Haynes-Glasscock-Shambaugh Surgery of the Ear (7th Ed)

Review by Anirvan Banerjee MS FRCSEd (ORL-HNS)
Middlesbrough UK

As book review editor I must express gratitude to the publishers for a paper copy of this book, even more so as it proved to be a hardback. A paperback version is expected in about a year, but the price of the current version is a truly remarkable bargain. We would expect a book of the quality to retail for hundreds of pounds, but more astounding is that the eBook is Open Access. Yes, it is free. This is a book ideal for reference and dipping into, so very much lends itself to that format. It is getting increasingly hard to get anything but on-line versions of new texts to review, something I find impossible in practice. Equally, finding reviewers that will actually deliver promptly is a challenge and we are all increasingly busy (even seven years retired). My colleague has produced an excellent review in a record time, so much so that I suggested he used AI (which here stands for Anirvan Intelligence of course)

Liam M Flood FRCS FRCSI
Middlesbrough, UK

There are few books in otology with the history of Surgery of the Ear. The fourth edition of Glasscock and Shambaugh was one of the mainstays of my own training in otology during my residency in India. I returned to it repeatedly, not simply to the dissection manual to learn the steps of an operation, but to understand the principles behind ear surgery and how experienced otologists approached difficult problems.

More than three decades later, it was therefore particularly interesting to read the seventh edition and see how both the book and the specialty have evolved. Much of the core otology remains familiar, but the scope of practice has changed enormously. Tympanoplasty, mastoid surgery and otosclerosis now sit alongside cochlear implantation, bone-conduction devices, endoscopic ear surgery, genetics, vestibular disorders and emerging therapies for the inner ear. At 1170 pages and 82 chapters, this is a substantial book, but it is sensibly organised and surprisingly easy to navigate. The sections move from basic science and clinical assessment through hearing rehabilitation and surgical principles, before covering disease of the external, middle and inner ear and, finally, lateral skull-base surgery. Perhaps the most striking difference from the edition I used as a trainee is the change in what we now regard as the scope of otology. Earlier editions were, understandably, dominated by the diagnosis and surgical treatment of ear disease. The modern otologist is equally concerned with hearing rehabilitation, implantable technology, vestibular disorders, genetics and increasingly with the prospect of biological therapies. The seventh edition reflects that transition very well. In that sense, it is not simply an updated textbook, but also a record of how the specialty itself has changed.

I particularly liked the way newer techniques are presented alongside established surgical principles rather than as replacements for them. Endoscopic ear surgery has its place, but so do conventional approaches to tympanoplasty and mastoid surgery. Similarly, cochlear implantation, bone-conduction hearing devices and other implantable technologies are presented as integral parts of contemporary otological practice rather than as peripheral subjects. This breadth is one of the strengths of the book. Modern otology is increasingly about selecting the most appropriate intervention rather than simply deciding which operation to perform. The choice may be between reconstruction, amplification, an implantable hearing device, cochlear implantation or, in some circumstances, no surgery at all. A contemporary textbook needs to reflect that wider decision-making process, and this edition does so.

As with any large multi-author textbook, there is some variation between chapters. Some are particularly practical and give a clear sense of how the authors actually approach patients and surgical problems. Others are more conventional reviews of the literature. Personally, I found the former more useful. When consulting a surgical textbook, one often wants to know not only what can be done, but how an experienced surgeon thinks about the problem. Its greatest strength is also, inevitably, one of its limitations. A book of this size cannot provide the same operative immediacy as a dedicated surgical atlas or a good video resource. For some procedures, particularly those where the sequence of dissection and handling of instruments are important, video will inevitably convey more than a series of still images. There is also some variation in style and depth between contributors. Neither detracts significantly from the value of the book, but both are inevitable consequences of attempting to cover such a large specialty comprehensively. There is also a predominantly North American perspective. This matters little when discussing anatomy, pathology or operative technique, but becomes more apparent in areas such as regulation, healthcare organisation and medicolegal practice. UK readers will therefore need to interpret some sections within the context of their own healthcare system and clinical practice.

The book is very well illustrated, which remains particularly important in otology. Operative videos may be better for demonstrating movement and the sequence of surgery, but a good diagram can still explain anatomy and surgical relationships more clearly than several paragraphs of description. The combination of the two is probably now the ideal way of learning operative otology. One particularly welcome feature is that the entire book is available open access. For a specialist textbook of this size and quality, that represents a significant act of academic generosity. Specialist surgical texts are expensive and, in many lower-income countries, access to current textbooks and well-resourced institutional libraries can be limited. Making the book freely available therefore has significance well beyond convenience.

It allows trainees and young surgeons, wherever they happen to be training, access to the same contemporary reference material as colleagues working in better-resourced healthcare systems. Having trained in India with an earlier edition of this book as one of my principal references, I particularly appreciate the value of this. For a textbook with such a long association with the education of generations of otologists, widening access in this way seems entirely appropriate.

This is not a book that most readers will read from beginning to end. Nor does it need to be. It is the sort of book that sits on the shelf—or increasingly on the screen—and is returned to when a particular clinical or surgical question arises. For trainees, it provides a broad foundation in contemporary otology. For fellows and established otologists, its value is more likely to be as a reference and as an opportunity to see how other experienced surgeons approach familiar and occasionally unfamiliar problems. The seventh edition manages to retain the authority and tradition associated with Glasscock and Shambaugh while adapting convincingly to the way otology is practised today. For someone who learnt otology from an earlier edition, perhaps the greatest compliment I can give the seventh is that I would be equally happy to place it in the hands of a trainee today.

Amazon Link: Surgery of the Ear
By purchasing books via this link you will help to fund the JLO