Color Atlas of Otoscopy: From Diagnosis to Surgery

Color Atlas of Otoscopy: From Diagnosis to Surgery

RATING: (4 of 5 ears)
AUTHORS: Sanna, M., Russo, A., DeDonato, G., Caruso, A., and Taibah, A.
ISBN: 1-58890-123-8 TNY / 3-13-111492-4 GTV
COST: US$79.00 (hardcover)

REVIEWERS: David A. Klodd, PhD, Professor of Otolaryngology and Thomas J. Haberkamp, MD, Associate Professor, Rush Medical College, Chicago

SYNOPSIS: The classic just got better. This color atlas of ear pathology is now in a larger format and the content has been expanded and updated. Normal otoscopic findings are precisely defined for the reader. Pathologies of the external auditory canal, otitis media in its variants, granuloma, cholesteatoma, glomus tumors, and retrotympanic masses as well graphic surgical approaches highlight the remainder of this excellent text. Finally, post surgical conditions that often require revision are highlighted for the practitioner and student alike. The index is logically arranged and accurate making this book easy to use in a short amount of time often available in a busy clinical practice.

REVIEW: This new second edition text is enlarged, updated and improved version of the original classic by the same author(s). The book contains over 600 color photos and illustrations depicting common and rare ear pathologies. Otoscopy and the normal landmarks of the ear are covered in detail initially. Ear pathologies affecting the external auditory canal are examined in considerable detail. Secretory otitis media and surgical approaches are covered in adequate depth. Cholesterol granuloma, atelectasis, tympanic membrane perforation and tympanosclerosis are discussed with an array of photographic images. Next chronic suppurative otitis media with cholesteatoma is examined. The authors cover congenital cholesteatoma and petrous bone cholesteatoma with the various surgical approaches to these problems. Vascular abnormalities such as glomus jugulare have excellent photographs. There are wonderful imaging studies for the rare retrotympanic masses and a discussion and illustration of surgical approaches. The text examines meningoencephalic herniation illustrating the transmastoid approach with microcraniotomy and the middle cranial fossa approach. Lastly, postsurgical conditions such as myringotomy and ventilation tube insertion, myringoplasty, tympanoplasty, and various types of mastoidectomy are followed by over 50 photographs of numerous post surgical abnormalities.

CRITIQUE: The book is an excellent for the resident, novice ENT physician, the audiologist and is a must for the Au.D. student in training. Even with the many advances in imaging, otoscopy remains the cornerstone in diagnosis of ear disease. Unfortunately, significant clinical experience in examining is required to become proficient in otoscopy. The beginning student or resident will find it helpful to study the text and illustrations carefully to build a better feel for the appearance of the ear in various conditions. The experienced audiologist will find this a useful reference text to consult after viewing questionable ear pathology in everyday practice. The index is well organized and appropriately detailed allowing for a quick and accurate reference. The bibliography is adequate but in no way an exhaustive list of classical or definitive articles of the various pathology. The authors make excellent use of illustrations but clinical history and most certainly audiological information is at best scarce. The numerous photographs utilize the Hopkins optical system with wide-angle lenses through a narrow diameter endoscope. There are also operative photographs taken with the Zeiss microscope. The operative photos are in many cases juxtaposed to the post operative photos, to show more clearly the correlation. Included in the text are rudimentary classifications of various disease processes, such as the Fisch classification of glomus tumors, and the Sade classification of atelectesis. There are also discussions on surgical planning for several disease processes such as cholesteatoma. These discussions are somewhat rudimentary, and they are not meant to be definitive. They do illustrate how one should examine an ear looking not just at what is seen, but looking at how the findings influence diagnosis, and management.

Radiological studies include CT, MRI and Angiography are adequate but certainly not definitive nor state of the art. MRA (Magnetic Resonance Angiography) is not mentioned. However, these studies are not the main focus of this atlas; they are used appropriately to simply add to the information provided by the photography.

We were particularly happy to see the chapter on post surgical conditions. The post surgical ear can be quite confusing for the novice as well as the experienced otoscopist. This chapter will prove quite helpful in learning to recognize the normal anatomy of the post surgical ear. The one flaw in the book is the scarcity of labeling and/or orienting information for many of the illustrations. The first chapter illustrates the normal anatomy in great detail. After this some of the photos have very rudimentary labels (with the list of abbreviations in the table of contents). However, most of the photos have no labeled structures at all. This flaw is more serious for the beginning otoscopist, who may have a great deal of difficulty orienting the more complex photos. Nevertheless, this atlas will prove helpful to any student of the ear. Careful study and re-study of the illustrations until the anatomy is understood will prove rewarding to any student of the ear.