Hearing: An Introduction and Practical Guide

I simply had to review this personally. That is partly because the influence of post-Christmas blues and the depths of the UK winter have driven many of my most reliable reviewers into somnolence. It is also because one of these authors is so familiar to me, as I do recall celebrating his birth with his father, who was a senior registrar during my registrar training, at University College Hospital London. That he is an established academic consultant himself, now, is a cautionary thought.

I felt I would have to be nice about this book then and that proved easy. I had imagined a rather heavy guide to the principles and practice of audiology, as the title might suggest. Sure enough, Section I starts with two chapters on anatomy and physiology. How I would have welcomed this to plagiarise for my own effort last year, in Logan Turner’s Diseases of the Nose, Throat and Ear: Head and Neck Surgery. The basics are there, but, cleverly, they have introduced just enough detail to prompt further reading. I feel better for seeing ‘a reconstruction of a labelled auditory nerve fibre end-bulb of Held synapse, terminating on a spherical bushy cell’. When I then read that these are amongst the largest synapses in the brain, I cringed and wished I could revise my own chapter. Seriously, these two topics are well introduced.

Section II covers clinical assessment of hearing (nice to see someone still approves of tuning forks), audiometry and imaging. The scans are very well printed and labelled, and it is nice to see such lesions as enlarged endolymphatic sacs and cochlear otosclerosis, and not just the usual cholesteatoma and acoustic neuroma (mind you, the bilateral acoustics that are shown are ‘impressive’!).

At this stage, we are only 58 pages into the total, including the index, of 198 pages. The rest is entitled ‘Hearing Loss and Rehabilitation’. The multi-author contributions here cover conductive hearing loss, sensorineural deafness, implants and aiding, but there is great imagination in the choice of topics for the final eight chapters. Hearing therapy, rehabilitation in children and then adults, tinnitus, hyperacusis, and auditory processing disorder are rarely tackled in general otology texts. A real treasure for any trainee is ‘Additional Support for Patients with Hearing Loss’, because reading and retaining the tips provided will put them way ahead of any examiner’s knowledge, in the final exams. Most of us, as surgeons, consider our role done, when we fill in the hearing aid form, after wax removal.

There is little to criticise. Otoscopic photography of the tympanic membrane really needs colour reproduction, but that increases costs. Most readers will be past the stage of needing illustrations of acute otitis media, anyway. Surgical techniques are, inevitably, covered superficially, with little information as to selection, in individual cases (I fully concede that there may actually be no scientific basis to that, all too often). I really looked forward to the final chapter ‘Future Therapies’ to see what the next generation is up to, especially reading the list of seven topics. Hair cell regeneration, tissue-engineered middle-ear mucosa, and improved resolution for cochlear implants seemed great examples and worth a book in themselves. This actually proved, disappointingly, the shortest chapter of all, just two pages of sparse text, with a single reference to just what I sought, a book I reviewed for The Journal of Laryngology & Otology a year ago, by the section author.

This paperback is excellent value. Chapters vary in value, contributors vary in their industry, but this is an easy-to-read text for the early years’ trainee and a good revision text for the unfortunate facing the exit exam. It is far more comprehensive than the title suggests; a personal favourite was the coverage of rehabilitation, the poor relation of our practice.