BM Zide and GW Jelks

Lippincott Williams & Wilkins,Philadelphia PA USA, 2006 ISBN: 0-7817-5081-4 Price: £85.50

‘Surgical Anatomy Around the Orbit’ has been written from a surgeon's perspective. It introduces a concept of zones for the orbital, periocular and facial region. This concept of zones allows the surgeons to familiarise themselves not only with the operative field that may be relevant but also with the adjacent surrounding tissues.

This book is better described as an atlas, as it uses figures and photographs to make it more pictorial and schematic. It has very little descriptive text and maximises the concept of visualisation to understand the anatomy. It takes the surgeon away from an artist's impression and instead uses more life-like pictures to identify tissue colour and textures. This is carried out with the help of photographs of patients and cadaveric dissections.

It begins with the more familiar and traditional structure of introducing orbital anatomy with its bony limits, blood supply and sensory nervous system. It succeeds in portraying a three-dimensional impression by maximising the use of different colours and textures. It shows the orbital anatomy, with its relations to the globe itself and to the skull base.

This book, although it should not be used on its own, would supplement the needs of the oculoplastic, lacrimal and orbital surgeon. The book assumes that the surgeon is already familiar with the basic orbital anatomy. It covers many aspects of this subspeciality which tend to be neglected or omitted, as it goes beyond the realm of an ophthalmic surgeon. The best example is reflected in the chapter of the Facial Nerve where the author describes the course of the Facial Nerve, with the help of a series of pictures and some very helpful surface landmark points of reference. It then goes on to dissect the course of this nerve, from the superficial to the deep layers. Another very useful chapter I found was the chapter on nerve blocks. It allows the surgeon to infiltrate and target very specific nerves, allowing for a more effective and efficient block.

From an oculoplastic surgoen's point of view, we are very familiar with the eyelids. However, there are occasions when we have to operate beyond this familiar zone. This book covers areas such as the suborbicularis oculi fat (SOOF), the retro-orbicularis oculi fat (ROOF) and the superomedial zone (which includes the corrugators and the procerus). Such structures become very important when we have to operate beyond the eyelids for reconstructive, traumatic or cosmetic work.

It has a brief chapter on intranasal anatomy which is becoming increasingly important with the wider use of endoscopic dacryocystorhinostomies. The floor of the orbit and the course of the infraorbital nerve is reasonably well covered to help the orbital surgeon preserve this nerve in orbital floor decompressions, for example.

The book tries to help the surgeon to visualise the anatomy and provides a CD-ROM.

The CD-ROM provides figures and minimal text for each chapter of the book. The images can be enlarged for higher resolutions. Options are provided to save the data locally in either JPEG or PDF formats.

The book also contains a number of pictures which are not quite in focus, although this could be a printing fault. Specific structures were identified using abbreviations in the figures. It would have been much easier to interpret these abbreviations if they were listed in a separate table next to the figure. This would have avoided the need to keep referring to the descriptive text.

In summary, this book does have a role to play in forming a three-dimensional concept of the area around the orbit and should be used as a supplement in extending one's knowledge of the orbit. It minimises the use of text and succeeds in portraying a true life impression of tissue anatomy with the extensive use of photographs and figures.