Showing papers by "William B. Armstrong published in 2007"

Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction

Abstract: ✓ Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections. The authors present an unusual case of Lemierre syndrome in a 16-year-old boy with cavernous sinus thrombosis and right internal carotid artery narrowing without neurological sequelae, right subdural empyema, and cerebritis in the right temporal and occipital lobes. Neuroimaging also demonstrated right jugular vein thrombosis. Cultures of samples from the blood proved positive for the presence of Fusobacterium necrophorum. The patient underwent unilateral tonsillectomy, drainage of the peritonsillar abscess, and a myringotomy on the right side. Postoperatively the patient was treated conservatively with antibiotic therapy resulting in an excellent outcome.

Recognizing schwannomatosis and distinguishing it from neurofibromatosis type 1 or 2.

Abstract: Background DataSchwannomatosis has become a newly recognized classification of neurofibromatosis. Although the genetic loci are on chromosome 22, it lacks the classic bilateral vestibular schwannomas as seen in NF-2. We present the surgical treatment of 4 patients with schwannomatosis, including a b

Aspiration of a capsule endoscope and description of a unique retrieval technique

Abstract: The capsule endoscope has revolutionized small-bowel inspection, which before was limited to indirect studies, such as barium radiography, scintigraphy, and angiography, or to direct but invasive push enteroscopy. It provides a direct, yet minimally invasive, visualization of the small bowel. Capsule endoscopy is approved by the FDA for detection of small-bowel mucosal abnormalities. To date its major application has been evaluation of occult gastrointestinal (GI) bleeding. The device has been used in 340,000 patients worldwide, with 105,000 procedures in the US within the last year. As its applications increase to include evaluation of conditions such as Crohn’s disease, small-bowel polyps, and abnormal small-bowel radiographic studies, its utilization will increase (sales increased by 18% over the last year), and clinicians should be aware of its complications. Three cases of capsule endoscope aspiration have been reported in gastroenterology literature to date. This is the first report in otolaryngology literature. Although rare, this complication is potentially fatal and should be considered an emergency. A 67-year-old man with history of anemia was referred for capsule endoscopy to evaluate for occult GI hemorrhage. Due to a past medical history of hypertension, diabetes mellitus, cerebrovascular accident, and intermittent dysphagia, endoscopic placement of a capsule endoscope (M2A, Given Imaging, Ltd, Duluth, GA) was recommended. However, the patient declined and chose to swallow the capsule, immediately after which he began to cough and exhibit dysphonia, which resolved. There was no respiratory distress, but he developed a persistent cough. Within 3 minutes the patient became tachypneic and tachycardic, but his oxygen saturation remained above 95%. There were ronchi, but no stridor. The physician recognized the possibility of interrogating the capsule endoscope to determine its location. Images from the capsule endoscope were downloaded and analyzed within 5 minutes and definitively revealed that the device was aspirated promptly after it was swallowed (Fig 1). This process took less time than obtaining plain radiographs. The patient was taken to the operating room for retrieval

High-speed three-dimensional endoscopic OCT using MEMS technology

Abstract: We present a three-dimensional (3-D) endoscopic optical coherence tomography (OCT) system using a dual axis scanning mirror. The MEMS device employed in this study utilized a 1.2 mm mirror and exhibited x and y-axis resonant frequencies greater than 1 kHz. The developed probe was packaged and integrated with an OCT system which has a scan rate of 3~8 frames/s. Preliminary in vivo and in vitro 3-D OCT images of biological tissue, such as human finger, vocal cord, rabbit trachea, were visualized to verify the achieved performance of the device.