Were Early Ear Treatments Quackery or Science?

To those of us that have had the opportunity to study contemporary hearing, deafness, and its treatment, the products discussed below in this post seem, at first glance, to be quackery.  Initial appearances suggest that these products were a con man’s idea of how to sell a device with no value to the hearing impaired. When considering the times and the prevalence of various hearing disorders, deafness was quite different than today and may offer a completely different rationale for these devices.  

 

Consider the Prevalence of Otosclerosis in 1900 

 

The American Academy of Otolaryngology/Head Neck Surgery (AAO/HNS) (2017) indicates that otosclerosis is the formation of spongy bone about the stapes and the oval window of the ear, causing progressive deafness.  While this genetic disorder affects about 10% of adult Caucasians, it is less common in Japanese and South American populations and is rare in African Americans.

The video describes the disease as a progressive disorder that affects mostly women although it does affect men as well. [Click on the picture for a description of otosclerosis]  The gradual deafness that begins in one ear and slowly causes hearing loss in the other ear with the progression of the hearing loss over a lifetime.

Sakihara, Christensen, and Parving (1999) found that the cohorts for 1910 to 1919 and 1920 to 1929 had basically the same incidence of otosclerosis as currently found in Caucasians.   It was known then that the hearing loss was caused by the stapes being dampened by the spongy bone within the oval window, impeding the sound transmission to the cochlea.

In the hands of a capable 2017 otologic surgeon, otosclerosis is about 85% curable with a stapendectomy operation.  In 1900, however, it was quite a different story.  Tod (1909) describes the state of surgery for otosclerosis of his time as a mobilization procedure.  The goal was to mobilize the stapes and restore hearing once again.  Dr. Tod describes the surgical results in 1909 as “difficult to foretell as it is chiefly dependent upon the extent of the adhesions already existing within the tympanic cavity and on the mobility of the stapes within the fenestra ovalis [oval window].  If the latter is already fixed, then improvement is impossible.  If, however, the adhesions are limited, a better result may be obtained by this method than by pneumo-massage and inflation.  The surgeon must be guided by the extent and duration of the improvement as to how long to continue treatment.  Unfortunately, relapses are not uncommon, though temporary benefit may be obtained.” 

If the surgery was declined, or considered not beneficial, then massage was conducted as a last resort “in the hope of obtaining some improvement in hearing.”  

Thus, according to Tod, surgery for otosclerosis was a mobilization to achieve at least a temporary respite from hearing loss; however, recurrence of hearing loss was not unlikely as the spongy bone grew back.  So why not consider the massaging approach?  Theoretically, it should work to move the eardrum, then the ossicles, and maybe the stapes bone that was stuck in the oval window. 

 

But If No Surgery…..Then What?

 

In 1900, hospitals were a place to go and die, not necessarily to get better, or restore hearing.  Thus, there were lots of “out patient” remedies for most everything, including some strange elixirs and devices thought to restore most anything.  For example, consider that radium had just been discovered in 1898 and by the early 1900s, radium was considered to be much more valuable than either gold or platinum. Radium or radon laced water was called “liquid sunshine” because it was believed to be a magical elixir that could promote health and prolong life by rejuvenating effects that provided a host of widespread benefits.  Given the views and limited knowledge of the times, the idea of massaging the eardrum and thus, the auditory ossicles for otosclerosis probably had some merit. 

It is well documented that Miller Reese Hutchinson first fit the Queen of England with his Akuophone device in 1902. Ear massagers debuted right about this time and appear to be the brainchild of Hutchinson.  According to Bauman (2017) of the Hearing Aid Museum, “at that time he was hobnobbing with the deaf royals of Europe.  And, remember that several of them were suffering from the results of otosclerosis.”  Of course, the royals of Europe had intermarried and perhaps this was a factor in why otosclerosis was a problem for many of them. 

It is Bauman’s contention that Hutchinson was probably trying to fix Alexandria’s hearing by inventing one of the very first vibration devices, Massacon Ear Treatment Device.  Originally called the “Akou-Massage”, the Massacon was a rather ingenious, non-invasive way to treat deafness caused by otosclerosis.  The treatment was to create a loud sound vibration through the earphone held against the patient’s ear.  Theoretically, the Massacon would cause severe vibration to the eardrum and, consequently, auditory ossicles as a means of loosening them in the oval window.  While this Massacon was made for the use of physicians and not as a home treatment for hearing loss, it produced ear-damaging levels of sound as its softest sound was about 120 dB and the volume went up from there.  Bauman feels that this was not necessarily a quack device, but a sincere attempt to create a device that would cure otosclerosis. 

The Massacon was just the beginning of devices specifically designed to work for otosclerosis.  The rare instrument to the left was used by Berlin physicians in the early twentieth century.  The patient would put on the stethoscope and listen to various sound frequencies played through a battery powered violin. This device complements the violin vibraphone above since it employed a violin bow to be used for the diagnosis of various forms of hearing impairment. 

Then there was the Dr. Guy Clifford Powell’s vibratory therapy or the Ardente “Aurashelle” Ear Treatment Device (Ear Vibrator) a 1930s device from England that was also to vibrate the ossicles.  The intent of the Aurashelle seems to have been to cause severe vibration to the eardrum and consequently the ossicles but the loud buzzing of the device was enough to cause sensorineural hearing loss and tinnitus.

 

There are probably a hundred other treatments that either never made it to prime time or have been lost over the years.  My conclusion is that, while these were feeble attempts to cure a hearing loss without much research, most were honest attempts at cures based upon the knowledge of the time.

 

References:

American Academy of Otolaryngology Head Neck Surgery (2017). Otosclerosis.  Retrieved February 27, 2017.

Bauman, N. (2017a).  The Massacon.  The Center for Hearing Help, Hearing Aid Museum.  Retrieved February 28, 2017.

Bauman, N. (2017b).  Oticon.  The Center for Hearing Help, Hearing Aid Museum.  Retrieved February 28, 2017.

Sikihara, Y., Christensen, B. & Parving, A. (1999). Prevelence of hereditry hearing loss in adults.  Scandinavian Audiology, 28(1), pp. 39-46.  Retrieved February 27, 2017.

Tod, H. (1909). Section III. Operations Upon the Ear, Chapter III, Operations Upon the Tympanic Membrane and Within the Tympanic Cavity.  In Burghard, FF (Ed) A System of Operative Surgery.  Oxford Medical Publications. pp. 350. Retrieved February 27, 2017.

Traynor, R. (2015).  The road to the first portable electronic hearing aid and beyond.  Hearing Health Matters.  Retrieved February 28, 2017.

Videos:

Varakala, V. (2017).  Otosclerosis.  You Tube.com Retrieved February 27, 2017.

 

About Robert Traynor

Robert M. Traynor, Ed.D., MBA is the CEO and practicing audiologist at Audiology Associates, Inc., in Greeley, Colorado with particular emphasis in amplification and operative monitoring, offering all general audiological services to patients of all ages. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was Senior International Audiology Consultant to a major hearing instrument manufacturer traveling all over the world providing academic audiological and product orientation for distributors and staff. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of the field of Audiology in over 40 countries. Dr. Traynor is the current President of the Colorado Academy of Audiology and co-author of Strategic Practice Management a text used in most universities to train audiologists in practice management, now being updated to a 2nd edition.