Fashion, science and technical change: the history of the treatment of glue ear

Abstract

One reason for the current epidemic in the rate of surgery for glue ear in children is that a shift in treatment has taken place from non-surgical to surgical methods. An historical review of the treatment of this condition reveals the existence of previous 'surgical epidemics' and the importance of two particular factors-technical developments, such as the design of tympanostomy tubes and the introduction of antibacterial drugs; and the lure of panaceas such as ionizing radiation. In addition, it reveals how medical practice is, like most human behaviour, subject to fashion. Despite this, there is a constant desire by practitioners to be adjudged 'scientific' in their work, and definitions of science are equally susceptible to change over time.

Otitis media surgery: Large variability between Finland and Norway

“…The differences may also be due to variance in clinical discretion between specialists in the two countries. This is likely to be reflected in the variability in incidence and type of treatment found in our study, and contrasts the advent of guidelines [1]. Professional uncertainty of indications and value of surgery has been postulated to be a major factor responsible for variation in treatment, and variation relates to individual doctor decisive values, also applicable to specialists [22].…”

“…Historically, surgical treatment of otitis media has been empirically based [1]. Further, rates of surgery has increased continuously without evidence of an equivalent rise in otitis media incidence [2,3].…”

Surgery for otitis media and infectious susceptibility in 10-year old school children

“…Treatment is medical and surgical; indication and result of treatment are controversial [2,3]. Operative treatment has a long tradition and involves myringotomy, adenoidectomy and insertion of tympanostomy tubes [4]. Outcome of operative intervention is difficult to gauge but research on otitis media surgery targets improved hearing, language and cognitive skills [5][6][7].…”

Never trust secondary references: Examples from the early history of myringotomy and grommets

“…Their history is fascinating on different points of views, notably the various indications and techniques described through the centuries. In the recent years, a few articles studied this history and the most cited ones written by Alberti [1], Black (1984) [2], Black (1985) [3], Brusis [4] and Rimmer [5] contain numerous inaccuracies which are perpetuated. This problem is all too common in history of otology [6] and probably in the history of medicine as well.…”