An ancient skull hints at the first ear surgery, 5,300 years ago

The prehistoric patient likely suffered "unbearable pain".
Chris Young
A picture of the 5,300-year-old skull.Scientific Reports

The early history of surgical interventions provides an ugly but timely reminder of the immense benefit and progress of modern medicine.

Now, archaeologists in Spain have uncovered the earliest evidence of ear surgery performed on a human, a new study reveals. The findings came after an analysis was carried out on a skull that dates back about 5,300 years.

They believe the patient was likely held down during the procedure or administered a psychotropic drug due to their "unbearable pain".

An early surgical procedure

Researchers from the University of Valladolid, Spain, analyzed the skull, which was unearthed in 2018 at the Dolmen of El Pendónis dig site, near the city of Burgos in the north of Spain. Their paper, published last week in the journal Scientific Reports, provides an analysis of two bilateral perforations in the skull on both mastoid bones, located below the ear. These bones are thought to protect the ear as well as help to regulate ear pressure.

The researchers believe the human whose skull they unearthed was likely the recipient of a primitive mastoidectomy surgical procedure, carried out to help reduce pain from inflammation. The individual in question was likely a woman between the age of 35 and 50 years old. The team behind the discovery believes this human survived for at least a few months beyond the surgery. "The results of this paper demonstrate the survival of the individual to both interventions," the researchers explained in their study.

Revising the history of mastoidectomy procedures

The surgery was likely used to clear out a type of infection that today is known to be able to cause hearing loss, blood clots, meningitis, or a brain abscess if left untreated. These infections can be detected as growths on the ear, which likely led to the prehistoric surgical intervention. "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," the scientists wrote in their paper.

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Still, the prehistoric patient would have likely suffered "unbearable pain" caused by circular and abrasive drilling — though it was difficult to determine the exact type of tool used, the scientists explained. They believe that the patient would likely have been held down or administered opium or a similar psychotropic substance to help with the pain.

The first written record of mastoidectomy procedures dates back to the pre-antibiotic era of the 17th century, the researchers said. Previous studies suggest that the Dolmen of El Pendónis dig site was thought to have been used as a funeral chamber for roughly 800 years between 3,800 and 3,000 B.C. As such, the scientists said they have discovered "the earliest [known] surgical ear intervention in the history of mankind."

Study Abstract:
Archaeological research in the Dolmen of El Pendón (Reinoso, Burgos, Spain) has brought to light the complex biography of a megalithic monument used throughout the 4th millennium cal. BC. The ossuary of this burial holds the bones of nearly a hundred individuals who suffered from diverse pathologies and injuries. This study presents the discovery of a skull with two bilateral perforations on both mastoid bones. These evidences point to a mastoidectomy, a surgical procedure possibly performed to relieve the pain this prehistoric individual may have suffered as a result of otitis media and mastoiditis. The hypothesis of surgical intervention is also supported by the presence of cut marks at the anterior edge of the trepanation made in the left ear. Furthermore, the results of this paper demonstrate the survival of the individual to both interventions. Given the chronology of this dolmen, this find would be the earliest surgical ear intervention in the history of mankind.

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