From the roots of otology: diseases of the ear and their treatment in Byzantine times (324-1453 A.D.).

HYPOTHESIS: The aim of this study is to present the therapeutic methods and surgical techniques in diseases of the ear during Byzantine times (324-1453 A.D.). BACKGROUND/METHODS: The original Greek language texts of the Byzantine medical writers were studied to research early otologic knowledge of symptomatology, conservative treatments, and surgical confrontation of diseases of the ear. RESULTS: A considerable number of conservative treatments for many otologic conditions were identified; these therapies were especially based on herbs, animal and mineral substances applied either as eardrops, clysters, poultices, or by using special instruments and apparatus. Among these were identified otitis, rupture of the eardrum, hemorrhage from the ears, deficiency of hearing and deafness, vertigo, tinnitus, and earwax. Furthermore, in these early texts, there were also described some surgical techniques in cases of atresia of the external auditory canal, of defects in or lack of the pinna, and for removal of foreign bodies and fleshy tumors. Some of the earliest hearing aids were also mentioned. CONCLUSIONS: From the study of the original works of Byzantine writers, it is evident that numerous treatments and surgical techniques relating to otology were practiced; these were derived not only from compilation of knowledge obtained from the ancient Greek medical sources, a considerable part of which are now lost, but also enriched by Byzantine physicians' personal experience. This knowledge influenced medieval European medicine and, through it, that of the rest of the world.