Heinemann, £75 /
ISBN 0 7506 3063 9

Do surgical textbooks have a future? Like traditional encyclopaedias, they now face competition from multimedia packages containing sound and video clips in addition to text and still pictures. Unlike a book, the reader does not have to switch constantly between text and pictures on CD ROM, you listen to the description while you look at pictures or watch a video. CDs can also contain many more colour pictures than it is economically reasonable to print in a book.

OTOROM is an interactive otological surgery package. There are some text based parts explaining the aetiology, presentation, and natural course of diseases. However, the largest part of the package describes the surgical management of various otological problemsùillustrated by a series of excellent microscopic operative photographs, which can be enlarged to fill the viewing screen, and several video clips. Some are presented as cases with history, clinical findings, investigations, medical management, and results of treatment in addition to step by step surgical management. Often the reader has options in management, such as complications encountered or prostheses used. Moving around is intuitive and easy?the instructions would fit on a postcardùand the only necessary computing skill is the use of a mouse.

This is an attractive and professional package, as you would expect from its origins. Some of the views expressed will not meet with universal approval, again as expected, but they are based on the vast clinical experience of the Causse Clinic. My one major criticism is that the alternative of fitting a hearing aid rather than surgery for otosclerosis is not even mentioned.

All otological trainees will learn a great deal from this CD, and it would be excellent preparation for the final fellowship examination. Most otolaryngologists, even experienced otologists, will also learn much from the surgical sections. There were certainly several operative situations that I have not encountered.

My first impression of this CD, at a Royal Society of Medicine meeting, was that it looked very pretty but there seemed to be a lot of time spent waiting for the next bit to load, though the salesman said it would run much faster on a powerful computer. Having now run it on a 166 MHz computer with an eight speed CD ROM drive, I must say the salesman was right. Changing between topics is quickùas fast as turning the page in a book, and certainly much faster than looking up an index and then finding the appropriate page. This is an impressive package that is much more enjoyable and, with the combination of pictures and commentary, much easier to use than a surgical textbook. It takes up much less room in my crowded study too.

Rating: ***

Iain R C Swan, senior lecturer, Department of Otolaryngology, Royal Infirmary, Glasgow