Atlas of the Facial Nerve and Related Structures

Review by L Flood
Middlesborough, UK

The first author is a former fellow of his co-author, Dr Rhoton, at the Microneuroanatomy Laboratory of the University of Florida. When I then also read that he is Board-certified as both a plastic surgeon and a neurosurgeon, I did feel that a part-time ENT surgeon, in sunny Middlesbrough, was hardly qualified to criticise or comment on his work! He specialises in facial reanimation surgery, hence this book. Dr Rhoton’s laboratory, plus the techniques developed there, allowed him to perfect the dissections and colourful silicon injections which characterise this atlas. The content is very much more the ‘and Related Structures’ of the title than just illustrating the complexities of facial nerve anatomy. 

There is osteology of the skull, with facial, orbital, temporal, neck and skull base dissections. Image quality is reproduced to the standard we would expect from this publisher, in full colour, and with clear labelling and appropriately brief text descriptions. This is basic science, pure anatomy, so do not expect guidance on finding that nerve in parotidectomy or revision mastoid surgery. That does not detract from its value. 

The book seemed much thicker than the approximately 100 pages of text suggested. Sure enough, half of its depth is taken up with a box, containing a set of stereoscopic goggles, a cardboard effort that folds into a box shape, which may yet prove fragile. The idea is to view online reproductions of the images in three dimensions (3D). As with any new technology post 1980, I did struggle with those at first. I am used to the red and blue lens system, which turns the National Aeronautics and Space Administrations fuzzy pictures of the surface of Mars into a scene one could walk through (incredible). No, instead this is the idea that goes back to the earliest days of photography. Two subtly different images are presented to each eye, to become 3D on gazing through the stereoscopic viewer. This is different however. The viewer actually sees three images and only the centre one is in 3D. That took my aged brain quite some time to fathom. Once I did work it out and use what neuroplasticity still remains to me, I found the effect dramatic. Even on the biggest monitor I could find, the pictures are still small however (although something tells that me my three sons could have instantly fixed that; indeed, my grand- daughters could have done better than me, I would bet). In the end, the result is remarkably effective, though, in transforming perception of the anatomical relationships. Truly, this VIIth cranial nerve is far more than just the stringy thing that makes one smile and makes constant bleeping noises, on the odd occasions when I do give in and use a monitor.

It is worth considering the value for money, for a book of this quality, if you do see this on the bookshelves. Probably this is more for those interested in the basic science, the trainees and scientists, rather than the busy clinician who spends more time avoiding the VIIth cranial nerve than picking out its many branches. This book is excellent value.

Amazon Link: Atlas of the Facial Nerve and Related Structures
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