This column is devoted to reviewing cancer related web-sites on the net. Carrying serious and light-hearted reviews of publicly accessible Internet pages, this column aims to analyze, inform, share good humor and encourage online activity and creativity.

Surgery movies, images and more

http://www.vesalius.com

A very nice site for the surgical anatomy and steps of surgery for a wide range sites in the human body. The steps for a wide variety of operations are easily explained with the help of colourful diagrams.

This page shows a series of thumbnail print images that can be clicked on to reveal their corresponding larger image. These are accompanied by a few advertisements, which may seem a nuisance, but on the whole are quite unobtrusive. Alternatively one can click on the links to the right of the images. These links labeled “narr” for narrative throw up an intuitively controlled console which enable one to scroll through the same enlarged images with additional narrative content included. I felt that this was the best option for viewing the images especially as it cut out most of the advertising guff. The thumbnail images could then be simply used as an index to the corresponding narrative link. The photographic images are of high quality, and well labeled.

All of the images, illustrations, photographs, animations, and multimedia resources on this website are freely available for downloading subject to the terms of use that govern this site. As a visitor you can view and download images, using them for educational or non-commercial purposes, provided that you don't modify the watermark on them or the illustrators signature. For all surgical images needs this is certainly one good site to visit.

Pathology reporting guidelines

http://www.rcpath.org/activities/publications/headneck.html

We have all been guilty of providing the barest minimum of information on our pathology forms expecting a fully detailed report in return. As an amusing study published in the British Medical Journal revealed, pathologists are not clairvoyant and so inevitably the rubbish in, rubbish out rule holds fast. This can obviously affect patient care as the various features of invasive head and neck carcinomas are important in deciding on the most appropriate treatment, giving a prognosis, and allowing comparison of surgical practice and patient in clinical trails. It is for this reason I recommend a visit to the Royal College of Pathologist at http://www.rcpath.or/activities/publications/headneck.html to view their minimal dataset for head and neck carcinoma histopathology reports. These guidelines provide advice as to how we surgeons should prepare and label resected specimens, as well as fill in the pathology form in order to get back a meaningful report. Life is a two way street after all. They also describe the core data that should be provided in histopathology reports of specimen of squamous carcinomas originating in the mouth, nose, pharynx and larynx. In short they give us a benchmark by which we can judge our pathology reports and seek improvements if necessary. Clinical governance is all the rage these days and this is certainly one area of patient care that can be improved upon with minimal cost and effort.

Trigeminal nerve anatomy

http://www.medinfo.ufl.edu/year1/trigem/home/html

Anatomy can be either extremely interesting of very boring indeed, depending on who is teaching it, or which textbook one reads. All medical students dream of simple interactive texts in which the layers of skin and muscle, bone and sinew can be stripped away like the layers of an onion, leading to that inner core of anatomical enlightenment. Sadly, the reality in medical school is largely one of intense cramming, and the mastering of voluminous amounts of facts whose relevance often only becomes clear year later, if ever. The complex anatomy of the 12 cranial nerves (which all good otolaryngologists should master) is a prime example.

Trigeminal nerve anatomy at is an anatomy teaching aid with a difference, displaying the anatomy and describing the function of the trigeminal nerve in a way that no regular textbook I have read ever has. Set up by a medical student for other medical student, it is simply anatomical nirvana. At last one can gradually build up the branchial, visceral and motor components of the trigeminal nerve separately, and bit by bit until the whole is revealed in all its pristine and intelligible glory. The cadavaric images are provided with the neat trick of clickable photographic enhancement, which highlight clearly the often wispy strands of the peripheral branches. The accompanying text is a masterpiece of relavance, clarity and brevity, linking anatomy to function and clinical importance, which is further strengthened by the three clinical case reports and photographs. All of this within a website that enhances the visit through its ease of navigation, speed of download and simplicity of design.

TNM Mobile edition

http://www.uicc.org/publ/uiccnews/win02/infoTNMmobile.shtml

A digital personal assistant or hand computer is now (along with a mobile phone) a necessary part of any self respecting ENT doctor's portable equipment. The software produced for these electronic wonders is getting increasingly sophisticated, and now the UICC has come out with a TNM / staging programme designed for the Palm Pilot and Visor hand-helds. Based on the UICC TNM staging (5th edition), this programme features the complete UICC / TNM cancer staging classification and integrates explanatory notes from the TNM supplement 92 ^nd edition). It also has an interactive cancer staging calculator that automatically stages disease when the doctor inputs the patients' T, N and M data. A free demonstration version can be down-loaded from http://www.wiley.com/go/tnm. If you have a palm hand – held, and deal with a lot of head and neck cancer patients it is probably well worth a try.

Health humour

http://www.thebestmedicalcare.com/humour/index.htm

On a final humorous note “a chuckle a day keeps the doctor away” as this web page engagingly promises. A series of cartoons by Dr. Hemant Morparia, MD, a radiologist and talented artist, whose work appears on the front page of the Bombay (Mumbai) Times, they will certainly produce a chuckle or two. Arranged in a series of four archives containing about 16 cartoons in all, the cartoons are presented as thumbprint images, which can be clicked on in order to enlarge them. Well worth viewing. If only they could invent something to keep managers away.

The author is the Editor-in-Chief of the Internet Journal of Otolaryngology. Kindly submit comments, suggestions or addresses for review by e-mail to rehan_kazi@yahoo.com