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Nerfs pe´riphe´riques. Anatomie et pathologie chirurgicale
ofPlastic Surgery (1QQl),44,X’-78 0 1991The Trusteesof British Associationof Plastic Surgeons
British Journal
Book Reviews Craniofacial Malformations. Edited by M. Stricker, J. Van
Surgery of the Musculoskeletal System. Volume 1, edited by
Der Meulen, B. Raphael, R. Mazzola and D. E. Tolhurst (Linguistic Editor). Pp. xiv + 593, illustrated. (Edinburgh, London, Melbourne, New York : Churchill Livingstone, 1990). Price E130. ISBN 0 443 03924 0.
C. McCollister Evarts. Pp. 5214 (5 volumes), illustrated. (New York, Edinburgh, London, Melbourne: Churchill Livingstone, 1990). Price E325 per set. ISBN 0 443 08516 1 (set).
If this book is an example of what can be achieved by European cooperation, we all have much to look forward to in 1992! The four Editors, from France, The Netherlands and Italy, are distinguished craniofacial surgeons with a wealth of experience and original ideas to share with the reader. It should be stressed that this is not a manual of surgical technique but, as the title suggests, a comprehensive review of the craniofacial field. There are 19 contributors in addition to the editors but these four have written most of the text. Continuity overall is remarkably good with virtually no overlap, and the English is faultless. The general organisation is into seven sections covering craniofacial development, genetics, classification of malformations, examination, treatment and complications. Early chapters cover both normal and abnormal developmental processes from a biochemical and microsomal level to major anatomical events. The clinical applications of the topics discussed are constantly stressed, the authors presenting their concept of a “helix of growth” beginning in the cranium, coursing through the maxillofacial complex and ending in the mandible. There are chapterson gross and comparative anatomy, with much attention being paid to the cranial and facial sutures in an attempt to promote a better understanding of their function, perhaps more as expansion joints than growth sites. Classification plays an important part in the understanding of complex deformities. The Editors have devoted twenty per cent of the book to a chapter on this aspect, in which they present their system based on the time during development or growth at which malformations occur. There are three major groups of dysplasias (cerebrocranial, cerebrofacial and craniofacial) with numerous subcategories attempting to encompass all cranial and facial anomalies. The theme of a growth helix centred at the sphenoid returns in the explanation of craniofacial dysplasias with dysostosis. Although one might take issue with some aspects of the system, the logic of basing it on growth and development is unarguably sound. A section covers examination from several specialties including psychology, ophthalmology, otology, speech and radiology. As with classification, the importance of pursuing a structured sequence is stressed. The last third of the book is devoted to treatment: orthodontic, anaesthetic and surgical. Most of the concepts and several of the illustrations have appeared in the Editors’ earlier publications in learned journals and so will be familiar to many. This section alone could, of course, have easily expanded to fill a sizeable book, and the effort to keep it relatively compact has resulted in some parts being a little sketchy. It was particularly surprising to find no mention of alveolar bone grafting in the treatment of cleft lip and palate, and disappointing that so many of the postoperative photographs are early views without the all-important long-term follow-up. Despite these criticisms, a very good overview of the surgical principles involved in the treatment of these challenging deformities is given. The overall presentation and style of this book are Iirst class and it is short enough (600 pages) to be read comfortably. Illustrations (both diagrammatic and photographic) are numerous, clear and relevant and the bibliography is exhaustive. It has a wide appeal, should be read by all with a serious interest in facial deformity and will provide residents with a valuable insight into a complex specialty. At El30 it represents good value. The Editors and Publishers are to be commended. B. M. JONES
This is the second edition of a five-volume text dedicated to “past, present and future orthopedic surgeons”. As stated by its editor, the purpose of this work is “to present in one source, the information needed to assess, plan, and perform a surgical procedure on the musculoskeletal system of the adult”. The text is divided into 12 sections and each section has an editor. The first volume, the subject of this review, includes two sections: Introduction and The Hand, edited by McCollister Evarts and Richard Burton respectively. The first-class production is what one has grown to expect from Churchill Livingstone. The format is comparable to that of Green’s @eratire Hand Surgery. The work includes contributions from an impressive group of authors who, as one would expect, have published similar material in a number of journals and textbooks: clear examples include the chapters on flexor tendon surgery, peripheral nerve repair, ischaemic conditions of the upper extremities, surgery for tetraplegia, and Dupuytren’s disease. Although the discussions are largely confined to the adult musculoskeletal system, there is a substantial chapter on the care of the child with congenital hand deformity. This section on The Hand may be more than adequate for general orthopaedic and plastic surgeons. However, it cannot “present in one source the information needed to assess, plan, and perform a surgical procedure” to the satisfactionof the specialist hand surgeon. A. A. QUABA
Nerfs
PMpbCriques. Anatomic et pathologie chirurgicale.
First edition. Volume 1: The Upper Limb. Edited by F. Bonnel and M. Mansat. Pp. x+269, illustrated. (Paris, Milan, Barcelona, Mexico: Masson, 1990). Pricenot notified. ISBN 2 225 81648 4. This book is the first volume in the intended series on the anatomy and clinicopathology of peripheral nerves. It has been edited by two Professors of Orthopaedic Surgery from Montpellier and Toulouse who also join 55 other authors in contributing to the text. As might be expected, most of the authors are French, but eight of the contributors are international “big names” in hand surgery. The Editors set out in a systematic way to describe the anatomy, distribution and surgical exposure of individual nerves. The anatomical sections cover the embryology, topography, blood supply and histology of individual nerves (each of which has a chapter dedicated to itselI). The general organisation is the same in each chapter, making reference easier. Typical subjects are “The brachial plexus in the adult, ” “The brachial plexus in the child,” and “Specific nerves of the upper limb”. The clear descriptions of surgical approaches are particularly helpful. There are also good sections on anatomical variations, a very sketchy account of the main neurological syndromes, excellent resumees on the patterns and mechanisms of motor and sensory loss, and brief chapters on regional anaesthesia and the principles of microsurgery as applied to the peripheral nerves of the hand and upper limb. There is a bibliography with 285 references from 1850 to 1984, with many useful insights into the European literature. The text is easy to follow (even for the surgeon who has only basic French), and the line illustrations are in general very useful. Some of the anatomical drawings are, however, over-ambitious: their fussy complication is reminiscent of some of the weightier plates in
71
British
78 Gray’s Anaromy but in monochrome and with heavy-handed crosshatching. A second colour would have made a tremendous difference in the detailed anatomical depictions. Even more illustrations could have been provided: Dr Narakas’s chapter on the surgical approach to the adult brachial plexus is supported by only one very modest sketch of skin incisions, and things are only slightly better in Dr Gilbert’s offering on the brachial plexus in the child. Let us not quibble, however. This book is compact, nicely presented and full of helpful information which is in a convenient form for ready reference. There is much practical advice from a wide panel of distinguished contributors. The price has not yet been announced but the book has enough intrinsic merit to win a place in every serious hand surgery library. When the illustrations have been improved and an English text is available, this book’s appeal will be immediate and international. C. T. K. KHOO
Tests in Cliniocopathology: Ear, Nose and Throat. By Nilkantha Apte and Vimal Kasbekar. Pp. 165, illustrated. (Bombay: Varghese Publishing House, 1989). Price Rs.225.
Picture
The authors of this book are ENT surgeons with academic and clinical appointments to the Grant Medical College and the J.J. Hospitals in Bombay, Dr Nilkantha Apte being an Emeritus Professor and Dr Vimal Kasbekar an Assistant Professor in the Department of Otorhinolaryngology. They state in their preface that “This book is essentially about clinicopathological abnormalities of the skull encountered in diseases of the ear, nose and throat. It illustrates actual skull specimens as well as clinical cases. It will be useful for students, practitioners in otorhinolaryngology, pathology, medical jurisprudence and particularly candidates preparing for higher examinations as well as those working in the different subdivisions of surgery of the head and neck .” Unfortunately the choice of format, the quality of the illustrations and the inadequacy of the text make it almost impossible to justify any of the claims made by the authors in their preface and reveal a conceptual failure that should have been apparent to both authors and publishers at the embryo stages of this book’s production. The format is that of a question and answer quiz: indeed its title includes the words picture tests in clinicopafhology. Some 82 picture tests have been selected for the reader: the pictures and questions appear on one page, the answers overleaf. Regrettably the quality of the illustrations is so poor that it is often impossible to identify the abnormality on which the questions are based. This is particularly so in the black and white photographic reproduction of skull specimens that form more than 70% of the illustrations in the book. We are told in the foreword by Mr John Ballantyne, Consultant ENT Surgeon to the Royal Free Hospital, that Professor Apte has amassed over a period of years a unique collection of skull
Journal
of Plastic
Surgery
bones demonstrating the wide variety of lesions that may be encountered by the ENT specialist in his surgical practice. The human skull, held in the hand in a well-organised tutorial class or carefully mounted in a well-lit pathology museum, with a clear description placed alongside, may well tell a very exciting and important clinicopathological story. However, when transferred to the printed page the anatomical detail should at least be clearly visible, preferably accompanied by a simple line drawing to highlight the salient three-dimensional features, and with a modicum of clinical detail. The questions asked of the reader are pitched at so many different levels of experience and knowledge that the cumulative effect is to irritate rather than instruct or interest the reader. The answers to many of the questions rarely fill more than half a page, often even less than a third, and this waste of precious, potentially educational space is unforgivable. Some of the answers are confusing both in terms of clinical accuracy and grammatical construction. In discussing why a cleft palate should be treated promptly we read “ The rhinolalia aperta results in nasal obstruction, rhinitis, recurrent middle ear effusion and defective speech. A cleft lip, even if minor as a submucosal cleft, is a predisposing cause of recurrent middle ear effusion .” (page 2). Again, in discussing the intracranial spread of disease from the ear we read that ” Persistent headache, signs of toxicity and raised intracranial tension are indications of papilloedema . . .” (page 72). The list of references at the end of the book is simpiy a list of 11 standard textbooks and one isolated reference to a paper with no indication of the journal or the year in which it was published. The avoidable misprints are far more easily noted than usual because of the paucity of the text. The book is certainly well printed on good paper and well bound. Its price may well be acceptable in its country of origin but I cannot recommend individuals or libraries to buy it. I can only express my sorrow that the authors and publishers should have spent so much time and effort on this unhappy volume and so missed a golden opportunity to produce something better and more worthwhile. M. N. TEMPEST
Notes on our Reviewers Barry M. Jones, MS, FRCS, Consultant Surgeon, London.
The Hospital
Plastic and Reconstructive for Sick Children, Great Ormond Street,
Christopher Khoo, FRCS, Consultant
Plastic Surgeon, Wexham Park Hospital, Slough, Berkshire. Awf A. Quabn, FRCSEd, Consultant Plastic Surgeon, Bangour General Hospital, Broxbum, West Lothian. Michael N. Tempest, MD, C&M,FRCSE, Llwyn Heulwen, Grange Park, St Arvans, Chepstow, Gwent NP6 6EA; Consultant Plastic Surgeon (retired), St Lawrence Hospital, Chepstow.
British Journal
Book Reviews Craniofacial Malformations. Edited by M. Stricker, J. Van
Surgery of the Musculoskeletal System. Volume 1, edited by
Der Meulen, B. Raphael, R. Mazzola and D. E. Tolhurst (Linguistic Editor). Pp. xiv + 593, illustrated. (Edinburgh, London, Melbourne, New York : Churchill Livingstone, 1990). Price E130. ISBN 0 443 03924 0.
C. McCollister Evarts. Pp. 5214 (5 volumes), illustrated. (New York, Edinburgh, London, Melbourne: Churchill Livingstone, 1990). Price E325 per set. ISBN 0 443 08516 1 (set).
If this book is an example of what can be achieved by European cooperation, we all have much to look forward to in 1992! The four Editors, from France, The Netherlands and Italy, are distinguished craniofacial surgeons with a wealth of experience and original ideas to share with the reader. It should be stressed that this is not a manual of surgical technique but, as the title suggests, a comprehensive review of the craniofacial field. There are 19 contributors in addition to the editors but these four have written most of the text. Continuity overall is remarkably good with virtually no overlap, and the English is faultless. The general organisation is into seven sections covering craniofacial development, genetics, classification of malformations, examination, treatment and complications. Early chapters cover both normal and abnormal developmental processes from a biochemical and microsomal level to major anatomical events. The clinical applications of the topics discussed are constantly stressed, the authors presenting their concept of a “helix of growth” beginning in the cranium, coursing through the maxillofacial complex and ending in the mandible. There are chapterson gross and comparative anatomy, with much attention being paid to the cranial and facial sutures in an attempt to promote a better understanding of their function, perhaps more as expansion joints than growth sites. Classification plays an important part in the understanding of complex deformities. The Editors have devoted twenty per cent of the book to a chapter on this aspect, in which they present their system based on the time during development or growth at which malformations occur. There are three major groups of dysplasias (cerebrocranial, cerebrofacial and craniofacial) with numerous subcategories attempting to encompass all cranial and facial anomalies. The theme of a growth helix centred at the sphenoid returns in the explanation of craniofacial dysplasias with dysostosis. Although one might take issue with some aspects of the system, the logic of basing it on growth and development is unarguably sound. A section covers examination from several specialties including psychology, ophthalmology, otology, speech and radiology. As with classification, the importance of pursuing a structured sequence is stressed. The last third of the book is devoted to treatment: orthodontic, anaesthetic and surgical. Most of the concepts and several of the illustrations have appeared in the Editors’ earlier publications in learned journals and so will be familiar to many. This section alone could, of course, have easily expanded to fill a sizeable book, and the effort to keep it relatively compact has resulted in some parts being a little sketchy. It was particularly surprising to find no mention of alveolar bone grafting in the treatment of cleft lip and palate, and disappointing that so many of the postoperative photographs are early views without the all-important long-term follow-up. Despite these criticisms, a very good overview of the surgical principles involved in the treatment of these challenging deformities is given. The overall presentation and style of this book are Iirst class and it is short enough (600 pages) to be read comfortably. Illustrations (both diagrammatic and photographic) are numerous, clear and relevant and the bibliography is exhaustive. It has a wide appeal, should be read by all with a serious interest in facial deformity and will provide residents with a valuable insight into a complex specialty. At El30 it represents good value. The Editors and Publishers are to be commended. B. M. JONES
This is the second edition of a five-volume text dedicated to “past, present and future orthopedic surgeons”. As stated by its editor, the purpose of this work is “to present in one source, the information needed to assess, plan, and perform a surgical procedure on the musculoskeletal system of the adult”. The text is divided into 12 sections and each section has an editor. The first volume, the subject of this review, includes two sections: Introduction and The Hand, edited by McCollister Evarts and Richard Burton respectively. The first-class production is what one has grown to expect from Churchill Livingstone. The format is comparable to that of Green’s @eratire Hand Surgery. The work includes contributions from an impressive group of authors who, as one would expect, have published similar material in a number of journals and textbooks: clear examples include the chapters on flexor tendon surgery, peripheral nerve repair, ischaemic conditions of the upper extremities, surgery for tetraplegia, and Dupuytren’s disease. Although the discussions are largely confined to the adult musculoskeletal system, there is a substantial chapter on the care of the child with congenital hand deformity. This section on The Hand may be more than adequate for general orthopaedic and plastic surgeons. However, it cannot “present in one source the information needed to assess, plan, and perform a surgical procedure” to the satisfactionof the specialist hand surgeon. A. A. QUABA
Nerfs
PMpbCriques. Anatomic et pathologie chirurgicale.
First edition. Volume 1: The Upper Limb. Edited by F. Bonnel and M. Mansat. Pp. x+269, illustrated. (Paris, Milan, Barcelona, Mexico: Masson, 1990). Pricenot notified. ISBN 2 225 81648 4. This book is the first volume in the intended series on the anatomy and clinicopathology of peripheral nerves. It has been edited by two Professors of Orthopaedic Surgery from Montpellier and Toulouse who also join 55 other authors in contributing to the text. As might be expected, most of the authors are French, but eight of the contributors are international “big names” in hand surgery. The Editors set out in a systematic way to describe the anatomy, distribution and surgical exposure of individual nerves. The anatomical sections cover the embryology, topography, blood supply and histology of individual nerves (each of which has a chapter dedicated to itselI). The general organisation is the same in each chapter, making reference easier. Typical subjects are “The brachial plexus in the adult, ” “The brachial plexus in the child,” and “Specific nerves of the upper limb”. The clear descriptions of surgical approaches are particularly helpful. There are also good sections on anatomical variations, a very sketchy account of the main neurological syndromes, excellent resumees on the patterns and mechanisms of motor and sensory loss, and brief chapters on regional anaesthesia and the principles of microsurgery as applied to the peripheral nerves of the hand and upper limb. There is a bibliography with 285 references from 1850 to 1984, with many useful insights into the European literature. The text is easy to follow (even for the surgeon who has only basic French), and the line illustrations are in general very useful. Some of the anatomical drawings are, however, over-ambitious: their fussy complication is reminiscent of some of the weightier plates in
71
British
78 Gray’s Anaromy but in monochrome and with heavy-handed crosshatching. A second colour would have made a tremendous difference in the detailed anatomical depictions. Even more illustrations could have been provided: Dr Narakas’s chapter on the surgical approach to the adult brachial plexus is supported by only one very modest sketch of skin incisions, and things are only slightly better in Dr Gilbert’s offering on the brachial plexus in the child. Let us not quibble, however. This book is compact, nicely presented and full of helpful information which is in a convenient form for ready reference. There is much practical advice from a wide panel of distinguished contributors. The price has not yet been announced but the book has enough intrinsic merit to win a place in every serious hand surgery library. When the illustrations have been improved and an English text is available, this book’s appeal will be immediate and international. C. T. K. KHOO
Tests in Cliniocopathology: Ear, Nose and Throat. By Nilkantha Apte and Vimal Kasbekar. Pp. 165, illustrated. (Bombay: Varghese Publishing House, 1989). Price Rs.225.
Picture
The authors of this book are ENT surgeons with academic and clinical appointments to the Grant Medical College and the J.J. Hospitals in Bombay, Dr Nilkantha Apte being an Emeritus Professor and Dr Vimal Kasbekar an Assistant Professor in the Department of Otorhinolaryngology. They state in their preface that “This book is essentially about clinicopathological abnormalities of the skull encountered in diseases of the ear, nose and throat. It illustrates actual skull specimens as well as clinical cases. It will be useful for students, practitioners in otorhinolaryngology, pathology, medical jurisprudence and particularly candidates preparing for higher examinations as well as those working in the different subdivisions of surgery of the head and neck .” Unfortunately the choice of format, the quality of the illustrations and the inadequacy of the text make it almost impossible to justify any of the claims made by the authors in their preface and reveal a conceptual failure that should have been apparent to both authors and publishers at the embryo stages of this book’s production. The format is that of a question and answer quiz: indeed its title includes the words picture tests in clinicopafhology. Some 82 picture tests have been selected for the reader: the pictures and questions appear on one page, the answers overleaf. Regrettably the quality of the illustrations is so poor that it is often impossible to identify the abnormality on which the questions are based. This is particularly so in the black and white photographic reproduction of skull specimens that form more than 70% of the illustrations in the book. We are told in the foreword by Mr John Ballantyne, Consultant ENT Surgeon to the Royal Free Hospital, that Professor Apte has amassed over a period of years a unique collection of skull
Journal
of Plastic
Surgery
bones demonstrating the wide variety of lesions that may be encountered by the ENT specialist in his surgical practice. The human skull, held in the hand in a well-organised tutorial class or carefully mounted in a well-lit pathology museum, with a clear description placed alongside, may well tell a very exciting and important clinicopathological story. However, when transferred to the printed page the anatomical detail should at least be clearly visible, preferably accompanied by a simple line drawing to highlight the salient three-dimensional features, and with a modicum of clinical detail. The questions asked of the reader are pitched at so many different levels of experience and knowledge that the cumulative effect is to irritate rather than instruct or interest the reader. The answers to many of the questions rarely fill more than half a page, often even less than a third, and this waste of precious, potentially educational space is unforgivable. Some of the answers are confusing both in terms of clinical accuracy and grammatical construction. In discussing why a cleft palate should be treated promptly we read “ The rhinolalia aperta results in nasal obstruction, rhinitis, recurrent middle ear effusion and defective speech. A cleft lip, even if minor as a submucosal cleft, is a predisposing cause of recurrent middle ear effusion .” (page 2). Again, in discussing the intracranial spread of disease from the ear we read that ” Persistent headache, signs of toxicity and raised intracranial tension are indications of papilloedema . . .” (page 72). The list of references at the end of the book is simpiy a list of 11 standard textbooks and one isolated reference to a paper with no indication of the journal or the year in which it was published. The avoidable misprints are far more easily noted than usual because of the paucity of the text. The book is certainly well printed on good paper and well bound. Its price may well be acceptable in its country of origin but I cannot recommend individuals or libraries to buy it. I can only express my sorrow that the authors and publishers should have spent so much time and effort on this unhappy volume and so missed a golden opportunity to produce something better and more worthwhile. M. N. TEMPEST
Notes on our Reviewers Barry M. Jones, MS, FRCS, Consultant Surgeon, London.
The Hospital
Plastic and Reconstructive for Sick Children, Great Ormond Street,
Christopher Khoo, FRCS, Consultant
Plastic Surgeon, Wexham Park Hospital, Slough, Berkshire. Awf A. Quabn, FRCSEd, Consultant Plastic Surgeon, Bangour General Hospital, Broxbum, West Lothian. Michael N. Tempest, MD, C&M,FRCSE, Llwyn Heulwen, Grange Park, St Arvans, Chepstow, Gwent NP6 6EA; Consultant Plastic Surgeon (retired), St Lawrence Hospital, Chepstow.