It is not often that I will laugh out loud reading the Preface to any book, but Dr Pasha's writing produced just that response. I hasten to add that is because it is so witty, not that there is some howler in the text.

The back cover reminds us that this is the fifth edition of what is truly a ‘classic’ pocket book. The predecessors will be familiar to many and available in the departmental library, so the question must be what is new and added value. We are promised numerous ‘improvements’, such as updated chapters, many a new contributor, an appendix on radiology, new illustrations, mnemonics to aid retention and updated cancer staging.

The new imaging is nicely presented, with concise coverage of normal anatomy, cholesteatoma cleverly compared with healthy temporal bone imaging, magnetic resonance imaging of vestibular schwannoma and computed tomography scans of sinus disease (into which some nicely labelled neck scans have somehow intruded). The format is the traditional brief notes, bullet points and highlighting, which all makes for easier ‘dipping into’ rather than reading cover to cover. This is the last minute revision or ready reference on the ward round, rather than the all-encompassing textbook.

Even then there are notably comprehensive chapters that do ‘stand alone’. Sleep Medicine rates a superb chapter. I finally understand lymphoma subtyping. I am now familiar with the Pindborg tumour, the Lindeman procedure, Stickler syndrome, and Rye's modification of the Luke and Butler classification (but I forget of what). That level of detail is impressive for what is a ‘clinical reference guide’.

I just know I do somewhere have the fourth edition, or I did until I loaned it to a grateful trainee, so I have not been able to directly compare, but the impression is indeed that a commendable effort has gone into producing a true update.