I have reviewed several manuals of temporal bone surgery of late and found each to differ in its approach and attractions, whether in 3D imaging, excellence in text or quality of diagrams. This is a remarkably cheap text book, the royalties of which go to the first author's project in supporting the training of ENT doctors in Rwanda. It is based on experience of temporal bone training courses going back to 1969, and is a conveniently sized, soft-back book of only 41 pages of text and diagrams. That does make for easy reference in the bone lab. The format is traditional, starting with an introduction to drill techniques, the microscope and preparation of the bone. On page 3, I found what most appealed in this book, the colour illustrations. These are remarkably lifelike colour artworks, far better than any photograph. The surface of the temporal bone, still less the middle ear, does not lend itself to the digital camera and the inevitable flash for illumination. Orientation is simple, but I do wish ossiculoplasty was as easy as these pictures suggest!
The text takes the trainee through a series of temporal bone dissection exercises, ranging from the antrotomy to the posterior tympanotomy and cochleostomy. The labyrinth and IAC is opened, and we are even treated to identification of the endolymphatic sac. I will resist the urge to comment on the Emperor's New Clothes and the countless times I have been assured that the sac is finally found, when observing surgery. Oddly, it seems to make little difference to outcome, but I digress!
The exercises close with practice at myringo/ossiculoplasty and stapedectomy. The techniques described do not always follow a logical sequence, to allow best use of that scarce resource, the temporal bone. I would have preferred a series of steps to turn one bone to dust, maximising the training value, but that is a very minor criticism.
Above all, this book is very good value indeed, especially for such brilliant artwork. Consider its price compared to a single burr for the temporal bone room!
