Oxford Textbook of Otolaryngology

Review by L Flood
Middlesbrough, UK

That delivery van outside was surely bringing my copy of “Napoleon’s Light Infantry and Artillery”, even if publication was not to be for another week. This promised book from Oxford University Press would take two to three weeks I was told, but here it was and it probably has proved a far better read. I am grateful to any publisher that will sacrifice a few trees to provide a paper copy, rather than expect me to read off a monitor, something I rarely consider. My second surprise then was to be presented with a hardback and that does make a difference. I had somehow, and no idea why, imagined a much smaller text for undergraduates and early years trainees. I guess I saw that as much less of an editorial challenge than this must have proved, as outlined by John Phillips in his Preface. He reminds us just how many books we can find which are pocketbook references, exam revision aids or the multivolume classics that warp the bookshelf. His challenge to authors was to create something that could be read from cover to cover and, as a reviewer, I too had to meet that challenge (and found it easy). Prof Valerie Lund’s Foreword reminds us that “No other speciality impacts so many physiological functions vital to our life and survival “ and she goes on to list them. She highlights the intention here, to provide Recommended Reading lists, rather than countless references, a worthy aim met in many, but not all chapters. I think the record was 99 references to one outlier chapter, but I will forgive that. We are told to seek an evidence base for any recommendation and that means publication in a peer-reviewed journal after all. The consistency of style throughout is commendable, nonetheless.

Again, the hardback version immediately reinforces that impression of quality, the sheer weight of the book is striking, but flicking through the pages will win over any reader. The book is visually very attractive with a uniform pattern of blue boxed information, green boxes for tables, the cover colour of burgundy for chapter headings and section titles and many a flow diagram. There is excellent reproduction of endoscopic colour images, most notably in the Paediatric section and it is striking how modern imaging is no longer the monochrome of tradition, but a rainbow of overmarking introduced by the radiologists.

The authorship is largely UK based, so many names which are familiar as former trainees in the North East or examination candidates suffering across a viva table, all now pillars of our speciality. We could only have had our own Emma Stapleton on “Necrotizing Otitis Externa” and I will forgive the US spelling. Equally I noticed the more senior contributors such as Andrew Swift, Peter Webber or Tim Woolford, to name but a few.

So far, I have manged to not say a single word about content, and I will resist the temptation to just list every one of the 90 chapters. I thought the opening section was inspired, as most books will start with the basic sciences as, however worthy, they are not always gripping reading. Instead, we get chapters on being a good doctor (by an orthopaedic surgeon), the rights of the patient (by a geriatrician, who provided some excellent boxed case studies) , anaesthesia for ENT (so good at covering controversies) and practice in the COVID era, reminding us of the timing of preparation of the book.

Even after six years retired, the Otology section still appealed. Chapter 12 lists 17 causes of conductive hearing loss with an intact tympanic membrane, most of which (but not all alas) I did get. The external ear chapter showed excellent tips on management of exostoses (much more challenging than generally realised) and a great photograph of an external canal cholesteatoma, a true rarity. In Chapter 19 I was really amused and delighted to read, under Controversies, “Pretty much everything other than you have to get the cholesteatoma out”. To highlight a few more favourites I would mention the operative photographs and coloured diagrams in Chapter 35 on rhinoplasty. Then Prof Claire Hopkins presented us, in the FESS chapter, with the Good (nice antrostomy), the Bad (missed ostium) and the Ugly (Failed surgery which defies my description). As with most chapters in the Rhinology section this did conform to the Tips and Pearls, Controversies and Further Reading requirement.

Head and neck practice takes up over 200 pages and is conventional in covering presentations, management options, with many a flow diagram, and especially rehabilitation. Chapters here will very much appeal to other members of the multidisciplinary team. The topic certainly lends itself to colour illustration, again of very high quality print. The paediatric section again allowed excellent endoscopic views of airway disorders but the real appeal here was the opening chapter on “Assessment of the neonate, infant, child and adolescent”. I think this would be my “standout” chapter of the entire book for any trainee. There is a table listing language, communication, social and motor skills in children of increasing age, followed by one listing indications for immunological investigations (so easily missed) and finally a table of the features that distinguish hearing loss from developmental delay and autistic spectrum disorder.
I learnt so much from this. I now am familiar with CLOSE, as a checklist for sinus scans, the Jarhrsdoefer grading system of aural atresia or Bamboo nodules on the vocal cords. This is quite a remarkable book, to prove such an easy read, rather than a dipping-into reference (however good the index does prove to be) and well meets the challenge set by the senior author.

Amazon Link: Oxford Textbook of Otolaryngology
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