The advances of medicine in the past two decades have been very rapid and exciting and hand in hand with this has gone advances in audiovisual aids and teaching. The technology that has brought the computer into most households has been truly amazing particularly for those of us who lived before the birth of the computer. This has led to a revolution in information technology and inter-communication. The world now seems a very small place, the Internet and the World Wide Web has ensured that this is the case but it has also led to the instant availability of a vast sea of knowledge about all aspects of life.

There are now new horizons in audio-visual technology and these can be utilised to teach both undergraduates and postgraduates. There are some that would say that the old fashioned apprenticeship is the gold standard in surgery but this CD-ROM by Blevins, Jackler, and Gralapp is an attempt to use computer technology to teach young surgeons the anatomy of the temporal bone and temporal bone dissection techniques. It is a totally novel idea and the authors are to be congratulated for their innovative approach.

The CD-ROM is divided into three sections, Temporal Bone Dissection which is an illustration of several operative techniques. The operator has to click on the scalpel to move it and to perform various surgical manoeuvres, similarly drills can be manipulated both with cutting burrs and diamond paste burrs. By clicking on the various anatomical structures the name of the structure appears which is a useful teaching aid. The surgical sequences, however, are somewhat simplistic and rather resemble cartoons. The operator learns by making a mistake and seeing and hearing a flow of blood indicating the haemorrhage that could ensue if, for example, a cutting burr is used over the lateral venous sinus. Although this is a wonderful way to use a computer and is certainly amusing the young otologist will not find this a substitute for hard graft in the temporal bone laboratory. The second aspect of this is a series of videos of surgical technique. Unfortunately the quality of the video is not terribly good. This may be due to technical reasons rather than to lack of preparation on the author’s part.

Undoubtedly, the best aspect to this interactive otology reference is the multi-planer MRI imaging and the CT scan. MRI and CT are complementary in the skull base and the authors have utilised the computer technology wonderfully in this sphere in order to meet the challenge of identifying the anatomical structures of the temporal bone in the axial, coronal and sagittal planes. An anatomical quiz has been formulated and the operator has to identify the structure by clicking on it. He has three attempts to do so and if correct then he will be awarded a mark which is cumulative, those scoring the highest marks being awarded the title of Professor, a good score which is not quite up to the professorial mark is classified as a Fellow, Senior Resident etc, down a marking scale. This makes learning fun and adds a competitive spirit which always goes down well with surgeons. The quality of the images are excellent and it is undoubtedly this aspect of Temporal Bone Dissector CD-ROM that is most useful and is a fun and painless way of learning three dimensional temporal bone anatomy.