Pocket Tutor Otolaryngology

Review by L Flood
Middlesborough, UK

Here, just for once, is a pocket book which merits that description. As with all in this well-established series from these publishers, this paperback is a manageable size for easy, quick reference. It does not need the pouches seen on military cargo pants, but is instead something the student or junior trainee can easily refer to, while no one is watching!

A second nice feature, in this new edition, is that the authors have already done much of the work of the reviewer in their Preface. They carefully list the many changes to what was already a little treasure. There is, for example, a completely new chapter entitled ‘Diagnostic Algorithms’, which presents four pages of flow diagrams covering the evaluation of facial weakness, hoarseness, otorrhoea and nasal obstruction. Each carries links to the appropriate text elsewhere and seems well thought out. Indeed, I was left wanting a few more of those, and wished I had had such when starting out decades ago. There is also new coverage of facioplastics, sleep medicine and paediatric otolaryngology.

In the Foreword, Prof Tony Narula tells us that even he has learnt from this book, ‘even though I have been practicing for more than 30 years’. Well, at 43 years since my first hesitant tonsillectomy (as his exact contemporary), I certainly also found this a useful revision. It takes skill to produce diagrams, clinical photographs, tables and boxed bullet points in the small format needed for a pocket book. The print standard is excellent, whether monochrome imaging (rendered to a very high resolution), colour photography or simply the text layout itself. There are ‘Clinical Insights’, presented as boxed pearls of wisdom, on almost every page.

My personal favourite? This would be Chapter 2, ‘Clinical Essentials’, which covers history taking, clinical examination and investigations, whether audiometric or laboratory based. It is nice to see tuning fork testing still being recommended, and there were a few serological tests that were unfamiliar to this ageing reviewer. I agree that the head mirror should still have a place, although many a trainee in my experience has never actually donned one. I was tempted to quibble over the illustration of an osteoma of the ear canal as being atypical, in that we are presented with two lesions, potentially confused with exostoses. The text did however, then distinguish them. I was initially puzzled by a photograph of the senior author carrying out a Dix–Hallpike manoeuvre. There seemed a curious pixilation of the subject’s hair, giving him an Afro style. Then I noticed the same for his mouth and assumed this was an attempt to anonymise him, but just misplaced. Then the penny dropped, but it did take a while. The idea is to focus our attention to where Abir (Bhattacharyya) is concentrating, the subject’s eyes, and seeking nystagmus! There are some great clinical photographs, such as the best images of endoscopic pouch stapling I have seen, or a bloodless branchial cyst excision.

Quite remarkable is the value for money represented here. It really does retail for less than £15, and is an essential purchase for the student and, possibly even more, the new trainee venturing onto the ENT ward for the first time.

Amazon Link: Pocket Tutor Otolaryngology
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