Essentials of Septorhinoplasty: Philosophy, Approaches, Techniques, 2nd Ed

Septorhinoplasty obviously lends itself to the atlas format of book and, with over 600 full colour illustrations, this does make for an impressive manual of operative surgery. This book, however, differs in that it is also very much a rhinologist’s, rather than a cosmetic surgeon’s, reference. I was struck by the emphasis on functional aspects of rhinoplasty, on coverage of septoplasty, of detailed descriptions of nasal physiology and objective nasal airway studies. This made a refreshing change from the traditional endless sequence of before and after profiles of ‘expensive noses’ that we expect from such books.

This is the second edition of a well-known textbook, and a 14-year interval has seen the introduction of several new topics. ‘Biostatic Surgery’ might not be a familiar term to all, but it turns out to apply to functional endoscopic sinus surgery based on the principles of Messerklinger and Stammberger. There is also new coverage of submucosal septal surgery, of radiofrequency surgery in the nose, new synthetic implants and, of course, endoscopic advances in assisting septorhinoplasty itself.

Multi-author chapters that will surely appeal include those on tip rhinoplasty, alar reduction, the deviated nose and the saddled nose. It is imaginative to include chapters on acute nasal trauma and its immediate correction, and on rhinoplasty associated with cleft lip repair. Assessment, pre-operative preparation and post-operative care are also well covered. A really nice introductory chapter, on the history of such surgery, shows how much we owe to our German colleagues in this field.

The final impression is of an authoritative book that provides a good introduction to the principles and techniques of septorhinoplasty, but also to much of general rhinological practice. There is enough advanced and detailed coverage to appeal to the aspiring subspecialist trainee, and the intra-operative photography is notably excellent. Of course, there are also those endless sequences of before and after profiles, which we can only hope to emulate. The third edition may have to cover transgender surgery, but one can only hope that paediatrics continues to follow the principles repeated here, to defer any surgery if at all possible!