5,300-Year-Old Skull Offers Earliest Known Evidence of Ear Surgery

Bone growth suggests the patient survived the procedure, which was likely conducted to treat an infection

skull remains
Archaeologists found a 5,300 year old skull, possibly from an elderly woman, that showed signs of early ear surgery. Scientific Reports

Some 5,300 years ago, humans in what is now northern Spain cut into an elderly woman’s skull, likely in an effort to relieve her ear pain. Now, reports Judith Sudilovsky for the Jerusalem Post, archaeologists say the woman’s skull represents the earliest known evidence of ear surgery.

Published in the journal Scientific Reports, the study centers on a skull discovered in 2018 among the remains of around 100 people in a large, single-chamber tomb called the Dolmen of El Pendón. The tomb—made up of two upright stones supporting a flat, horizontal stone—is located in Reinoso, a town in the Spanish province of Burgos, and remained in use between roughly 3800 and 3000 B.C.E., notes Vishwam Sankaran for the Independent.

The woman’s skull shows evidence of two separate procedures. As the study notes, the first was conducted on the right ear, perhaps to treat an infection or problem “sufficiently alarming to require an intervention.” The second, which could have taken place “back-to-back or several months, or even years” later, targeted the left ear. Bone growth around the perforations indicate the woman survived both surgeries by at least a month, reports the Agencia de Noticias para la Difusión de la Ciencia y la Tecnología (DiCYT).

scanned images of skull
Front and lateral view of skull Scientific Reports

According to the Independent, the placement of the cuts suggests the patient had a mastoidectomy—surgery undertaken to treat an infection of the mastoid bones, which are located just behind each ear. (These bones help regulate ear pressure and protect the delicate structures of the ear.) If left untreated, the infection could have spread to the air pockets of the mastoid bones, filling them with infected material and creating potentially life-threatening conditions like meningitis or blood clots.

“In this case, the prehistoric surgeon located the focus of the problem—probably because the infection was evident to the naked eye—and successfully intervened, as proven by the bone regeneration observed in both mastoid bones,” write the researchers in the study.

Mastoidectomies were a relatively common surgical procedure for treating middle ear infections before the advent of antibiotics in the 20th century. The first written descriptions of the surgery date to the 17th century. But the earliest physical evidence of mastoidectomies—aside from the newly analyzed skull—is much older, dating to the Proto-Byzantine period (around 330 to 824 C.E.).

“What we can say is that certain individuals would have attained a degree of anatomical knowledge and experience as ‘healers’ or budding physicians, if you like, to succeed in this kind of primitive healing,” study co-author Manuel Rojo-Guerra, an archaeologist at the University of Valladolid, tells the Jerusalem Post.

The procedure carried out on the woman’s skull would have been far more painful than modern mastoidectomies. Per the study, the surgery involved “progressive circular and abrasive drilling” of the skull, which would have caused “unbearable pain.” The woman was likely held down by community members or given some kind of opiate or psychotropic drug to relieve pain or even lose consciousness.

Speaking with DiCYT, Rojo-Guerra says that a flint blade discovered at the dolmen shows traces of being used to cut bone. The tool was heated multiple times to temperatures of up to 662 degrees Fahrenheit, possibly for the purpose of cauterization.

Get the latest stories in your inbox every weekday.