I will confess to an initial heart-sink moment when I received this book. I tend to take a ‘surgical approach’ to such topics. Once the deed is done, the really intelligent folk step in and start the hard work. Indeed, before waking the implantee, out come the laptops, the experts read the modern entrails, those patterns across the screen, and they repeat mysterious numbers and words like ‘impedance’, and it sounds more like a National Aeronautics and Space Administration control room. Books like this are usually highly cerebral and aimed at our audiological fraternity. Discussions of processing strategies, rehabilitation and neurophysiology are worthy, but daunting to one such as this reviewer, who could not tell a spondee from a zombie.

What a relief then to find out just how clinically orientated this book is. I thought the first few chapters were a bit brief and superficial. Indeed, Chapter 4 ‘Cochlear Implantation in Adults’ comprised fewer than three pages of text, consisting mostly of headings, spaces and references! Two opening chapters on the history of cochlear implantation gave some international perspective, but never did address the serious ethical issues raised by the deaf community in the USA especially.

By Chapter 5, I was won over, however. ‘Bilateral Cochlear Implantation’ contained such subheadings as ‘What benefits?’, ‘How soon for the second side?’ and ‘What effect on quality of life?’ Successful implantation of cochlear malformations merits a surgical chapter, but even more coverage was provided in the excellent imaging sections. Chapter 7 ‘The Traditional Approach and its Alternatives’ was a personal favourite. This presented an updated account of the options available to those who would wield the drill. The chapters on single-sided deafness, revision surgery and hearing preservation surgery are followed by superb coverage of imaging prior to surgery. Illustrations are uniformly of excellent quality, with the monochrome contrast and decent printing that are essential for this topic. The book then moves on to brain stem implantation and, in Part II, to middle-ear implants. Colour illustration of transmastoid surgery can be challenging, but Chapter 19, on the Envoy Esteem middle-ear implant certainly rises to that. Overall, the topics of osseointegration and various middle-ear implants are covered in five chapters.

Now, there is some coverage of outcomes and rehabilitation, but set at a level that still makes this a surgeon's (or radiologist's) manual. The text is highly topical and updated, and makes for very easy reading. This is truly an ‘all you need to know’ on the topic for trainees, and a good update for their examiners and trainers. Of course, there is also the bonus material of four further chapters, videos and so on online, more for the generation to whom this book is aimed than for this reviewer.

A final chapter on economic considerations in ‘low resource settings’ (a euphemism for those even worse off economically than the UK in 2017) cleverly addresses the challenge of benefits, with so many competing demands on healthcare costs. This raised a final thought. One would expect to find many a US contributing author and a smattering from our continental colleagues. Notable here is how much Indian units have also contributed to the authorship and editing of this textbook.