Transnasal Endoscopic Skull Base and Brain Surgery: Surgical Anatomy and its Applications, 2nd edn

Review by C Hopkins
London, UK

I was really looking forward to getting my hands on this textbook. I am always left ever so slightly stunned by Aldo Stamm’s lectures; they feel a little like a rollercoaster journey, where one is taken on a thrilling ride through the endoscopic anatomy of the skull base, with arteries and cranial nerves flying past at every turn. As a lecturer, Aldo is hard to beat in terms of both charm and dynamism, but sometimes I am left feeling a little inadequate as I can’t quite keep up. I was therefore quite looking forward to the opportunity to stroll through at a slightly gentler pace, with the option to turn back the page and re-read a section, in the way you could never quite do in a lecture. ‘Excuse me, could you just run through those last three slides again’ doesn’t really work out so well.

In many respects, the book lived up to expectations – the quality of the images throughout is very good, and those from the Rhoton collection, in particular, are spectacular. The anatomy is described first, in the classical way, with osseous and cadaveric specimens. Each section then proceeds to applied anatomy, and different surgical approaches and procedures are carefully described. The vast majority of endoscopic images throughout the book are of very high quality. A real strength is the collection of accompanying videos, added since the first edition, although they are not well sign-posted throughout the text itself. While there is some overlap between chapters, this is generally helpful as it reinforces key points, but also shows some different tips – as with all surgery there is certainly more than one way to skin the infratemporal fossa…

There are some sections of the book that are a little disappointing. Notably, the section on imaging is distinctly lacking in images; it seems such a shame to list the characteristic features of different skull base lesions when they could be so easily illustrated. The illustrations in the pre-operative assessment chapter don’t really seem to fit the accompanying text. Furthermore, one would hope that a surgeon attempting endonasal skull base surgery had already mastered basic diagnostic endoscopy, and so the 10 pages dedicated to describing a three-pass technique seem a little redundant. In contrast, there are only a handful of images on a frontal drill-out procedure, and the video lacked accompanying audio commentary. It would also have been good to see an inside-out approach described. The chapter on transnasal resection of a juvenile nasopharyngeal angiofibroma has no endoscopic images to illustrate the different steps that are described in the text, while an antrostomy has three series of images to accompany the lengthy description.

Overall, this is great reference text for those starting out in the field of endoscopic skull base surgery. It’s a hefty tome, so at about £180 it is pretty good value – although I seem to be unable even to give textbooks away to our residents as they appear to be able to access everything digitally. I think I’m missing the rollercoaster ride, but perhaps it won’t seem quite so scary next time…

Amazon Link: Transnasal Endoscopic Skull Base and Brain Surgery: Surgical Anatomy and its Applications, 2nd edn
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