Fatterpekar GM, Som PM, Naidich TP. The Teaching Files: Head and Neck. Elsevier-Saunders 2010, 480 pages, $129.00.
Self-evaluation in diagnostic radiology is more readily available, more robust, and more sought after than ever, driven by Board examinations and ongoing re-certification. This fact undoubtedly accounts for the plethora of these types of teaching files publications. Enter a new contribution in Head and Neck radiology by Drs. Fatterpekar, Som and Naidich (all well known and accomplished radiologists), with a good variety of cases which are properly described and illustrated well. The pages are set up adequately, (but not ideally), for a quiz format; the left hand side gives the history, findings, discussion and diagnosis while the right hand side shows the images with the findings labelled. To this reviewer, the material would have been more challenging and more of a quiz if the images were shown on one page with no labels and no legends followed by the written material on an overleaf page.
Another impression of this and all similar publications is the fact that you are shown very specific images which you know have to be abnormal. With that, the reader formulates a differential diagnosis. That is fine if the only object is to prep oneself for a Board Examination. It does not, however, parallel a real life situation where often the main challenge is to find the abnormality, rather than having it handed to you. That said, I guess there is no way around this in a book format. Perhaps one innovation would be to have images displayed which are variants of normals or borderline abnormal and have the reader decide if this is a positive study or not.
In any event, this book and its online supplement (Expertconsult.com) covers abnormalities of the orbit, paranasal sinuses/nasal cavity, facial bones, temporal bone sella/skull base, salivary glands, oral cavity, jaw and TMJ, pharynx, larynx, parapharyngeal space, brachial plexus, and miscellaneous abnormalities of the neck. The image findings are described; there is a discussion which gives background clinical and radiologic information, a differential diagnostic list, and then the correct diagnosis.
Overall the cases are challenging and the explanations are brief and to the point. If one cares not to use this text as a self test then the cases are listed at the end of the book so you can look up and read about a particular abnormality. The illustrated material is chosen well so that a wide breadth of pathology is shown. There are some redundancies in cases, but that does serve to re-enforce the findings. Do not expect to see some of the newer applications in imaging such as perfusion MR to distinguish tumor grades or MR spectroscopy.
I could list many illuminating cases which the authors show, such as Gaucher’s disease of the maxillary sinus many unusual lesions of the nasal cavity ( including angiomatous polyps, melanona plasmacytoma), malformed ossicles along with congenital and developmental temporal bone anomalies, subtle and/or unusual lesions of temporal bone and its contents, Goldenhan syndrome, sialosis, parotid tumor with involvement of the intratemporal 7th Nerve, multiple types of jaw lesions, epiglottic cyst, Lemierre Syndrome, subtle parathyroid adenomas, Maddlung disease in addition to the more common traumatic, neoplastic and inflammatory head and neck lesions. The orbital cases are instructive although in the case of pseudotumor it would have been instructive to include an axial image so abnormalities of the tendon sheaths, not just the muscles could have been seen.
This book is recommended as a worthwhile purchase for a Departmental library and can serve as a preparation for the ABR examinations.
