Clinical ENT (2000). By Gerard M. O'Donoghue, Anthony A. Narula, & Grant J. Bates. Singular Publishing Group, Inc., Thomson Learning Company. 401 West A St., Suite 325, San Diego, CA 92101-7904. $68.95. Reviewed by Claire Marcus-Bernstein, Chevy Chase, MD.

This excellent textbook is a fine introduction to otolaryngology. It is a practical reference for common ear, nose, and throat (ENT) disorders and was developed with nonspecialists and medical students in mind. It is, by far, the best short reference of its that kind I've come across.

The text is eminently practical, well written, and well organized. Particularly impressive is its frequent use of tables to present both key pathology-associated features and treatment options. The authors attempt to ensure that non-specialists know when to refer for further medical work-up and when to have an increased index of suspicion. For example, they caution against the over-diagnosis of Meniere's disease-explicitly directing the physician to be alerted to the possible diagnosis of acoustic neuroma when patients present with unilateral inner-ear problems.

The strong practice-oriented approach is evident in their distillation of information into key points in every chapter. For example, in facial trauma, a simple checklist is given for evaluation of facial mobility. The use of a key points format further strengthens this book.

The outstanding feature of this book is by far the abundance and quality of clinical photographs. The authors offer a comprehensive compendium of photos depicting most frequently encountered clinical pathology of the ear, nose, and throat. These photos are a wonderful teaching device, assisting differential diagnoses by visual inspection. CT and MRI images further elucidate the diagnostic process and add another valuable dimension to this book.

My only reservations focus on the nonmedical management areas. I have some concerns about the hearing aid chapter. The authors' recommendation of "fitting the good ear" runs counter to the standard clinical practice of binaural amplification. Given the considerable technological advances in digital and programmable aids, it is also surprising to find only brief mention of their importance. Their recommendations may be appropriate for the British National Health Service, but have limited application in the United States.

All in all, this book has much to recommend it. Its superb textual organization, placement of diagnostic criteria in table form, and use of key points and photos make this book an easy-to-use reference for the nonspecialist for ENT diagnostic and treatment options. This book will serve as an excellent reference for internists and pediatricians alike and is likely to achieve the authors' goal of inspiring medical students to consider ENT as an exciting career.