Diseases of the ear have been recorded and treated since ancient times. Ex-votos have been offered to heal deafness. Noninvasive treatments have evolved into minor, and later more advanced, surgical techniques to treat head and neck issues. Paul of Aegina (ca 625-690 ad) perfected his medical skills in the School of Alexandria in Egypt. His medical encyclopedia, Medical Compendium, described a broad series of surgical operations, including a chapter “On the atresia of the auditory canal,” which vividly described a surgical technique to open the ear canal. This surgery is particularly interesting, as it exceeds the limits of resection and amputation known at that time and describes a novel surgical technique. His innovative methods paved the way for future surgeons.