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The clinical management of craniosynostosis
  1. S A Wall

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    Edited by Richard Hayward, Barry Jones, David Dunaway, Robert Evans. Cambridge: Cambridge University Press, 2004, £80.00 (hardback), pp 304. ISBN 1 898 68336 0

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    In the introduction of this text the editors have indicated their desire to produce a volume that does not constitute a specialised text for experts, but rather a source of information for associated professionals who perform an essential role in the management of these complex patients frequently at a significant distance from the “home institution”. In this regard the book has been successful in its aim, and it is certainly refreshing to see a book of craniofacial surgery not concentrating on surgery for surgeons.

    In fact the contents of the book highlights the fact that surgical intervention, although a key factor in the treatment of these complex cases, is only a relatively small/short phase of a coordinated multidisciplinary care pathway in these frequently complex cases.

    The authors have acknowledged the fact that this text constitutes a single unit philosophy, and as such is a distillation of “local” approaches and beliefs albeit in a major busy unit with a substantial case load. These are presented in clear sections supported by good literature reviews.

    As with any texts from multiple authors overlapping in terms of clinical expertise, the book does reflect a degree of repetition, particularly in the earlier chapters.

    The overall quality of sections is good, with some excellent chapters, particularly on ophthalmology, airway management, and issues addressing raised intracranial pressure.

    Certain sections which are highly complex may lose the non-specialist readers. These are mainly related to the genetic and molecular aetiopathogenesis of the conditions. This is a complex subject which realistically is of such a nature that it cannot effectively be simplified without becoming meaningless.

    As indicated by the authors, the surgical options presented are not meant as a surgical atlas but are aimed at giving an overview of the options possible. They have acknowledged the fact that the surgical techniques presented are some of a number of options guided by individual preferences. This specific chapter is one which could possibly have benefited from photographic illustrations in pre- and postoperative cases, rather than relying on simple line diagrams as the only form of illustration.

    In conclusion, this text represents a worthwhile contribution to the craniofacial literature. It is generally a readable and accessible source of information, achieving the aims outlined by the editors, and all contributors should be congratulated on a book highlighting the fact that a coordinated multidisciplinary approach is essential in the treatment of all patients with craniosynostosis.

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