Book Review

Neoplasms of the Larynx

N Engl J Med 1994; 330:1165April 21, 1994

Article

Neoplasms of the Larynx
Edited by Alfio Ferlito. 618 pp., illustrated. New York, Churchill Livingstone, 1993. $195. ISBN: 0-443-04571-2

Neoplasms of the Larynx is an exhaustive and major study of benign and malignant tumors affecting the organ of communication. Nearly half the book is an encyclopedic study of the histopathological aspects of laryngeal tumors. The many illustrations and large format lend themselves beautifully to this endeavor.

The book opens with a detailed and well-written historical perspective. After a review of embryology and anatomy, the book focuses on tumors. Since in many instances laryngeal cancer is preventable, chapters on epidemiology, prevention, and carcinogenesis are included. All are written by experts.

Dr. Ferlito, a professor of otolaryngology at the University of Padua School of Medicine, has taken the histopathological features of laryngeal cancer as his special interest, and his involvement as the author of a number of chapters, rather than simply the editor, is quite apparent, as is his penchant for detail and thoroughness. The many photographs are clear and crisp. Each chapter has an extensive bibliography. Indeed, the reader may become overwhelmed by the volume of information, particularly in the discussions of tumors that are exceptionally rare. Unfortunately, each is given equal weight, although squamous-cell carcinoma is by far the primary neoplasm of the larynx.

The second half of the book delves into diagnostic imaging, documentation, and areas of therapy. Golden and Lavender contribute a unique chapter on perioperative medical considerations. Since patients with laryngeal tumors often have airway compromise and have often been heavy drinkers and smokers, they face unique medical issues that must be addressed. This chapter is of considerable value to practitioners.

The chapters on therapy cover laser surgery, radiation therapy, chemotherapy, and surgery (entailing either conservation of the larynx with preservation of the voice or radical total laryngectomy). Complications of surgery are discussed, as are treatment failure and options for retreatment. Lastly, material on the psychological aspects confronting the patient and the physician is included.

The chapter by Silver and associates on the surgical treatment of laryngeal cancer is well illustrated, particularly from Dr. Silver's own textbook. This should not, however, lead the reader to believe that this is a surgical atlas, since Dr. Silver's book and others currently available are more focused on this area.

The book is beautifully illustrated, but the one criticism I would make concerns the lack of color photomicrographs, which would have been beneficial in a book emphasizing histopathological aspects.

Neoplasms of the Larynx is an ultimate resource not only for the laryngologist, but also for the pathologist whose interest is in this organ. It is certainly accessible to the reader, being well indexed, well organized, and thorough. However, the $195 price tag may put this book out of reach of most residents.

Marvin P. Fried, M.D.
Harvard Medical School, Boston, MA 02115