History of Mastoidectomy: PubMed, Best Matches, Secondary References, and Inaccuracies

150 years ago: Schwartze's 1873 mastoidectomy and its implementation over the following 2 years

BACKGROUND

In 1873, Hermann Schwartze and Adolf Eysell described a new surgical technique for treating mastoid disease using a mallet, chisels, and gouges of various sizes instead of trephines or drill instruments also called "modern mastoidectomy." On the 150th jubilee of this landmark article, we pay tribute by studying the reception and implementation of mastoidectomy in the 2 years following its publication.

METHODS

The commentaries published in the otological and medical literature between the second part of 1873 to the end of 1875 were studied with an emphasis on the three specialized otological journals and the otological textbooks that existed during this period.

RESULTS AND CONCLUSION

The princeps paper Ueber die künstliche Eröffnung des Warzenfortsatzes ("On the artificial opening of the mastoid process") by Hermann Schwartze and Adolf Eysell published in 1873 was rapidly disseminated in the medical literature for nearly 1 year, and then entered a phase of evaluation followed by a phase of extension and implementation, before finding its definitive place in the history of mastoid process surgery.

Jean Riolan the Younger (1580 - 1657) and the Trepanation of the Mastoid Process: More Than a Suggestion?

INTRODUCTION

The Parisian anatomist Jean Riolan the Younger (1580 - 1657) is usually associated with the first proposal to surgically open the mastoid for certain ear pathologies with varying degrees of accuracy. The purpose of this historical research is to go back to the original texts and try to understand what probably prompted Riolan the Younger to suggest the surgical opening of the mastoid, thus paying him the correct tribute and restoring him to his rightful place in the history of mastoid surgery.

METHODOLOGY

Review of the published secondary literature on the history of the surgical opening of the mastoid, completed by a detailed study of most of the original works written by Riolan the Younger.

RESULTS

The study of Riolan the Younger's original texts shows that he suggested the perforation of the mastoid process for three different clinical situations: whistling in the ear, deafness at birth, and deafness related to a blockage of the eustachian tube. These three suggestions were made between 1629 and 1649. No one before him had made such suggestions. This study also shows that Riolan the Younger did not propose to open the mastoid process in case of ear infection.

CONCLUSION

Riolan the Younger must be considered as the true initiator of this surgery and thus must take its proper place in any history of surgical opening of the mastoid.

The Coronoid Insertion of the Human Masseter Muscle was Well Described in the 18th Century

INTRODUCTION

A recent paper in Annals of Anatomy (The human masseter muscle revisited: First description of its coronoid part) claimed to have discovered a previously unrecognized anatomical component of the deep layer of the masseter muscle. The goal of this study is to emphasize the importance of undertaking comprehensive exploration of the historical literature before asserting primacy of an anatomical discovery.

METHODS

A search was conducted of historical texts describing the anatomical structure of the masseter muscle, spanning the 18^th, 19^th, and early 20^th centuries. Historical sources were obtained via Google Books, the Internet Archive, and the digital collections of Stanford Lane Library Medical History Center, Paris University Numerical library Medica (France), and the State Library of Bavaria (Germany). Contemporary anatomical studies were identified via PUBMED search RESULTS: Rather than a "first description" of newly discovered anatomical feature, the paper we comment upon has added important anatomical details of the length, width, thickness, and fiber orientation of coronoid portion of the deep layer of the masseter. As early as the 18^th century, anatomists had described the masseter as possessing a three rather than two-layer structure with a deep layer which inserts on the coronoid process.

DISCUSSION

Assertions of primacy (ie. "first description") of an anatomical structure in the 21^st century necessitates a diligent search of literature, including sources which were published during the era when anatomical studies reigned supreme at the forefront of medical science. Systematic scanning of historical medical material has made older texts widely and freely available and digital translation tools have helped to remove language barriers. It is important to study original articles as secondary citations of historical material are less reliable. Without rigorous historical investigation, assertions of primacy cannot be made with confidence.

A Critical Evaluation of "The Ear that Hears Badly" in the Ebers Papyrus

OBJECTIVE

The Ebers papyrus (1,550 BC) is one of the most complete medical papyri of Ancient Egypt. It contains a few paragraphs about otology, about both treatments of the external ear and ideas concerning the ears and deafness. Over the years, many scholarly interpretations of these paragraphs have been made by learned Egyptologists and academic historians of otology. They do not always agree and have often been critical of each other. This historical review compares and contrasts all the main published academic translations of the Ebers papyrus by looking at the original document and their interpretations.

METHODOLOGY

Historical research, based on the various translations of the Ebers papyrus.

RESULTS

Eight complete translations of the whole Ebers manuscript have been analyzed. Four of these contain transliteration of the hieroglyphics. The hieroglyph associated with the ear is a pictogram of a cow's ear. It has two possible interpretations. It can mean the ear itself but it can also be used to denote either deafness or hearing.

CONCLUSION

Insights into the early Egyptians perception of the ear may be obtained, but study of primary references shows that there is scant evidence of knowledge of anatomical details in the Ebers papyrus.