Otology and Neurotology – Past, Present and Future

During the 48th Brazilian Congress of Otorhinolaryngology there was a presentation named The Future of Otolaryngology. I decided to include in my list of blogs this slightly expanded version of my presentation. Some of the names mentioned here have been presented in other pages of this blog.

PART I

Time is a relative dimension.
The past, the present and the future are all interlinked.
The things we do today are a consequence of the past,
and the things we will do in the future
are a consequence of what we do today.

All journeys start with a first step. I include here some of the people I believe were responsible for first steps at different times.

   Galen was a Greek physician who spent most of his life in Rome. He was born in 129 and died in 200. His concepts dominated medical science for nearly two thousand years.

   He performed many anatomical studies, based on dissections of monkeys and pigs, since the Roman law prohibited the dissection of human cadavers. He used the word “labyrinth” to describe the very complex structure of the inner ear.

The Labyrinth and the Cochlea

The vestibular labyrinth has existed for 580 million years, since the advent of the coelenterates.

Labyrinth of a teleost fish

The cochlea, present only in mammals, is much newer; it has existed for only 225 million years.

Jean Pierre Flourens

This pioneering French neurophysiologist demonstrated for the first time that the vestibular semicircular canals were sensors for movements, not for hearing, as it was then believed. Destroying semircular canals of pigeons, he demonstrated that they were disoriented and could not fly, but they could hear. 

Jan Evangelista Purkiyně

A Czech anatomist and physiologist whose contributions were probably more significant in other areas; he is famous for the Purkiyně cells of the cerebellum and the Purkiyně fibers of the miocardium. But he also studied the neurophysiology of the senses and studied vertigo and nystagmus on himself.

Prosper Menière

The symptom of vertigo was known for many centuries, but it was believed that it was a neurological disease, like epilepsy. Menière demonstrated that it originated in the semicircular canals of the vestibular labyrinth.

Sir William Wilde

I believe that he was one of the first eye & ear specialists, working in his private hospital where he practiced eye and ear operations. He became a knight, in 1864, for his medical contributions, that included his successful cataract operation of the king of Sweden.

Josef Breuer and Ernst Mach

Breuer was a distinguished German neurologist who made important contributions to neurophysiology and laid the foundation to psychoanalysis, as developed by his disciple Sigmund Freud.

Mach was an Austrian physicist, mathematician and philosopher, considered as a precursor of Einstein’s relativity theory who pioneered the studies on accelerations. His cyclostat was the first pendular rotatory chair.

Both of them attempted used rotatory chairs to induce vertigo in animals and attempted to explain the physiology of the vestibular system; their proposals became known as the Mach-Breuer theory.

Alfred Adler

Adler was an Austrian neurologist and psychotherapist, one of the disciples of Sigmund Freud. He was the first physician to describe the benign paroxysmal positional vertigo (BPPV), that he described as paroxysmal vertigo.

Part II will include Ádam Politzer, Wladimir Bechterew, Ernst Ewald, Robert Bárány, Gunnar Holmgren, Maurice Sourdille, Carl-Olof Nylén, Julius Lempert, Hallowell Davis, C. S. Hallpike, Fritz Zöllner, Horst Wullstein, Georg von Békésy, Harold Schuknecht and John Shea, Jr., William F. House, Jun-Ichi Suzuki, Yaoaki Yanagihara, G. Michael Halmagyi, David Newman-Toker, David Zee, Jorge Kattah, and the Future.