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 Scott-Brown’s EIGHTH EDITION

Otorhinolaryngology
Head and Neck
Surgery

K17879_Volume II_Book.indb 1 4/30/18 12:19 PM

 VOLUME 1
Basic Sciences, Head and Neck Endocrine Surgery,
Rhinology

VOLUME 2
Paediatrics, The Ear, Skull Base

VOLUME 3
Head and Neck Surgery, Plastic Surgery

K17879_Volume II_Book.indb 2 4/30/18 12:19 PM

 Scott-Brown’s EIGHTH EDITION

Otorhinolaryngology
Head and Neck
Surgery
VOLUME 2

Editors
John C Watkinson MSc (Nuclear Medicine; London) MS (London) FRCS (General Surgery) FRCS (ENT) DLO
One-Time Honorary Senior Lecturer and Consultant ENT/Head and Neck and Thyroid Surgeon, Queen Elizabeth Hospital
University of Birmingham NHS Trust and latterly the Royal Marsden and Brompton Hospitals, London, UK
Currently Consultant Head and Neck and Thyroid Surgeon, University Hospital, Coventry and Warwick NHS Trust; and
Honorary Consultant ENT/Head and Neck and Thyroid Surgeon, Great Ormond Street Hospital (GOSH)
Honorary Senior Anatomy Demonstrator, University College London (UCL)
Business Director, Endocrine MDT, The BUPA Cromwell Hospital, London, UK.
Raymond W Clarke BA BSc DCH FRCS FRCS(ORL)
Consultant Paediatric Otolaryngologist, Royal Liverpool Children’s Hospital, Liverpool, UK
Senior Lecturer and Associate Dean, University of Liverpool, UK.

Section Editors
Christopher P Aldren MA (CANTAB) MBBS FRCS (Eng) FRCS (ORL-HNS)
Consultant Otolaryngologist, Wexham Park Hospital, Slough, UK.
Doris-Eva Bamiou MD MSc FRCP PhD
Professor in Neuroaudiology, Honorary Consultant in Audiovestibular Medicine
MSc in Otology & Audiology (UCL) Course Co-Director, UCL Ear Institute, Royal National Throat Nose Ear Hospital, London, UK.
Raymond W Clarke BA BSc DCH FRCS FRCS(ORL)
Consultant Paediatric Otolaryngologist, Royal Liverpool Children’s Hospital, Liverpool, UK
Senior Lecturer and Associate Dean, University of Liverpool, UK.
Richard M Irving MD FRCS (ORL-HNS)
Consultant in Neurotology, University Hospital Birmingham NHS Trust and Diana Princess of Wales (Birmingham Children’s) Hospital,
Honorary Senior Lecturer, University of Birmingham, Birmingham, UK.
Haytham Kubba MBBS MPhil MD FRCS(ORL-HNS)
Associate Professor, Department of Paediatrics, University of Melbourne,
Consultant Otolaryngologist, Royal Children’s Hospital, Parkville, Australia.
Shakeel R Saeed MD FRCS (ORL)
Clinical Director RNTNEH, Professor of Otology/Neuro-otology, UCL Ear Institute
Consultant ENT and Skull Base Surgeon, The Royal National Throat, Nose & Ear Hospital and
National Hospital for Neurology and Neurosurgery, London, UK.

K17879_Volume II_Book.indb 3 4/30/18 12:19 PM

 CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742

© 2018 by Taylor & Francis Group, LLC

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

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International Standard Book Number-13: 978-1-138-09461-1 (Hardback; Volume 1)

International Standard Book Number-13: 978-1-138-09463-4 (Hardback; Volume 2)
International Standard Book Number-13: 978-1-138-09464-2 (Hardback; Volume 3)
International Standard Book Number-13: 978-1-4441-7589-9 (Hardback; Set)
International Standard Book Number-13: 978-1-138-19652-0 (International Student Edition; restricted territorial availability)

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Library of Congress Cataloging‑in‑Publication Data

Names: Watkinson, John C., editor. | Clarke, Ray (Raymond), editor.

Title: Scott-Brown’s otorhinolaryngology and head and neck surgery : basic sciences, endocrine surgery, rhinology / John Watkinson, Ray Clarke.
Other titles: Scott-Brown’s otorhinolaryngology, head and neck surgery |Otorhinolaryngology and head and neck surgery.
Description: Eighth edition. | Boca Raton : CRC Press, [2018] | Preceded by Scott-Brown’s otorhinolaryngology, head and neck surgery.
7th ed. c2008. | Includes bibliographical references and index.
Identifiers: LCCN 2017032760 (print) | LCCN 2017033968 (ebook) | ISBN 9780203731031 (eBook General) | ISBN 9781351399067 (eBook PDF) |
ISBN 9781351399050 (eBook ePub3) | ISBN 9781351399043 (eBook Mobipocket) | ISBN 9781138094611 (hardback : alk. paper).
Subjects: | MESH: Otolaryngology--methods | Otorhinolaryngologic Diseases--surgery | Head--surgery | Neck--surgery | Otorhinolaryngologic
Surgical Procedures—methods.
Classification: LCC RF20 (ebook) | LCC RF20 (print) | NLM WV 100 | DDC 617.5/1--dc23
LC record available at https://lccn.loc.gov/2017032760

Visit the Taylor & Francis Web site at

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and the CRC Press Web site at

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K17879_Volume II_Book.indb 4 4/30/18 12:19 PM

 Contents
Contributors........................................................................ ix 15: Chronic otitis media.................................................... 155
Foreword........................................................................... xix William P.L. Hellier
Preface.............................................................................. xxi
16: Microtia and external ear abnormalities...................... 165
A Tribute to Bill Scott-Brown............................................xxiii Iain Bruce and Jaya Nichani
Acknowledgements..........................................................xxiv
Volume 1 – Table of Contents........................................... xxv 17: Disorders of speech and language............................. 175
Suzanne Harrigan and Andrew Marshall
Volume 3 – Table of Contents...........................................xxix
Abbreviations...................................................................xxxii 18: Cleft lip and palate...................................................... 185
David M. Wynne and Louisa Ferguson
Section 1 Paediatrics 19: Craniofacial surgery.................................................... 195
Benjamin Robertson, Sujata De, Astrid Webber and
1: Introduction to paediatric otorhinolaryngology................. 3 Ajay Sinha
Raymond W. Clarke
20: Balance disorders in children..................................... 219
2: The paediatric consultation.............................................. 7 Louisa Murdin and Gavin A.J. Morrison
Raymond W. Clarke
21: Facial paralysis in children.......................................... 231
3: Recognition and management of the sick child............. 15 S. Musheer Hussain
Julian Gaskin, Raymond W. Clarke and Claire Westrope
22: Epistaxis...................................................................... 241
4: A
 naesthesia for paediatric otorhinolaryngology Mary-Louise Montague and Nicola E. Starritt
procedures..................................................................... 23
Crispin Best 23: Neonatal nasal obstruction......................................... 251
Michelle Wyatt
5: The child with special needs.......................................... 33
Kate Blackmore and Derek Bosman 24: Paediatric rhinosinusitis and its complications........... 261
Daniel J. Tweedie
6: The child with a syndrome............................................. 41
Thushitha Kunanandam and Haytham Kubba 25: Lacrimal disorders in children..................................... 279
Caroline J. MacEwen and Paul S. White
7: Management of the immunodeficient child.................... 47
Fiona Shackley 26: The adenoid and adenoidectomy............................... 285
Peter J. Robb
8: Hearing screening and surveillance................................ 55
Sally A. Wood 27: Paediatric obstructive sleep apnoea.......................... 293
Steven Powell
9: Hearing tests in children................................................. 65
Glynnis Parker 28: Stridor......................................................................... 311
Kate Stephenson and David Albert
10: Management of the hearing impaired child.................. 75
Chris H. Raine, Sue Archbold, Tony Sirimanna and 29: Acute laryngeal infections........................................... 325
Soumit Dasgupta Lesley Cochrane
11: Paediatric implantation otology.................................... 93 30: Congenital disorders of the larynx, trachea
James Ramsden and Payal Mukherjee
and bronchi................................................................. 333
Chris Jephson
12: Congenital middle ear abnormalities.......................... 107
Jonathan P. Harcourt
31: Acquired laryngotracheal stenosis.............................. 347
Michael J. Rutter, Alessandro de Alarcón and
13: Otitis media with effusion............................................ 115 Catherine K. Hart
Peter J. Robb and Ian Williamson
32: Juvenile-onset recurrent respiratory papillomatosis......367
14: Acute otitis media....................................................... 137 Rania Mehanna and Michael Kuo
Peter A. Rea and Natalie Ronan

K17879_Volume II_Book.indb 5 4/30/18 12:19 PM

 vi Contents

33: Paediatric voice disorders.......................................... 377 51: Psychoacoustic audiometry....................................... 627

Ben Hartley and David M. Wynne Josephine E. Marriage and Marina Salorio-Corbetto

34: Foreign bodies in the ear, nose and throat................. 385 52: Evoked measurement of auditory sensitivity.............. 649
Adam J. Donne and Katharine Davies Jeffrey Weihing and Nicholas Leahy

35: Paediatric tracheostomy............................................. 395 53: Prevention of hearing loss.......................................... 663

Michael Saunders Shankar Rangan and Veronica Kennedy

36: Perinatal airway management..................................... 413 54: Hearing aids................................................................ 671

Pensée Wu, May M.C. Yaneza, Haytham Kubba, Harvey Dillon
W. Andrew Clement, and Alan D. Cameron
55: Beyond hearing aids: an overview of adult
37: Cervicofacial infections............................................... 423 audiological rehabilitation........................................... 685
Nico Jonas and Ben Hartley Lucy Handscomb

38: Diseases of tonsils, tonsillectomy and tonsillotomy..... 435 56: Age-related sensorineural hearing impairment........... 693
Yogesh Bajaj and Ian Hore Linnea Cheung, David M. Baguley and
Andrew McCombe
39: Salivary glands............................................................ 443
Neil Bateman and Rachael Lawrence 57: Noise-induced hearing loss and related conditions......701
Andrew McCombe and David M. Baguley
40: Tumours of the head and neck in childhood............... 451
Fiona B. MacGregor and James Hayden 58: Autosomal dominant non-syndromic
sensorineural hearing loss.......................................... 711
41: Cysts and sinuses of the head and neck.................... 465 Polona Le Quesne Stabej and Maria Bitner-Glindzicz
Keith G. Trimble and Luke McCadden
59: Ototoxicity.................................................................. 721
42: Haemangiomas and vascular malformations.............. 477 Andrew Forge
Daniel J. Tweedie and Benjamin E.J. Hartley
60: Idiopathic sudden sensorineural hearing loss............ 739
43: Drooling and aspiration............................................... 491 Tony Narula and Catherine Rennie
Haytham Kubba and Katherine Ong
61: Tinnitus and hyperacusis............................................ 753
44: Reflux and eosinophilic oesophagitis......................... 501 Don McFerran and John Phillips
Ravi Thevasagayam
62: Evaluation of balance.................................................. 775
45: Oesophageal disorders in children............................. 513 Adolfo M. Bronstein
Graham Haddock
63: Ménière’s disease....................................................... 817
Section 2 The Ear Vincent W.F.M. Van Rompaey

Audiovestibular medicine 64: Benign paroxysmal positional vertigo......................... 831

Yougan Saman and Doris-Eva Bamiou
46: A
 natomy and embryology of the external and
middle ear................................................................... 525 65: Superior semicircular canal dehiscence..................... 843
Peter Valentine and Tony Wright Harry R.F. Powell and Shakeel R. Saeed

47: A
 natomy of the cochlea and vestibular system: 66: Vestibular neuritis........................................................ 849
relating ultrastructure to function................................ 545 Charlotte Agrup
Jonathan Gale and Andrew Forge
67: Vestibular migraine..................................................... 855
48: Physiology of hearing.................................................. 567 Louisa Murdin and Linda M. Luxon
Soumit Dasgupta and Michael Maslin
68: Vestibular rehabilitation............................................... 863
49: Physiology of equilibrium ........................................... 593 Marousa Pavlou
Floris L. Wuyts, Leen K. Maes and An Boudewyns
69: Auditory neuropathy spectrum disorder and
50: Perception of sounds at the auditory cortex.............. 617 retrocochlear disorders in adults and children........... 873
Frank E. Musiek and Jane A. Baran Rosalyn A. Davies and Raj Nandi

K17879_Volume II_Book.indb 6 4/30/18 12:19 PM

 Contents vii

70: Understanding tinnitus: a psychological perspective..... 893 89: Otosclerosis.............................................................. 1061

Laurence McKenna, Elizabeth Marks and David J. Scott Christopher P. Aldren, Thanos Bibas, Arnold J.N.
Bittermann, George G. Browning, Wilko Grolman,
71: Auditory processing disorders across the age span.....901 Peter A. Rea, Rinze A. Tange and Inge Wegner
Doris-Eva Bamiou and Cristina Ferraz B. Murphy
90: Otological effects of paget’s disease........................ 1093
72: Neuropsychiatric aspects of vestibular disorders....... 909 Ian D. Bottrill
Julius Bourke, Georgia Jackson and Gerald Libby
91: Ear trauma................................................................ 1099
Otology Stephen C. Toynton

73: Clinical examination of the ears and hearing.............. 919 92: Otalgia....................................................................... 1141
George G. Browning and Peter-John Wormald Philip D. Yates

74: Furunculosis................................................................ 931 Implantation otology

Malcolm P. Hilton
93: Bone-conduction hearing devices............................ 1149
75: Myringitis..................................................................... 935 James Ramsden and Chris H. Raine
Samuel A.C. MacKeith
94: Cochlear implants..................................................... 1157
76: K
 eratosis obturans, primary auditory canal Andrew Marshall and Stephen Broomfield
cholesteatoma and benign necrotizing otitis externa.....941
Tristram H.J. Lesser 95: Middle ear implants.................................................. 1169
Maarten J.F. de Wolf and Richard M. Irving
77: Acquired atresia of the external ear............................ 949
Jonathan P. Harcourt 96: Auditory brainstem implantation............................... 1177
Shakeel R. Saeed and Harry R.F. Powell
78: Otitis externa and otomycosis.................................... 953
A. Simon Carney Section 3 Skull Base
79: Perichondritis of the external ear................................ 959 97: Imaging of the temporal bone................................... 1187
James W. Loock Steve Colley

80: Exostosis of the external auditory canal .................... 963 98: Anatomy of the skull base and infratemporal fossa. 1197
Philip J. Robinson and Sophie J. Hollis Charlie Huins

81: Osteoradionecrosis of the temporal bone.................. 967 99: Evaluation of the skull base patient.......................... 1211
James W. Loock Jeyanthi Kulasegarah and Richard M. Irving

82: Acute otitis media and otitis media with effusion 100: Vascular assessment and management.................. 1221
in adults...................................................................... 971 Joe J. Leyon, Kurdow Nader and Swarupsinh Chavda
Anil Banerjee
101: Natural history of vestibular schwannomas............ 1229
83: Chronic otitis media ................................................... 977 Mirko Tos†, Sven-Eric Stangerup and
George G. Browning, Justin Weir, Gerard Kelly and Per Caye-Thomasen
Iain R.C. Swan
102: Surgical management of vestibular schwannoma.... 1239
84: Myringoplasty........................................................... 1021 Shakeel R. Saeed and Christopher J. Skilbeck
Charlie Huins and Jeremy Lavy
103: Stereotactic radiosurgery........................................ 1259
85: Ossiculoplasty ......................................................... 1029 Paul Sanghera, Geoffrey Heyes, Helen Howard,
Daniel Moualed, Alison Hunt and Christopher P. Aldren Rosemary Simmons and Helen Benghiat

86: Eustachian tube dysfunction ................................... 1039 104: Neurofibromatosis 2................................................ 1267
Holger H. Sudhoff D. Gareth R. Evans

87: Otoendoscopy.......................................................... 1047 105: Non-vestibular schwannoma tumours of the

David A. Bowdler, Annabelle C.K. Leong and cerebellopontine angle............................................ 1275
David D. Pothier Simon K.W. Lloyd and Scott A. Rutherford

88: Tuberculosis of the temporal bone........................... 1057

Ameet Kishore † deceased

K17879_Volume II_Book.indb 7 4/30/18 12:19 PM

 viii Contents

106: Middle fossa surgery............................................... 1289 112: The facial nerve and its non-neoplastic disorders.....1381
Raghu N.S. Kumar, Sunil N. Dutt and Christopher Skilbeck, Susan Standring and
Richard M. Irving Michael Gleeson

107: Jugular foramen lesions and their management..... 1299 113: Tumours of the facial nerve..................................... 1413
Rupert Obholzer Patrick R. Axon and Samuel A.C. MacKeith

108: Petrous apex lesions .............................................. 1317 114: Osteitis of the temporal bone.................................. 1419
Michael Gleeson Cheka R. Spencer and Peter Monksfield

109: Approaches to the nasopharynx and 115: Squamous cell carcinoma of the temporal bone......1425
Eustachian tube ..................................................... 1325 Liam Masterson and Neil Donnelly
Gunesh P. Rajan
116: Complications of skull base surgery....................... 1435
110: Tumours of the temporal bone................................ 1339 Abdul Karim Nassimizadeh and Chris Coulson
Marcus Atlas, Noweed Ahmad and Peter O’Sullivan
Index............................................................................... 1445
111: Clinical neuroanatomy............................................. 1351
John J.P. Patten

K17879_Volume II_Book.indb 8 4/30/18 12:19 PM

 Contributors
Charlotte Agrup MD MSc FRCP PhD David M Baguley MSc MBA PhD
Consultant Audiovestibular Physician Head of Audiology
UCLH Addenbrooke’s Hospital
London, UK. Cambridge, UK.

Noweed Ahmad MBChB BSc (HONS) MSc FRCS Ed (ORL-HNS) Yogesh Bajaj FRCS ORLHNS
Consultant Otolgist, Neuro-Otologist and Skull Base ENT Consultant
Surgeon Royal London Hospital
Department of Otolaryngology London, UK; and
James Cook University Hospital Visiting Professor
Middlesbrough, Cleveland, UK. Canterbury University
Kent, UK.
Alessandro De Alarcón MD MPH
Associate Professor of Otolaryngology-Head and Doris-Eva Bamiou MD MSc FRCP PhD
Neck Surgery Professor in Neuroaudiology
Division of Paediatric Otolaryngology-Head and Honorary Consultant in Audiovestibular Medicine
Neck Surgery MSc in Otology & Audiology (UCL) Course CoDirector
Cincinnati Children’s Hospital Medical Centre UCL Ear Institute
Department of Otolaryngology-Head and Neck Surgery Royal National Throat Nose Ear Hospital
University of Cincinnati College of Medicine London, UK.
Cincinnati, USA.
Anil Banjeree MBBS FRCS FRCS(ORL-HNS)
David Albert FRCS Consultant ENT Surgeon/Honorary Senior Lecturer
Senior Consultant ENT Surgeon University Hospitals of Leicester/Leicester University
Department of Otolaryngology Medical School
Great Ormond Street Hospital for Children Leicester, UK.
London, UK.
Jane A Baran PhD
Christopher P Aldren MA FRCS (ENG) FRCS (ORL-HNS) Professor and Chair
Consultant Otolaryngologist Department of Communication Disorders
Wexham Park Hospital University of Massachusetts Amherst
Slough, UK. Amherst, USA.

Sue Archbold PhD (HON) LLD Neil Bateman BMedSci BM BS FRCS (ORL-NHS)
Consultant on Research, Public Policy and Practice on Consultant Paediatric Otolaryngologist
Deafness and Hearing Loss, Cochlear Implantation Royal Manchester Children’s Hospital
and Deaf Education Manchester, UK.
Consultant to The Ear Foundation
Helen Benghiat FRCR
Marcus Atlas MBBS FRACS Consultant Clinical Oncologist (Neuro-Oncology)
Garnett Passe and Rodney Williams Memorial Hall-Edwards Radiotherapy Research Group
Foundation Chair Cancer Centre
Otolaryngology Head and Neck Surgery Queen Elizabeth Hospital
Director, Ear Science Institute Australia Birmingham, UK.
Ear Sciences Centre
University of Western Australia. Crispin Best MBBS FRCA
Consultant in Paediatric Anaesthesia
Patrick R Axon MD FRCS (ORL-HNS) Department of Anaesthesia
Consultant Otologist and Skull Base Surgeon Royal Hospital for Sick Children
Department of Otolaryngology, Cambridge University Glasgow, UK.
Hospitals
Cambridge, UK.

ix

K17879_Volume II_Book.indb 9 4/30/18 12:19 PM

 x Contributors

Thanos Bibas Cert Math MSc PhD FRCSI(Otol) Adolfo M Bronstein MD PhD FRCP
Assistant Professor in Otolaryngology Professor of Clinical Neuro-otology
University of Athens Head, Neuro-otology Unit, Division of Brain Sciences,
Athens, Greece Imperial College London
Honoray Reader Consultant Neurologist
UCL Ear Institute Charing Cross Hospital (Imperial NHS)
London, UK. National Hospital for Neurology and Neurosurgery,
Queen Square (UCLH)
Maria Bitner-Glindzicz BSc MBBS DCH FRCP PhD London, UK.
Professor of Clinical and Molecular Genetics
Genetics and Genomic Medicine Programme Stephen Broomfield FRCS
UCL Institute of Child Health; and Consultant Otologist
Great Ormond Street Hospital for Children University Hospitals Bristol NHS Foundation Trust
London, UK. Bristol, UK.

Arnold JN Bittermann MD PhD George G Browning MD FRCS

ENT Surgeon (special interest Paediatric ENT) Emeritus Professor of Otorhinolaryngology/Head and
University Medical Center Utrecht Neck Surgery
The Netherlands. University of Glasgow; and
Visiting Professor to the MRC/CSO Institute of Hearing
Kate Blackmore FRCS(ORL-HNS) MClinEd Research
ENT Consultant and Honorary Clinical Senior Lecturer Glasgow, UK.
The James Cook University Hospital
Middlesbrough, UK. Iain Bruce MD FRCS(ORL-HNS)
Consultant Paediatric Otolaryngologist
Derek Bosman FRCS Royal Manchester Children’s Hospital
ENT Consultant Manchester, UK.
The James Cook University Hospital
Middlesborough, UK. Alan D Cameron FRCOG FRCP(Glas) MD MBChB
Consultant Obstetrician and Subspecialist in Maternal
Ian D Bottrill BM FRCS FRCS(ORL) and Fetal Medicine
Consultant ENT Surgeon The Ian Donald Fetal Medicine Unit
Oxford University Hospital NHS Trust; and Southern General Hospital; and
Honorary Senior Lecturer Honorary Professor
University of Oxford University of Glasgow
John Radcliffe Hospital Glasgow, UK.
Oxford, UK.
A Simon Carney BSc (HONS) MBChB FRCS FRACS MD
An Boudewyns MD PhD Associate Professor and Head of ENT Unit
Antwerp University Hospital Flinders University and Flinders Medical Centre
Department of Otorhinolaryngology, Head and Adelaide, South Australia.
Neck Surgery
Edegem, Belgium. Per Caye-Thomasen MD DMSc
Associate Professor
Julius Bourke MBBS MRCPsych Ear, Nose and Throat Department
Principal Investigator: The Brain in Pain Study Gentofte Hospital, University of Copenhagen
Clinical Senior Lecturer in Neurophysiology and Clinical Hellerup, Denmark.
Psychiatry
Honorary Consultant Liaison Psychiatrist Swarupsingh Chavda MBChB DMRD FRCR
Centre for Psychiatry Consultant Diagnostic & Interventional Neuroradiologist
Wolfson Institute for Preventive Medicine Queen Elizabeth Hospital
Barts and The London School of Medicine and Dentistry Birmingham, UK.
London, UK.
Linnea Cheung BSc(HONS) MBChB MRCS-DOHNS
David A Bowdler MBBS FRCS (GEN SURG) FRCS (OTOLARYN) Speciality Registrar in Otorhinolaryngology
Consultant ENT Surgeon Severn Deanery
Gloucestershire, UK.

K17879_Volume II_Book.indb 10 4/30/18 12:19 PM

 Contributors xi

Raymond W Clarke BA BSC DCH FRCS FRCS(ORL) Harvey Dillon BEng PhD
Consultant Paediatric Otolaryngologist Senior Research Scientist
Royal Liverpool University Children’s Hospital National Acoustic Laboratories
Alder Hey Visiting Professor of Auditory Science
Liverpool, UK. University of Manchester; and
Adjunct Professor
W Andrew Clement FRCS MBChB Macquarie University
Consultant Paediatric Otolaryngologist Sydney, Australia.
Department of Paediatric Otolaryngology
Royal Hospital for Sick Children Adam J Donne PhD FRCS (ORL-HNS)
Yorkhill Consultant Paediatric Otolaryngologist
Glasgow, UK. Alder Hey Children’s NHS Foundation Trust
Liverpool, UK.
Lesley Cochrane BSc FRCS
Consultant Paediatric Otolaryngologist Neil Donnelly MSc FRCS (ORL-HNS)
Great Ormond Street Hospital for Children Consultant ENT Surgeon
London, UK. Department of Neuro-otology and Skull Base Surgery
Cambridge University Teaching Hospitals NHS Trust
Steve Colley MB ChB MRCS FRCR Cambridge, UK.
Consultant Head & Neck Radiologist
Queen Elizabeth Hospital Sunil N Dutt MS DNB PhD FRCS (ED) FRCS (ORL-HNS)
Birmingham, UK. DLO (ENG) DORL
Professor, Senior Consultant and Clinical Director
Chris Coulson PhD FRCS (ORL-HNS) Department of Otolaryngology and Head and Neck
Consultant Otolaryngologist Surgery
NIHR Clinical Lecturer, Otolaryngology Head and Apollo Group of Hospitals
Neck Surgery Bangalore, India.
School of Cancer Sciences, University of Birmingham
Queen Elizabeth Hospital D Gareth R Evans MBBS MRCP MD FRCP
Birmingham, UK. Medical Genetics and Cancer Epidemiology
Manchester University
Soumit Dasgupta MBBS DLO MS FRCS MSc FIAOHNS Manchester, UK.
Consultant Audiovestibular Physician and Neurotologist
Alder Hey Children’s NHS Foundation Trust, Liverpool Louisa Ferguson BSc FRCS(ORL-HNS)
Sheffield Vertigo and Balance Centre, Sheffield Cleft Fellow
Honorary Tutor, University of Manchester Evelina London Children’s Hospital
Manchester, UK. London, UK.

Katharine Davies MBBCh MRCS (DOHNS) Andrew Forge PhD MSc BSc
ENT Registrar Emeritus Professor of Auditory Cell Biology
Aintree University Hospital UCL Ear Institute
Liverpool, UK. London, UK.

Rosalyn A Davies FRCP PhD Jonathon Gale PhD

Honorary Consultant in Audio-Vestibular Medicine Professor of Auditory Cell Biology and Interim Director
The National Hospital for Neurology and Neurosurgery UCL Ear Institute
London, UK. London, UK.

Sujata De FRCS(ORL-HNS) Julian Gaskin MBChB FRCS (ORL-HNS) DOHNS

Consultant Paediatric ENT Surgeon Consultant ENT Surgeon
Alder Hey Children’s Hospital University Hospitals Bristol NHS Foundation Trust
Liverpool, UK. Bristol Royal Hospital for Children
Bristol, UK.
Maarten de Wolf MD PhD
Consultant ENT Surgeon
AMC Amsterdam
The Netherlands.

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 xii Contributors

Michael Gleeson MD FRCS FRACS FDS William PL Hellier FRCS(ORL-HNS)

Professor of Otolaryngology and Skull Base Surgery Consultant Paediatric Otolaryngologist
Institute of Neurology University College London Great Ormond Street Hospital for Children
Consultant, Guy’s, Kings and St Thomas’ London, UK.
and the National Hospital for Neurology and
Neurosurgery Geoffrey Heyes PhD
Honorary Consultant Skull Base Surgeon Lead Physicist for Stereotactic Radiotherapy
Great Ormond Street Hospital for Sick Children Hall-Edwards Radiotherapy Research Group
London, UK. Cancer Centre
Queen Elizabeth Hospital
Wilko Grolman MD PhD Birmingham, UK.
Professor of Otorhinolaryngology
Department of Otorhinolaryngology, Head and Neck Malcolm P Hilton MA BM BCh FRCS (ENG) FRCS (ORL-HNS)
Surgery Consultant Otolaryngologist
University Medical Centre Utrecht Royal Devon and Exeter Hospital; and
Utrecht, The Netherlands. Clinical Sub-Dean
University of Exeter Medical School
Graham Haddock MBChB MD FRCS(GLAS) FRCS(PAED) Exeter, UK.
FFST(EDIN)
Consultant Neonatal and Paediatric Surgeon Sophie J Hollis MRCS (DO-HNS)
Royal Hospital for Children ENT Registrar
Glasgow, UK University Hospitals Bristol
Honorary Clinical Associate Professor Bristol, UK.
University of Glasgow
Glasgow, UK. Ian Hore FRCS (ORL-HNS)
ENT Consultant
Lucy Handscomb MSc Evelina London Children’s Hospital
Clinical Scientist London, UK.
Module Co-ordinator (Rehabilitation,
Counselling Skills, Tinnitus Helen Howard MSc
UCL Ear Institute Hall-Edwards Radiotherapy Research Group
London, UK. Cancer Centre, Queen Elizabeth Hospital
Birmingham, UK.
Jonathan P Harcourt MA FRCS
Consultant ENT Surgeon Charlie Huins MSc FRCS (ORL-HNS)
Charing Cross Hospital Consultant ENT Surgeon Specialising in Otology
London, UK. Queen Elizabeth Hospital
Birmingham, UK.
Suzanne Harrigan BSc
Speech & Language Therapist Alison Hunt FRCS
The Ear Foundation Consultant Otolaryngologist
Nottingham, UK. Milton Keynes General Hospital
Milton Keynes, UK.
Catherine K Hart MD
Assistant Professor of Otolaryngology, Head and S Musheer Hussain MBBS MSc (MANC) FRCS (EDIN)
Neck Surgery FRCS (ENG) FFST FRCS (ORL)
Division of Paediatric Otolaryngology, Head and Consultant Otolaryngologist Head and Neck Surgeon
Neck Surgery Honorary Professor of Otolaryngology and Consultant
Cincinnati Children’s Hospital Medical Centre; and ENT Surgeon; and
Department of Otolaryngology, Head and Neck Surgery Licenced Teacher of Anatomy
University of Cincinnati College of Medicine Ninewells Hospital & University of Dundee Medical
Cincinnati, USA. School
Dundee, UK.
Benjamin EJ Hartley MBBS BSc FRCS(ORL-HNS)
Consultant Paediatric Otolaryngologist Richard M Irving MD FRCS (ORL-HNS)
Great Ormond Street Hospital for Children Consultant in Neurotology
London, UK. University Hospital Birmingham NHS Trust
and Diana Princess of Wales (Birmingham Children’s)
James Hayden PhD FRCPCH Mb ChB Hospital
Consultant Paediatric Oncologist Honorary Senior Lecturer
Alder Hey Children’s NHS Foundation Trust University of Birmingham
Liverpool, UK. Birmingham, UK.

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 Contributors xiii

Georgia Jackson MBBS MRCPCH PG D(AUDIOVESTIB Thushitha Kunanandam MBChB FRCS(ORL-HNS)

MED (DIST) Consultant Paediatric Otolaryngologist
Previously Consultant Community Paediatrician Royal Hospital for Children
Royal Berkshire Hospital NHS Foundation Trust Glasgow, UK.
Reading, UK.
Michael Kuo PhD FRCS (Eng) FRCS (ORL-HNS) DCH
Chris Jephson BSc FRCS (ORL HNS) Consultant Otolaryngologist – Head and Neck Surgeon
Consultant Paediatric Otolaryngologist Birmingham Children’s Hospital
Great Ormond Street Hospital for Children Birmingham, UK.
London, UK.
Jeremy Lavy MBBS (LON) FRCS (ENG) FRCS (ORL-HNS)
Nico Jonas MBChB FRCS FCORL(SA) MMed Consultant Otologist
Consultant Paediatric Otolaryngologist Royal National Throat and Ear Hospital
Addenbrooke’s Hospital London, UK.
Cambridge University Hospital Foundation Trust
Cambridge, UK. Rachael Lawrence MBBS BSc
ENT Registrar
Gerard Kelly MB ChB MD Med FRCS(ED) FRCS(ORL-HNS) East MidlandsDeanery
Consultant ENT and Skull Base Surgeon Leicester, UK.
Leeds Teaching Hospitals NHS Trust
Honorary Senior Lecturer in Otolaryngology Nicholas Leahy AuD
University of Leeds Clinical Audiologist
Leeds, UK. Louisville
Kentucky, USA.
Veronica Kennedy MBBS FRCS MSc
Consultant Audiovestibular Physician Annabelle CK Leong MBBS (HONS)(LOND) BSc (HONS)
Bolton NHS Foundation Trust DOHNS FRCS (ORL-HNS)
Halliwell Children’s Centre Consultant ENT Surgeon/Otologist
Bolton, UK. Singapore Medical Specialists Centre
Paragon.
Ameet Kishore MBBS(AFMC) FRCS(GLAS) FRCS(EDIN)
FRCS-ORL(UK) Polona Le Quesne Stabej DVM PhD
Ear Nose Throat Neuro-Otology & Cochlear Implants Research Associate
Director & Chief Consultant, ADVENTIS (Advanced Centre for Translational Genomics – GOSgene
ENT Service) Genetics and Genomic Medicine Programme
Senior. Consultant Surgeon & Professor, Indraprastha UCL Great Ormond Street Institute of Child Health
Apollo Hospitals London, UK.
Founder & Managing Trustee, I Can Hear Foundation
ENT OPD, Indraprastha Apollo Hospitals Tristram HJ Lesser AKC MBBS FRCSEd MS FHKCORL
New Delhi, India. Consultant ENT Surgeon
Renacres Hospital NHS Treatment Centre
Haytham Kubba MBBS MPhil MD FRCS(ORL-HNS) Lancashire, UK.
Associate Professor
Department of Paediatrics Joe J Leyon MBBS MRCP FRCR
University of Melbourne; and Consultant Diagnostic & Interventional Neuroradiologist
Consultant Otolaryngologist Royal Preston Hospital
Royal Children’s Hospital Lancashire, UK.
Parkville, Australia.
Gerald Libby FRCP FRCPsych
Jeyanthi Kulasegarah MD FRCS (ORL-HNS) Professor of Gastrointestinal Psychiatry
Fellow in Neurotology King Edward VII Hospital; and
University Hospital Birmingham NHS Trust and Diana Barts and The London School of Medicine and Dentistry
Princess of Wales Hospital London, UK.
University of Birmingham
Birmingham, UK.

Raghu Nandhan Sampath Kumar MS DNB MRCS (ED)

DOHNS FRCS (ORL-HNS) MCh PhD
Clinical Fellow in Neurotology and Skull Base Surgery
Queen Elizabeth University Hospitals NHS
Foundation Trust
Birmingham, UK.

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 xiv Contributors

Simon KW Lloyd MBBS BSc(HONS) MPhil FRCS(ORL-HNS) Josephine E Marriage BSc Speech Science MSc
Professor of Otolaryngology Audiology PhD
Consultant Otolaryngologist Clinical Scientist in Audiology
Department of Otolaryngology Director at Chear Ltd., Director at Chear Ltd.,
Salford Royal Hospital; and Bermondsey; and
Department of Otolaryngology Research Associate
Manchester Royal Infirmary Cambridge University
Manchester academic Health Science Centre Cambridge, UK.
University of Manchester
Manchester, UK. Andrew Marshall FRCS
Consultant Otologist
James W Loock MBChB (UCT) FCS(SA)ORL FRCS (ENG) Nottingham University Hospitals NHS Trust
ad eundem Nottingham, UK.
Professor and Head
Department of Otorhinolaryngology Michael Maslin MSc PhD
University of Stellenbosch Audiologist and International Clinical Trainer
Tygerberg Hospital Interacoustics Academy
Cape Town, South Africa. Middelfart, Denmark.

Linda M Luxon CBE BSc FRCP Liam Masterton FRCS ORL-HNS

Emeritus Professor of Audiovestibular Medicine Department of Neuro-otology and Skull Base Surgery
UCL; and Cambridge University Teaching Hospital NHS Trust
Honorary Consultant Physician in Neuro-otology Cambridge, UK.
National Hospital for Neurology and Neurosurgery,
UCLH​NHS Trust Luke McCadden MB BCh FRCS(ORL-HNS)
London, UK. Specialist Registrar Otolaryngology
Royal Victoria Hospital
Caroline J MacEwan MBChB MD FRCS FRCOphth Belfast, UK.
FFSEM FRCP(ED)
Consultant Ophthalmologist Andrew McCombe MC FRCS
Ninewells Hospital Dundee; and Consultant ENT Surgeon
Professor of Ophthamology Mediclinic City Hospital, Dubai; and
University of Dundee Adjunct Clinical Professor of Surgery
Dundee, UK. Mohammed bin Rashid University Medical School
Dubai, UAE.
Fiona MacGregor MBChB FRCS (ORL-HNS)
Consultant Otolaryngologist Don McFerran BA MA MB BChir FRCS FRCS (ORL-HNS)
Gartnavel General Hospital Consultant ENT Surgeon
Galsgow, UK. Colchester Hospital University NHS Foundation Trust
Colchester General Hospital
Samuel AC MacKeith MBChB FRCS(ORL-HNS) Colchester, UK.
Consultant ENT Surgeon
Department of Otolaryngology Laurence McKenna M Clin Psychol PhD
John Radcliff Hospital Clinical Psychologist
Oxford, UK. Royal National Throat, Nose & Ear Hospital
London, UK.
Leen K Maes PhD
Professor and Doctor (Audiologist) Rania Mehanna MBBChBAO BMedSci FRCS(ORL-HNS)
Department of Speech, Language and Hearing Sciences Paediatric ENT Consultant
Faculty of Medicine and Health Sciences Our Lady’s Children’s Hospital
Ghent University Crumlin Private Clinic
Ghent, Belgium. Dublin, Ireland.

Elizabeth Marks D Clin Psy Peter Monksfield FRCS (ORL-HNS)

Clinical Psychologist Consultant ENT and Skull Base Surgeon
Royal National Throat, Nose & Ear Hospital University Hospitals Birmingham
London, UK. Birmingham, UK.

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 Contributors xv

Mary-Louise Montague MBChB(Hons) PGDipClinEd Jaya Nichani FRCS(ORL-HNS)

FRSC(ORL-HNS) Consultant Paediatric Otolaryngologist
Consultant Paediatric Otolaryngologist, Honorary Royal Manchester Children’s Hospital
Clinical Senior Lecturer Manchester, UK.
The Royal Hospital for Sick Children
Edinburgh, UK. Rupert Obholzer BA(Oxon), MBBS, FRCS (ORL-HNS)
Consultant ENT / Skull Base Surgeon
Gavin AJ Morrison MA MBBS FRCS Guys Hospital, Kings College Hospital; and
Consultant ENT Surgeon The National Hospital for Neurology and Neurosurgery
Guy’s, St Thomas’ and Evelina Hospitals London, UK.
London, UK.
Katherine Ong B App Sci (Speech Path) MA (Appl Ling)
Daniel Moualad MA MRCS Speech Pathologist
Specialist Registrar in Otolaryngology Royal Children’s Hospital
Oxford Deanery Parkville, Australia.
Oxford, UK.
Peter O’Sullivan Bsc MPhil FRCSI (ORL-HNS)
Payal Mukherjee MBBS MS FRACS Clinical Fellow, Neurotology
Clinical Associate Professor Department of Otolaryngology
University of Sydney Sir Charles Gairdner Hospital
Executive Member - RACS NSW Committee Nedlands, Western Australia.
ENT Research Lead - RPA Institute of Academic Surgery
Adult and Paediatric ENT Surgeon Glynis Parker MB ChB FRCP DCH MSc
Otologist, Cochlear Implant and Skull Base Surgeon Audiovestibular Physician
Sydney, Australia. Sheffield Children’s Hospital
Sheffield, UK.
Louisa Murdin PhD MRCP
Consultant Audiovestibular Physician John JP Patten BSc MB FRCP
Guy’s Hospital Consultant Neurologist (retired)
London, UK. South West Thames Regional Health Authority
London, UK.
Cristina FB Murphy PhD
Specialist Audiologist Marousa Pavlou PhD BA MCSP
Cromwell Hospital Lecturer in Physiotherapy
London, UK. Centre of Human and Aerospace Physiological Sciences
King’s College London
Frank E Musiek PhD London, UK.
Professor
Speech, Language, and Hearing Sciences John Phillips BSc(HONS) MBBS MRCS(ENG) FRCS(ORL-HNS)
University of Arizona Consultant ENT Surgeon
Tucson, USA. Norfolk & Norwich University Hospitals NHS
Foundation Trust
Kurdow Nader MBBS MSC FRCR Norfolk, UK.
Consultant Diagnostic & Interventional Neuroradiologist
Queen Elizabeth Hospital David D Pothier MSc MBChB FRCS (ORL-HNS)
Birmingham, UK. Staff Neurologist
Assistant Professor
Raj Nandi FRCS MSc University of Toronto; and
Consultant in Audio-Vestibular Medicine Department of Otolaryngology, Head and Neck Surgery
Department of Neuro-otology Toronto General Hospital
Royal National Throat, Nose and Ear Hospital University Health Network
London, UK. Toronto, Canada.

Antony Narula FRCS FRCS(ED) Harry RF Powell MBBS BSc DOHNS FRCS (ORL-HNS)
Consultant ENT Surgeon Consultant ENT
Professor of Otolaryngology Auditory Implant Surgeon
London, UK. Guy’s and St Thomas’ NHS Foundation Trust
London, UK.
Abdul-Karim Nassimizadeh MBChB, BMedSci, MRCS (ENT)
ENT Specialty Registrar
University Hospital Birmingham
Birmingham, UK.

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 xvi Contributors

Steven Powell MBBS MSc FRCS(ORL) Natalie Ronan FRCS (ORL-HNS)

Consultant Paediatric Otolaryngologist Consultant ENT Surgeon
Newcastle-Upon-Tyne NHS Foundation Trust Torbay Hospital
Newcastle-Upon-Tyne, UK. Torbay, UK

Chris H Raine MBE ChM FRCS(ORL-HNS) Scott A Rutherford MBChB FRCSEd(NEURO SURG)
Consultant ENT Surgeon Consultant Neurosurgeon
Yorkshire Auditory Implant Service Department of Neurosurgery
Listening for Life Centre Salford Royal NHS Foundation Trust
Bradford Royal Infirmary Manchester, UK.
Bradford, UK.
Michael J Rutter MBChB FRACS
Gunesh P Rajan MD DM FMH FRACS Professor of Otolaryngology – Head and Neck Surgery
Professor & Head of Otolaryngology, Head & Neck Division of Paediatric Otolaryngology – Head and Neck
Surgery Surgery
Otolaryngology, Head & Neck Surgery Cincinnati Children’s Hospital Medical Center; and
School of Surgery Department of Otolaryngology – Head and Neck Surgery
University of Western Australia University of Cincinnati College of Medicine
Perth, Australia. Cincinnati, USA.

James Ramsden FRCS PhD Shakeel R Saeed MD FRCS (ORL)

ENT Consultant & Honorary Clinical Lecturer Clinical Director RNTNEH
University of Oxford; and Professor of Otology/Neuro-otology
ENT Department UCL Ear Institute
John Radcliff Hospital Consultant ENT and Skullbase Surgeon
Oxford, UK. The Royal National Throat, Nose & Ear Hospital and
National Hospital for Neurology and Neurosurgery
Shankar Rangan MBBS DLO FRCS MSc London, UK.
Consultant Audiovestibular Physician
Wirral University Teaching Hospital NHS Trust Marina Salorio-Corbetto PhD AFHEA
Wirral, UK. Research Associate
Department of Experimental Psychology
Peter A Rea MA FRCS (ENG) FRCS (ORL-HNS) University of Cambridge
Consultant Otolaryngologist Cambridge, UK.
Leicester Royal Infirmary
Leicester, UK. Yougan Saman MBBCh MSc FCORL(SA) PhD
Head of Department
Catherine Rennie BSc MBBS DOHNS PhD FRCS Nelson R Mandela School of Clinical Medicine
ENT Consultant University of KwaZulu-Natal
Charing Cross Hospital Durban, South Africa.
Imperial College Healthcare NHS Trust.
Paul Sanghera FRCR
Peter J Robb BSc(HONS) MBBS FRCS FRCS (ED) Consultant Clinical Oncologist (Neuro-oncology/
Consultant ENT Surgeon Head & Neck)
Epsom & St Helier University Hospitals NHS Trust University Hospitals Birmingham NHS Foundation Trust
Epsom, UK. Queen Elizabeth Hospital, Queen Elizabeth Medical
Centre
Benjamin Robertson BDSc(HONS) MBBS PGDiP OMS Birmingham, UK.
FRACDS (OMS) FRCS (OMFS)
Craniofacial and Oral & Maxillofacial Surgeon Mike Saunders MD FRCS
Alder Hey Children’s Hospital Supra-Regional Consultant Otolaryngologist
Craniofacial Unit Bristol Royal Hospital for Children and St Michael’s
Liverpool, UK. Hospital
Bristol, UK.
Philip J Robinson MB ChB FRCS FRCS (OTOL)
Consultant Adult & Paediatric Otolaryngologist David J Scott BA Dip Clin Psy (Otago)
University Hospitals Bristol NHS Trust Clinical Psychologist
Bristol, UK. Royal National Throat, Nose & Ear Hospital
London, UK.

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 Contributors xvii

Fiona Shackley Holger H Sudhoff MD PhD FRCS (LON) FRCPath (LON)

Consultant Paediatrician (Allergy and Immunology) Professor and Chairman
Sheffield Children’s Hospital Department of Otolaryngology, Head and Neck Surgery
Sheffield, UK. Bielefeld Academic Teaching Hospital
Münster University
Rosemary Simmons BSc Bielefeld, Germany.
Radiotherapy Lead Manager
Hall-Edwards Radiotherapy Research Group Iain RC Swan MD FRCS
Cancer Centre Consultant Otologist
Queen Elizabeth Hospital Glasgow Royal Infirmary
Birmingham, UK. Glasgow, UK.

Ajay Sinha MS MCh FRCS(SN) Rinze A Tange MD PhD UHD

Consultant Neurosurgeon Associate Professor of Otology
Alder Hey Children’s NHS Foundation Trust Department of ORL, Head and Neck Surgery
Liverpool, UK. Academic Medical Centre
University of Amsterdam
Tony Sirimanna MBBS DLO(RCS-UK) FRCS(ED) FRCP Amsterdam, The Netherlands.
MS(OTO) MSc
Consultant Audiological Physician Ravi Theyasagayam FRCS(ORL-HNS)
Great Ormond Street Hospital for Children NHS Consultant ENT Surgeon
Foundation Trust Sheffield Children’s Hospital
London, UK. Sheffield, UK.

Christopher J Skilbeck MPhil FRCS Mirko Tos† MD DMSc

Consultant ENT Surgeon Emeritus Professor
Guy’s & St Thomas’ NHS Foundation Trust Ear, Nose and Throat Department
London, UK. Gentofte Hospital, University of Copenhagen
Hellerup, Denmark.
Cheka R Spencer MSc FRCS (ORL_HNS)
ENT Specialist Registrar Stephen C Toynton MB FRCS(OTOL)(ENG) FRCS(ORL)
University Hospitals Birmingham Consultant Otolaryngologist
Birmingham, UK. Hawke’s Bay Soldier’s Memorial Hospital
Hastings, New Zealand; and
Susan Standring MBE PhD DSc FKC FRCS(HONS) Honorary Consultant
Emeritus Professor of Anatomy Plymouth Hospital’s NHS Trust, UK
Department of Anatomy Former Otology Advisor to Diving Diseases Research
King’s College Centre and Hyperbaric Medical Unit
London, UK. Plymouth, UK.

Sven-Eric Stangerup MD DMSc Keith G Trimble MB MCh MPhil FRCS(ORL-HNS)

Associate Professor Consultant Paediatric Otolaryngologist
Ear, Nose and Throat Department Royal Belfast Hospital for Sick Children
Gentofte Hospital, University of Copenhagen Belfast, UK.
Hellerup, Denmark.
Daniel J Tweedie MA FRCS (ORL-HNS) DCH
Nicola E Starritt MBBS MD FRCS(ORL-HNS) Consultant Paediatric ENT, Head and Neck Surgeon
Consultant Paediatric Otolaryngologist Evelina London Children’s Hospital NHS Trust
The Royal Hospital for Sick Children Guildford, UK.
Edinburgh, UK.
Peter Valentine BSc FRCS (ORL-HNS)
Kate Stephenson FRCS FCORL-HNS(SA) MMed Consultant Otologist and ENT Surgeon
Consultant Paediatric Otorhinolaryngologist Royal Surrey County Hospital NHS Trust
Head and Neck Surgeon Guildford, UK.
Birmingham Children’s Hospital
Birmingham, UK.

† deceased

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 xviii Contributors

Vincent WFM Van Rompeaey MD PhD Peter-John Wormald MD FRACS FRCS (EDIN) FCS (SA) MBChB
Senior staff member Chairman and Professor of Otolaryngology Head and
Antwerp University Hospital Neck Surgery
FacultY of Medicine and Health Sciences Professor of Skull Base Surgery
University of Antwerp University of Adelaide
Belgium. Adelaide, Australia.

Astrid Webber BSc MBBS FRCP Tony Wright LLM DM FRCS Tech RMS
Consultant in Clinical Genetics Emeritus Professor of Otorhinolaryngology
Liverpool Women’s NHS Foundation Trust UCL Ear Institute
Liverpool, UK. London, UK.

Inge Wegner MD PhD Pensee Wu MRCOG MD (RES) DFSRH MBChC

Resident Otorhinolaryngology and Head and Honorary Consultant Obstetrician and Subspecialist in
Neck Surgery Maternal and Fetal Medicine
University Medical Centre Utrecht Lecturer in Obstetrics and Gynaecology
Utrecht, The Netherlands. University if Keele; and
Department of Obstetrics and Gynaecology
Jeffrey Weihing PhD CCC-A, FAAA University Hospital of North Staffordshire
Audiologist Stoke-on-Trent, UK.
Maine Medical Center
Maine, USA Floris L Wuyts PhD
Professor, Faculty of Sciences
Justin Weir MBBS MD FRCPath Lab of Biophysics and Biomedical Physics
Consultant Head and Neck Pathologist Antwerp University Research Center for Equilibrium and
Charing Cross Hospital; and Aerospace
Imperial College Healthcare Trust Antwerp, Belgium.
London, UK.
Michelle Wyatt MA (CANTAB) FRCS (ORL-HNS)
Claire Westrope MBCHB MRCPCH Consultant Paediatric Otolaryngologist
Consultant PICU/ECMO Head of Clinical Service for ENT, Cochlear Implant and
Clinical Lead PICU/CICU Audiology
University Hospitals Leicester NHS Trust Great Ormond Street Hospital
Leicester, UK London, UK.

Paul S White MBChB FRACS FRCS (Ed) David M Wynne MB ChB PgDip FRCS
Consultant Rhinologist, Ninewells Hospital Consultant Paediatric Otolaryngologist
Honorary Senior Lecturer, University of Dundee Royal Hospital for Children
Dundee, UK. Glasgow, UK.

Ian Williamson MD FRCSEd FRCGP May MC Yaneza FRCS-ORL PGDip PGCert DOHNS MRCS
Clinical Senior Lecturer MBBS BSc
School of Medicine, Primary Care & Population Sciences ENT Registrar West of Scotland
University of Southampton Department of Paediatric Otolaryngology
Southampton, UK. Royal Hospital for Sick Children
Glasgow, UK.
Sally A Wood MSc
Consultant Clinical Scientist (Audiology) Philip D Yates MB ChB FRCS (ORL-HNS)
NHS Newborn Hearing Screening Programme Consultant Otolaryngologist
UK National Screening Committee/NHS Screening Newcastle upon Tyne Hospitals NHS Foundation Trust
Programmes Newcastle upon Tyne, UK.
Public Health England
London, UK.

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 Foreword
The eighth edition of Scott-Brown signals the beginning of never have imagined. It lays the groundwork for the
a new and exciting era for ear, nose and throat surgeons, current generation to make their contribution that
and also the end of 10 years of very hard work undertaken will, no doubt, be prompted by technological develop-
by John Watkinson and Ray Clarke, the Editors-in-Chief, ments, an evidence base of what is wise and what is not,
their team of subeditors and, not least, the publishers. together with the experience gained by teamwork with
Whatever subspeciality the current generation of trainees other clinicians in today’s multidisciplinary approach
decides to follow, they will all have to read and refer to to patient care.
Scott-Brown in order to complete their education and gain Simply looking at the table of contents it is clear to see
accreditation. It will be a constant companion and guide that our role in endocrine surgery has increased dramati-
throughout their professional lives. cally over the last 10 years. The thyroid and parathyroids
When asked to write the foreword for this edition, I was now account for 30 chapters. How would Scott-Brown
immediately reminded that I had read John Ballantyne have viewed that when the tonsils and adenoids justify just
and John Groves’s third edition as a trainee, bought the one chapter each, and the sore throat has a mere passing
fourth edition as a senior registrar, written chapters for reference? Times have certainly changed and ENT surgery
Alan Kerr and Philip Stell in the fifth edition, edited the has grown up. We have reflected on our past practices,
Basic science volume of the fifth edition and was ultimately and the evidence base for our management protocols that
Editor-in-Chief of the seventh edition. As each edition takes was emphasized in the previous edition of Scott-Brown
about 10 years to produce, that makes me very old indeed. has been taken to heart.
John and Ray have one final task as Editors-in-Chief: to I hope that this edition will find its way into every medi-
recommend their successors to the publishers. That was cal library in the world and onto every ENT surgeon’s
made easy for me as both of them had proved themselves bookshelf. It will serve and guide surgeons throughout the
more than capable with the previous edition, and the English-speaking world, whether they live in high- or low-
eighth edition is now their masterpiece. They can enjoy the income countries. It is said that the tragedy of getting old
next 10 years as thousands of surgeons worldwide recog- is that we feel young. Reading these volumes makes me
nize and thank them for their industry. wish that I had my time all over again.
This edition reflects the continued expansion of our
speciality into fields that Scott-Brown himself could Michael Gleeson

xix

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K17879_Volume II_Book.indb 20 4/30/18 12:19 PM
 Preface
When we were asked to head up the editorial team for time zones with a few keystrokes. The bulky packages con-
this, the eighth edition of Scott-Brown, we were mindful taining grainy photographic prints and the reams of paper
of Michael Gleeson’s towering achievement in bringing the with closely-typed and heavily scored text that accumu-
seventh edition to fruition. Michael delivered a much-loved lated on authors’ and editors’ desks are a distant memory.
text – conceived in the early post-war years when antimi- References, guidelines and systematic reviews are all avail-
crobials, the operating microscope and the National Health able online; the editorial ‘red pen’ has been replaced by a
Service were all in their infancy – in an entirely new format cursor on the screen. This ‘new age’ has enabled us to look
that befitted modern surgical scholarship. Authors, editors ever further for expertise. We are proud to have enlisted the
and readers alike had become acutely conscious of the need support of authors from more than 20 countries for this
to quote high-quality evidence to guide clinical decisions; edition. Scott-Brown always enjoyed particular affection
the concept of grading clinical recommendations – and, by and respect in Asia, Australia, Africa and the Middle East.
implication, acknowledging gaps in the evidence base of our It has been a joy to welcome authors in increasing numbers
practice – was born. Recognizing the enormity of Michael’s from many of these parts of the world. We are now a truly
contribution led us into the trap that has befallen every editor global specialty and the eighth edition fully reflects this.
who has come before us; we grossly underestimated the task What has not changed is the huge time commitment authors
ahead. We had misjudged the pace of change. What began and editors need to make. That time now has to be fitted into
as an ‘update’ of some outdated chapters became a com- an increasingly pressurized work environment. Revalidation,
plete rewrite to reflect the advances that marked the decade mandatory training, more intense regulatory scrutiny, expand-
between editions, but we were determined to keep the text ing administrative burdens and ever-expanding clinical com-
to a manageable size. In the end, we have 330 chapters, but mitments leave little time for scholarship. Our section editors
with a slightly smaller page count than the seventh edition. are all busy clinicians. They have generously given their time,
The basic science knowledge that underpins our clinical first instructing authors, cajoling them and then editing their
practice is no longer focused just on anatomy and physiol- chapters, virtually all of which have been completely rewritten
ogy; genetics, molecular biology, new techniques for auditory since the last edition. Each author was chosen because of his or
implantation, information technology, new medical therapies her specific clinical and scientific expertise and none has disap-
for many old disorders together with seismic changes in endo- pointed. Authors and section editors receive no reward other
scopic technology and in medical imaging have transformed than the satisfaction of knowing that they have made a contri-
our specialty. Today’s head and neck surgery would have bution to teaching and learning in a specialty that has given us
been unrecognizable to the early authors and editors. Surgical all so much professional satisfaction. We are profoundly grate-
oncologists have recourse to completely different treatment ful to them and hope that their endeavours spur the next gen-
strategies than did their predecessors and now work as part eration of otolaryngologists to carry on this noble tradition.
of multidisciplinary teams. They deal with different disease Scott-Brown simply wouldn’t happen without this generous
patterns and vastly changed patient expectations. Thyroid and dedicated commitment, unstintingly and graciously given.
and parathyroid surgery has become almost exclusively the It is impossible to produce a book like Scott-Brown with-
domain of the otolaryngologist. Surgery of the pituitary fossa out the contribution of many individuals working behind
has come within our ambit, as has plastic and reconstructive the scenes. We would like to express our gratitude to our
surgery of the head and neck as well as aesthetic facial surgery. Publishers, Taylor and Francis, and to the staff who have
Neurotology, audio-vestibular medicine, rhinology and paedi- worked on this project from its early days in 2011 to publica-
atric otolaryngology are accepted subspecialties, each with its tion in 2018. In particular we would like to mention Cheryl
own corpus of knowledge and skills and each warranting a size- Brandt who with good humour and patience helped to reel in
able section of this text. Contemporary otolaryngology is now many of the 330 chapters. Miranda Bromage joined the team
a collection of subspecialty interests linked by common ‘stem’ in 2016 and her publishing experience and enthusiasm for
training and a shared passion for looking after patients with medical education have helped guide this new edition through
disorders of the upper respiratory tract and the head and neck. its final phases to publication. Finally, we are indebted to
There is a view that a single text – even a multivolume Nora Naughton who has dedicated so much more than just
tome of this size – cannot cover the entire knowledge base her extensive publishing skills to this project. Nora’s meticu-
of modern clinical practice. The subspecialist will, of course, lous attention to detail, combined with her warmth and wis-
need recourse to supplementary reading. The pace of change dom have encouraged us all at the end of this endeavour.
shows no sign of slowing down, but there is still a need for a We are truly ‘passing on the torch’ of a huge amount of
comprehensive working text embracing the whole spectrum accumulated knowledge and wisdom; it is this that gives
of our workload. That was the task we set our authors and us, the Editors-in-Chief, the greatest pleasure.
section editors; we think they have done our specialty proud. Read on and enjoy, our thoughts are yours.
In the new ‘digital’ editorial world authors create manu-
scripts on personal computers. They transmit chapters, RWC
figures, amendments and revisions across continents and JCW

xxi

K17879_Volume II_Book.indb 21 4/30/18 12:19 PM

 I wish to acknowledge the love, happiness and inspiration that have been passed on to me by both my
parents and grandparents. I recognise and value the friendship of my dear friend Ray Clarke who has
been with me all the way on this rewarding and worthwhile endeavour. I would specifically like to thank
Esme, Helen and William, without whom none of this would have been achievable. Their love and support
has helped guide me through the years leading up to the publication of this tome, and my final thanks go to
Angela Roberts and Sally Holden for their typing and editing skills.

JCW 2018

Thanks to my wife Mary for her patience and support. My parents, Emmet and Doreen Clarke, both sadly
died during the preparation of this book. They would have been proud to have played a part in such a
scholarly enterprise.

RWC 2018

Black Hut on the River Test – Pastel by W G Scott-Brown – circa 1970. Reproduced by kind permission of Mr Neil Weir,
who was presented with the original by the artist.

K17879_Volume II_Book.indb 22 4/30/18 12:19 PM

 A Tribute to Bill Scott-Brown
They were made available to young physicians to help them
travel to overseas centres specifically to study tuberculosis,
then rampant and one of the commonest causes of death in
young adults. The young Scott-Brown visited the leading
pioneers of the day in Berlin, Vienna, Budapest, Stockholm,
Copenhagen, Madrid and Venice. Here he developed his
considerable endoscopy skills. He reported that his first
bronchoscopies were done on a Venetian street entertainer
who, for a few coins, would inhale sundry objects that the
doctors would then dexterously retrieve from his main stem
and segmental bronchi – without of course any anaesthesia!
Times were lean on Scott-Brown’s return. Margaret
(‘Peggy’) was now a popular and well-established GP
who supported him as his private practice developed.
Eventually he secured appointments at East Grinstead, the
Royal National and Royal Free Hospitals. He had a thriv-
ing Harley Street practice and was the favoured otolaryn-
gologist of the aristocracy. His reputation was such that he
become laryngologist to the Royal family, was appointed
Commander of the Victorian Order and was a particu-
lar favourite of the then Princess Royal, HRH Mary the
Countess of Harewood.
Walter Graham (‘Bill’) Scott Brown. 1897–1987 By 1938 he was wealthy enough to purchase a farm
in Buckinghamshire where he bred prize-winning short-
Walter Graham (‘Bill’) Scott-Brown was twenty-three when horn cattle. Ironmongery and blacksmith work were hard
he arrived at Corpus Christi College Cambridge in 1919. to come by during the war years, so Scott-Brown prided
One of the generation of young men whose entry to univer- himself on his ability to make his own agricultural imple-
sity and the professions was delayed by their participation ments, cartwheels and farm wagons in a makeshift forge
in the First World War, he had joined the Gunners in 1915 he himself established on the farm. He would while away
as an 18-year-old. He considered himself blessed to have endless hours here at weekends following a busy week in
survived – although wounded – when so many of his con- London. An accomplished fly fisherman, he was part of
temporaries never returned from the Front. In those early the exclusive Houghton Club whose members fished the
post-WW1 years the medical school at St Bartholomew’s River Test in Hampshire, where he numbered aristocrats
(‘Barts’) in London was keen to attract ‘gentlemen’. To this including the Prince of Wales among his circle.
end a series of scholarships – ‘Shuter’s scholarships’ – was Scott-Brown’s celebrated textbook came about in the
established to lure those with humanities degrees from early 1950s, when he became ill with jaundice and heart
Oxford and Cambridge into medicine. It was via this scheme trouble. He was advised to rest, and took 6 months off
that the young Scott-Brown qualified MB, BCh in 1925. By work. Not satisfied with editing what has become the
now married to Margaret Bannerman, one of the very few standard UK textbook, he took up painting as well. He
women medical graduates of her generation, the two estab- became a celebrated artist whose work is still prized in
lished a general practice in Sevenoaks, Kent. His work here many private collections. One of his pastels is reproduced
involved looking after children with poliomyelitis, which on the preceding page.
was then commonplace, and his MD thesis was on polio- Bill Scott-Brown lived to be 90. He died in July 1987,
related bulbar palsy. It earned him the Copeman Medal for six weeks after his beloved Peggy and just as the fifth edi-
research from the University of Cambridge. While work- tion of the celebrated textbook that still bears his name
ing in general practice, Bill pursued his interest in the then was going to press. His legacy lives on in the pages of this
fledgling specialty of otolaryngology, securing fellowships book, and we are proud to continue the tradition of schol-
from London and Edinburgh. Postgraduate training was arship and learning which he established all those years
haphazard; there were no structured programmes or even ago.
junior posts, so the young Scott-Brown was fortunate to We would like to thank Martin Scott-Brown for his
be awarded a Dorothy Temple Cross Travelling Fellowship. help in compiling the biography above.
Mrs Florence Temple Cross had set up these awards (now
administered by the Medical Research Council) in mem- John C. Watkinson and Raymond W. Clarke
ory of her daughter, who died in 1927 aged thirty-two. London, 2018

xxiii

K17879_Volume II_Book.indb 23 4/30/18 12:19 PM

 Acknowledgements
We acknowledge our debt of gratitude to the many authors who have contributed to previous editions of Scott-Brown’s
Otorhinolaryngology, and in particular to authors from the seventh edition, published in 2008. We are also grateful to
Neil Bateman who helped with the initial planning of the Paediatrics section.

Chapter 10, Management of the hearing impaired child, Chapter 97, Imaging of the temporal bone, contains some
contains some material from ‘Investigation management material from ‘Anatomy of the skull base and infratempo-
of deaf child’ by Sujata De, Sue Archbold and Ray Clarke. ral fossa’ by Charlie Huins. The material has been revised
The material has been revised and updated by the current and updated by the current author.
author.
Chapter 106, Non-vestibular schwannoma tumours of
Chapter 28, Stridor, contains some material from ‘Acute the cerebellopontine angle, contains some material from
laryngeal infections’ by Susanna Leighton. The material ‘Evaluation of the skull base patient’ by Ranit De and
has been revised and updated by the current author. Richard M Irving. The material has been revised and
updated by the current author.
Chapter 31, Acquired laryngotracheal stenosis, contains
some material from ‘Jugular foramen lesions and their
management’ by Kees Graamans. The material has been
revised and updated by the current author.

xxiv

K17879_Volume II_Book.indb 24 4/30/18 12:19 PM

 Volume 1 – Table of Contents
Section 1 Basic sciences 17: Human papillomavirus
Mustaffa Junaid and Hisham M. Mehanna
Cell biology
18: Connective tissue diseases: ENT complications
1: Molecular biology Eileen Baildam
Michael Kuo, Richard M. Irving and Eric K. Parkinson
Microbiology
2: Genetics in otology and neurotology
Mohammed-Iqbal Syed 19: Microorganisms
Ursula Altmeyer, Penelope Redding and Nitish Khanna
3: Gene therapy
Seiji B. Shibata and Scott M. Graham 20: Viruses and antiviral agents
4: Mechanisms of anticancer drugs Richard B. Townsley, Camille A. Huser and
Chris Hansell
Sarah Payne and David Miles

5: Radiotherapy and radiosensitizers 21: Fungal infections

Christopher D. Scrase, Stewart G. Martin and Emily Young, Yujay Ramakrishnan, Laura Jackson and
David A.L. Morgan Shahzada K. Ahmed

6: Apoptosis and cell death 22: Antimicrobial therapy

Angela Hague Ursula Altmeyer, Penelope Redding and Nitish Khanna

7: Stem cells 23: Human immunodeficiency virus

Navin Vig and Ian C. Mackenzie Neil Ritchie and Alasdair Robertson

8: Aetiology and pathogenesis of goitre Haematology

Neil Sharma and Kristien Boelaert

9: Genetics of endocrine tumours 24: Blood groups, blood components and

Waseem Ahmed, Prata Upasna and Dae Kim alternatives to transfusion
Samah Alimam, Kate Pendry and Michael F. Murphy
Wound healing
25: Haemato-oncology
Robert F. Wynn and Mark Williams
10: Soft and hard tissue repair
Sarah Al-Himdani and Ardeshir Bayat 26: Haemostasis: Normal physiology, disorders of
11: Skin flap physiology haemostasis and thrombosis
Colin MacIver and Stergios Doumas Elizabeth Jones and Russell David Keenan

12: Biomaterials, tissue engineering and their Pharmacotherapeutics

application in the oral and maxillofacial region
Kurt Busuttil Naudi and Ashraf Ayoub 27: Drug therapy in otology
Wendy Smith
Immunology
28: Drug therapy in rhinology
13: Defence mechanisms Wendy Smith
Ian Todd and Richard J. Powell
29: Drug therapy in laryngology and head and neck surgery
Wendy Smith and Rogan Corbridge
14: Allergy: Basic mechanisms and tests
Sai H.K. Murng
Perioperative management
15: Evaluation of the immune system
Moira Thomas, Elizabeth Drewe and Richard J. Powell 30: Preparation of the patient for surgery
Michael Murray and Urmila Ratnasabapathy
16: Cancer immunology
Osama Al Hamarneh and John Greenman 31: Recognition and management of the difficult airway
Valerie Cunningham and Alistair McNarry

xxv

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 xxvi Volume 1 – Table of Contents

32: Adult anaesthesia 48: Image-guided surgery, 3D planning and reconstruction

Daphne A. Varveris and Neil G. Smart Ghassan Alusi and Michael Gleeson

33: Adult critical care 49: Interventional techniques

Robert I. Docking and Andrew Mackay James V. Byrne

34: Paediatric intensive care 50: Laser principles in otolaryngology, head and
Louise Selby and Robert Ross Russell neck surgery
Brian J.G. Bingham
Safe and effective practice
51: Contact endoscopy of the upper aerodigestive tract
35: Training, accreditation and the maintenance of skills Mario Andrea and Oscar Dias
B. Nirmal Kumar, Andrew Robson, Omar Mirza and
Baskaran Ranganathan
Section 2 Head and neck endocrine surgery
36: Communication and the medical consultation
Uttam Shiralkar Overview

37: Clinical governance and its role in patient safety 52: History of thyroid and parathyroid surgery
and quality improvement Waraporn Imruetaicharoenchoke, Ashok R. Shaha and
Samit Majumdar and S. Musheer Hussain Neil Sharma

38: Medical ethics 53: Developmental anatomy of the thyroid and

Paul Baines parathyroid glands
Julian A. McGlashan
39a: Medical jurisprudence in otorhinolaryngology
Maurice Hawthorne 54: Developmental anatomy of the pituitary fossa
John Hill and Sean Carrie
39b: Medical negligence in otorhinolaryngology
Maurice Hawthorne 55: Physiology of the thyroid and parathyroid glands
Martin O. Weickert
40: Non-technical skills for ENT surgeons
Simon Paterson-Brown and Stephen R. Ell 56: Physiology of the pituitary gland
Mária Hérincs, Karen Young and Márta Korbonits
Interpretation and management of data
57: Imaging in head and neck endocrine disease
41: Epidemiology Steve Colley and Sabena Fareedi
Jan H.P. van der Meulen, David A. Lowe and Jonathan
M. Fishman 58: Thyroid and parathyroid gland pathology
Ram Moorthy, Sonia Kumar and Adrian T. Warfield
42: Outcomes research
Iain R.C. Swan and William Whitmer Thyroid disease
43: Evidence-based medicine in medical education 59: Clinical evaluation of the thyroid patient
and clinical practice Andrew Coatesworth and Sebastian Wallis
Phillip Evans
60: Investigation of thyroid disease
44: Critical appraisal skills Anthony P. Weetman
Paul Nankivell and Christopher Coulson
61: Benign thyroid disease
Advances in technology Christopher M. Jones and Kristien Boelaert

45: Electrophysiology and monitoring 62: Management of differentiated thyroid cancer

Patrick R. Axon and Bruno M.R. Kenway Hisham M. Mehanna, Kristien Boelaert and Neil Sharma

46: Optical coherence tomography 63: Management of medullary thyroid cancer

Jameel Muzaffar and Jonathan M. Fishman Barney Harrison

47: Recent advances in technology 64: Management of anaplastic thyroid cancer/lymphoma

Wai Lup Wong and Bal Sanghera James D. Brierley and Richard W. Tsang

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 Volume 1 – Table of Contents xxvii

65: Management of locoregionally recurrent 81: Medicolegal aspects of head and neck
differentiated thyroid cancer endocrine surgery
Iain J. Nixon and Ashok R. Shaha Barney Harrison

66: Non-surgical management of thyroid cancer Pituitary disease

Laura Moss
82: Clinical evaluation of the pituitary patient
Thyroid surgery Sean Carrie, John Hill and Andrew James

67: Thyroidectomy 83: Investigation of pituitary disease

Ricard Simo, Iain J. Nixon and Ralph P. Tufano Thozhukat Sathyapalan and Stephen L. Atkin

68: Surgery for locally advanced and nodal disease 84: Primary pituitary disease
Joel Anthony Smith and John C. Watkinson Christopher M. Jones and John Ayuk

69: Minimally invasive and robotic thyroid surgery 85: Surgical management of recurrent pituitary tumours
Neil S. Tolley Mihir R. Patel, Leo F.S. Ditzel Filho, Daniel M.
Prevedello, Bradley A. Otto and Ricardo L. Carrau
70: Surgery for the enlarged thyroid
Neeraj Sethi, Josh Lodhia and R. James A. England 86: Adjuvant treatment of pituitary disease
Andy Levy
Parathyroid disease

71: Clinical evaluation of hypercalcaemia Section 3 Rhinology

Mo Aye and Thozhukat Sathyapalan
87: Anatomy of the nose and paranasal sinuses
72: Investigation of hyperparathyroidism Dustin M. Dalgorf and Richard J. Harvey
M. Shahed Quraishi
88: Outpatient assessment
73: Management of hyperparathyroidism Martyn L. Barnes and Paul S. White
Neil J.L. Gittoes and John Ayuk
89: Physiology of the nose and paranasal sinuses
74: Management of persistent and recurrent Tira Galm and Shahzada K. Ahmed
hyperparathyroidism
David M. Scott-Coombes 90: Measurement of the nasal airway
Ron Eccles
75: Management of parathyroid cancer
Pamela Howson and Mark Sywak 91: Allergic rhinitis
Quentin Gardiner
Parathyroid surgery
92: Non-allergic perennial rhinitis
Jameel Muzaffar and Shahzada K. Ahmed
76: Bilateral parathyroid exploration
R. James A. England and Nick McIvor
93: Occupational rhinitis
Hesham Saleh
77: Minimally invasive parathyroidectomy
Parameswaran Rajeev and Gregory P. Sadler
94: Rhinosinusitis: Definitions, classification and diagnosis
Carl Philpott
78: Surgical failure and reoperative surgery
Schelto Kruijff and Leigh Delbridge
95: Nasal polyposis
Louise Melia
Thyroid and parathyroid outcomes
96: Fungal rhinosinusitis
79: Complications of thyroid and parathyroid surgery Eng Cern Gan and Amin R. Javer
and how to avoid them
Erin A. Felger, Dipti Kamani and 97: Medical management for rhinosinusitis
Gregory W. Randolph Claire Hopkins

80: Thyroid and parathyroid surgery: Audit and outcomes 98: Surgical management of rhinosinusitis
David Chadwick A. Simon Carney and Raymond Sacks

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 xxviii Volume 1 – Table of Contents

99: The frontal sinus 109: Granulomatous conditions of the nose

Salil Nair Joanne Rimmer and Valerie J. Lund

100: Mucoceles of the paranasal sinuses 110: Abnormalities of smell

Darlene E. Lubbe Richard L. Doty and Steven M. Bromley

101: Complications of rhinosinusitis 111: Disorders of the orbit

Stephen Ball and Sean Carrie Nithin D. Adappa and James N. Palmer

102: The relationship between the upper and lower 112: Diagnosis and management of facial pain
respiratory tract Rajiv K. Bhalla and Timothy J. Woolford
Nigel K.F. Koo Ng and Gerald W. McGarry
113: Juvenile angiofibroma
103: Nasal septum and nasal valve Bernhard Schick
Shahram Anari and Ravinder Singh Natt
114: Endoscopic management of sinonasal tumours
104: Nasal septal perforations Alkis J. Psaltis and David K. Morrissey
Charles East and Kevin Kulendra
115: Surgical management of pituitary and parasellar
105: Management of enlarged turbinates diseases
Andrew C. Swift and Samuel C. Leong Philip G. Chen and Peter-John Wormald

106: Epistaxis 116: Extended anterior skull base approaches

Gerald W. McGarry Carl H. Snyderman, Paul A. Gardner,
Juan C. Fernandez-Miranda and Eric W. Wang
107: Nasal and facial fractures
Dae Kim and Simon Holmes 117: Imaging in rhinology
Gregory O’Neill
108: CSF leaks
Scott M. Graham

K17879_Volume II_Book.indb 28 4/30/18 12:19 PM

Exploring the Variety of Random
Documents with Different Content
Philosopho," Breslau, 1834; " Ueber Einige Schwierigkeiten in der
Pathologic der Hundswuth," Breslau, 1829; "Zur Gesch. der Medicin
in Schlesien," ib. 1837 ; " Das Medicinische Doctoral, Seine
Nothwendigkeit und Seine Reform," ib. 1848. Bibliography: Hirsch,
Biog. Lex.; De le Rol, Juden-Missi/in, vol. 11., p. 241. s. F. C.
HENSCHEL, ELIAS H. : German physician ; born at Breslau April 4,
1755; died in 1839; father of A. W. Henschei.. He commenced life as
an errand-boy, and for some time was valet to a physician. He did
not, however, miss any opportunity of acquiring knowledge, in which
he was encouraged and materially aided by a professor of anatomy
named Morgenbesser, who also induced several of his coreligionists
to take a substantial interest in him. Henschel was enabled to
commence the study of anatomy at the age of twenty-five. In 1785
he entered the University of Halle (M.D. 1787). Henschel devoted
himself especially to obstetrics, and was appointed public
accoucheur at Breslau. He was one of the first to. treat the thigh
tumor of lying in women as a special malady, and was instrumental
in introducing vaccination in Silesia. Notwithstanding his numerous
duties and extensive practise, Henschel spent a great deal of his
time in the hospital for the Jewish poor, acted as an accoucheur in
many benevolent institutions, and, in the troublous times of 1813,
added to his other activities the care of a lazaretto at Neustadt
containing 228 beds. He also rendered useful services during a
cholera epidemic; and about this time he published his "Outer Rath
bel Annahrung der Cholera " (Breslau, 1831 ). He also wrote " Ueber
die Gew5hnlichsten Krankheiten der Schwangern " {ib. 1797) and
"Ein Beitrag zur Heilung der Kopfgeschwulst der Neugeborenen
Kinder" (1828). Bibliography : Hirsch, Biographisehes Lexikon der
Hervor~ ragenden Aerzte. 8. J. D. B. HENSCHEL, GEORG (ISIDOR) :
German composer and barytone singer; born Feb. 18, 1850, at
Breslau, where he studied with Wandelt and SchafEer. He made his
first appearance as a pianist at twelve years of age. At the Leipsic
Conservatorium (1867-70) he was a pupil of Wenzel and Moscheles
(pianoforte), GOtze (singing), and Richter (theory and composition).
Subsequently he studied in Berlin under Schulze (singing) and Kiel
(composition). After making several concert tours through Europe, in
1877 he went to England, where he lived for three years. In 1881
Henschel became conductor of the Boston Symphony Orchestra, at
Boston, Mass., and he retained the position' till 1884. In 1885 he
settled permanently in London, where in the following year he
founded the London Symphony Concerts. From 1886 to 1888 he was
professor of singing at the Royal College of Music, London. Of
Henschel 's compositions the more important are: "Stabat Mater,"
oratorio, first performed at the Birmingham Musical Festival of 1894
; the One Hundred and Thirtieth Psalm, for chorus, soli, and
orchestra; a canon-suite for string orchestra; "Zigeuner Serenade,"
for orchestra; "Friedrich der SchQne," opera; "A Sea Change, or
Love's Castaway," comic operetta (libretto by W. D. Howells);
"Nubia," grand opera, first performed at Dresden in 1899. On the
death of his wife (nee Lilian Bailey) Henschel retired from the
concert platform, and has since lived on his estate at Aviemore in
the Scottish Highlands, occasionally conducting his own works or
lecturing on Johannes Brahms. A requiem composed by Henschel in
memory of his wife was first performed in Boston, Mass., Dec. 3,
1902, and has since been given in Holland, Germany, etc.
Bibliography : Baker, Bwg. Diet, of MvMcians, New York, 1900 ;
Rtemann, Musik-Lexikon ; Grove, Diet, of Musie and Musicians. s. A.
P. HEP ! HEP ! A cry stated to have been used by the Crusaders
during their attacks upon the Jews. It appears, however, to have
been first used during
 851 THE JEWISH ENCYCLOPEDIA HenscheX Herder the so-
called " Hep ! Hep ! " riots of 1819 at Frankforton-the-Main and
along the Rhine (see Gratz, " Gesch." xi. 357); e.g., ou Aug. 2, 1819,
by anti-Semitic students atWilrzburg as a term of reproach to
Professor Brendel of that university, who had written in favor of the
Jews. The students themselves claimed that the word was derived
from " Hierosolyma est perdita " ; others claim that it is a contraction
for " Hebraer," while a further attempt has been made to derive it
from " Hab ! Hab ! " The brothers Grimm, in their dictionary, trace it
from a call to animals in the Franconian district, especially to the
goat, and suggest that it was applied to Jews because of their
beards. Their earliest quotation is from W. Hauff (1802-27). A person
named Brouseis stated to have been condemned to three months'
imprisonment for having used the expression against a Jew and his
■wife ("Arch. Isr." 1848, p. 47). During the antiSemitic movement in
Germany a pamphlet appeared in favor of the Jews with the title "
Hepp ! Hepp I Slisssaure St6ckerei in 1 Vorschrei und 7 Gejohlen "
(Jacobs, "The Jewish Question," No. 25). The expression has since
become a synonym for an outbreak against the Jews, and is thus
used by George Eliot in lier essay " The Modern Hep ! Hep ! Hep ! "
in " Impressions of Theophrastus Such. " It is stated that on some
occasions in 1819 the Jews replied to the cry of " Hep ! Hep ! " with
the similarly sounding one of "Jep! Jep!" meaning "Jesus est
perditus" ("Notes and Queries," 4th series, iii. 580). J • HEPHER: 1.
A son of Gilead (Num. xxvi. 32, xxvii. 1 ; Josh. xvii. 2-3). The clan
was known as the Hepherites (Num. xxvi. 32). 2. One of David's
captains (I QXaon. xi. 36). 3. Member of the tribe of Judah (I Chron.
iv. 6). 4. Royal city of the Canaanites, the site of which is unknown
(Josh. xii. 17 ; comp. I Kings iv. 10). E. G H. M. Sc. HEPHZI-BAH (ni-
'Xan, "my delight in her"): 1. Name to be borne by the restored
Jerusalem (Isa. Ixii. 4), in token that God will not abandon it. 2.
Name of the queen of King Hezekiah and mother of Manasseh (II
Kings xxi. 1). E. G. H. M. Sbl. HEFNER, ADOLF: German-American
journalist; born at Schmiegel, Posen, Nov. 24, 1846; educated at the
gymnasium at Lissa, the rabbinical seminary at Breslau, and the
universities of Breslau and Berlin. He became a socialist in 1868, and
two years later was associated with Liebknecht and Bebel in editing
a socialistic paper at Leipsic. Soon afterward he was accused with
them of high treason, but was acquitted in 1872. Being expelled
from Leipsic in the following year, he removed to Bi-eslau, and
became a publisher, but failed in business. In 1882 Hepner
emigrated to the United States, and in 1886 settled in St. Louis, Mo.,
where he is now (1903) living. Up to 1897 he edited the daily labor
paper "St. Louis Tageblatt." and since that year he has been the
editor of the "Westliche Post." Besides many essays for the papers of
his political party, Hepner' has written "Good Night, Schatz," a one-
act play (1894) A. F. T. H. HERALDRY. See Coat of Akms. HERBS. See
Botany. HERCZEGHY, MORIZ: Hungarian physician and author; born
in Budapest Aug. 19, 1815; died in Vienna Dec. 23, 1884. He studied
medicine in Budapest and Vienna, and afterward took part in the
Revolution of 1848 in the latter city. He went from Vienna to Paris,
and thence in 1860 to Italy, where he became chief physician in
Garibaldi's army. He returned to Hungary in 1865, but left again in
1868 for Constantinople, where for eight years he acted as chief
military physician. Being severely wounded during the Russo-Turkish
war, he had to give up his practise, and then traveled in Europe and
in the East. The more important of Herczeghy's literary works deal
with political topics, and include: "Weder Deutsch noch Russisch,
Sondern Oesterreichisch," Vienna, 1849; "Das Bombardement des
Flirsten Windischgratz zu Prag,"ii. 1849; "Mein Tagebuch 1848-50,"
ib. 1850; "Memoires sur Men Sejour k Paris," Milan, 1853. He wrote
also treatises on cretinism (1864) and on epidemics (1874).
Herczeghy's chief work, however, was a sociological study on the
woman question, published in French (Paris, 1864) and in Hungarian
(Budapest, 1883). Bibliography: PallaaLtx. s. L. V. HERCZEL, KAITd
DE SZENTF^TERI: Hungarian physician; born in Szegedin July 1,
1861; studied successively in his native city, in Ujvidek, in Budapest,
in Vienna, in Strasburg, and in Paris. After having taken his degree
of M.D. (1884), he practised for two years in Nothnagel's clinic in
Vienna, and was thereafter for live years assistant to Czerny at
Heidelberg, where in 1889 he became privat-docent in surgery. In
1892 he was appointed chief of the Szt. IstvSn Hospital in Budapest.
His specialty is the treatment of diseases of the kidneys. Herczel is
the author of the following works: "Ueber die Wirkung des Anilin,
Acetanilin und Kampheranilin," Vienna, 1887; "Ueber Operative
Behandlung der Nierensteine," Vienna, 1887; "Ueber die Operative
Fixation der Wanderniere," Vienna, 1892; "Ueber Grosse Defecte der
BlasenScheidewand," Vienna, 1894. In 1902 Herczel was elevated by
Emperor Francis Joseph I. to the Hungarian nobility, and he assumed
the name of " Szentpeteri. " BIBLIOGRAPHY : Szlnnyei, Magyar IrbU
Elete. 8. L. V. HERDER, JOHANN GOTTFRIED VON: German
Protestant theologian, poet, and writer; born at Mohrungen, East
Prussia, Aug. 25, 1744; died at Weimar Dec. 21, 1803. He studied
theology, philosophy, and the humanities at the University of
KOnigsberg, where he acquired avast knowledge of German and
foreign literature. In 1764-69 he was teacher and preacher at Riga;
in 1771-76, court preacher and member of the consistory of
Biickeburg; from 1776 until his death, court preacher and member,
later president, of the consistory of Weimar. His works on Hebrew
Biblical literature exercised
 Heredia Heresy THE JEWISH ENCYCLOPEDIA 352 great
influence. His "Die Aelteste Urkunde des Menscliengeschleclits "
(Riga, 1774-76) develops the idea that the oldest Biblical poems —
the history of Creation, of the Flood, and of Moses — are to be
considered Oriental national songs. The usual interpretation of the
Mosaic history of Creation as a divine revelation appears to Herder
not only indefensible, but pernicious, since it fills the mind with false
ideas and leads to persecution of the physical scientist. In 1778 he
wrote " Lieder der Liebe," in which he divested the Canticles of all
mystical and allegorical accretions. In these deeply felt love-songs he
recognized the natural expressions of Jewish sentiment. After
having, in his letters on theology, extended this view to the whole
Bible, he published (Dessau, 1782-83) his famous " Vom Geiste der
Ebraischen Poesie. " In a letter to Hatnann he wrote that " since his
childhood he had nourished it in his breast. " He says that Hebrew
poetry is the world's oldest, simplest, and most soulful poetry, full of
the inner feeling of nature and of the poetic consciousness of God.
He translated many of the Hebrew poems. According to Gratz
("Gesch." xi. 349), Herder, although filled with admiration for Jewish
antiquity and for the Hebrew people of the Biblical age, and
foretelling a time when Christian and Jev/ would work together for
the development and refinement of civilization, felt a dislike for the
Jews whicli manifested itself in his earlier relations with Moses
Mendelssohn, Not until after Lessing's death did he become more
friendly toward Mendelssohn. Bibliography: Hettner, lAteraturgesch.
des Achtzehnten JahrhunderU, vol. v., Brunswick, 1872. D. S. Man.
HEBEDIA, PAtTLUS (PABLO) DE : Spanish anti- Jewish writer; born
about 1405 iu Aragon; died at an advanced age after 1486. Baptized
late in life, he attacked Judaism, though he had at one time
defended it and his former coreligionists. Tn order to assail the
Talmud and its commentators, which he had studied in his youth, he
wrote a mystical work, "Iggeret ha-Sodot," which he ascribed to the
Mishnaic teacher Nehunya ben ha-Kana and his alleged son Ha-
Kana, asserting that he had found it and translated it into Latin. In
his ignorance, Paulus de Heredia put into the mouth of Nehunya
passages from the work of Judah ha-Nasi, who lived much later, and
in the work " Galie Razaya " made him answer eight questions,
addressed to him by his imperial friend Antoninus, in an entirely
Christian sense. He admits the chief mysteries of Christianity, e.g.,
the doctrine of the Trinity. Nehunya, who is made to say, " Ego ex lis
unus sum qui credidenmt in eum et baptisatus fui et ambulo in viis
rectis," finally exhorts his son to recognize Jesus as the Messiah.
Heredia's works " De Mj'steriis Pidei " and " Corona Regia, " on the
immaculate conception (the latter dedicated to Pope Innocent VIII.),
were also intended to convert the Jews. The latter, however, whom
he assailed in the work " Ensis Pauli " with all the fire of a fanatical
neophyte, vouchsafed no reply to his gross attacks on their faith.
Paulus de Heredia was alleged to have collaborated on the
Complutensian polyglot, issued under the auspices of Cardinal
Ximenez. BiBLiOGKAPHT ; Nlo. Antonio, Bibl. Hispania, 1. 216 ; Wolf,
Bihl. Hebr. 11., 111., 11J87 ; Kios, Estudios, pp. 45B et seq. ; Idem,
Hist. ill. 413, 424 et seq. ; Grfitz, Gesch. vlii. 231 et seq. K. M. K.
HEREFORD : County town of Herefordshire, England, situated on the
River Wye, of some commercial importance in early times. When
Richard I. returned from captivity, ten Jews of Hereford contributed
£15 lis. lid. to a "donum" made by the Jews of England at
Northampton (1194). They were under the jurisdiction of the sheriff,
notwithstanding the Bishop of Hereford claimed the right to judge
them (Tovey, "Anglia Judaica," pp. 7879). In 1275 the " archa " was
removed from Worcester to Hereford, where it remained till the
Expulsion. From some of the bonds still extant the Jews of Hereford
appear to have adopted the corn trade when refused permission by
the "statute of Judaism " in 1275 to take usury, but this may have
been merely an evasion of tlie statute. Twenty-four of the burghers
of Hereford were appointed in 1282 as special guardians of the
peace in favor of the Jews (Cal. Patent Rolls, 1283-93, p. 15). Four
years later one of the important Jews of Hereford invited some of his
Christian friends to the wedding of his daughter. This attracted the
notice of Bishop Swinfeld, who refused permission, and threatened
excommunication to any of his flock who attended the wedding
("Household Expenses of Bishop Swinfeld," Camden Society, pp. clx.-
cxi., 137). When the Jews were expelled in 1390 the king seized the
debts due to the forty Jews of Hereford, composing about twenty
families. The chief person seems to have been Isaac of Worcester,
who had apparently moved there in 1375; he, with four of his sons
and two of his daughters, was engaged in money-lending. The
largest individual lender, however, appears to have been Aaron, son
of Elias le Blund. Abraliam " the Chaplain " is mentioned, with two
Evesques. Thirteen houses and the synagogue also fell into the
hands of the king, with rentals amounting to 55s. 6d. Since that time
there has been no congregation at Hereford. Bibliography : Jacobs,
Jews of Angevin England, pp. 163, 376; Transactinns Jew. Hist. Snc.
Eng. 1. 13&-159; R. Johnson, Customs of Hereford, pp. 70-71. J.
HEREM. See Excommunication. HERES : 1 . City in Egypt, mentioned
in Isa. xix. 18; "In that day there shall be five cities in the land of
Egypt that speak the language of Canaan, and swear to the Lord of
hosts ; one shall be called 'Ir ha-Heres" (A. V. "the city of
destruction"; R. V. margin, "Heres"). The Masoretlc text, Aquila,
Theodotion, and Peshitta read Dinn "Ty "City of Destruction."
Symmachus, the Vulgate, Men. 110a, Saadia, and some Hebrew
manuscripts read Dinn TJ? ("City of the Sun"). The Septuagint has
T^olii aaedeK (" City of Righteousness "). There are many
differences of opinion regarding the proper reading of this name. It
is, however, probable that " Heres " is the correct reading, and that
Heliopolis, in Egypt, is referred to by Isaiah. The alteration of "'Ir ha-
Heres" (City of the Sun) into "'Irha-Heres" (City of Destruction) was
influenced by a later antagonism toward the Onias temple. On the
other hand.
 353 THE JEWISH ENCYCLOPEDIA Heredla Heresy the
alteration of " Heres " into " Zede^: " ([City of] Righteousness) was
a result of the desire for a distinct prediction regarding that temple.
For other opinions see Hastings, "Diet. Bible"; Geiger, "Urschrift," p.
79. 2. Mountain (Din in) mentioned in' Judges i. 35, in connection
with Aijalon and Shaalbim, as one of the mountains from which the
Danites were unable to expel the Amorites. It has been conjectured,
and with probability, that, since "heres" is synonymous with
"shemesh," "Heres" here may mean "Bethshemesh " (I Kings iv. 9; II
Chron. xxviii. 18) or " Ir-shemesh " (Josh. xix. 41), between
Judahand Dan. 3. Hill ("the ascent of Heres"; Judges viii. 13, E. V.)
by which Gideon returned from the battle with Zebah and Zalmunna.
Its location is uncertain, and the text is variously transmitted.
BiELiOGKAPHY : Hastings, Dtct. Bible; Cheyne and Black, Encyc.
Bib!. E. G. H. M. So. HERESY AND HERETICS : The Greek term
«jpE(7;f originally denoted "division," "sect," "religious " or "
philosophical party, " and is applied by Josephus ("B. J." ii. 8, § 1,
and elsewhere) to the three Jewish sects — Sadducees, Pharisees,
and Essenes (comp. Acts v. 17, xxvi. 5, and, with reference to the
Christian sect, the alpeaig of the Nazarenes, xxiv. 5, 14; xxviii. 32).
In the sense of a schism to be deprecated the word occurs in I Cor.
xi. 19, Gal. V. 20, and particularly in II Peter ii. 1 ; hence alpeTinoq
("heretic") in the sense of "factious" (Titus ii. 10). The specific
rabbinical term for heresies, or religious divisions due to an unlawful
spirit, is "minim " (lit. "kinds [of belief]"; the singular "min," for
"heretic" or "Gnostic," is coined idiomatically, like " goy " and " 'am
ha-arez " ; see Gnosticism). The law " Ye shall not cut yourselves "
(mjnn vh) is interpreted by the Rabbis : " Ye shall not form divisions
[nnUN nmJN ItJ'Vn Vi% but shall form one bond " (after Amos ix. 6
[A. V. "troop"]; Sifre, Deut. 96; comp. Jew. Encyc. iv. 592, s.v.
Didascalia, Book VI.). Besides the term "min" for "heretic, "the
Talmud uses the words " hizonim" (outsiders), " apikoros," and
"kofer ba-Torah" (R. H. 17a), or "kofer ba-'ikkar" (he who denies the
fundamentals of faith; Pes. xxiv. 168b) ; also " poresh mi-darke
zibbur " (he who deviates from the customs of the community;
Tosel, Sanh. xiii. 5 ; R. H. 17a). Of all these it is said that they are
consigned to Gehinnom for all eternity (Tosef., Sanh. I.e. ; comp. ib.
xii. 9, apparently belonging to xiii. 5: "He who casts off the yoke [of
the Law], and he who severs the Ahrahamic covenant; he who
interprets the Torah against tlie halakic tradition, and he who
pronounces in full the Ineffable Name— all these have no share in
the world to come "). The Mishnah (Sanh. x. 1) says the following
have no share in the world to come: "He who denies that the Torah
is divinely revealed [lit. "comes from Heaven "], and the apikoros. "
R. Akiha says, " also he who reads heretical books " (" sefarim
hizonim "). This is explained in the Talmud (Sanh. 100b) to mean
"sifre Zedukim " (Sadducean writings); but this is an alteration ijy
the censor of " sifre ha-Minim " VI.— 23 (books of the Gnostics or
Heretics). The Biblical version, "That ye seek not after your own
heart" (Num. XV. 89), is explained (Sifre, Num. 115; Ber. 12b) as "
Ye shall not turn to heretic views [" minut "] which lead your heart
away from God " (see Maimonides, "Yad," 'Akkum, ii. 3). In
summarizing the Talmudic statements concerning heretics in Sanh.
90-103, Maimonides ("Yad," Teshubah, iii. 6-8) says: " The following
have no share in the world to come, hut are cut oft, and perish, and
reoelye their punishment for all time for their great sin : the minim,
the apikoresim, they that deny the belief In the Torah, they that
deny the belief in resurrection of the dead and in the coming of the
Redeemer, the apostates< they that lead many to sin, they that turn
away from the ways of the [Jewish] community. Five are called '
minim ' : (1) he who says there is no God and the world has no
leader ; (2) he who says the world has more than one leader ; (3)
he who ascribes to the Lord of the Universe a body and a figure ; (4)
he who says that God was not alone and Creator of all things at the
world's beginning; (5) he who worships some star or constellation as
an intermediating power between himself and the Lord of the World.
" The following three classes are called ' apikoresim ' : (1) he who
says there was no prophecy nor was there any wisdom that came
from God and which was attained by the heart of man ; (2) he who
denies the prophetic power of Moses our master ; (3) he who says
that God has no knowledge concerning the doings of men. "The
following three are called 'koferlm ha-Torah ' : (1) he who says the
Torah is not from God : he is a kofer even if he says a single verse or
letter thereof was said by Moses of his own accord ; (3) he who
denies the traditional Interpretation of the Torah and opposes those
authorities who declare it to be tradition, as did Zadok and Boethus ;
and (3) he who says, as do the Nazarenes and the Mohammedans,
that the Lord has given a new dispensation instead of the old, and
that he has aboUshed the Law, though it was originally divine." It is
noteworthy, however, that Abraham ben David, in his critical notes,
objects to Maimonides characterizing as heretics all those who
attribute corporeality to God; and he insinuates that the cabalists are
not heretics. In the same sense all Biblical critics who, like Ibn Ezra
in his notes on Deut. i. 2, doubt or deny the Mosaic origin of every
portion of the Pentateuch, would protest against the Maimonidean
(or Talmudic ; see Sanh. 99a) conception of heresy. See Apikoros ;
Articles op Faith ; Judaism; Gnosticism. K. On. Legal Status : The
status of heretics in Jewish law is not clearly defined. While there
are certain regulations scattered throughout the Talmud concerning
the minim, the nearest approach to the English term " heretic, "
these are mostly of a haggadic nature, the codes taking little
cognizance of them. The governing bodies of the Synagogue
frequently exercised, from motives of self-defense, their power of
excommunication against heretics. The heretic was excluded from a
portion in the world to come (Maimonides, "Yad," Teshubah, iii. 6-
14); he was consigned to Gehenna, to eternal punishment (R. H.
17a : comp. Ex. R. xix. 5 ; see Apikoros, and compare D. Hoffmann,
" Der Schulchan Aruch und die Rabbinen ilber das Verhaltnis der
Juden zu Andersglaubigen, " 2d ed., Berlin, 1894); but the Jewish
courts of justice never attended to cases of heresy; they were left to
the judgment of the community. There are, however, in the rabbinic
codes, laws and regulations concerning the relation of the Jew to the
heretic. The sentiment against the heretic was much stronger than
that against the pagan.
 Heresy Henuon THE JEWISH ENCYCLOPEDIA 854 While the
pagan brought his oflerings to the Temple in Jerusalem and the
priests accepted them, the sacrifices of the heretic were not
accepted (Hul. 13b, et al.). The relatives of the heretic did not
observe the laws of mourning after his death, but donned festive
garments, and ate and drank and rejoiced (Sem. ii. 10; " Yad," Ebel,
i. 5, 6; Yoreh De'ah, 345, 5). Scrolls of the Law, teflUin, and mezuzot
written by a heretic were burned (Git. 45b; Shulhan 'Aruk, Orah
Hayyim, 39, 1 ; Yoreh De'ah, 281, 1) ; and an animal slaughtered by
a heretic was forbidden food (Hul. 13a; Yoreh De'ah, 3, 5). Books
written by heretics did not render the hands impure (" Y'ad," She'ar
Abot ha-Tum'ot, ix. 10 ; comp. Yad. iv. 6 ; see Puuity) ; they might
not be saved from fire on tlie Sabbath (Shab. 116a; Orah Hayyim,
334, 21). A heretic's testimony was not admitted in evidence in
Jewish courts (Hoshen Mishpat, 34, 23; see "Be'er ha-Golah" ad loc);
and if an Israelite found an object belonging to a heretic, he was
forbidden to return it to him (Hoshen Mishpat 266, 2). The "mumar
le-hak'is" (one who transgresses the Law, not for personal
advantage, but out of defiance and spite) was placed by some
Classes of of the Rabbis in the same category as Heretics, the minim
('Ab. Zarah 26a; Hor. 11a). Even if he habitually transgressed oce
law only (for example, if he defiantly violated one of the dietary
laws), he was not allowed to perform any religious function (Yoreh
De'ah, 2, 5; SHaK and "Pithe Teshubah," ad loc), nor could he testify
in a Jewish court (Sanh. 27a; "Yad," 'Edut, x. 3; Hoshen Mishpat, 34,
2). One who violated the Sabbath publicly or worshiped idols could
not participate in the"'erub hazerot" ('Er. 69a; "^Yad," 'Erubin, ii. 16;
Orah Hayyim, 385, 3; see 'Ekub), nor could he write a bill of divorce
(Shulhan 'Aruk, Eben ha-'Ezer, 123, 2). One who would not permit
himself to be circumcised could not perform the ceremony on
another (Yoreh De'ah, 264, 1, Isserles' gloss). While the court could
not compel the mumar to divorce his wife, even though she
demanded it, it compelled him to support her and her children and
to pay lier an allowance until he agreed to a divorce (Eben ha-'Ezer,
154, 1, and "Pithe Teshubah," nd loc). At his death those who are
present need not tear their garments (Yoreh De'ah, 340, 5, and "
Pithe Teshubah," ad loc). The mumar who repented and desired
readmittance into the community was obliged to take a ritual bath,
the same as the proselyte (Yoreh De'ah, 268, 12, Isserles' gloss, and
"Pithe Teshubah," ad loc; comp. "Sefer Hasidim," ed. Wistinetzki,
gt^ 200-209). If he claimed to be a good Jew, although he was
alleged to have worshiped idols in another town, he was believed
when no benefit could have accrued to him from such a course
(Yoreh De'ah, 119, 11, and "Pithe Teshubah," ad loc). See Apostasy;
Atheism; Gnosticism. BiBLiOGRAPHT : Krauss, Begriff und Form der
HUreHe nach Talmud umi Midraschim, Hamburg, 1896; Goldfahn,
Ueher den Ursprung und die Bedeutung des Ausdruekes pc, in
MonaUschrift, 1870. B. o. J. H. G. HERITAGE. See Inhekitancb.
HEKMANMIESTETZ : City in Bohemia. Jews were living there as early
as 1509, engaged in commerce and money-lending ; but the Jewish
community proper dates from 1591. The Jews were confined to a
ghetto under the protectorate of the overlords of the city. One of
these. Count Johaim Wenceslaus Spork, built a synagogue in 1760,
which was modernizled in 1870. The Jewish parochial school was
transformed into a German public school. Since 1891
Hermanmiestetz has been the seat of a district rabbi, the dependent
communities being Chrudim, Roubowitz, and Drevikau. The following
have offlciated as rabbis in Hermanmiestetz : Bunem (d. 1734) ;
Selig-Landsteiner (d. 1743) ; Hayyim Traub (d. 1790) ; Ellas Treitel
(d. 1823) ; Samuel Brod (d. 1850); Moses Bloch, till 1855 (since 18
77 professor at the rabbinical seminary at Budapest); Benjamin
Feilbogen, till 1863; S. Rosenberg, 1864-68; Dr. Nehemias Kronberg,
the present incumbent, called in 1891. Judah Lob Borges (d. 1872),
a member of the community distinguished for his Talmudic and
literary attainments, officiated temporarily ■whenever there was a
vacancy in the rabbinate. The commimity supports a burial society, a
society for nursing the sick, a Talmud Torah, and a women's society.
The cemetery must have existed as early as the sixteenth century ;
for it is recorded in a document that in 1667 a field was bought from
a citizen for the purpose of enlarging the burial-ground. In 1903 the
Jews of Hermanmiestetz numbered 300, those of the whole district
aggregating 1,100. n. N. K. HERMANN, LUDIMAR: German
physiologist; born in Berlin Oct. 21, 1838; M.D. Berlin, 1859. He
engaged in practise in his native cit}', and in 1865 became privat-
docent at its university. In 1868 he was appointed professor of
physiology at Zurich, and in 1884 he accepted a similar chair at the
University of KOnigsberg. His chief works include: "Lehrbuch der
Physiologic," 12th ed., Berlin, 1900; " Handbuoh der Physiologic "
(together with other physiologists), 6 vols., Leipsic, 1879-81;
"Leitfaden fiir das Physiologische Praktikum," ib. 1898; "Lehrbuch
der Experimentellen Toxikologie," Berlin, 1894j "Physiologische
Jahresberichte, " beginning with 1873. His essays, most of which
have appeared in Pfl tiger's " Archiv fur die Gesch. der Physiologic "
and in Poggendorfl's " Annalen fiir Physik," cover nearly the whole
field of physiology and part of that of physics. Most of them deal
with muscular and nervous physiology, the organs of sense, and the
nature of phonetics. S. HERMENEUTICS. See Bible Exegesis;
Methodology; Talmud. HERMES, BOOKS OF: Hermes (the Greek
Mercury), in popular belief the leader of souls to Hades, was in later
times identified in Egypt with the local god Thot, who was also the
messenger of the gods and the heavenly scribe and inventor of
writing. Forty -two sacred books, containing all the wisdom and
secret lore of the Egyptians, were asci'ibed to Hermes-Thot (see
Plutarch, "De Iside et Osiri," Parthey's ed., 1850, Ixi. 154, 255,
notes; Clement of Alexandria, "Stromata," vi. 4). Necromancers and
Gnostics also ascribed their magic and mystic lore tn Hermes
(Dieterich, "Abraxas," 1891, pp. 63-70, 165). The names of Moses,
Thoth, and
 365 THE JEWISH ENCYCLOPEDIA Heresy Hermon Hermes
served as pseudonyms for many a writer of magic books or hymns.
As many as a, 000, and even 86,525, books on mystic lore were said
to have been written by Hermes (lambUchus, "De Mysteriis," viii. 1).
Lactantius (" Institutiones Uivina;," iv. 6, vii. 18) quotes the K6yoi
TMeiof, a dialogue of Hermes with ^sculapius, along with the
Sibylline and the Plystaspes oracles, as containing Messianic
prophecies; which goes to show that the Books of Hermes were
used like the Jewish pseudepigrapha in religious arguments. What
share the Jews had in the composition of the Books of Hermes has
not yet been fully ascertained ; DITD), and this alone explains why
they were contrasted by the Sadducees (Yad. I.e.) with the sacred
Scriptures. Various other suggestions have been made as to the
meaning of these words. They are interpreted as " Books of Homer "
(DIT'DIH) by Mussafla in his notes to the 'Aruk, by Derenbourg in his
"Palestine " (p. 133), and by Krauss in his " LehnwOrter " (ii. 230);
as "Pleasure Books" (? " Himeros") by Cdssel in his edition of "Me'or
'Enayira" (p. 84); as "Chronicles" {BipTua •ll/iTHj^am), "Daily
Books," or " Journals, " in " Monatsschrift " (1870, p. 138). But these
are certainly not of such a character as to come iluL.NT lltK.MON.
(From a photograph by Bonfils.) certain it is that Christians
composed some of the later ones. It was these Books of Hermes
(D'Din '"IDD, corrupted intoDT'Dn ■'"ISD) that were always on the
Ups of Elisha ben Abuyah or fell from his lap (Hag. 16b), and that
were declared not to possess the character of holy writings which
make the hands that touch them unclean (Yad. iv. 6; Yer. Sanh. x.
28a [a passage corrupted by negligent copyists ; see Joel, "Blicke in
die Religionsgesch. " 1888, i. 7075] ; IIul. 60b, uncensored ed. ;
Midr. Teh. and Yalk.,'P3. i.). Geonic tradition was still aware of the
fact that the "Sifre Homerus," as it spelled the words, were heretical
books (see Hai Gaon to Yad. I.e. ; R. Hananecl to Hul. I.e. ; the
'Aruk, s.v. into discussion as " sifre minim," or heretic writings.
According to Jewish writers there existed under the name " Hermes
" a number of works in Arabic literature also (see Steinsclineider,
"Hebr. Bibl." 1861, p. 675; 1862, p. 91; idem. "Hebr. Uebers." 1898,
p. 514). Bibliography: Kohler. In J. Q. B. y. 41.5 ; Perles, in B. B. J.
iii. 114 (comp. Kohut, ib. iii. .546); Knhut, Aruch Ccympletum: Levy,
Neuhehr. Wfirterh.; Jastrow, Diet. s.y. Dn
 Hermon Herod I. THE JEWISH ENCYCLOPEDIA 356 and
adjoining the plateau of Bashan (Deut. iii. 8; Josh. xi. 17, xii. 1; I
Chron. v. 23). The name is translated hy some "prominent peak," by
others " sacred mountain " (see Gesenius, " Th. "), both being
suitably applied to it. The Sidonians called it " Sirion" (JVIC}'), and
the Amorites "Shenir" Ci^JB*: Deut. iii. 9; both appellations signify
"breastplate "), evidently on account of its rounded top, which,
covered with snow, gleamed and shone in the sunlight. It is also
called " Sion " ()1N''C: Deut. iv. 48), probably on account of its
height. But it appears from Cant. iv. 8 and I Chron. v. 23 that Shenir
was the name of a part of Mount Hermon, probably of one of its
three peaks, which are collectively called "Hermonim" (="the
Hermons": Ps. xlii. 7, Hebr.). The name " Sanir " occurs in a
cuneiform inscription (see Halevy in "R. E. J." xx. 206). Because of
its snow-covered top Hermon is called " Tur Taiga " in the Targumim
and " Har ha-Sheleg " (snow-mountain) in Sifre (ed. Friedmann, p.
47b). "Mount Hermon" (]lD"in in) occurs in Deut. iii. 8; Josh. xi. 17;
xii. 1, 5; xiii. 5, 11; I Chron. v. 23; "Hermon" alone in Josh. xi. 3; Ps.
Ixxxix. 12, cxxxiii. 3 ; Cant. iv. 8. Hermon was before the invasion
held by the Hivites (Josh. xi. 3) ; it was the northern landmark of the
Israelites : " from the river of Arnon unto mount Hermon" (Deut. iii.
8 et al.). When the half-tribe of Manasseh conquered their allotted
territory, they are said to have " increased . . unto mount Hermon "
(I Chron. v. 23). In one passage (Ps. Ixxxix. 12) Hermon seems to
be used as a synonym for " north, " j ust as the sea ( D') is used as
a synonym for "west." The name "Baal-hermon " (Judges iii. 3)
would indicate that it was at one time the seat of a shrine. It was a
religious center in the Roman period also, and was surrounded by
small temples, built on the slopes. A temple on the summit is
referred to by Eusebius and Jerome ("Onomastica Sacra," s.«.
".^rmon"). In Enoch (vi. 6) the summit of Hermon is mentioned as
the place where the wicked angels alighted in the days of Jared, and
its name is explained as referring to the oath which they had sworn
upon it. Hermon was famous for its dews (Ps. cxxxiii. 3), which have
been celebrated by modern travelers also (Tristram, "Land of Israel,"
2d ed., p. 608), and the part called "Shenir "was abundant in
cypresses (Ezek. xxvii. 5). Hermon is now called " Jabal al-Shaikh "
(the mountain of the chief), so called as the residence of the
religious sheik of the Druzes. BiBLior.RAPHT : Eoblnson, Besearches,
Iii. 357 ; Hastings, IHct. Bible ; Winer, B. R. ; Cheyne and Black,
Encyc. Bibl. B. G. H. M. SeL. HEROD I. (surnamed the Great): King
of Judea 40-4 B.C. ; founder of the Herodian dynasty ; born about
73 b.c. ; son of Antipater, and, consequently, of Idumean origin. It is
said that when he was a boy of twelve an Essene named Menahem
predicted that he would reign over Judea. Indeed, nature had
endowed him with the qualities of ascendency. He was of
commanding presence; he excelled in physical exercises; he was a
skilful diplomatist; and, above all, he was prepared to commitany
crime in order to gratify his unbounded ambition. At the age of
twenty -five (the age fifteen given by Josephus is generally believed
to be erroneous) Herod was appointed prefect of Galilee by his
father, who was procurator of Judea. By his first act Herod showed
that he intended to please the Romans at any cost. Contrary to the
Jewish law, which granted to the vilest criminal the right of trial by
the Sanhedrin, to which tribunal alone belonged the authority to
pass sentence of death, Herod executed a band of fanatics who had
attacked heathen towns and robbed caravans. This assumption of
power, for which he was highly lauded by the Romans, inf uriated
the leaders of the national party, who perceived Herod's
ultimateaims. Bringing pressure to bear upon the weak Hyrcanus II.,
they obtained permission to arraign the prefect before His First the
Sanhedrin. Instead of presentExploit, ing himself before that august
body clad in black, as was the usual custom, Herod appeared
arrayed in purple and attended by a strong guard, capable of
meeting any emergency. He did not condescend to offer the slightest
defense Copper Coin of Herod the Great. Obverse : BASIAeus
HPQAOY round a helmet. In Held to left tr (year 3-38 or 35 B.C.) ; in
field to right a monoRrain. Reverse : Macedonian shield, with disk
surrounded by rays. (After Madden, " History of Jewish Coinage.") of
his conduct, but tendered a letter of Sextus Caesar, governor of
Syria, in which Hyrcanus was threatened with dire consequences
should Herod not be cleared of the charges preferred against him.
Overawed, the judges did not dare to utter a word in his
condemnation till the president of the tribunal, Shemaiah, rose to
rebuke their pusillanimity and warned his colleagues that some day
they would pay dearly for their weakness. At this turn of affairs
Hyrcanus adjourned the session until the following day, and
recommended the culprit to leave Jerusalem secretly during the
night. Herod then took refuge with Sextus Caesar, who appointed
him prefect of Coele-Syria. Herod collected an army and advanced
on Jerusalem with the purpose of chastising the Sanhedrin ; but he
was dissuaded from his intended vengeance by his father and his
brother Phasael. The disturbance throughout the Roman empire
caused by the murder of Julius Caesar (44 b.c.) did not impede
Herod's advancement, who knew how to turn every circumstance to
his advantage. The protege of Sextus Ca;sar became, at the
assassination of the latter, the friend of the Roman governor of
Syria, Cassius, whose favor he won by promptly levying the hundred
talents which Galilee was required to contribute to the war-tax of
seven hundred talents imposed upon Judea. He was con 
 357 THE JEWISH ENCYCLOPEDIA Hermon Herod I. finned
in his position of prefect of Coele-Syria, and even received from
Cassius a promise that he would be acknowledged King of Syria
when the war against the triumvirs should be ended. Meanwhile his
father was poisoned (43 b.c.) by the hireling of one Malich, who
aspired to an influential position In Judea. Herod hastened to take
the place of his father, but did not neglect to avenge his death.
Malich was enticed to Tyre and there slain by hired assassins, with
the connivance of Cassius. However, after the departure of the latter,
Judea was in a state of revolt. Antigonus, the younger son of
Aristobulus II., made an attempt, with the assistance of Ptolemy, the
son of Mennseus of Chalcis, to secure the sovereignty of Palestine.
Herod succeeded in quelling the revolt and in deBetrothed feating
Antigonus. On his return to to Jerusalem he was greeted as a
triumMariaume. phant general by Hyrcanus, who, seeing in him the
deliverer of the country, gave him in marriage to his beautiful
granddaughter, Mariamne, daughter of Alexander and Alexandra.
The battle of Philippi (43 B.C.) put an end to the rule of the
murderers of Julius Caesar. The national Copper Coin ok Herod the
Great. Obverse : a tripod with tray ; on either side a palm-branch.
Reverse : BA[ci]AEnc (indiatiuct) round a wreath, withlu which is an
X. (After Madden, " History of Jewisli Coinage.") party in Jerusalem
now hoped to see the downfall of Herod and of his brother Phasael,
who had been overzealous in support of the opponents of the
victorious triumvirate. Some Jewish nobles met the victor, Antony, at
Bithynia and comi^lained of the maladministration of Judea. But
Herod succeeded by bribes and flatteries in winning the favor of
Antony, who remembered that while he (Antony) was fighting under
Gabinius in the East, Antipater had rendered him many services. The
charges against Herod were several times renewed, but they were of
no avail. Hyrcanus himself pleaded the cause of the Idumean
brothers, and they were appointed by Antony governors of Judea
with the title "tetrarch." The year 40 was the turning-point in Herod's
life. With the help of the Parthians, who in that year overran Syria,
Antigonus was proclaimed King of Palestine. Phasael was taken in an
ambuscade and forced to commit suicide, Herod escaping a similar
fate by flight. After passing throuKh great hardships and greater
dangers, he succeeded in reaching the fortress of Masada, where he
left his family in the care of his brother Joseph. After having
unsuccessfully attempted to obtain help from the Nabataans of
Petra, Herod went to Alexandria. There Cleopatra offered him a
generalship in her army; but he declined it, and, braving all dangers,
went to Rome. The triumvir Octavianus Elected was won over as
Antony had been, King by and, both pleading Herod's cause bethe
Boman fore the Senate, that assembly invested Senate. him with the
ardently desired kingship. At the conclusion of the session Herod,
walking between Antony and Octavianus and preceded by the
consuls, went to the Capitol to return thanks to the gods. The new
king disembarked at Acre, and was soon at the head of a small
army. The Roman generals Ventidius and Silo received the order to
assist him in the conquest of Judea, which naturally was not willing
to acknowledge his sovereignty ; but they had been bribed by
Antigonus, and their support was ineffectual. It was only in the
spring of the year 37 that Herod, assisted by a large Roman force
under the command of Caius Sosius, laid siege to Jerusalem. While
the works were in course of construction, he went to Samaria to
celebrate his marriage with the Hasmonean princess Mariamne, to
whom he had been engaged for five years, after repudiating his first
wife, Doris, the mother of Antipater. After a siege of several months
Jerusalem fell (probably in July) into the hands of the Romans. For
several days the troops, unrestrained, indulged in murdering and
pillaging, and Herod, to stop these horrors, had to pay out of his
private fortune large sums to the legionaries. Antigonus was carried
away captive by Sosius to Antioch, where by Antony's orders,
instigated by Herod, he was executed. Herod inaugurated his reign
with acts of vengeance and cruelty. Forty-five of the most wealthy
and most prominent of Antigonus' partizans were executed, and
their estates confiscated in order to fill the empty treasury. Herod's
agents showed themselves so greedy as to shake the dead bodies in
order that any gold hidden in their shrouds might be disclosed. All
the members of the Sanhedrin, with the exception of Pollio
(Abtalion) and Shemaiah, were slain. Of the members of the
Hasmonean family with whom Herod had to contend, his bitterest
enemy was his mother-in-law, Enmity of Alexandra. As the aged
Hyrcaniis, Alexandra, who had now returned from his Parthian exile,
could not reenter the highpriesthood, owing to the physical
mutilation which had been inflicted upon him by Antigonus, Herod
chose as high priest an utterly unknown and insignificant Babylonian
Jew of the sacerdotal family, named Hananeel. This selection
offended Alexandra, who considered that her young son Aristobulus,
brother of Mariamne, was entitled to this oflice. She complained to
Cleopatra; and Herod, fearing that the latter might exert her
influence upon Antony, deposed Hananeel and gave the office to
Aristobulus, his brother-in-law, who was then sixteen years old (3.5
b.c). When the young high priest appeared before the public at the
Feast of Tabeinacles, arrayed in the gorgeous robes of his otfice,
great enthusiasm prevailed, and a demonstration was made in his
favor. Herod, who saw in him a possible rival, took umbrage, and
determined to get
 Herod I. THE JEWISH ENCYCLOPEDIA 358 rid of him. At
the close of the feast he went with the priest to Jericho, where
Alexandra had invited them to an entertainment. After the meal,
while Aristobulus was refreshing liiniself with others in the bath, he
was pushed under water, as if in sport, by some of the bathers who
had been bribed by Herod, and held down until lie was drowned.
Herod feigned the most profound grief; but no one was deceived by
his tears, and least of all Alexandra, She again invoked the help of
Cleopatra, and Herod was summoned to Laodicea (34 u.c.) to justify
himself before Antony. He did not, however, go empty-handed, and
as a result was dismissed with honors. With this event began the
iirst act of the drama of wliich Herod's own household became later
the theater. Before leaving Jerusalem Herod had committed
Mariamne to the care of his uncle and brotherin-law Joseph,
directing him to slay her in case he (Herod) should not return. On
arriving at Judea, Herod's sister Salome, who wished to get rid of
her husband, Joseph, and at the same time to revenge herself on
the haughty princess, who taunted her with her low birth, charged
them with Ex6cution adultery. At first Herod gave no of heed to the
calumny; but when he His Uncle learned that Mariamne knew of the
Joseph. secret command he had given to .Joseph, he concluded
therefrom that Salome's charges were well founded, and caused
Joseph to be executed, without afiording him an opportunity of
being heard. In the same year Herod had the mortification of being
obliged to receive at Jerusalem his enemy Cleopatra, who came to
inspect the Palestinian coast and the most pi'ecious of Herod's
domains, the district of Jericho, which had been given to her by
Antony. During the civil war between Antony and Octavianus (33
B.c.\ Herod, who would have helped his protector Antony, was by a
happy chance sent by Cleopatra to combat the Nabatsean king
Malich. At first Herod's army suffered a crushing defeat, but in the
end he was victorious. On returning home Herod learned of the
defeat of his protector Antony. The question now was how the new
master of Rome would treat the friend of his defeated Execution
enemy. Herod promptly decided upon of his course of action, and
resolved to Hyrcanus. go and meet Octavianus. He contrived,
however, to have the aged Hyrcanus removed, the only one who
might prove a dangerous rival, as being nearer to the throne than
himself. Upon the pi'etended charge of having conspired against
Herod with the Arabian king, Hyrcanus was executed. In the spring
of the year 30 b.c. Herod met Octavianus at Rhodes. With
considerable acjroitness he pointed out the great friendship that had
existed between himself and Antony and the benefits the latter had
derived from it. This friendship he was now ready to give to
Octavianus, to whom he would be equally true. Octavianus believed
Herod, and confirmed him in all his titles. Herod succeeded so well in
gaining Caesar's favor that In the following year Octavianus gave
him back Jericho and the other cities that Antony had taken from his
domains, adding to them the towns of Gadara, Hippos, Samaria,
Gaza, Anthedon, Joppa, and Strato's Tower. While his political affairs
were thus prospering, his household became the scene of a tragedy
of which Mariamne was the heroine. BeExecution fore he had gone
to Rhodes Herod of had given the order to a certain SoMariatnne.
hemus to slay Mariamne should he not return . Mariamne came to
know this, and gave to Herod on his return proofs of her aversion.
The charge of unlawful intercourse was repeated by Salome; and
Herod saw again in the betrayal of his secret order a proof of guilt.
Sohemus was immediately executed; Mariamne, after a judicial
investigation by a sort of privy council, was condemned and
executed (29 b.c). After the execution Herod, tortured with remorse,
plunged into wild excesses to distract his thoughts. While he was
hunting in Samaria he fell ill. A rumor of Ms death got abroad at
Jerusalem. Alexandra then began to scheme so that in the event of
Herod's death she might secure the throne. She tried to gain over
the commanders of the two fortresses in Jerusalem ; this was
reported to Herod, and he caused her to be executed (38 b.c).
Herod's recovery was the signal for fresh crimes and bloodshed. The
members of a family called "the sons of Baba " had signalized
themselves under Antigonus by their zeal for the Hasmonean prince.
In the moment of danger they were saved by Costobarus, who, after
the execution of Joseph, had married Salome, the sister of Herod.
Salome, having by this time become tired of her husband, betrayed
all his secrets to Herod, who immediately put to death Costobarus
and the sons of Baba (25 B.c). The throne was now firmly
established. Of all the members of the Hasmonean family who could
give him umbrage there remained only the daughter of Antigonus.
Herod then entered upon the prosperous period of his reign.
Splendid public works were commenced and new cities were built.
Thus Herod rebuilt the city of Samaria, to which he gave the name
of "Sebaste," in honor of the Builds Roman emperor. The small town
on Sebaste the seaooast called the Tower of Strato and was
transformed Into a magnificent Csesarea. city with an artificial
harbor, on a scale of the utmost grandeur, and named " C;esarea. "
Temples in honor of Augustus were multiplied in all directions. To
celebrate the quinquennial games which had been instituted in
almost all of the Roman provinces, likewise in honor of Augustus,
Herod erected in Jerusalem a theater, an amphitheater, and a
hippodrome. Citadels and cities rose in honor of the different
members of Herod's family : Antipatris, in honor of his father;
Cypres, commemorating his mother; Phasaelis, as a memorial to his
brother; and Ihe two strongholds named Herodiuni in honor of
himself. Military colonies were planted at Gaba in Galilee, and at
Hoshbon; and the fortresses Alexandrium, Hyrcania, Machaerus, and
Masada were rendered impregnable.
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