Cranial Nerves: Functional Anatomy

Abstract

This book is pocket-sized, with a soft but sturdy cover and clearly identified titles on the front cover and spine. The inside cover contains a description of the book, highlighting the functional approach to the contents. There are five parts covering organisation of individual cranial nerves and four functionally based topics focusing on the role of cranial nerves during the passage of food through the head and neck. The author has made it clear that the drive for the book is on the clinically useful rather than academic completeness. A note to the reader warns that previous knowledge is needed and also targets undergraduate students in dentistry, medicine and speech therapy, while offering support for postgraduate physicians and healthcare practitioners interested in head and neck medicine. Part I describes the organisation of cranial nerves. The style of the text is conversational, which helps to remove the daunting formality usually associated with the topic. Essential definitions are addressed before explaining cranial nerve motor and sensory nuclei, tracts and brain stem relationships. The style is relaxed, so much so that for the first time this reviewer has encountered the term ‘etc’ used in an anatomical text! Figures add supporting information for the more difficult concepts, focusing on the schematic in favour of the anatomically accurate. Overall, the aims are achieved and the reader advances onto the next parts with a sound basis. Part II commences with a general description of cranial nerves, designed around their role in key functions involved in the eating and swallowing of food. Starting with cutaneous sensation and chewing, the text describes the Vth, VIIth and XIIth cranial nerves. While the detail is broad, the depth does at times fall short of that expected in the more specialist practices such as dentistry and head and neck surgery. Issues such as the sensory nerves involved in supplying maxillary teeth, description of the muscles of mastication and the area of tongue sensation detected by trigeminal nerve branches are the most notable omissions. The facial and hypoglossal nerves are covered accurately and succinctly but surgeons with an interest in parotid gland surgery will be surprised to hear that facial nerve injuries incurred during surgery rarely recover! Part III deals mainly with swallowing and speech, focusing on the role of the IXth, Xth and XIth cranial nerves. The topics covered are wide, informative and well written but the depth at times does fall short of the level expected in most postgraduate specialist examinations. Part IV deals with taste and smell, with very good illustrations of the parasympathetic pathways in the head and neck. The sympathetic system is also well described but suffers from the lack of a suitable illustration. Part V finishes the book by looking at vision and balance. The intricacies of various reflexes are very well covered and the supporting diagrams are an essential adjunct. The role of the IIIrd, IVth and VIth cranial nerves in extra-ocular function is not covered although the various reflexes of the pupil are worthy entries. Balance and hearing, a traditionally complicated topic, is well addressed and presented in an understandable fashion. Each chapter finishes by giving excellent examples of the clinical impact of some of the nerves covered at each stage. This is valuable for the newer student and those still confused by the impact of the information provided. The reading lists provided are reasonable but it does seem strange that no mention is made of Last's Anatomy, which has provided the bulk of the information in the field to the majority of those entering a surgical career. So to whom would this book appeal? For the candidate revising for examinations who had reached a point where larger texts had lost their appeal, this text would allow for a review of facts fast fading and serve to refocus the mind on the important issues. However, the reader would need to be aware that of necessity for a book of this size the depth falls short in some crucial areas. For this reason, it could not be a first choice for those beginning their studies, as candidates may find themselves short of the required knowledge level, especially dental students. Its content and size does make it a worthy companion for preexamination revision but the warning that some prior knowledge is a benefit is something of which the reader should take note.