Basic Otorhinolaryngology: A Step-by-Step Learning Guide, 2nd edition

Review by L Flood
Middlesborough, UK

It cannot be easy to think up a new approach to an ENT textbook, especially considering the profusion of such publications from Thieme in recent years. This title certainly attracts, as there is a real need for a simple introductory text to inform (even to attract) those outside our specialty. This book, we are told, is specifically targeted at residents and trainees in ENT and related specialties, and at students on rotation. One of this reviewer’s best-received lectures was 40 minutes long, entitled ‘How to bluff your way in ENT’, delivered to general practitioners. The need is to deliver the simple, but crucial, information, the ‘hot tip’, which helps the inexperienced to detect cholesteatoma, treat acute airway obstruction and manage a facial palsy.

Any criticism of this book must be based on that requirement and must acknowledge that it is quite a bargain, even for a paperback (and there is an electronic version too). If it has any shortcoming, it is that it may be too detailed in many topics. One will rarely see a better diagrammatic representation of the central and peripheral anatomy of the glossopharyngeal nerve, but might question its place in a ‘Basic’ title. Few readers will be familiar with the Aachen Aphasia Test or require the knowledge of audiology presented (one of the strongest features of the book, however).

Structure is emphasised in the preface, and is possibly overdone and distracting, with text boxes, study units, learning objectives and so on. The result is certainly colourful. Some chapters carry tables in blue boxes; all also carry text on green backgrounds. The latter is ‘knowledge in depth’, which, we are told, can be skipped over by those in a hurry (and, to be fair, does include the course of the lower cranial nerves!). Algorithms abound, with a colour code for the boxed text of quite some complexity. Diagrams are superbly reproduced throughout. A personal favourite is the histological progression from dysplasia to invasive squamous cell carcinoma, rarely understood by trainees. The snag is that it requires an understanding of the cellular changes so well illustrated, but not actually explained. Many of the colour photographs (e.g. endoscopic and operative images) show excessive colour saturation, a hazard of photography in the pre-digital age. Otoscopic shots are too small and there is no convincing image of cholesteatoma, surprisingly. There is always the temptation to publish the rarities from one’s image collection and a few have crept in here. The radiology images are very well selected and printed.

It is gratifying to see that indirect laryngoscopy is still recommended, if an unrealistic ideal. Few trainees can now don a head mirror, let alone perform a mirror examination of the nasopharynx as illustrated. The auroscope used evokes a feeling of nostalgia for the days of England’s World Cup success.

Now, I have been harshly critical of what is a very comprehensive textbook (because we have lots of them), published at a bargain price (a rarity). I really like this book and will recommend it to my advanced trainees, especially as the final exams approach. It is excellent in terms of the (far from basic) sciences, audiology in general and vestibular assessment especially. It is a valuable quick-reference tool, which has been extensively expanded for the second edition. It is simply that it is far from ‘Basic’. Beware of confusing it with the original, as the covers are very similar. Unsurprisingly for this book, the main difference is the addition of yet more colours to the head and neck anatomy diagram.

Amazon Link: Basic Otorhinolaryngology: A Step-by-Step Learning Guide, 2nd edition
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