An Introduction To Neurotology, 21u1 Edition by Dr. Anirban BiswasPublished by Bhalani Medical Book House, 11, Mavawala Building, Parel,(Opp. KEM Hospital), Mumbai-400012, India, E-mail: Bhalani@vsnl.com

Hard bound, 340 pages, all color, 235 illustrations, with CD, Price Rs. 1295/-

For most otolaryngologists, a heart-sinking moment is inevitable whenconfronted by a patient presenting withvertigo. The diagnosis and managementof vertigo has always been an enigmabecause of the complexity of the balancesystem and because inherentcompensatory mechanisms as well as

redundancy of functions renders the system immune to mostdiagnostic tests. The complexity of the subject has led to thedevelopment of the new & specialized discipline calledNEUROTOLOGY and the book under review deals with this subjectvery deftly and in great detail. Most ENT textbooks lack acomprehensive section in neurotology due to which moststudents and clinicians find it difficult to do justice to balancedisorder patients. This book on balance disorder fills in the voidfor an easily understandable text on vertigo.

The author of the book, Dr. Anirban Biswas is one of the foremostneurotologists in the country and is credited with establishingthe subjects of medical audiology and neurotology on a firmfooting in this part of the world. Another of his books titledCLINICAL AUDIOVESTIBULOMETRY is now a standardtextbook and a "must read" for all post-graduate students in ENTand neurology. Dr. Biswas regularly holds workshops and coursesin neurotology in different parts of the country and has beensingularly instrumental in promoting the subject amongst ENTsand neurologists. No wonder this book showcases his deepknowledge on this subject and excellent teaching skills.

This comprehensive 340 page A-4 size book on neurotology, veryattractively produced in good quality art-paper with superb 4-colours printing is divided into 15 chapters. The book covershistory-taking, clinical tests, investigations in neurotology,imaging, diagnostic work-up for balance-disorder patients, thedifferent neurotological diseases including their patho-physiology / clinical presentation / diagnosis / managementoptions, drug-therapy in vertigo, surgical therapy in vertigo,physical therapy and vestibular rehabilitation, balance disordersin old-aged persons, balance disorders in children, cervical vertigoand also a chapter on tinnitus. The last chapter deals with 22different types of cases presenting with vertigo / balance disordersand their detailed analysis.

The book is a reader's delight and is sure to spark an interest inneurotology in the previously uninspired. The chapters have avery natural flow, are logically sequenced and carry the readerright up to the end (of the book, not his patience!). The readabilityof the text is excellent and the handling of complex subject mattersis superbly done with to-the-point, logical and easilyunderstandable explanations. Even the "not-interested-in-vertigo"group among us will probably not leave the book unread if theydare to start reading it, as the size of the book is quite formidableand intimidating.

The chapters 2nd to 5 1h deal with the diagnostic part i.e. historytaking, clinical tests, vestibular investigations and imaging andgives the reader a very clear idea about the logic behind thediagnostic work-up. The limitation and fallacies of the differenttests are also very elaborately discussed.

The chapters on drug therapy (chapter 8), surgical management(chapter 9), and physical therapy (Chapter 14) outline the role ofeach of these therapeutic modalities in the management of vertigo,including their indications, relevance and limitations very well.The fallacies of these modalities and the self-defeating nature ofthe commonly used drugs for vertigo are very well projected. Thespecial role of psychotropic drugs in vertigo is highlighted inchapter 8.

The major achievement of the book and where it scores over otherbooks on the subject is that is has been able to completelystandardize the diagnostic protocol, be it history-taking/clinicaltests/investigations and also fix standard management protocolsfor the different specific and the nonspecific types of balancedisorders. This is the most important contribution of this book tothe subject of neurotology, as standardization of diagnostic testsand management protocols is very much essential in a complexsubject like this. The book is a very worthy buy for all clinicianswho have to handle vertigo patients. The presentation is verylucid and being fortified by more that 200 illustrations, it diffuses ahuge lot of retainable information in the shortest possible time andspace.

There is CD that comes with the book. This CD contains a nearly1 hour video on practical demonstration of the clinical tests to bedone in vertigo patients and their interpretation. All the differenttypes of abnormal eye moments have been very well depicted inanimated videos and their clinical relevance discussed. An overviewof Audiovestibular Data Management Software — an interactivesoftware authored by Dr. Anirban Biswas for running a completeneurotology clinic right from documentation of history-taking,clinical tests, report generation of the different neurotological andaudiological investigations and the automatic generation of theprobable diagnosis and the relevant prescription is also a part ofthe CD that comes packaged with the book.

The book along with the CD priced at Rs. 1295/- it is a worthypossession for all ENT/neurology PGTs and also all medicalprofessionals dealing with vertigo patients. The author needs tobe complimented for this excellent publication. It is sure to generatea lot of interest on this difficult subject and clear a lot of gray areasin our understanding of neurotological disorders and theirmanagement.

Dr. Alok ThakkarAssociate Professor of Otolaryngology,All India Institute of Medical Sciences,New Delhi

215Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 58, No. 2, April-June 2006