An Account of Roman Surgical Treatments for Ozena: Historical Review.

Abstract

Objective: To analyze a first-century Roman account of surgery for ozena-a tetrad of nasal crusting, ulceration, bony involvement, and foul odor-with a focus on historical context, etymology, and surgical management.

Data sources: This historical review draws from the authors' translation of De Medicina. Primary sources detailing Roman surgical instruments from the House of the Surgeon in Pompeii, as well as secondary sources of surgical techniques, were utilized.

Review methods: An in-depth review of Celsus' descriptions of surgical techniques for ozena was conducted using independent translation and exegetical analysis of primary sources. Archaeological findings were investigated to correlate surgical tools with the interventions described.

Results: Proto-Indo-European and Classical interpretations of ozena revealed a unifying feature of malodor and a simultaneous relationship to nasal ulceration and suppurative lesions. Celsus detailed two procedures for ozena: closed cauterization using a heated probe and an open technique involving dissection, direct cauterization, and structural repair. These align with ancient Roman understanding of wound care and caustic applications. Three surgical instruments were identified for these procedures based on archaeological finds from the House of the Surgeon in Pompeii and other collections.

Conclusion: Celsus' ancient structural interventions for ozena demonstrate an advanced understanding of anatomy and a mastery of instrumentation. This study underscores the importance of the historical contextualization of ancient medical practices, providing a foundation for the treatments of nasal pathology still in use today.

Levels of evidence: Not applicable.