Although not inspired particularly by the concept of the book, I was reassured by the introduction that the theory behind image guided surgery (IGS) would be presented in a way that was accessible, with “all technical descriptions trimmed to the bare essentials” so that I would learn to make better use of my image guidance and have a greater understanding of potential applications, as well as its limitations.

Unfortunately I did not feel the book met this aim. This is a very technical book detailing the history and physics behind IGS. Several commercial user manuals are simply reproduced without additional helpful tips based on practical application. There is a single chapter on clinical applications, which essentially focuses on sinus surgery – despite both the cover picture and title suggesting broader implications would be discussed.

Three-quarters of the book are devoted to theoretical explanation of CT, MRI and image-guided technologies. However, as an ENT surgeon, I’m not really sure that I need to see the complex mathematical equation for “relaxation time” – the latter to me is a gin and tonic on a Friday night. There were a few useful explanations on accuracy and error – for example, I now understand why the accuracy declines the deeper into the nose that surgery extends when using surface recognition. However, I had already known that it does, and the book can’t give any advice on how to overcome this. The history of how IGS was developed will be of interest to some, particularly those of us still able to remember looking at plain X-rays, but for the millennials it is likely to be met with the same disdain I get from my children when I explain that there was a time when not all phones had touch screens.

I’m just not sure who this book is really targeted at – but I think it’s too technical and lacking in practical applications to be of interest to ENT surgeons.

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Claire Hopkins

FRCS (ORLHNS) DM (Oxon), BACO 2023 Academic Chair; Guy’s and St Thomas’ Hospitals, London, SE1 9RT; Reader in ENT Surgery, King’s College London, UK.

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