Airway Reconstruction Surgical Dissection Manual

Review by L Flood
Middlesborough, UK

There is an old London saying (relevant to those of a certain age who are suddenly entitled to a free pass) that you wait hours for a bus and then three come together. Only six months ago I reviewed a laryngeal dissection guide, commenting on its novel idea, and here is a similar offering. Now, instead of cadaver human specimens, the subjects are living (anaesthetised, I hasten to add) piglets, something that may not universally appeal. I defy anyone, seeing the two ‘volunteer piglets’ gazing out of their cage on page 3, not to cringe.

Doubtless, there is a need for such training. As surgeons, we are generally more comfortable gaining experience on our own species (curiously), possibly because consent is more assured. The preface notes the scarcity of experience in laryngeal reconstructive surgery in humans, with the reduced prevalence of subglottic stenosis. It is also reassuring to note that issues with restricted working hours for trainees are not limited to the UK!

This multi-author work is based on the Toronto training programme. It is a ring-bound manual, printed on tough glossy paper, ideally suited to its likely working environment. There are large and clear colour illustrations throughout, with brief explanatory text. An early chapter takes the novice through an anatomical dissection and cleverly contrasts the porcine anatomy with the human. Fortunately, they do seem well matched. Exercises that follow include cricoid split surgery and laryngotracheoplasty, in all their forms, with guides to harvesting alar and rib cartilage for grafting. Tracheostomy, cricotracheal resection, tracheoplasty and stenting are particularly suited to what is true surgical practice, after all, rather than a cadaver exercise.

This is a highly specialised field, but the manual would make excellent reading for any laryngologist or paediatric ENT surgeon. The illustrations are of such a high quality, with every step shown, that even a humble otologist felt this looked like easy work. The real message, I am sure, is that this would convince any interested reader to sign up for such a hands-on course.

Amazon Link: Airway Reconstruction Surgical Dissection Manual
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