Description

This text provides an excellent overview of the multidisciplinary management of craniofacial trauma. Contributors to the book are recognised experienced clinicians from a background of collaborating specialties including neurosurgery, accident and emergency medicine, otorhinolaryngology, oral and maxillofacial surgery, ophthalmology, oculoplastic surgery, neuroradiology and anaesthesia. This up-to-date book emphasises recent concepts of management such as interdisciplinary team working, early and complete assessment of injuries and the trend towards earlier combined intervention and early definitive repair and reconstruction. Initial chapters on the management of multiple injuries and airway control conform closely to the principles of advanced trauma life support (ATLS) with special reference to the head injured casualty. The subsequent chapter on head injuries and the principles of craniofacial repair was a joy to read presenting a clear and concise overview for the non-neurosurgeon. The text is supplemented by numerous well-chosen examples of radiological investigations with clear abnormalities seen on plain films, CT scan and MRI.

Surgical approaches to the intracranial cavity are included such as burrholes and craniotomy however I would like to see included detail of how to preserve the temporal branch of the facial nerve which can be divided if proper care and approach are not used. In addition, division of the temporalis muscle can produce long-term limitation of mouth opening which unfortunately, is occasionally seen after frontal craniotomy. Attention to details such as these improves the subsequent quality of life of patients who survive their injury. Chapter 5 provides an overview of management of facial fractures including low energy impact injuries such as mandibular and zygomatic fractures frequently resulting from interpersonal violence and high energy middle and upper one-third facial injuries often associated with road traffic accidents. The section on the management of frontal sinus and nasoethmoidal injuries is particularly useful although the indications for the use of a W-shaped incision approach to the frontal sinus must be limited, due to the visible scar and the risk of supra-orbital and supratrochlear nerve injury. The section on medial canthal ligament injury is I believe more relevant to localised eyelid lacerations rather than canthal ligament disruption associated with craniofacial trauma when transnasal wiring techniques are more likely to be of value if the ligament is separated from its bony attachment with mid-facial comminution. Otherwise this chapter provides a comprehensive review of maxillofacial injuries although the chapter is marred by one or two proof-reading errors such as illustration figures not matching the text and an upside down radiograph on page 84. The final section on non-accidental injury is disturbing and does not fit comfortably in the text. The chapter on soft tissue injuries is useful and the principles of soft tissue repair of the face are covered fairly well though scrubbing of the wound should be emphasised when foreign material contaminates the wound such as road dirt. Also I cannot condone the physical restraint of a child as proposed in the opening section under any circumstances in order to carryout soft tissue repair under local anaesthesia. Further excellent chapters follow on orbital and eye injuries and imaging of the head, face, orbits and cervical spine. All chapters are well supported by references which are listed at the end of the book. The quality of the black and white illustrations is good and line drawings excellent with 18 colour plates included demonstrating predominantly ocular injuries.

Craniofacial Trauma is comprehensive, up-to-date and easily readable and represents good value for money. This book should be considered essential reading for staff at all levels within surgical and medical specialties who may be called upon to treat trauma patients and should be stocked in all hospital libraries.