This book represents all that most of us will ever need to know about middle-ear surgery. It is written by a master in his field, a prolific author, teacher and, above all, a surgeon. It is suitable reading for trainees and established surgeons alike, covering every aspect of middle ear and mastoid surgery likely to be encountered. The style is didactic, based on the author's own massive experience. He has clearly dealt with all the scenarios in this book many times and seems to have a surgical solution to every problem that we are likely to encounter; for example, he shows how to modify standard stapes prostheses to cope with anomalous anatomy in stapedectomy cases. Radiology is used extensively to aid diagnosis and treatment planning in a way that is difficult to reproduce in some countries, with limited time and resources, but demonstrates how a high standard of otology can be practised in the right circumstances. The scans presented are relevant and illustrate the pathology well. Line diagrams used throughout the book are clear and easy to follow, if not always easy to emulate in practice. One is taken step by step through the various surgical processes in such a logical way that one is tempted to wonder why one never thought of some of the solutions before. The section on middle-ear reconstruction describes the use of autologous tissues as well as prosthetic devices and results are given for each. Some outcome figures are from follow-up at 10 years, which makes them reliable. Cochlear implant surgery and bone-anchored hearing aids are only touched upon but, as these procedures are mainly carried out in specialised centres, I do not regard this as a weakness. The main areas covered by this book are encountered by every practising otologist and this is one of the book's strengths. The appendix covering theatre equipment is helpful insofar as one can take it to a manager when procuring a new middle-ear set and quote the master's requirements. It does, however, rely heavily on one manufacturer. The section on stapedectomy is very thorough and quotes Fisch's own results for primary, secondary and anomalous surgery. There is no real information on the use of the laser in middle-ear surgery and stapedectomy, so knowledge of this modality will have to be sought elsewhere. This second edition can be regarded as the standard reference and surgical guide for this subject. It is small enough to remain in one's briefcase, ready for those occasions when we see a horrible middle ear and wonder if there is a reliable way of preserving or restoring some function. Few surgeons will ever amass Fisch's experience but, with this book, they will be prepared to tackle almost all eventualities. All one has to do then is to try and reproduce some of his surgical skill.