History of myringotomy and grommets

Abstract

The first recorded myringotomy was in 1649. Astley Cooper presented two papers to the Royal Society in 1801, based on his observation that myringotomy could improve hearing. Widespread inappropriate use of the procedure followed, with no benefit to patients; this led to it falling from favour for many decades. Hermann Schwartze reintroduced myringotomy later in the nineteenth century. It had been realised earlier that the tympanic membrane heals spontaneously, and much experimentation took place in attempting to keep the perforation open. The first described grommet was made of gold foil. Other materials were tried, including Politzer's attempts with rubber. Armstrong's vinyl tube effectively reintroduced grommets into current practice last century. There have been many eponymous variants, but the underlying principle of creating a perforation and maintaining it with a ventilation tube has remained unchanged. Recent studies have cast doubt over the long-term benefits of grommet insertion; is this the end of the third era?

The glue ear ‘epidemic’: a historical perspective

“…Politzer had introduced rubber ventilation tubes for the ear in the 19th century, but these were associated with infection and were quickly extruded 24. Armstrong presented successful results in five patients from a ‘new treatment’ in 19541: polypropylene, and subsequently Teflon, proved ideal materials to make a flanged tube which would stay in the ear drum for long periods without causing reaction and infection.…”

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

“…It later transpired that the criminal in question was a cousin of Cheselden. Furthermore, the partly deaf mistress of King George II, Lady Suffolk, who was hoping to be cured if the findings were promising, had obtained the Pardon'' [5]. Rimmer mentions Black (1985) as reference.…”

“…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.…”

Transmyringeal ventilation tube treatment in children: Hearing outcome after 10 years

“…Although the practice of insertion of ventilation tubes (VT) has been known for a century and a half [1] its modern form was introduced in 1954 by Armstrong [2]. It has since then been the standard surgical procedure for treatment of recurrent acute otitis media (rAOM) and persistent secretory otitis media (SOM).…”