway and Sleep Quality in Patients With Unilateral Cleft Lip and Palate Undergoing Orthognathic Surgery: A Pilot Study
    Marina de Almeida Barbosa Mello, Caroline de Paula Oliveira Gringo, Ana Carolina Bonetti Valente, Bruno Marcos Zeponi Fernandes de Mello, Luiz Fernando Manzoni Lourençone, Sergio Henrique Kiemle Trindade, Ivy Kiemle Trindade Suedam, Renato Yassutaka Faria Yaedú
    Cleft Palate Craniofacial Journal, 2026
    Objective To evaluate the impact of bimaxillary osteotomy on upper airway metrics and patient-reported sleep quality in patients with cleft lip and palate. Design Retrospective cohort study involving Class III patients. Setting A specialized craniofacial surgery center within a tertiary care institution. Patients/Participants Eight patients with unilateral cleft lip and palate were included, undergoing pre- and postoperative assessments (≥1 year after surgery). Interventions Bimaxillary orthognathic surgery, including mandibular setback and maxillary advancement. Cone-beam computed tomography (CBCT), nasopharyngoscopy, and polysomnography were performed, along with sleep quality questionnaires (Epworth and Berlin scales). Main outcomes Upper airway (UA) volume and minimum cross-sectional area assessed via CBCT; apnea–hypopnea index (AHI) from polysomnography; airflow analysis and sleep quality assessments. Results No significant changes were observed in UA volume or minimum cross-sectional area, including the oropharynx and hypopharynx regions. Similarly, there were no clinical repercussions on sleep, with AHI remaining stable between pre- and postoperative assessments. Conclusions In this cohort of 8 patients with unilateral cleft lip and palate, bimaxillary osteotomy did not result in significant changes in upper airway metrics or patient-reported sleep quality.
  • Robin Sequence and Isolated Cleft Palate are Associated With a High Prevalence of Obstructive Sleep Apnea in School-Aged Children
    Fábio Luiz Banhara, Ivy Kiemle Trindade-Suedamm, Inge Elly Kiemle Trindade, Lais Mota Furtado Sena, Sergio Henrique Kiemle Trindade
    Cleft Palate Craniofacial Journal, 2026
    Objective To analyze the prevalence of obstructive sleep apnea (OSA) in children aged 6 to 12 years with nonsyndromic Robin sequence (NSRS) and in those with nonsyndromic cleft palate (NSCP). All patients presented complete cleft palate (Veau II). Design Cross-sectional study. Setting Tertiary public hospital. Patients A total of 146 children divided into 2 groups: (1) NSRS (n = 69), (2) NSCP (n = 77). Interventions (1) Anthropometric assessment, dentoskeletal, and facial analysis. (2) Clinical interview with “Sleep Disturbance Scale for Children” and “Congestion Quantifier Five-Item” (CQ5); and (3) 48 patients: Type IV polysomnography. Main Outcome Measures Frequency of OSA in children with NSRS and NSCP, assessed by Type IV polysomnography. Results Positive scores for OSA were found in 59.42% of children with NSRS and 46.75% of those with NSCP ( P > .05). Excessive daytime sleepiness was observed in 23.19% of the NSRS group and 9.01% of the NSCP group ( P > .05). Positive scores for nasal obstruction were noted in 14.49% with NSRS and 20.78% of those with NSCP ( P > .05). In polysomnography IV subgroups, an Oxygen Desaturation Index compatible with mild to moderate OSA was observed in 89.65% of the NSRS group and 78,94% of the NSCP group ( P > .05). Also, facial and pharyngeal alterations, such as Angle Class II malocclusion, Mallampati classifications III and IV, and deep crossbite, were associated with OSA. Conclusion Both children with NSRS and NSCP have a high frequency of mild to moderate OSA, highlighting the need for systematic evaluation of the presence of sleep-disordered breathing in this population.
  • Obstructive sleep apnea and upper airway morphophysiology in orofacial clefts
    Ivy Kiemle Trindade-Suedam, Thiago Henrique dos Santos Antunes Albertassi, Marcela Cristina Garnica-Siqueira, Sergio Henrique Kiemle Trindade
    Seminars in Orthodontics, 2025
  • Are There Morphophysiological Airway Alterations in Syndromic Craniosynostosis? A 3D Computed Tomography and CFD Analysis
    Michele Garcia-Usó, Amelia Fischer Drake, Luiz André Pimenta, Marcela Cristina Garnica-Siqueira, Thiago Henrique dos Santos Antunes Albertassi, Cristiano Tonello, Sérgio Henrique Kiemle Trindade, Ivy KiemleTrindade-Suedam
    Cleft Palate Craniofacial Journal, 2025
    Objectives Characterize the upper airways (UAW) in individuals with syndromic craniosynostosis (SCS) using computed tomography scans and correlate with the airflow dynamics and craniofacial pattern. Design Observational, cross-sectional study. Setting Tertiary craniofacial center. Individuals Twenty-nine individuals were included, divided in 2 groups: CON (n = 19; 21.2 ± 3.7 y), individuals with no craniofacial anomalies and no UAW morphological alterations, and SCS (n = 10; 22.1 ± 5.1 y) individuals with SCS prior to maxillomandibular surgery. Interventions Volume (V, cm 3 ) and minimal cross-sectional area (mCSA, mm 2 ) was calculated (Mimics, Belgium). Computational fluid dynamics (ANSYS, EUA) was performed and flow (F, L/min), pressure (P, Pa), and resistance (R, Pa/[L/min]) were calculated. Cephalometric analysis (SNA[ o ]), ANB[ o ], Ba-S-N[ o ]) was also assessed (Dolphin Imaging, USA). Main Outcome The morphophysiology of the UAW in SCS individuals was severely impaired compared with the CON group. Results The SCS group exhibited significant volumetric reduction in the total UAW (−29%), nasal cavity (−21%), and pharynx (−37%) compared with the CON group. The mCSA was 57% smaller in the SCS group. CFD simulations demonstrated decreased flow (−9%), increased pressure (136%), and resistance (156%) in the SCS group. UAW resistance presented a strong positive correlation with mCSA (CON: r = 0.77 / SCS: r = 0.88). Cephalometric findings revealed significant differences between CON and SCS, with the SCS group exhibiting values outside the normal range. Conclusion The UAW of individuals with SCS was anatomically and functionally impaired, suggesting a significant risk for obstructive sleep apnea.
  • Characterization of upper airway airflow dynamics in young adults with isolated Robin sequence: An exploratory investigation
    Maria Noel Marzano-Rodrigues, Sergio Henrique Kiemle Trindade, Ivy Kiemle Trindade-Suedam
    Journal of Oral Biology and Craniofacial Research, 2025
    Impaired upper airway dimension in adults with Isolated Robin Sequence (IRS) can alter airflow dynamics, increasing the risk of pharyngeal collapse and the onset of obstructive sleep apnea. This study aimed to characterize the upper airways of six young adults (20.83 ± 6.40 years) with IRS, using computational fluid dynamics. Upper airways of six patients were reconstructed using 3D segmentation, generating unstructured hybrid meshes with ≥4 million tetrahedral elements. Flow simulations at 15 l/min were solved using the realizable k-ε model and the finite volume method. Morphophysiological variables assessed were: total airway volumes, minimal cross-sectional areas, average pressure, velocity magnitude, wall shear stress, turbulent kinetic energy (k) production, and resistance. Airway volume corresponded to 29.32 ± 4.65 cm³ and minimal cross-sectional area was 1.00 ± 0.55 cm 2 . Pressure drop, airway resistance to airflow, velocity of the airflow and turbulent kinetic energy corresponded to 31.341 ± 15.837 Pa, 0.125 ± 0.063 (Pa s/ml), 1.882 ± 0.514 (m/s) and 0.152 ± 0.056 (m2/s2). The total airway volume exhibited a strong negative correlation with airway resistance (−0.899) and the inlet-to-outlet pressure drop (−0.899). The minimal cross-sectional area of the pharynx at the retroglossal level showed a strong negative correlation (−0.912) with the area-weighted average velocity magnitude of the airflow and with k production (−0.924). In conclusion, airway volume reduction and retroglossal obstruction in young adults with IRS are associated with altered fluid flow characteristics, including increased velocity magnitude, pressure drop, resistance, and turbulent kinetic energy production. These changes may increase the effort to breathe and predispose patients to sleep-disordered breathing. • Adults with Isolated Robin Sequence (IRS) exhibit reduced airway volume and retroglossal obstruction, which are strongly associated with increased inner pressure and resistance to airflow, potentially predisposing them to sleep-disordered breathing.
  • Nasal septum deviation after rapid maxillary expansion in the early mixed dentition
    Rodrigo Teixeira, Daniela Garib, João Gabriel Rando Poiani, Camila Massaro, Guilherme Adam Fraga, Sergio Henrique Kiemle Trindade, Luiz Fernando Manzoni Lourençone, Djessyca Miranda e Paulo, Carlos Flores-Mir
    Angle Orthodontist, 2025
    Objectives To evaluate nasal septum changes after rapid maxillary expansion (RME) during the mixed dentition and to verify the association between quantitative and qualitative assessments of nasal septum deviation (NSD) by ear, nose, and throat (ENT) specialists. Materials and Methods The sample comprised 24 patients (11 male, 13 female) with a mean age of 7.62 ± 0.92 years with maxillary transverse deficiencies. Cone-beam computed tomography (CBCT) images were obtained before and after RME. Three CBCT coronal sections passing through the maxillary first molars, 5 mm anterior and 5 mm posterior, were used for quantitative assessment. NSD was calculated using the ratio of nasal cavity height to nasal septum contour. Additionally, five ENT professionals evaluated NSD qualitatively using scores from 1 to 3 through CBCT sequential axial and coronal sections. Absent NSD was scored as zero. Interstage changes were assessed using Wilcoxon tests. Spearman correlation and linear regression were performed to evaluate the association between quantitative and qualitative analyses (P < .05). Results No significant change was observed in the NSD ratio. In pre-expansion CBCT images, absence of NSD and scores 1, 2, and 3 for NSD were found for 45.8%, 41.7%, 12.5%, and 0%, respectively. In the qualitative assessment, no significant change in NSD was observed after expansion. A strong association was found between NSD ratio and ENT score (r = 0.750). Conclusions In the mixed dentition, no significant change was observed in the NSD ratio. Qualitative analysis of NSD was associated with quantitative assessment of the ratio between nasal septum contour and nasal cavity height.
  • Tomographic Evaluation of the Upper Cervical Spine in Patients with Cleft lip and Palate and Class III Malocclusion
    Ricardo Correa da Costa Dias, Maria Noel Marzano Rodrigues, Ivy Kiemle Trindade-Suedam, Sergio Henrique Kiemle Trindade
    Cleft Palate Craniofacial Journal, 2024
    Objective To perform a morphometric analysis of the upper cervical spine (UCS) by means of cone-beam computed tomography (CBCT) for the diagnosis of malformations or craniocervical instabilities in patients with cleft lip and palate (CLP) and class III malocclusion. Materials and Methods A total of 72 CBCTs from adult patients (48 male and 24 female) with Angle Class III malocclusion were divided into three groups: 1) Unilateral cleft lip and palate (UCLP) (n = 29; male = 65.5%; age = 24, 2 ± 4.2 years); 2) Bilateral cleft lip and palate (BCLP) (n = 18; male = 83.3%; age = 26.4 ± 6.0 years); 3) Control group (CON) (n = 25; male = 56.0%; age = 27.8 ± 9.3 years). The version 11.7 of the Dolphin® software (Chatsworth, California, USA) was used to evaluate the morphometric measurements and anomalies of the UCS. Data were analyzed by descriptive and inferential statistics (p ≤ 0.05). Results For the UCLP, BCLP and CON groups, respectively, the measures were: atlantodental interval (2.1 ± 0.5; 2.1 ± 0.4; 2.0 ± 0.3 mm), basion-opisthion (35.9 ± 3.2; 36.4 ± 3.0; 34.7 ± 1.9 mm), hyoid-C3 (34.5 ± 3.7; 34.5 ± 5.2; 35.3 ± 4.5 mm), and hyoid-sella (108.1 ± 9.8; 111.3 ± 9.2; 109.7 ± 10 mm); clivus-canal angle (152.3 ± 13; 150.3 ± 10; 150.7 ± 10°) and Torg-Pavlov index (1.0 ± 0.2; 1.0 ± 0.1; 1.1 ± 0.2). Potentially unstable anomalies and malformations were more prevalent in the UCLP group (34,4%). Conclusion Subjects with UCLP presented compressive or unstable anomalies on upper cervical spine, more frequently than controls and BCLP, despite the lack of statistically significant differences among groups. Future studies could increase the safety of patients and healthcare professionals specialized in craniofacial anomalies.
  • Assessment of Internal Nasal Dimensions of Individuals With Cleft Lip and Palate and Obstructive Sleep Apnea Syndrome by Computed Tomography
    Natalia Bortotti Loureiro, Maria Noel Marzano-Rodrigues, Ivy Kiemle Trindade-Suedam, Alessandro D Aquino, Sergio Henrique Kiemle Trindade
    Cleft Palate Craniofacial Journal, 2024
    To evaluate nasal cavity (NC) dimensions of individuals with cleft lip and/or palate (CL/P), obstructive sleep apnea (OSA), and primary snoring, by tomographic image analysis, compared to individuals with OSA without CL/P (N-CL/P). Cross-sectional and retrospective. Tertiary referral center. Patients were divided into 2 groups: (G1) CL/P + OSA or primary snoring, n = 11; (G2) N-CL/P + OSA, n = 13. NC tomographic images were reconstructed using ITK-SNAP software, and measurements were obtained from these three-dimensional models using SpaceClaim software. Total NC volumes, right and left NC volumes, and volumes of the nostril to the nasal valve (V1) and from the nasal valve to the superior limit of the nasopharynx (V2), cross-sectional areas, and perimeters. NC volumes (total, right, and left sides), V1, and V2, though smaller in the CL/P + OSA, did not differ significantly from the N-CL/P + OSA. Cross-sectional areas and perimeters of the superior limit of the nasopharynx, in the CL/P + OSA, presented significantly higher values compared to the N-CL/P + OSA ( P ≤ .05). The internal nasal dimensions of patients with CL/P do not seem to be part of the etiopathogenesis, nor constitute a risk factor for OSA with greater severity, in this special group of patients.
  • Screening for Obstructive Sleep Apnea and Associated Risk Factors in Adolescents and Adults With Isolated Robin Sequence
    Mariana Mendes Semensato, Sergio Henrique Kiemle Trindade, Maria Noel Marzano-Rodrigues, Leandro Scomparin, Ivy Trindade-Suedam
    Cleft Palate Craniofacial Journal, 2024
    Objective To investigate the subjective risk for obstructive sleep apnea (OSA) in adolescents and young adults with isolated Robin sequence (IRS). Additionally, to investigate the association of OSA risk with respiratory signs/symptoms, and retrognathia. Design Prospective, observational, and cross-sectional study. Setting Tertiary reference hospital for the rehabilitation of craniofacial anomalies. Participants Adolescents and adults (n = 30) with IRS were clinically evaluated and screened through the Berlin Questionnaire (BQ) and Respiratory Symptoms Questionnaire. The maxillomandibular relationship was assessed on lateral cephalograms of those that reached skeletal maturity (n = 13). Polysomnography (PSG) was performed in a subgroup of 4 individuals. Results The mean age of the sample was 18.2 (±3.4) years, 17 (56.7%) were adolescents (14-19 years), and 16 were (53.3%) female, all presented a repaired cleft palate. Clinical Parameters Systemic arterial pressure (118.0 ± 4.1/76.3 ± 4.9 mmHg), body mass index (BMI) (20.9 ± 2.8 kg/m2), neck (33.2 ± 2.3 cm), and waist circumferences (72.0 ± 5.8 cm) were within normal ranges. A skeletal class I pattern was observed in 61.5% of the participants while a class II was seen in 15.4% of them. A high risk for OSA was detected in 16.7%, and it was associated with nasal obstruction, snoring and drowsiness, and a skeletal class II pattern ( P ≤ .05). One patient presented with mild OSA (apnea–hypopnea index [AHI] = 10.1 events/hour) at the PSG exam. Conclusions A high risk for OSA can be observed with a moderate frequency among adolescents and young adults with IRS, especially among those who are concurrently suffering from nasal obstruction, snoring and retrognathia.
  • Evaluation of the impact of alveolar bone graft surgery on the nasal cavity of individuals with cleft lip and palate
    Maryana Lourenço Bastos do Nascimento, Ivy Kiemle Trindade-Suedam, Natalia Bortotti Loureiro, Maria Noel Marzano-Rodrigues, Marcela Cristina Garnica Siqueira, Thiago Henrique dos Santos Antunes Albertassi, Sergio Henrique Kiemle Trindade
    Journal of Applied Oral Science, 2024
    OBJECTIVE Cleft lip and palate are the most common congenital malformations in the craniofacial region, occurring at a rate of 1:700 births in Brazil. These conditions lead to functional impacts on patients, such as changes in breathing, teeth, speech, chewing, swallowing and sucking. Treatment begins with primary surgeries, including lip and palate repair, which aim to reconstruct the soft tissues. Secondary alveolar bone grafting (SABG) reconstructs the bone defect in the cleft region, with the main goal of supplying bone tissue to the cleft region and restore the continuity of the alveolar process. To measure the changes in cross-sectional areas (CSAs) and nasal volume in patients and their impact on the nasal cavity (NC) in the two-month postoperative period (PO2M). METHODOLOGY This study included 15 patients with complete unilateral cleft lip and palate (U/CLP) indicated for alveolar bone grafting (ABG). Cone beam computed tomography scans obtained prior to SABG and at PO2M were compared. Nasal volumes and CSAs were measured by marking the masks delimiting the nasal cavity on CT scans using Mimics™ software. RESULTS NC volumes (total, right and left sides) were statistically lower at PO2M in patients with left-sided UCLP. In right-sided UCLP, these volumes were only significant for the total NC and left NC. The CSAs of the internal nasal valve in both groups showed significantly lower values compared to the preoperative period (p≤0.05). CONCLUSION In the short term, alveolar bone graft surgery reduces the volume of nasal cavities and the cross-sectional areas of the right and left internal nasal valve as a whole, not only the cleft area where the graft material was placed.
  • Web survey during COVID-19 pandemic in São Paulo state: how are medical students sleeping and living?
    Karen Wellen da Silva Beltrame, Ivy Kiemle Trindade-Suedam, Sergio Henrique Kiemle Trindade, Maria Noel Marzano-Rodrigues
    Sleep Science, 2023
  • Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study
    Leticia Dominguez Campos, Inge Elly Kiemle Trindade, Sergio Henrique Kiemle Trindade, Luiz André Freire Pimenta, Julia Kimbell, Amelia Drake, Maria Noel Marzano-Rodrigues, Ivy Kiemle Trindade-Suedam
    Sleep Science, 2023
  • Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence
    Fábio Luiz Banhara, Inge Elly Kiemle Trindade, Ivy Kiemle Trindade-Suedam, Marilyse de Bragança Lopes Fernandes, Sergio Henrique Kiemle Trindade
    Brazilian Journal of Otorhinolaryngology, 2022
  • Impact of CPAP treatment for a short period in moderate-to-severe OSAS patients: a randomized double-blind clinical trial
    Jefferson Luis de Barros Phys, Willian Caetano Rodrigues, Antônio Carlos Marão, Letícia Cláudia de Oliveira Antunes, Sérgio Henrique Kiemle Trindade, Silke Anna Theresa Weber
    Brazilian Journal of Otorhinolaryngology, 2022
  • Are reduced internal nasal dimensions a risk factor for obstructive sleep apnea syndrome?
    Sergio Henrique Kiemle Trindade, Inge Elly Kiemle Trindade, Andressa Sharllene Carneiro da Silva, Bruna Mara Adorno Marmontel Araújo, Ivy Kiemle Trindade-Suedam, Ana Claudia Martins Sampaio-Teixeira, Silke Anna Theresa Weber
    Brazilian Journal of Otorhinolaryngology, 2022
  • Reduced pharyngeal dimensions and obstructive sleep apnea in adults with cleft lip/palate and Class III malocclusion
    Leticia Dominguez Campos, Inge Elly Kiemle Trindade, Marilia Yatabe, Sergio Henrique Kiemle Trindade, Luiz Andre Pimenta, Julia Kimbell, Amelia F. Drake, Ivy Kiemle Trindade-Suedam
    Cranio Journal of Craniomandibular Practice, 2021
  • Effects of organic and inorganic compounds of diesel exhaust particles on the mucociliary epithelium: An experimental study on the frog palate preparation
    Sergio Henrique Kiemle Trindade, Robson Seriani, Geraldo Lorenzi-Filho, João Ferreira de Mello Júnior, Luiz Ubirajara Sennes, Paulo Hilário Nascimento Saldiva, Mariângela Macchione
    Ecotoxicology and Environmental Safety, 2018
  • Nasal airway dimensions of children with repaired unilateral cleft lip and palate
    Inge Elly Kiemle Trindade, Adriana De Oliveira Camargo Gomes, Marilyse De Bragança Lopes Fernandes, Sergio Henrique Kiemle Trindade, Omar Gabriel Da Silva Filho
    Cleft Palate Craniofacial Journal, 2015
  • Internal nasal dimensions of adults with nasal obstruction
    Inge Elly Kiemle Trindade, Priscila Capelato Prado Conegliam, Sergio Henrique Kiemle Trindade, Norimar Hernandes Dias, Ana Claudia Martins Sampaio-Teixeira
    Brazilian Journal of Otorhinolaryngology, 2013
  • Nasal mucus transportability in children with cleft palate
    Sergio Henrique Kiemle Trindade, Mariângela Macchione, Eliane Tigre Guimarães, Inge Elly Kiemle Trindade, Paulo Hilário Nascimento Saldiva, Geraldo Lorenzi-Filho
    International Journal of Pediatric Otorhinolaryngology, 2008
  • Nasal cavity geometry of healthy adults assessed using acoustic rhinometry
    Adriana de Oliveira Camargo Gomes, Ana Claudia Martins Sampaio-Teixeira, Sergio Henrique Kiemle Trindade, Inge Elly Kiemle Trindade
    Brazilian Journal of Otorhinolaryngology, 2008
  • Adult nasal volumes assessed by acoustic rhinometry
    Inge Elly Kiemle Trindade, Adriana de Oliveira Camargo Gomes, Ana Claudia Martins Sampaio-Teixeira, Sergio Henrique Kiemle Trindade
    Brazilian Journal of Otorhinolaryngology, 2007
  • Methods for studying mucociliary transport
    Sergio Henrique Kiemle Trindade, João Ferreira de Mello Júnior, Olavo de Godoy Mion, Geraldo Lorenzi-Filho, Mariângela Macchione, Eliane Tigre Guimarães, Paulo Hilário Nascimento Saldiva
    Brazilian Journal of Otorhinolaryngology, 2007
  • Endoscopic findings in children with stridor
    Regina H.G. Martins, Norimar H. Dias, Emanuel C. Castilho, Sérgio H.K. Trindade
    Brazilian Journal of Otorhinolaryngology, 2006
  • Training the osteoplastic flap technique in dogs.
    Onivaldo Bretan, Emanuel Araújo Nogueira, Eriverton Ferreira da Silva, Sérgio Henrique K. Trindade
    Revista Brasileira De Otorrinolaringologia English Ed, 2005
  • The dysphonic child: Diagnostic, treatment and clinical evolution
    Regina H. G. Martins, Sérgio H. K. Trindade
    Revista Brasileira De Otorrinolaringologia, 2003