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As a first approach, the book impresses with the hardback cover and the glossy 442 pages. Published in March 2015, the book reflects an effort to deliver the main advances and updates of allergy and clinical immunology relevant to otolaryngology to the general otolaryngologist.

The introduction gives the basics on immunity, types of hypersensitivity and allergic response as well as immunoglobulins and their role. A good explanation of the allergic pathway is outlined as well as treatment modalities, from antihistamines to anti IgE treatments. Valuable knowledge is shared on skin testing and laboratory evaluation methods of allergic disease, absolutely necessary for the trainee as well as the general ENT surgeon.

The chapter on allergic rhinitis and rhinosinusitis reflects current classifications, according to ARIA guidelines, however elsewhere in the book the old classification of seasonal and perennial allergic rhinitis is used (page 280).

Useful knowledge, certainly for the senior trainee and the generalist is the description of paradoxical vocal fold movement disorder as well as the management of chronic urticaria.

Some of the chapters focus in great detail on immunological aspects and pathways, leaving the reader rather disinterested, whilst simple mistakes could be avoided (i.e. dog allergen is described as Fel d 1 and cat allergen is described as Can f 1; error on page 281).

The chapter of Rheumatic Diseases and Vasculitides covers a variety of conditions that the otolaryngologist should be familiar with, however leaves the description of sarcoidosis rather brief with no comment on the nasal manifestations and their management.

Important matters, such as the significance of the quadruple vaccine for HPV (Gardasil) in prevention of recurrent laryngeal papillomatosis (RRP) are not even mentioned.

A useful attempt at explaining and updating knowledge on immunotherapy is made towards the end of the book, failing to give the recent trends and treatment modalities available in Europe.

In conclusion, the book, which costs between £115 to £150 attempts to host the main allergy and immunology related subjects for the general ENT surgeon. Whilst some parts of the book are brilliant, some others are rather dated and in contradiction with or in repetition of other parts of the same book. Overall, the chapters do not avoid an overlap and sometimes give a fragmented view of the conditions described. Despite the above, the book is a useful catalogue of the immunological conditions and their management; it is to be decided if the price reflects its value.

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Anastasia Rachmanidou

Lewisham & Greenwich NHS Trust, London, UK.

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