Climate change sensitivity index for Pacific salmon habitat in southeast Alaska.

Global climate change may become one of the most pressing challenges to Pacific Salmon conservation and management for southeast Alaska in the 21st Century. Predicted hydrologic change associated with climate change will likely challenge the ability of specific stocks to adapt to new flow regimes and resulting shifts in spawning and rearing habitats. Current research suggests egg-to-fry survival may be one of the most important freshwater limiting factors in Pacific Salmon's northern range due to more frequent flooding events predicted to scour eggs from mobile spawning substrates.

Management of manifestations of epidermolysis bullosa.

Purpose Of Review: Children with epidermolysis bullosa can present with disease(s) of the ears, nose, and throat, often related directly to the pathophysiology of their epidermolysis bullosa. Otolaryngologic diseases in children with epidermolysis bullosa have to be managed having a proper understanding of the diagnosis and pathophysiology of epidermolysis bullosa. The purpose of this review is to describe the current nomenclature and diagnostic algorithms for epidermolysis bullosa, and methods for the management of cutaneous and mucosal lesions.

Use of historical logging patterns to identify disproportionately logged ecosystems within temperate rainforests of southeastern Alaska.

The forests of southeastern Alaska remain largely intact and contain a substantial proportion of Earth's remaining old-growth temperate rainforest. Nonetheless, industrial-scale logging has occurred since the 1950s within a relatively narrow range of forest types that has never been quantified at a regional scale. We analyzed historical patterns of logging from 1954 through 2004 and compared the relative rates of change among forest types, landform associations, and biogeographic provinces.

Refractory choanal atresia: what makes a child susceptible? The great Ormond Street Hospital experience.

Objective: An outcome analysis of factors that predispose patients to require multiple surgical procedures for choanal atresia repair.

Design: Retrospective case note review of choanal atresia patients identified from a prospectively collected database at Great Ormond Street Hospital for Children, London, between 1992 and 2005.

Setting: Specialist centre in pediatric otolaryngology.

Single-stage and multistage pediatric laryngotracheal reconstruction.

Acquired pediatric laryngotracheal stenosis almost always results from prolonged intubation for prematurity. An understanding of the process by which this occurs helps in prevention and treatment. Before deciding to perform cartilage augmentation procedures, more limited techniques such as medical therapy or endoscopic surgery need to be considered.

Cidofovir: to use or not to use?

Purpose Of Review: Cidofovir is an antiviral agent that has been used increasingly in the last decade as an adjuvant therapy for recurrent respiratory papillomatosis. It has been used in patients with moderate to severe recurrent respiratory papillomatosis requiring frequent surgical intervention or if there is evidence of distal spread. Intralesional administration after surgical debulking delivers the medication directly to the site of disease and is thought to have fewer systemic side effects than intravenous infusion.

Safe reliable atraumatic replacement of misplaced paediatric tracheostomy tubes.

Objective: Displacement of tracheostomy tubes, especially soon after insertion has a high morbidity and mortality rate. We present a safe atraumatic reliable method of tracheostomy tube replacement.

Setting: Tertiary paediatric centre.

Successful treatment of laryngeal stenosis in laryngo-onycho-cutaneous syndrome with topical mitomycin C.

Laryngo-onycho-cutaneous syndrome is a very rare entity found in Punjabi families. It affects the skin, nails, and larynx. Laryngeal involvement may cause lethal airway obstruction, and has in the past proved very difficult to treat.

The effect of aryepiglottoplasty for laryngomalacia on gastro-oesophageal reflux.

Objective: to investigate whether relief of airway obstruction in laryngomalacia by aryepiglottoplasty affects gastro-oesophageal reflux.

Methods: a prospective study of consecutive infants and children with suspected laryngomalacia. Gastro-oesophageal reflux was measured before and after diagnostic microlaryngobronchoscopy and aryepiglottoplasty.

The changing indications for paediatric tracheostomy.

Objective: To investigate whether the incidence and indications for paediatric tracheostomy in this unit have changed over recent years.

Methods: All paediatric tracheostomies performed between 1993 and 2001 were identified from our departmental database. The indications for these were ascertained by retrospective case note review.

Tuberculous mastoiditis: when is surgery indicated?

Mycobacterium tuberculosis is a rare cause of mastoiditis, but diagnosis is often delayed, with potentially serious results. We present the case of a 7-year-old child who failed to improve even once the diagnosis was made and appropriate medical treatment initiated. At mastoidectomy, a bony sequestrum was found which had not been evident on CT scanning.

A review of the current management of infantile subglottic haemangioma, including a comparison of CO(2) laser therapy versus tracheostomy.

Objectives: We reassessed the current practice and treatment options used in the management of subglottic haemangiomas (SGHs), including the place for open submucosal surgical excision, and have compared the results of different therapeutic modalities used for SGHs.

Methods: The two studies were conducted as separate exercises; (1) a retrospective review of 36 patients collected over a recent 8-year period to assess the current practice and treatment options in use; (2) a retrospective comparative study of a previous cohort of 51 patients with SGHs treated in one of four groups: (a) tracheostomy alone, (b) tracheostomy and CO(2) laser, (c) systemic steroids and CO(2) laser (no tracheostomy) and (d) intralesional steroid injection, CO(2) laser therapy, or both, followed by intubation.

Results: Systemic steroids were the most commonly used modality of treatment.