Astley Cooper, an Englishman born in 1768, promoted myringotomy for indications that would be acceptable today. However, the challenge was maintaining the patency of the myringotomy. Before the 1860s, when Politzer introduced a hard rubber eyelet to keep a myringotomy open, catgut string, fishbone plugs, and lead wires had been tried. These techniques were abandoned because of "the high failure rate coupled with a high infection rate."7 Thus, postoperative otorrhea was a problem long before Armstrong reintroduced tympanostomy tubes in 1954.

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