Head and Neck Trauma: An Interdisciplinary Approach

A. Ernst, M. Herzog, and R.O. Seidl, eds. New York: Thieme Medical Publishers; 2006. 236 pages, 249 illustrations, $129.95.

Despite what is suggested in the title, this book is only interdisciplinary if one excludes radiology as a discipline. It is a clinical book written by ear, nose, and throat (ENT) or maxillofacial surgeons only. It is not geared toward radiologists, though it does contain some imaging. This relatively short book does contain much good solid information on the subject of trauma to the facial region, skull base, and neck. The book is divided into 3 broad sections. The initial section has individual chapters dealing with emergency management, first aid, and principles of trauma care, which include much valuable information about the initial care for patients with such injuries. Some of the material comprises physical findings, triage, flow charts for individual types of injuries, and general information on trauma management. Although not specifically relevant to radiology per se, this section probably contains good general knowledge for anyone who might encounter a trauma on the street or be compelled to perform an emergency cricothyrotomy in a restaurant.

The second section is divided into chapters devoted to individual trauma sites such as the cranium and craniocervical junction, skull base, ear and temporal bone, facial nerve, orbit, mandible, teeth, pharynx and soft-tissue neck, and laryngotracheal area. These chapters are subclassified into sections on surgical anatomy, mechanisms and classifications of injuries, clinical signs and symptoms, diagnosis (to include a small amount of imaging), and treatment. Although the accompanying illustrations (gross photographs and diagrams), imaging, and tables are of uniformly high quality, it seems that these chapters really provide an overview, not a comprehensive treatise on the subject. Furthermore, the amount of imaging is fairly limited. Having said that, I found the presentation of the orbital and maxillofacial factures to be quite good.

The third and final section is devoted to therapy of head and neck trauma. It includes chapters that are devoted to the same injury sites that were discussed in the chapters on diagnosis. These sections are almost entirely clinical, with relatively few radiographs.

In summary, this relatively compact yet very readable book is clearly not geared toward radiologists. In fact, I am not aware of any book on this subject that is specifically intended for radiologists. Who then is the ideal target audience? Clearly surgical and ENT trainees would benefit. As for radiologists who want to be taken seriously, there is a clear-cut benefit in understanding the clinical aspects of trauma management and, indeed, of any disease. This knowledge makes us better radiologists, and it also facilitates intelligent communication with the treating physician. I believe this book has enough clinical pearls to be useful in the radiology reading room of a busy trauma department and perhaps any emergency department. This book might just suggest questions for the radiologist to ask the clinician that would clarify not only image interpretation but possibly imaging strategies as well.

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