Practical Head and Neck Ultrasound

Reviews / Votes

This short fact-filled text is ideally suited as a practical guide and bench book. There are brief, but comprehensive sections on anatomy, which are aimed to be a practical guide to assist in the assessment of pathological processes within the head and neck. It is indicated in the introduction that the majority of texts on imaging of the head and neck are CT and MRI orientated and, apart from specific chapters on ultrasound of the thyroid or salivary glands, there is no dedicated text covering the whole of head and neck imaging. As a practical guide, the diagrams are easy to understand and the ultrasound images are, on the whole, of excellent quality. The text is fairly comprehensive with bullet points and highlighted box points to bring out the major points from the body of the text and make it easy to quickly access the relevant data. Within a textbook of this length it is not possible to include all the rarities, but this is made clear. The limitations of ultrasound are also well addressed, with advice as the next logical imaging investigations. There are also excellent chapters on what the surgeon needs to know and why, as well as the practical aspects of fine needle aspiration and core biopsy, including a number of handy hints to maximise yield and to avoid pitfalls. This is not only an excellent textbook for the trainee, but also for the more experienced sonographer who has not had much experience with head and neck imaging. The topic of head and neck ultrasound is unique, because the use of this modality varies widely in different areas of the world. Being a radiologist reviewing a radiology book for a nonradiology journal, this review may be different from the standard review. The authors of this text and the institution where they work are very experienced in ultrasound and strongly believe, in fact advocate, its use in all parts of the body. There is a progressive trend for greater use of ultrasound especially in underdeveloped areas of the world where ultrasound is a more cost-effective modality that CT or MR. In fact, there is a growing body of literature that suggests that ultrasound is useful for the initial evaluation of a variety of neck masses. This is especially true in children, because it is a noninvasive technique. Ultrasound combined with ultrasound-guided fine needle aspiration of cervical lymph nodes also appears to be an accurate technique for nodal staging in patients with squamous cell carcinoma of the head and neck. Despite its benefits, ultrasound of the head and neck has not replaced CT and MR imaging in most radiology departments in the United States, Europe and Asia. This is due in part to widespread availability of CT and MR and the excellent anatomic detail they provide and also to the time required to perform a single study. This is the first edition of 'Practical Head and Neck Ultrasound'. The intent of the book as stated in the introduction is to be "...a practical guide and bench book. It is to be hoped that it will encourage anyone with a reasonable knowledge of ultrasound to pick up the (appropriate) transducer and start scanning the neck effectively rather than simply 'gel spreading'." The book is divided into nine chapters: anatomy and technique, salivary glands, thyroid and parathyroids, lymph nodes, lumps and bumps in the head and neck, larynx, what the surgeon needs to know and why, fine needle aspiration or core biopsy, carotid and vertebral ultrasonography? The next question is which individuals would best benefit from this text? This text is not meant to teach someone how to scan, and as stated in the introduction the "..book is intended for those who actually scan". The textbook would be most useful for sonographers and radiologists experienced in head and neck ultrasound or those experienced individuals who intend to begin sonography of this difficult area. This book may not be as useful for radiologists who primarily depend on cross-sectional imaging for evaluating the head and neck. However, it would be a welcome addition to complete their library. The short chapter on carotid and vertebral ultrasonography may not be useful to individuals only working in a vascular laboratory. However, it may be useful to a general ultrasonographer. An important group of individuals that may greatly benefit from this book are general otolaryngologists or those persons with a specific interest in pediatric otolaryngology or head and neck surgery. The value of ultrasound is slowly becoming apparent to the surgeon. This has been expedited by the lack of use in the head and neck by most radiologists. The machines are portable, so the studies can be performed in an office-based setting and the tests are noninvasive. In the future, it is not inconceivable that the role of ultrasonography to the head and neck surgeon may become similar to use of ultrasound by the obstetrician and gynecologist. This book would be a valuable asset to those otolaryngologists or head and neck surgeons who wish to incorporate ultrasound into their practice. However, it is important to reiterate that this book will not teach the surgeon how to scan patients but would be helpful in a problem solving role in certain patients who are scanned by an experienced head and neck ultrasonographer.The chapters are subdivided into different topics. The subheadings are succinct and to the point. All the chapters are nicely illustrated and are enhanced by color images and pertinent schematic illustrations. However, the sonographic images can only be fully appreciated by those experienced in head and neck sonography or while doing the actual procedure. The information presented in the text is accurate but is not as extensive as would be found in the major radiology or otolaryngology texts. I think this is a very informative and well-written text that clearly meets the objectives stated in the introduction. There are several areas that could have been expanded. I would have liked to see a more in depth discussion of vascular malformations, including an explanation of how to differentiate high-flow from low-flow malformation. This information is important, because these are often seen in children, and the information on the flow rate will directly affect treatment. The section on biopsies could be enhanced by an explanation of the technique of ultrasound-guided fine needle aspiration specifically of cervical lymph nodes. This topic is especially important to the otolaryngologist, because it appears that ultrasound-guided fine needle aspiration may be the most sensitive imaging technique for evaluating the NO neck. A picture of the neck during the actual procedure demonstrating the surface transducer and insertion of the needle would have been helpful. Because of the subject matter the book would be especially helpful in underdeveloped areas, I think a more thorough discussion of tuberculosis would have been useful. The section on the thyroid gland could have been improved by a review of the author's experience on how to assess patients with multiple thyroid nodules. Advice on how to evaluate and when to biopsy patients with multiple thyroid nodules would have been welcome.