It would be easy for the unwary reader to confuse this with many similar titles, by these and other publishers, so do watch out for the Volume 10 note on the cover. Google showed identical titles going back to 1958 and 1973, but things have moved on somewhat fortunately. These publishers started this project as more of a yearbook, and indeed I reviewed Volume 3 in 2014 and Volume 6 in 2017,Reference Flood¹ then edited by Lalwani and Pfister. The last appearance was in 2015, with Sudhoff and Bhutta at the helm, but, wisely, ten years have elapsed for this volume and that allows some genuine updating, which is certainly achieved here. There is an extra section added on innovations and technical breakthroughs, but, throughout, coverage of the expected super-specialities (Pat Bradley will not tolerate sub-specialities as a term) includes many innovations, far more in some than others inevitably.

There is a common chapter format which is a credit to the editors of any multi-author book. Every chapter carries boxed bullet points, Pearls and Pitfalls (especially good) and ‘Evidence Based Medicine Highlights’. Each chapter is followed by references, usually well over 50, which are notably recent, with few, other than the ‘classics’, predating Volume 9. There are excellent colour illustrations and sharp reproduction of scans, well labelled. This print quality from India is now far better than we often see in textbooks from ‘over the pond’.

The cover puzzled me, but is explained by the artist, a trainee in otolaryngology. It represents a human with XX chromosomes (chosen to reflect the prevalence of such amongst our consultant staff now) facing the challenges of robotics and artificial intelligence (AI). It is fun to work out just how many procedures this rather intimidating latter character has undergone.

The ‘stand-out’ section for me was that on Rhinology and facioplastics, the former so long the ‘Cinderella’ of ENT, so much so that this journal dropped it from its title back in 1920. As the ‘-mabs’ multiply exponentially, Chapter 5 on such biologics in nasal disease proved to be ‘recent advances’ coverage at its best, with a very sensible review of risk/benefit. Not every rhinologist will tackle anterior skull base tumours or every laryngologist correct laryngotracheal stenosis, but what is new is bound to start with the international experts, as here. One of the longest chapters in the book, that on laryngotracheal stenosis, benefits from superb illustrations, coverage of an extraordinary range of causative diseases, tips for reconstruction and no fewer than 83 references for further reading. ‘Pepper-potting’ of obstructive lesions with a laser certainly counts as a novel recent advance to this aged and retired otologist.

In the Head and Neck section, thyroid cancer is an obvious inclusion, as so many of us will remember when that was solely the province of the general surgeon. Even more to be expected is a chapter on minimally invasive, especially robotic, surgery. Personally, I am grateful that AI and autonomous robots had nothing to do with my experience, despite the inevitable title and that instead a human hand and brain were employing what is truly remote control.

Chapter 14 did, however, demonstrate what AI may add to practice. Machine learning, deep learning and natural language processing are increasingly prevalent terms in the ENT literature and can contribute much already to image, histopathologic and genetic interpretation in the field of Head and Neck. This chapter extended its coverage with speculation of what is yet to come, but I am reminded of one of Yoda’s daftest quotes from Star Wars, ‘Ah, hard to see the future is’.

At first, I was disappointed by the seeming brevity of the final chapter on technological advances, until I realised, on my third reading, that I had twice jumped from page 253 to 256, missing the most important section. Curiously, the sentence I had mistakenly read was grammatically fine, but made little sense (try it). Such are the perils for a reader at the very end of a book needing speedy review. I was struck by the relative lack of recent advances in otology, however well written the chapters (and they certainly are). Imaging of hydrops may yet convince the sceptics, and I will bet that Ebselen produces relief of vertigo in Ménière's disease in 75% of patients (what does not?)

This book lives up to its title and proves a very easy and entertaining read. It is appealing to the advanced trainee, to the established senior and, above all, to the examination candidate.