Temporal Bone Dissection Guide

Review by L Flood
Middlesborough, UK

Reviewing this book has proved a nostalgia exercise for me. Was it really way back in 1983 that I travelled to Michigan on a TWJ fellowship and first met John Niparko? With a two-year-old lad in tow, an exhausted Flood family arrived at Detroit airport, to find that this young trainee had driven all the way from Ann Arbor, waited some hours, and then proceeded to ferry us to our new home. The foreword of the book is presented by our trainer back then, Malcolm Graham; of him, I can only repeat what the preface tells us: ‘A good teacher is worth more than all the training literature ever written’.

The content of this book is very familiar to me. I was delighted to be invited to sit on the Ann Arbor Temporal Bone Course, but this was tempered by the news that I was then to demonstrate on the next course, in two weeks’ time!

This is a large format, if appropriately slim, spiral-bound book, ideally suited for the temporal bone dissection room. There is excellent use of illustrations, whether monochrome drawings, CT scans or histology sections. The artwork is quite remarkable, especially in its use of shading. The thinned canal wall really does seem to transilluminate; the microscope lamp reflects off the metal bone holder. (I confess a personal interest, if not this level of skill.)

The text follows the traditional sequence. An introduction to best use of the microscope and drill tells us that required instrumentation includes ‘malleus snipers’. Watch that tree line then! Temporal bone anatomy covers surface landmarks, histology sections (perhaps the only area where colour might have helped) and CTs in axial and coronal planes. The novice is then taken through a series of steps to render the temporal bone down to dust. Throughout, there are useful clinical tips (‘technical pearls and potential pitfalls’); a particular favourite is the diagram of the low dura, leading you straight into the descending facial nerve.

There are many such works, but another novelty here lies in the final chapter, ‘Achieving Procedural Competence etc’, which reproduces a checklist of competency assessment for various stages of mastoidectomy, and a global evaluation of technical and competency skills. There is a lot packed into 63 pages of text, in what the authors well describe as ‘this highly graphic primer’.

Highly recommended (and thanks for the lift, John).

Amazon Link: Temporal Bone Dissection Guide
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