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Surgical approaches in otorhinolaryngology
British Journal of Plastic Surgery (2000),53, 269 9 2000The BritishAssociationof PlasticSurgeons
I
BRITISH
JOURNAL
PLASTIC
OF
SURGERY
Book reviews DOI:10.1054/bjps.1999.3292
DOI:I0.1054/bjps.1999.3337
Surgical approachesin otorhinolaryngology
Manual of systematic eyelid surgery,
By W. F. Thumfart, W. Platzer, A. R. Gunkel, H. Maurer and E. Brenner. Georg Thieme Verlag, Stuttgart, 1999. ISBN 3-13-116591-X. Pp viii+362, ill. Price DM 298.00.
By J. R. O. Collin. Butterworth Heinemann, Oxford, UK, 1989. ISBN 0-7506-4572-5. Pp xii+166; ill. Price s It is hard to believe that this manual was first published almost 20 years ago. This reprint is the second edition which itself is already l l years old. The relevance of the book is not diminished by time, howevel, which demonstrates how carefully chosen was each procedure at the time of the first publication. The manual is at its most useful for plastic surgeons when discussing entropion and ectropion, ptosis, injuries and surgery of the lacrimal system and socket surgery, as the ophthalmic bias serves to inform the non-ophthalmic surgeon extremely well. Predictably, from a plastic surgeon's perspective, it remains weak in the section on eyelid reconstruction and tumour management where the sparse diagrams, which work so well elsewhere in the text, unfortunately fail to demonstrate the 3-dimensional aspect of resection and reconstruction in this area. One would indeed expect a little more advice relating to medial canthal tumours. Most, if not all, of the reconstructive methods in use today are demonstrated, but basic oncological principles are not dealt with satisfactorily. The section on cosmetic surgery is of little use to anyone other than the occasional cosmetic operator who confines themselves to minor procedures. It is surprising to see transnasal medial canthal wire fixation included in this chapter. With the above exceptions, it remains a textbook which is immensely useful to all of those surgeons engaged in eyelid surgery. The text is succinct and usually well illustrated. The book is robust and easily transported, thereby fulfilling the requirements of 'a manual'. It is still good value and should be owned by every plastic surgeon.
Textbooks are necessarily difficult to write. It requires a huge effort and is almost a labour of love. I think operative textbooks are particularly difficult to produce because of the difficulty of conveying the practical, and in this case, a very three-dimensional subject clearly and concisely. What we have here is a beautifully produced volume. The style is uniform throughout, with clear concise crisp descriptions of the various practical steps in each of these approaches. It is lavishly, clearly and beautifully illustrated. The high quality colour wash drawings are a delight. Sadly, for me this book fails to achieve its aim. Throughout the volume there is simply little discussion as to which approach is applicable to which problem. There are discussions of hazards in all the approaches, but no real mention of inevitable limitations, morbidity and major technical difficulties. An example of this is a discussion of mandibular osteotomy. Apart from very little thought being given to how the mandible might be divided through the literature on the subject and how it might be fixed, there is no intelligent discussion as to whether one should perform a lateral mandibulotomy or a median mandibulotomy. Parasagittal mandibulotomy is not discussed. This is an example of a limitation which is repeated in many areas throughout the volume. I think this is very important because one of the key decisions in dealing with a lesion is to choose the approach and to weigh the risks and benefits of each approach to a given problem in an individual patient's case. One may take the view that, with experience, of course the right choices tend to be made. A very experienced head and neck surgeon would not need to use this text. If one were to ask the question 'Should this be a book that we should have in our library?' then the answer would be, possibly. Is this a must-have book for all practising head and neck surgeons? The answer would be emphatically no. It is a great shame that such a beautifully produced tome ultimately fails in its aim, which is to inform, presumably, the trainee head and neck surgeon as to how he should and could safely approach any given volume of pathology within the head and neck.
M. J. EARLEY MB, MCh, FRCS(Plast) Suite 15, 69 Eccles Street, Dublin 7, Ireland.
A N D R E W G. G. BATCHELOR FRCS Consultant Plastic Surgeon, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK.
269
I
BRITISH
JOURNAL
PLASTIC
OF
SURGERY
Book reviews DOI:10.1054/bjps.1999.3292
DOI:I0.1054/bjps.1999.3337
Surgical approachesin otorhinolaryngology
Manual of systematic eyelid surgery,
By W. F. Thumfart, W. Platzer, A. R. Gunkel, H. Maurer and E. Brenner. Georg Thieme Verlag, Stuttgart, 1999. ISBN 3-13-116591-X. Pp viii+362, ill. Price DM 298.00.
By J. R. O. Collin. Butterworth Heinemann, Oxford, UK, 1989. ISBN 0-7506-4572-5. Pp xii+166; ill. Price s It is hard to believe that this manual was first published almost 20 years ago. This reprint is the second edition which itself is already l l years old. The relevance of the book is not diminished by time, howevel, which demonstrates how carefully chosen was each procedure at the time of the first publication. The manual is at its most useful for plastic surgeons when discussing entropion and ectropion, ptosis, injuries and surgery of the lacrimal system and socket surgery, as the ophthalmic bias serves to inform the non-ophthalmic surgeon extremely well. Predictably, from a plastic surgeon's perspective, it remains weak in the section on eyelid reconstruction and tumour management where the sparse diagrams, which work so well elsewhere in the text, unfortunately fail to demonstrate the 3-dimensional aspect of resection and reconstruction in this area. One would indeed expect a little more advice relating to medial canthal tumours. Most, if not all, of the reconstructive methods in use today are demonstrated, but basic oncological principles are not dealt with satisfactorily. The section on cosmetic surgery is of little use to anyone other than the occasional cosmetic operator who confines themselves to minor procedures. It is surprising to see transnasal medial canthal wire fixation included in this chapter. With the above exceptions, it remains a textbook which is immensely useful to all of those surgeons engaged in eyelid surgery. The text is succinct and usually well illustrated. The book is robust and easily transported, thereby fulfilling the requirements of 'a manual'. It is still good value and should be owned by every plastic surgeon.
Textbooks are necessarily difficult to write. It requires a huge effort and is almost a labour of love. I think operative textbooks are particularly difficult to produce because of the difficulty of conveying the practical, and in this case, a very three-dimensional subject clearly and concisely. What we have here is a beautifully produced volume. The style is uniform throughout, with clear concise crisp descriptions of the various practical steps in each of these approaches. It is lavishly, clearly and beautifully illustrated. The high quality colour wash drawings are a delight. Sadly, for me this book fails to achieve its aim. Throughout the volume there is simply little discussion as to which approach is applicable to which problem. There are discussions of hazards in all the approaches, but no real mention of inevitable limitations, morbidity and major technical difficulties. An example of this is a discussion of mandibular osteotomy. Apart from very little thought being given to how the mandible might be divided through the literature on the subject and how it might be fixed, there is no intelligent discussion as to whether one should perform a lateral mandibulotomy or a median mandibulotomy. Parasagittal mandibulotomy is not discussed. This is an example of a limitation which is repeated in many areas throughout the volume. I think this is very important because one of the key decisions in dealing with a lesion is to choose the approach and to weigh the risks and benefits of each approach to a given problem in an individual patient's case. One may take the view that, with experience, of course the right choices tend to be made. A very experienced head and neck surgeon would not need to use this text. If one were to ask the question 'Should this be a book that we should have in our library?' then the answer would be, possibly. Is this a must-have book for all practising head and neck surgeons? The answer would be emphatically no. It is a great shame that such a beautifully produced tome ultimately fails in its aim, which is to inform, presumably, the trainee head and neck surgeon as to how he should and could safely approach any given volume of pathology within the head and neck.
M. J. EARLEY MB, MCh, FRCS(Plast) Suite 15, 69 Eccles Street, Dublin 7, Ireland.
A N D R E W G. G. BATCHELOR FRCS Consultant Plastic Surgeon, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK.
269