The Chronic Ear

Review by L Flood

The title of this book takes me back to my TMJ (Thomas Wickham Jones) Foundation Fellowship Michigan days, with its title that might seem ‘foreign’ to many a UK reader. How well I recall being asked whether I thought a lady had a ‘chronic ear’. I was only half joking when I replied, in the Texas accent I had rapidly acquired (do not ask, it is a long story) ‘Well it sure looks like she’s had it there for a powerful long time, boy… ’. Truly that common language does divide us.

But we all know what they mean: chronic suppurative otitis media, which takes too long to say. This book reminds us that chronic ear disease can include myringitis (with a particularly useful chapter on a baffling topic), obliterative otitis externa (can anyone prevent it progressing?), eustachian tube dysfunction and, of course, systemic diseases, such as the granulomatosis of He Who Must Not be Named.

A glance at the 48 chapter titles shows how comprehensive this multi-author book is. It has a refreshingly international authorship, with authors from Finland to Japan, from Australia to Dublin in the Land of Saints and Scholars. Our own Patrick Axon covers autograft ossicular reconstruction. Matthew Yung proves yet again to be an expert, now on the topic of biomaterials in tympanomastoid surgery.

From these publishers, one expects high-quality reproduction of imaging in monochrome, but what is especially notable here is the reproduction of endoscopic and microscope views in superb colour. The text layout makes for very easy reading or browsing, and the print style suits this aging reader, who increasingly plays trombone with textbooks. Thus, I read section 19.6.1 and learnt all about primary T tube cartilage tympanoplasty, which was news to me!

The book opens with nine chapters on the basic sciences, ranging from middle-ear mechanics to tympanic membrane wound healing and epithelial migration. Basic sciences can be presented in an uninspiring account of anatomy, physiology and pathology, but not here. Any chapter title that starts with ‘Pearls in…’ must appeal. The radiography chapter even dips into otosclerosis, but that seems generally agreed not to be a chronic ear disease, not even appearing in the index.

There is excellent coverage of a wide range of the surgical techniques employed in tympanoplasty, cholesteatoma removal, cavity design and reconstruction. I am now inspired to try ‘canal wall reconstruction using the titanium mesh cage’, and David Pothier almost convinces me to try going back to using the endoscope for more than just photography.

Maybe this book particularly appeals to me as it concentrates on my professional life’s work, over the decades (even if I am now a part-timer and in far more demand as a screen for head and neck cancer). I wish I had seen this book 20 years ago. The book is as valuable to the expert as to the neophyte trainee. It is a superb publication, and if it does not win an international prize I will be surprised frankly.

Amazon Link: The Chronic Ear
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