Not to ​push back too hard on this, but creating tickets instantly isn't that difficult to accomplish.
http://forums.otterhub.org/viewtopic.php?f=60&t=20319 provides a concept for Windows environments. In Exchange, create: a Contact for otrs@otrs.local a Send Connector for otrs.local that points the smarthost to be the otrs server and forward support@yourdomain to the otrs@otrs.local contact (Mail Flow Settings, Delivery). For OTRS on-premises Exchange, this doesn't require opening up any Internet-facing firewall ports at all. While it's beyond this scope to cover all possibilities, email forwarding + MX record of some sort / smarthost usually isn't outside the realm of workable. Plus, you know, instant tickets and not having to ask a question like "how many emails can I fetch at a time?" The answer would be, of course, all of them.
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