This is the second edition of this book written by Robert Jackler, one of the world experts in skull base surgery. In the preface, he offers a short but honest insight on the evolution of this field. Poignantly, he describes his struggle to achieve the best results for his patients and to limit the morbidity associated with these procedures. The experience that he has gained through his career has allowed him to develop ‘function-sparing strategies’ enabling less aggressive resection of benign tumours in selected cases. I have never met Robert Jackler but I like him already!

The book itself is a surgical guidebook with hundreds of pictures which are of outstanding clarity. Credit must be given to medical illustrator Christine Gralapp, who has worked with Jackler for over 20 years. Her illustrations make the intricate, three-dimensional anatomy of this area easily understandable, and offer step-by-step pictorial descriptions of the surgical techniques discussed.

The majority of the book's chapters begin with ‘Approaches to…’; more specific descriptions are given when dealing with acoustic neuromas, glomus tumours, squamous cell carcinoma of the temporal bone and meningioma, to mention a few. There are also chapters on facial nerve surgery, vestibular surgery and cochlear implantation. All of these descriptions make these difficult operations easily understandable, to the point that they seem very straightforward.

The target audience is trainee otolaryngologists and neurosurgeons, especially those about to embark on a skull base fellowship. Without a shadow of a doubt, this is a truly remarkable book which any skull base unit should at the very least have available to their trainees. For those trainees embarking on a skull base fellowship, it is essential.