Clinical Management of the Airway

Clinical Management of the Airway, James T. Roberts. Philadelphia: WB Saunders, 1994, ISBN 0-7216-3670-5, 507 pp, $69.00. This text was produced by an author/editor known for clinical and academic excellence. The format is the classic multiauthor approach and covers the topic exhaustively. Important considerations are elucidated. References and a bibliography guide the serious reader to further study. Individual chapters are generally excellent in their coverage of the topic. Dr. Roberts has been successful in producing a coherent volume. There is appropriate overlap of some topics, but this only enhances understanding. The indexing is excellent, making answers to specific questions more accessible. Photographs are abundant, although in some instances the concepts might be better presented by schematics or radiologic views (e.g., Figs. 20-4 through 20-7). The absence of color is notable (e.g. Chapter 2 and Figs. 19-5, 9, and 15). While this was probably the publisher's judgment relating to cost, color presentations of fiberoptic views and pathology would enhance the reader's understanding. The chapter on airway considerations for otolaryngology surgery is superficial in scope and references. There is no review of the problems of plastic and oral surgery (especially the temporomandibular joint), although maxillofacial trauma is addressed in Chapter 37. This is particularly cogent regarding maxillofacial dysostoses and craniofacial reconstruction. The chapter on radiology is well presented. Xeroradiography is no longer generally available owing to radiation exposure levels and discontinuation of production of requisite equipment. Also, the usual medium for contrast laryngography (Dionosil Registered Trademark) is no longer available, although viscous Esophotrast Registered Trademark (barium sulfate) can be substituted. In any event, both these techniques have now been supplanted by computed axial tomography and magnetic resonance imaging. There is also no mention of the portable fluoroscope (C-arm) for evaluation and intubation. Three chapters deserve special commendation. Chapters 7 and 8 present unusual applications of acoustic response measurements, and Chapter 8 discusses sound transmission analyses. They are thought-provoking and elucidate new possibilities in the study of the airway. Chapter 19 is unique in its descriptions of game plan patterns for management of the difficult airway. On balance, this is a very valuable volume. It is a "must" for the serious practitioner, dealing with all aspects of airway management. This reviewer learned from the text, and practitioners will similarly enhance their fund of knowledge. It certainly belongs in every academic library. Martin L. Norton, MSPH, MD, JD Director, Difficult Airway Courses, Towsley Center for Continuing Medical Education, University of Michigan Medical Center, Ann Arbor, MI 48104