The history of the microscope for use in ear surgery.
OBJECTIVE
To study the historical development of the binocular microscope used in ear surgery.


METHODS
Compilation of the texts of the era and books dealing with ear surgery, and a review of the international literature on the subject.


RESULTS
The first descriptions of the microscope date to the 17th century; however, it was not until 1921 that the microscope was used for the first time in ear surgery by a Swedish otologist, Carl Olof Nylen. This monocular microscope was rapidly replaced by a binocular microscope developed in 1922 by Gunnar Holmgren. Because of its limited field of vision, very short focal distance, poor light quality, and instability, this microscope was seldom used initially. Despite the development of many different models, it was not until 1951 that a new model appeared, perfected by Littmann and the Zeiss Company. This model replaced all other models progressively, thanks to its ease of use and the possibility of changing the magnification without modifying its focal distance. It allowed for the development of tympanoplasties and stapes surgery. The latest developments include the three-dimensional imaging and navigation systems.


CONCLUSIONS
The microscope followed an evolutionary process that led to the actual binocular microscope, which is found in every institution where otology and ear surgery are performed.
Mudry
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Ear, Nose and Throat Department, University Hospital, Lausanne, Switzerland.
D004423:Ear / Q000601:surgery; D004867:Equipment Design; D005060:Europe; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D008853:Microscopy / Q000266:history* / Q000295:instrumentation; D010036:Otolaryngology / Q000266:history* / Q000295:instrumentation