Review by L Flood
I felt I was bound to like a book whose Preface states ‘This book is very different. It focuses not only on what skull base surgeons do, but also equally how they think and strategize’. The book title certainly caught my eye, when most texts concentrate on tactics (what you do when you get there) rather than strategy (how and why you got there in the first place). I will admit that the cover set me thinking. How the king, already in check from the pawn, ended up in checkmate, even then with one escape square, I cannot figure out. But never mind. This is a ‘thinking man’s guide’ to neurosurgery. That is not the oxymoron we might once have insisted, in the days of intense rivalry. The battle between neurosurgery and otology was settled on the US West Coast decades ago. The more recent neurosurgery and radiosurgery conflict is mentioned in the Foreword, but seems largely resolved. This book, with its emphasis on decision-making, is obviously essential reading for neurosurgeons at any level of experience, but carries much for the rhinologist or neuro-otologist.
The opening chapter is really well thought out. ‘Modern Skull Base Surgery and Timeless Strategic Philosophy’ sets the theme nicely. Boxed text repeatedly draws on Sun Tze’s The Art of War and then applies each point to neurosurgical thinking. Headings such as ‘How do we start?’, ‘How do we get there?’ and ‘What do we do when we arrive?’ illustrate the content perfectly. High-quality illustrations of monochrome imaging, coloured anatomical and surgical diagrams, and operative photography complement the text on every single page.
The multi-author contributions (largely but not exclusively from the USA, and neurosurgeons at that) still manage a continuity of style and concentration, emphasising decision-making rather than simple descriptions of surgical approaches. Surgical Pearls, Case Histories with associated questions and answers, and Recommended Reading, all appear in every chapter and particularly appeal. Otolaryngologists do contribute to chapters on the olfactory groove, the nasopharynx and pterygopalatine fossa, and a series of chapters on ‘Tumours around the Petrous Bone’. As always from this publisher, the purchaser also gets access to the e-book and many surgical videos (e.g. the endoscopic endonasal approach to the anterior cranial fossa, the same to the clivus, or re-anastomosis of the facial nerve).
This book is then a ‘must’ for any post-graduate library, and it will obviously be of greatest relevance to neurosurgeons in training. I do hope, however, that this review will encourage the trainees in otolaryngology to dip into those many sections that cover regions where we can contribute, whether with that nasendoscope or otological drill. Well thought out and indeed ‘different’, as claimed.
Amazon Link: Skull Base Surgery: Strategies
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