superior to any of the other existing surgical atlases. Perhaps a weakness of the text is that it only deals with a standard complete (block) neck dissection with preservation of the 11th nerve and does not discuss any of the existing modifications of this operation. The real strength in the text lies in its remaining chap- ters, which deal with surgery of the larynx, upper tra- chea, and cervical esophagus. These are areas where Dr. Montgomery has a vast clinical and basic science experience. The use of the various silicone prostheses, which he pioneered, including salivary bypass tubes, tracheal cannulas, tracheal T-tubes, and laryngeal stents, are very well covered, and this text will serve as a reference guide for their use. Unlike most other atlases which deal mainly with surgery for malig- nancy in these areas, this text focuses on benign disor- ders, such as tracheal and laryngeal stenosis, laryn- geal paralysis, and is the best I have seen for approaches to problems in these regions.

The quality of the book in terms of its text, illus- trations, and tables, remains excellent. Many of the figures from the first edition have been updated and improved upon. The paper used has allowed for an ex- cellent reproduction of the radiographs. There is an excellent index, and the references at the end of each chapter have been brought up to date.

Many surgical atlases have been published since Dr. Montgomery first brought out his two-volume set. Despite this, I feel that this revision of his surgical at- las remains as a standard for the teaching and prac- tice of head and neck surgery and has been worth the wait. I would recommend it very highly.

JAMES I. COHEN, MD Portland, Oregon

ATLAS OF HEAD AND NECK SURGERY, VOL 1 Edited by Michael E . Johns, John C . Price, Douglas E. Maddox. B.C. Decker, Philadelphia, 1990, 429 pp, $250.00

The Atlas of Head and Neck Surgery, Volume 1 is the product of the faculty a t The Johns Hopkins Univer- sity School of Medicine produced to reflect the current management and philosophy at that institution. This text is more than an atlas inasmuch as each main sur- gical topic contains a discussion of indication, preoper- ative considerations, operative steps, and postopera- tive care, as well as a brief discussion of risks, complications, and sequela. An especially useful and interesting addition is a section on “perils and pit- falls” included in each section. A limited bibliography accompanies each chapter. The entire text is copiously illustrated with color drawings.

Volume 1 addresses a rather diverse group of oto- laryngologic procedures. Chapter 1 includes endo- scopic procedures, such as laryngoscopy, bronchoscopy, and esophagoscopy. Chapter 2 addresses functional

endoscopic sinus surgery. This chapter is decidedly ab- breviated by addressing only the “basics.” Subsequent chapters on the nose and the paranasal sinuses in- clude topcis, such as nasal polypectomy, the Caldwell- Luc procedure, external ethmoidectomy, and frontal sinus trephination and lead one to believe that func- tional endoscopic sinus surgery has not yet put tradi- tional surgery of the sinuses to rest a t The Johns Hop- kins University. Concluding chapters address surgery of the thyroid and parathyroids, salivary glands, and the neck.

There are abundant illustrations in support of the text. As is so often the case, illustrations tend to sim- plify technically demanding procedures, such as clo- sure of nasoseptal perforations, septa1 dermoplasty, and midface degloving procedures.

The authors have produced an attractive and in- formative book which provides inciteful information on the clinical approach to a multitude of otolaryn- gologic problems as currently undertaken at The Johns Hopkins University. The term “atlas” underes- timates the value of the extensive accompanying text, which is the most appealing aspect of this volume in that it offers the reader an insight into the approach of an outstanding group of authors toward commonly encountered otorhinolaryngologic problems. No at- tempt is made to comprehensively cover the field. This work is not intended to replace the standard text- books, but is a colorful and entertaining addition to even the most complete library.

JONAS JOHNSON, MD Pittsburgh, Pennsylvania

MICROSURGICAL TISSUE TRANSPLANTATION Edited by D. Riediger, M. Ehrenfeld. Lombard, Illi- nois, Quintessence, 1989,243 pp, $48.00

Microsurgical Tissue Transplantation is a compilation of papers presented at the International Symposium on Microsurgical Tissue Transplantation in Tubingen, Federal Republic of Germany, November 22-29,1987. Many experts of internatinoal reputation participated in this meeting, which presented a critical evaluation of state-of-the-art free tissue transfer and microneural surgery.

This soft cover book is divided into 5 sections. The first 2 sections deal with free tissue transfer recon- struction of the head and neck. The chapters in these 2 sections, for the most part, represent each of the au- thors’ clinical experience. K. Harii (Tokyo, Japan) pre- sents a complete review of his experience with 326 consecutive cases, which happens to be the world‘s largest experience. The papers, however, uniformly suffer from a lack of critical evaluation. Complications in donor site morbidity are discussed in passing if at all. Only a limited number of donor site options are presented, particularly with reference to revascular-

Book Reviews HEAD & NECK September/October 1990 453

ized bone reconstruction. J. Reuther (Wurzburg, West Germany) does present an excellent basic science and clinical review of the use of revascularized jejunum for intraoral reconstruction.

The third section of the book deals with free tissue transfer reconstruction of the trunk and the extremi- ties. H. Millesi (Vienna, Austria) begins the fourth section of this book with an excellent chapter on the present state of microneural surgery. The remaining 4 chapters in this section deal with various aspects of nerve grafting and present little new information to

454 Book Reviews

this area. The fifth section of the book is dedicated to basic research in microsurgery.

This book is not intended to be a comprehensive review of microvascular surgery. It is merely pub- lished papers from the International Symposium on Microsurgical Tissue Transplantation. The authors in- tend for this book to be used as a reference like any other nonrefereed journal publication.

MICHAEL J. SULLIVAN, MD Ann Arbor, Michigan

HEAD & NECK SeptemberiOctober 1990