Is glue ear a modern phenomenon? ?a historical review of the medical literature
There are many anecdotal reports of the recent increase in the incidence of surgery for glue ear, a phenomenon that the medical literature has considered to be a reflection of both an increased prevalence of the underlying condition and its increased detection. However, there has been no attempt to assess these considerations by means of an historical study. This reveals that, contrary to contemporary belief, the condition for which surgery is carried out has been recognized as a commonly occurring problem from at least the early 19th century. This suggests that changes in the surgical rate are more likely to reflect an 'apparent' rather than a 'real' increase in the underlying morbidity rate.
We thank Daniels and colleagues for their comments on our report ([1][1]). Given that the Cleveland Clinic is the main referral center of patients with germline PTEN mutations in the United States, it is certainly possible that ascertainment bias may exist, an issue we acknowledged in our report.