The great figures in the history of otology
•Descargar como PPTX, PDF•
15 recomendaciones•4,012 vistas
Dr Fernanda Muñoz. a ENT resident at Son Espases University Hospital gave this fascinating talk in the ENT department on Wednesday 25th November 2015
Recomendados
Más contenido relacionado
La actualidad más candente
La actualidad más candente (20)
Similar a The great figures in the history of otology
Similar a The great figures in the history of otology (20)
Más de Jonathan McFarland
Más de Jonathan McFarland (20)
Último
Último (20)
The great figures in the history of otology
- 1. Fernanda Muñoz Proto ENT Resident Son Espases Hospital
- 2. Descriptions of battle injuries on the temporal region and its effect on hearing and language of the wounded. The frequency of bleeding from the ear in head injuries is mentioned and regarded as an unfavourable sign. Many references to injuries of the nose. Edwini Smith Egyptian Papyrus (3000-2500 B.C) Edwini Smith Egyptian Papyrus
- 3. Contains prescriptions for diseases of the ear: “For an ear that is suppurating, olive oil, frankincense and sea salt syringed into the ear;" “For an ear that hears badly, red lead and resin, grind to a powder, rub in fresh olive oil and apply to the ear." It is possible that the existence of the eustachian tubes were known, as it is stated 108 in the Papyrus, 'the breath of life passes by the right ear, the breath of death by the left ear." Ebers Egyptian Papyri (1500 B.C) Ebers Egyptian Papyri
- 4. The first to describe the tympanic membrane "a dry thin spun web," and he connected it with the organ of hearing. Case reports of cases of otitis, and one of his aphorisms reads: "Children suffer from ear discharge, adults from deafness.“ Father of Medicine Hippocrates 460 – 370 B.C Kos, Greece
- 5. "An insect must first be killed with vinegar, and then removed with a probe, the patient should be encouraged to sneeze, or better still, he should be bound to a table with the affected ear downwards, and the table should then be forcibly struck with a hammer so that the foreign body may be shaken out of the ear.” Injuries of the external ear: Careful suturing of the skin, if broken. If intact and a swelling occurs below it, the ear is to be opened from behind and a window cut in the cartilage. Aulus Cornelius Celsus 25 B.C – 50 A.D Rome
- 6. Some of his writings were centuries in advance of their time. He advised that carious bone should be removed after making an incision behind the ear. The first reference to mastoid operative surgery, but centuries were to pass before his advice was put into practice. Claudius Galen 130 - 216 A.C Pergamon (Modern Bergama, Turkey)
- 7. Professor of Anatomy at Padua. Revolutionized anatomy. He gave a detailed description of the malleus and incus, two of the small bones in the middle ear. Andreas Vesalius 1514–1564 Brussels, Habsburg Netherlands (modern-day Belgium)
- 8. He wrote the first textbook devoted to the ear. He gave an accurate description of the eustaquian tube its structure and position, but made no mention of its function. He described: The internal and anterior muscles of the malleus and the stapedius, The anatomy of the cochlea. Bartolomeo Eustachi 1500 or 1514 –1574 San Severino, Italy
- 9. He described and named some of the following structures: The inner and middle ears. The chorda tympani, trigeminal, auditory and glossopharyngeal nerves. He described the bony canal for the facial nerve which bears his name. His knowledge was mainly anatomical, as he regarded purulent discharge from the ear as "excrement of the brain." Gabriele Falloppio 1523-1562 Modena, Italy
- 10. French anatomist 1683: Eustachian tube was not an avenue of breathing, but existed simply as a means of renewing the air within the tympanum. He compared the cochlea to a musical instrument suggesting that the lower tones were perceived by the basal coil. Pus was often found in the tympanum even when the brain was normal, so the pus could not have come from the brain as was the accepted theory at that time. Guichard Joseph Duverney 1648-1730 Freur, France
- 11. German physician and physicist. Measured the speed at which the signal is carried along a nerve fiber. High tones were perceived in the basal coil, and the low- tones by the apical portion. Hermann von Helmholtz 1821-1894 Potsdam, Germany
- 12. He wrote Tractatus de Aure Humana. He coined the term Eustachian tube. 1704: First in demostrate the ankylosis of the stapes. Valsalva Maneuver Inflating the middle ear by closing the mouth and nose and forcing air up the eustachian tubes. "Gangrenous pus does not taste good“ Antonio María Valsalva 1966-1723 Imola, Italy
- 13. 1760: Petit successfully opened the mastoid in a case of suppuration, but the pathology not being understood, the operation was tried for cases of deafness without suppuration. Astley Cooper observed cases of perforation of the tympanic membrane with little deafness: Deafness due to eustachian obstruction might be relieved by puncturing the tympanic membrane. Twenty years later, Itard gave the true indications for the operation: Presence of exudate in the middle ear which was unable to escape. Otitis Media
- 14. Eustachian tube catheterisation (1724), Myringotomy or piercing of the ear drum (1801) Early attempts at mastoidectomy (1774) were Until anaesthetics and antisepsis were introduced. Main surgical treatments until the middle of the 19th century
- 15. 1800 in London, UK. The first firm to begin commercial production of the ear trumpet. Rein also sold hearing fans, and speaking tubes. These instruments helped amplify sounds, while still being portable. Frederick C. Rein
- 16. Surgeon, anatomist, neurologist, and philosophical theologian Difference between sensory nerves and motor nerves in the spinal cord. 1821: Published anatomic diagrams of the facial nerve and the innervation of the facial muscles. Described Bell's palsy. Sir Charles Bell 1774 - 1842 Edinburgh, Scotland
- 17. Dissections of over two thousand ears. 1841: Described otosclerosis and demonstrated ankylosis of the stapes of the oval window in 160 temporal bones. His findings that the organ of hearing itself was intact in otosclerosis, led surgeons to investigate the possibility of bypass the middle ear obstruction and reach the intact cochlea by surgery. Joseph Toynbee 1815–1866, Lincolnshire, UK
- 18. Father of Oscar Wilde. He was the first to teach otology in the United Kingdom, and students came from all over the world, particularly America. His name is still associated with the method of treating mastoiditis by a post- aural incision-Wilde's Incision. Sir William Wilde 1815 -1876 Dublin, Ireland
- 19. 1893: Described the features of Otosclerosis: Abnormal new bone formation in the ottic capsule disorder and he named it. He developed surgical instruments: Ear perforator, surgical knife, grommets for the ventilation after paracentesis. Politzer's method to restore permeability to the Eustachian tube by using an insufflator. Politzer's otoscop Acoumeter for measuring hearing acuity 2 early acoustical hearing aids. Ádám Politzer 1835 - 1920 Alberti, Hungary
- 20. 1861: He described a syndrome of sudden vertigo linked to progressive hearing loss and tinnitus. He defined these discomforts as caused by a problem in the inner ear, as previously considered a form of epilepsy. Stopped patients affected by this disease being treated as mentally ill. 1874: Jean-Martin Charcot named Meniere’s Disease. Prosper Menière 1799 -1862 Angers, France
- 21. In the mid-1800s, a young man with otosclerosis was noted to have hearing improvement following a skull fracture. Post-mortem examination of his temporal bones revealed a fracture through the horizontal semicircular canal. Kessel attempted to create a similar fistula in patients with otosclerosis using a hammer and gouge. In 1876, Kessel removed the stapes and covered the oval window with scar tissue. These early attempts at treatment failed. Johannes Kessel (1839 Salzen Hessen)
- 22. Discovered what he called the caloric reaction. Syringing fluid to a patient and the patient experienced vertigo and nystagmus with cold water and to the opposite direction with warmed water. “The direction of flow of the endolymph was providing the propioceptive signal to the vestibular organ.” This observations made surgical treatment of vestibular organ diseases possible. 1914: Nobel Prize in Physiology or Medicine for his work on the Physiology and pathology of the vestibular apparatus. He also investigated other aspects of equilibrium control, including the function of the cerebelum. Robert Bárány 1876-1936 Vienna, Austria- Hungary
- 23. 1929: Opening in the lateral semicircular canal covered by a tympanic membrane muco-cutaneous flap. 1937: He published the first successful case of fenestration for treatment of deafness caused by Otosclerosis. This operation was described in 2, 3 or more stages to combat infection. Maurice Sourdille 1885-1961 Nantes, France
- 24. Tumarkin reported that decompression stylomastoid artery was necessary for the proper treatment of Bell's palsy. Balance and Duel described the decompression of the distal portion of the facial nerve in the stylomastoid foramen. Sterling Brunell performed the first facial nerve repair with a graft for the recovery of facial muscle movement. Bell’s Palsy 1930’s
- 25. Long Island Medical School. 1.5 mts tall. He visited the Manhattan Eye and Ear Infirmary, Mount Sinai, Columbia, and NYU residency programs. One stage fenestration of the lateral semi-circular canal operation for otosclerosis. Dental drill for mastoidectomy. Precursor to the operating microscope, he employed a bright headlight and magnifying loops so he could see well. Julius Lempert 1891-1968 Lublin, Poland
- 26. ENT in Mount Sinai hospital. 1952: Rosen accidentally mobilised the stapes during routine stapes mobility test of the ossicular chain before fenestration. He found a significant, immediate hearing improvement. He design a new surgical technique: Rosen mobilization. Fracture of the anterior crus Remove portion of the footplate Mobilization the rest of the footplate anteriorly However, he did not receive widespread acclaim in his own country. Samuel Rosen 1897- 1981 Syracuse, US
- 27. Hardvard Medical School in 1928. ENT in Massachusetts Eye and Ear Hospital in Boston >400 articles in medical journals, edited the Archives of Otolaryngology for 10 years, and wrote the textbook Surgery of the Ear (1959), which remains in print. His medical career spanned 70 years: he continued to see patients until a week before his death. First physician to use an operating microscope in delicate ear surgery in the US. George E. Shambaugh Jr. 1903 –1999 Chicago US
- 28. He studied chemistry and physics. He was offered a by Barany (he dismissed because of the hard Swedish winters). He went to Harvard and the Hawaii. He was able to observe that the basilar membrane moves like a surface wave when stimulated by sound. The placement of each sensory cell (hair cell) along the coil of the cochlea corresponds to a specific frequency of sound (the so-called tonotopy). 1961: Nobel Prize for discovering the physical mechanism that occurs in stimulating the cochlea. Békésy audiometer operated by the patient. Georg von Békésy 1899-1972 Budapest, Hungary
- 29. He developed and invented the Cochlear implant. Dentist He earned a medical degree from the University of Southern California after two years in the US Navy. 1946 he co-founded The House Ear Institute with his older half brother, Howard House (physician, otologist) 1961: First cochlear implantation. Unsuccessful because it was rejected by the patient's body. 1969: Successfully implanted longer lasting model. William P. House 1923 – 2012 Kansas City, US
- 30. Hardvard Medicine School. ENT in "Massachusetts Eye and Ear Infirmary" en Boston 1956: He performed the first successful reconstructive stapedectomy. Removed the stapes, covered the oval window with a vein graft and inserted a prosthesis to replace the diseased stapes bone. The patient’s hearing was restored and she heard well for long time. He has pioneered numerous techniques in the treatment of hearing loss and dizziness, developed many instruments and prostheses. Performed > 40,000 stapedectomies, (> 90% success rate) His technique, perhaps with some modifications, is still practiced worldwide. John J. Shea, Jr. 1924 –2015 Memphis, Tennessee
- 31. Thanks!
Notas del editor
- Another well-known name in otology is Antonio Valsalva. He wrote a book called Tractatus de Aure Humana, published in 1704. He was the first to demonstrate ankylosis of the stapes at post-mortem. 'rhe significance of this observation was not appreciated for over a century. His name is associated with the test of inflating the middle ear by closing the mouth and nose and forcing air up the eustachian tubes. rhe eustachian catheter was invented by Edine-Gilles Guyot, a postmaster at Versailles. He succeeded in relieving his own deafness by the use of a curved tube passed into the mouth and behind the palate. Nearly twenty years later, Archibald Cleland, a Scottish military surgeon, recommended passing a silver tube via the nose and syringing with water. It did not occur to him that air might be blown in. He studied medicine and philosophy in Bologna. He was taught by Marcello Malpighi, who is known as the founder of microscopic anatomy. In 1705, he was appointed professor of anatomy at Bologna. He was later chosen as president of the Academy of the Sciences. Valsalva taught Giovanni Battista Morgagni who edited Valsalva’s complete writings and published a biography on Valsalva, both in 1740. In 1709, Valsalva married Elena Lisi. As he lost his health, he lost his sense of smell, but he recognized the prodromal symptoms, in the form ofdyslalia, of the disease that would eventually cause his death from stroke at Bologna in 1723. The Valsalva family donated a collection of dried anatomical specimens to be used for educational purposes to the Institute of Sciences founded in 1711. The wear of this material that followed possibly inspired the work of the Bolognese school of wax modeling and the artists Ercole Lelli and Giovanni and Anna Morandi Manzolini. This new anatomic collection includes models of the heart and lungs and is today presented at the Museum of Anatomy. Valsalva was described as a skillful surgeon and excellent physician, a meticulous anatomist with high scientific integrity, and a man of great kindness. Morgagni wrote ". . . there is nobody of those times who goes ahead of him, very few who are his equals." Research[edit] Opera, 1741 His main interest was the middle and internal ear, including the muscles of the external ear and the pharyngeal muscles. Valsalva named the Eustachian tube and described its function and that of its muscle. He showed the connection between the mastoid cells and thetympanic cavity, and made observations on physiologic and pathologic processes of the ear. De aure humana tractatus published in 1704 contains a description of the Valsalva maneuver and patency test of the auditory tubes. A skilled anatomist, Valsalva conducted many autopsies on deceased patients. During the 17th century, lacking chemical tests and knowledge of disease transmission mechanisms, he sometimes tasted the fluids he encountered in cadavers in an effort to better characterize them. "Gangrenous pus does not taste good", he wrote, "leaving the tongue tingling unpleasantly for the better part of the day."[2] Valsalva device in spacesuits[edit] The Valsalva device is a device used in spacesuits to allow astronauts to equalize the pressure in their ears by performing the Valsalva maneuverinside the suit without using their hands to block their nose. It has also been used for other purposes, such as to remove moisture from the face.[3]
- In the nineteenth century, otology made great strides. Joseph Toynbee gave otology a scientific basis by his beautiful dissections of over two thousand ears, these formed the Toynbee Collection in the Museum of the Royal College of Surgeons, which was destroyed by enemy action in 1941. He described otosclerosis and demonstrated ankylosis of the stapes of the fenestra avolis in 160 speci. rnens.
- In 1938, Lempert of New York described a one-stage operation with approach through the meatus. In 1940 and 1941, he described further modifications, and in 1942 Shambaugh of Chicago added the use of constant irrigation, and the use of a binocular dissecting microscope when drilling the external canal. This is the type of operation which is being done to-day.
- Biography[edit] He went to school in Budapest, Munich, and Zürich. He studied chemistry in Bern and received his PhD in physics on the subject: "Fast way of determining molecular weight" from the University of Budapest in 1926. He then spent one year working in an engineering firm. He published his first paper on the pattern of vibrations of the inner ear in 1928. He was offered a position at Uppsala University by Róbert Bárány, which he dismissed because of the hard Swedish winters. Before and during World War II, Békésy worked for the Hungarian Post Office (1923 to 1946), where he did research on telecommunications signal quality. This research led him to become interested in the workings of the ear. In 1946, he left Hungary to follow this line of research at theKarolinska Institute in Sweden. In 1947, he moved to the United States, working at Harvard University until 1966. After his lab was destroyed by fire in 1965, he was offered to lead a research laboratory of sense organs in Honolulu, Hawaii. He became a professor at the University of Hawaii in 1966 and died in Honolulu. He became a well-known expert in Asian art. He had a large collection which he donated to the Nobel Foundation in Sweden. His brother, Dr. Miklós Békésy (1903-1980), stayed in Hungary and became a famous agrobiologist who was awarded the Kossuth Prize. Research[edit] Békésy developed a method for dissecting the inner ear of human cadavers while leaving the cochlea partly intact. By using strobe photography and silver flakes as a marker, he was able to observe that the basilar membrane moves like a surface wave when stimulated by sound. Because of the structure of the cochlea and the basilar membrane, different frequencies of sound cause the maximum amplitudes of the waves to occur at different places on the basilar membrane along the coil of the cochlea.[2] High frequencies cause more vibration at the base of the cochlea while low frequencies create more vibration at the apex.[3] He concluded that his observations showed how different sound wave frequencies are locally dispersed before exciting different nerve fibers that lead from the cochlea to the brain. He theorized that the placement of each sensory cell (hair cell) along the coil of the cochlea corresponds to a specific frequency of sound (the so-called tonotopy). Békésy later developed a mechanical model of the cochlea, which confirmed the concept of frequency dispersion by the basilar membrane in the mammalian cochlea. But this model could not provide any information as to a possible function of this frequency dispersion in the process of hearing.[2] In a posthumous 1974 article looking back over progress in the field, he remarked "In time, I came to the conclusion that the dehydrated cats and the application of Fourier analysis to hearing problems became more and more a handicap for research in hearing,"[4] referring to the difficulties in getting animal preparations to behave as when alive, and the misleading common interpretations of Fourier analysis in hearing research.