REVIEWS
A s a service to our readers, Plastic and Recon-
structive Surgery® reviews books, DVDs, prac-
tice management software, and electronic media
items of educational interest to reconstructive and
aesthetic surgeons. All items are copyrighted and
available commercially. The Journal actively solicits
information in digital format (e.g., CD-ROM and
Internet offerings) for review.
Reviewers are selected on the basis of relevant
interest. Reviews are solely the opinion of the re-
viewer; they are usually published as submitted,
with only copy editing. Plastic and Reconstructive
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Surgery® does not endorse or recommend any re-
view so published. Send books, DVDs, and any
other material for consideration to: Jack A. Fried-
land, M.D., Review Editor, Plastic and Reconstructive
Surgery, UT Southwestern Medical Center, 5323
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75390-8820.
Jack A. Friedland, M.D.
Review Editor
Anesthesia in Cosmetic Surgery
Edited by Barry L. Friedberg. Pp. 263. Cambridge Uni-
versity Press, New York, N.Y., 2007. Price: $95.
I t is difficult to perform
surgery without anesthe-
sia, so all plastic surgeons
have some interest in this
topic. Dr. Friedberg has
specifically excluded oral
and intravenous sedation
given or directed by the sur-
geon; the book deals exclu-
sively with anesthesia given
and directed by an anesthe-
siologist. The book is writ-
ten by and for anesthesiol-
ogists, with a primary emphasis on Dr. Friedberg’s
approach of “Minimally Invasive Anesthesia.” This
technique is a combination of premedication with
clonidine followed by bispectral index (of EEG)
monitoring of a propofol-ketamine intravenous
anesthetic. His goal is to give the least amount of
anesthesia to achieve sedation and amnesia. He
believes that this leads to a faster recovery and
discharge as well as a lower incidence of nausea
and vomiting. An interesting component is the
need for the surgeon to provide adequate local
anesthesia. His admonition to anesthesiologists
that they will not have success with his technique
without having a working relationship with their
Copyright ©2008 by the American Society of Plastic Surgeons
www.PRSJournal.com
surgeon, one that allows them to let the surgeon
know that the patient needs more local anesthesia,
provides some insight into the view an anesthesi-
ologist has of surgeons and surgery. It is a re-
minder that any anesthetic technique that at-
tempts to limit intravenous or inhaled agents is
dependent on achieving local anesthesia. To this
end, there are good chapters on lidocaine toxicity
and nerve block techniques in the head and neck.
Chapters on preanesthetic assessment and psycho-
logical aspects of cosmetic surgery should also in-
terest plastic surgeons and are worth reading if you
find that you have access to this text. Other chap-
ters had little to offer a surgeon other than the
issues, viewpoint, and understanding that anes-
thesiologists have when providing anesthesia for
outpatient surgery.
This book is a worthwhile read for anyone who
has a strong interest in the anesthetic manage-
ment of outpatient surgery. The take-home mes-
sage is that if you would like your patients to re-
ceive less medication, give them more or better
local anesthetic. You could team up with your
anesthesiologist to provide this if you have a work-
ing relationship with him or her. If you believe that
surgery is surgery and anesthesia is anesthesia, this
book is not for you.
DOI: 10.1097/01.prs.0000307724.98190.ce
Neil A. Fine, M.D.
Oral Cancer: Diagnosis, Management,
and Rehabilitation
Edited by John W. Werning, M.D. Pp. 448. Thieme, New
York, N.Y., 2007. Price: $129.95.
C ancer of the oral cavity
and the treatment re-
quired to cure the disease
can be among the most de-
bilitating problems in med-
icine. Whereas early tumors
can be handled by limited
resections without adjunc-
tive therapy, advanced can-
cers often require extensive
surgery, radiation, and/or
chemotherapy. All of these
options frequently result in
loss of functional swallowing and speech. Dr.
Werning and his co-authors have created a com-
prehensive, detailed review of every significant as-
pect of oral cancer. While most general texts offer
one or two chapters on the oral cavity, this text
deals with complexities and substantial differ-
ences in each subsite.
673
 Plastic and Reconstructive Surgery • February 2008
The early chapters deal with the usual stag-
ing, preoperative evaluations, and epidemio-
logic and anatomic reviews quite nicely. They
take a mundane subject and make a strong at-
tempt to dig into the details and make them
relevant to the reader.
The next natural division deals with cancers of
the various sites, options for treatment, and the
authors’ experiences and recommendations. All
of these chapters are written by Drs. Werning and
Mendenhall. Although having the same two au-
thors for so much of the book has the potential to
result in treatment tunnel vision, I felt it was a
positive in this case. The problems are arranged in
an organized, consistent format, and the authors
effectively deal with the discrete issues in each oral
subsite.
The reconstructive chapters are excellent with
regard to indications, details to consider in recon-
struction, and understanding the issues created in
ablation of the various structures of the oral cavity.
These chapters are limited in techniques and
make no attempt to be a surgical atlas of all details
of all possible reconstructive options. They accom-
plish very well the primary purpose of understand-
ing the enemy and developing strategies to over-
come the obstacles created by ablation.
674
The final chapters of the book deal with var-
ious topics related to nonsurgical treatment as well
as the consequences of treatment. These chapters,
in addition to those on speech therapy, prosthet-
ics, chemoprevention, and newer strategies, tie up
every loose end possible in oral cavity cancer treat-
ment. Much more would be needed to cover each
of these subjects in the same depth as the evalu-
ation and surgical sections. For instance, there are
two chapters dealing with radiation and chemo-
therapy. They furnish adequate general under-
standing of the topics for the intended reader, but
treatment of head and neck cancer is evolving
rapidly and patients treated nonsurgically actually
comprise an ever-growing proportion of advanced
cases.
The strengths of the book lie in the early and
middle chapters dealing with evaluation and sur-
gical management. The latter sections cover their
bases and are well done, giving a good overall
picture of how to deal with the problems associ-
ated with cancer treatment. These latter subjects
would be difficult to cover completely within the
scope and mission of the book, and a lengthier
treatise would not be as effective.
DOI: 10.1097/01.prs.0000307725.05814.ae
John M. Truelson, M.D.