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A closeup of how the earliest ear surgery skull in history (from over 5,000 years ago) was discovered in a Neolithic tomb in Spain in 2018.					Source: Fotógrafos Photography Study / Scientific Reports

Evidence of Ear Surgery From 5,300 Years Ago Discovered in Spain

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Modern science has lent a certain sophistication to human history, allowing for various genetic and acquired deficiencies to be addressed. Today, our eyes and ears can be repaired with simple and effective surgical interventions. What did ancient humans do? Evidence of cranial surgery dating back 2,000 years from Greece and Peru have been found, and one example of trepanation dating back 11,000 years was found in Turkey. Now new evidence from Spain adds a new stream to the age of surgery. According to a study published in the journal, Scientific Reports , by researchers from the University of Valladolid, an ear surgery was performed on an elderly woman found in a 5,300-year-old Neolithic Spanish tomb, presenting the earliest evidence of ear surgery ever.

Set of cut marks identified on the left temporal bone of the skull that had an ear surgery. Lateral view of the left side of the skull (a), detail of the left temporal bone with the ear surgery (b), and an enlarged image of the cut marks located at the anterior edge of the surgical trepanation made in the left ear, next to the mastoid process (c). (Scientific Reports)

Set of cut marks identified on the left temporal bone of the skull that had an ear surgery. Lateral view of the left side of the skull (a), detail of the left temporal bone with the ear surgery (b), and an enlarged image of the cut marks located at the anterior edge of the surgical trepanation made in the left ear, next to the mastoid process (c). ( Scientific Reports )

Neolithic Ear Surgery Points to Pre-Historic Anatomical Knowledge?

Seven cuts were found near the left ear canal of a 5,300-year-old skull, indicating a Neolithic ear surgery to alleviate aural pain. This indicates that the ear surgery was conducted by a person with some “ anatomical knowledge ,” said the Spanish researchers.

“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 ,” said Manuel Rojo-Guerra of the Department of Prehistory and Archaeology, who, together with colleagues Sonia Díaz-Navarro and Cristina Tejedor-Rodríguez from the University of Valladolid, have been excavating the site since 2016.

Computer tomography scans reveal both ear canals had been surgically altered through trepanation, wherein, holes were drilled into the skull on either side, an “old-school” technique.

“The hypothesis proposed in this research is that the individual to whom the skull belonged was probably surgically intervened on both ears. Based on the differences in bone remodelling between the two temporals, it appears that the procedure was first conducted on the right ear, due to an ear pathology sufficiently alarming to require an intervention, which this prehistoric woman survived,” the authors wrote in the study.

Computed tomography scans (c and d) of both the temporal bones of the skull (a and b) that had an ear surgery over 5,000 years ago in Spain. (Scientific Reports)

Computed tomography scans (c and d) of both the temporal bones of the skull (a and b) that had an ear surgery over 5,000 years ago in Spain. ( Scientific Reports )

Carrying out the Procedure

The skull discovered among the human remains of nearly 100 people, found in a single-chamber, multi-phase tomb known as the Dolmen of El Pendón in Reinoso , Burgos, Spain, dating from the late Neolithic period, reports the Jerusalem Post . A dolmen is a tomb-like structure with two or more monumental stones, or megaliths, attached to a flat horizontal stone in a tabular sense.

The initial discovery of the skull was made in 2018. The drilled burr holes in the temporal lobes, led the researchers to postulate that this was “the first known radical mastoidectomy in the history of humankind.”

The tomb also revealed the presence of a very sharp flint blades , with traces of cut bone, which had been reheated several times. In fact, the evidence showed that some of the blades had been reheated repeatedly to temperatures in the 300-350 degrees Celsius range (572-662 degrees Fahrenheit). The absence of fire cracks and other types of heat treatment marks determined these temperatures. This led the researchers to ascertain that this was “an authentic cautery or surgical instrument to carrying out the operation.”

The skull was found to be broken, but the neurocranium was intact, and the missing teeth and thyroid cartilage ossification indicate that she lived till an old age and probably died of natural causes. Inflammation and infection of the mastoid bone can follow an ear infection, and in the era of no medicine, often resulted in death. The same skull also displays evidence of bone regeneration, clearly implying that that the prehistoric woman survived the procedure, who was adjudged to be between 35-50 years old by Dr. Manuel.

A selection of flint lithic tools, blades, geometric microliths, and arrowheads, from the El Pendón ossuary in Spain where the ear surgery skull was found. (Scientific Reports)

A selection of flint lithic tools, blades, geometric microliths, and arrowheads, from the El Pendón ossuary in Spain where the ear surgery skull was found. ( Scientific Reports )

A Highly Delicate and Painful Affair

The delicate nature of such a surgical intervention, particularly without the technology we have today, cannot be understated. The “healers” naked eye would have to be used to judge whether there indeed was an infection in the ear (presuming that the holes were drilled properly in the first place).

The procedure would have been performed through “progressive circular and abrasive drilling causing unbearable pain under normal conditions.” The patient would have to be physically restrained by other members of the community or given mood changing substances or hallucinogens to relieve pain and/or lose consciousness.

The Dolmen of El Pendón has yielded a huge amount of bone remains belonging to about 100 individuals “who suffered from diverse pathologies and injuries,” suggesting perhaps that these remains are evidence of early surgical procedures of which many backfired.

Top image: A closeup of how the earliest ear surgery skull in history (from over 5,000 years ago) was discovered in a Neolithic tomb in Spain in 2018. Source: Fotógrafos Photography Study / Scientific Reports

By Sahir Pandey

References

Diaz-Navarro, S., Tejedor-Rodriguez, C., et al. 2022. The first otologic surgery in a skull from El Pendón site (Reinoso, Northern Spain) . Scientific Reports, 12. Available at: https://www.nature.com/articles/s41598-022-06223-6

Funnell, R. 2022. 5,300-Year-Old Skull Reveals Earliest Evidence Of Ear Surgery. Available at: https://www.iflscience.com/editors-blog/5300yearold-skull-reveals-earliest-evidence-of-ear-surgery/

Sudilovsky, J. 2022. 5,300-year-old skull shows signs of first known ear surgery . Available at: https://www.jpost.com/archaeology/article-696691

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