Advanced Craniomaxillofacial Surgery: Tumor, Corrective Bone Surgery and Trauma

Review by L Flood
Middlesborough, UK

This is a sizeable book, aimed primarily at our colleagues in oral and maxillofacial surgery, but the advanced work described clearly needs multidisciplinary input. There have been major advances in techniques, materials and diagnostic tools in the capable hands of our associates, but there is still some role for the subspecialist otolaryngologist head and neck surgeon. One editor (Neal D Futran) is such, and contributes chapters on ‘Encephaloceles’, ‘Access Surgery to the Skull Base’, ‘Secondary Frontal Sinus Surgery’ and ‘Midface Resection and Reconstruction’. Our multitalented specialty features amongst the 80 or so international authors, and contributes to topics such as mandibular implants, and even endoscopy in mandibular and midface trauma.

At first glance, the book cover shows this is not quite in the classical house style of Thieme, but the print, colour illustrations and diagrams, and reproductions of imaging, are all of the quality we have come to expect.

This is, of course, primarily complex carpentry of bone rather than soft tissue surgery, and so the opening chapters deal with bone grafting and synthetic replacements. One hundred pages follow, dealing with ablative and reconstructive surgery of the mandible. An unforgettable series of images, starting on page 141, shows a remarkable outcome from a truly impressive ameloblastoma of the mandible. Perhaps what is most striking is that this was accomplished over 18 years ago.

Ablative and reconstructive surgery then moves above the jaws to the midface, orbit, skull base and even cranial vault, over a series of eight chapters. A fourth section ‘Correction of Complex Deformities…’ opens with a chapter on gunshot injuries and some unforgettable photographs of the challenges presented. These are not for the squeamish. A chapter I found particularly interesting was on ‘Medication-related Osteonecrosis of the Jaw’. As throughout the book, this closed with an impressive list of very up-to-date references.

Coming curiously late in the book is an extensive section on imaging and planning technologies. Here we see three-dimensional planning, and the roles of endoscopy, intra-operative monitoring and computer-assisted surgery. A promising chapter titled ‘Interspeciality Interface in Head and Neck Oncology’ disappointingly proved the shortest in the book, and I thought this was a missed opportunity to widen the book’s appeal. However, a fascinating final chapter was less about the technique of facial allotransplantation than about patient selection and team organisation.

This book is then of greatest appeal to the oral and maxillofacial, or the plastic and reconstructive, surgeon and trainee. There is, however, still much here that is of relevance to the otolaryngologist, the neurosurgeon or the ophthalmologist. Certainly, most of the book’s content is sadly now missing in UK general otolaryngology training.

Amazon Link: Advanced Craniomaxillofacial Surgery: Tumor, Corrective Bone Surgery and Trauma
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