This 5,300-year-old skull shows evidence of the first known ear surgery

Archaeologists have recovered a 5,300-year-old skull from a Spanish cemetery and determined that the seven scars near the left ear canal are strong evidence for a primitive surgical procedure to treat otitis media. This makes this the first known example of ear surgery to date, according to author A last paper Published in Scientific Reports. The Spanish team also identified a stone knife that may have been used as an ironing tool.

The excavation site of the Dolmen of El Pendón in Burgos, Spain, consists of the remains of a stone monument dating to the 4th century BC, i.e. the late Neolithic period. The ruins include a bone temple that houses the bones of nearly 100 people, and archaeologists have been excavating these remains since 2016.

In July 2018, the team discovered the skull that was the subject of this new study. The skull lay on its right side, facing the entrance to the burial chamber, and while the skull was mostly intact, no teeth remained. The missing teeth, combined with the loss of bone density and completely ossified thyroid cartilage, suggest that this is the skull of an elderly woman 65 years of age or older.

Evidence of holes has been found on both sides of the skull near the mastoid bone (located just behind the ear). The authors suggested that this perforation was the result of two surgical interventions, one in each ear, by someone with basic anatomical knowledge. There was more bone remodeling in the right ear, suggesting that the first surgery was performed to treat what is likely a life-threatening condition, given the risks associated with such a procedure over the years.

The woman survived the first procedure and underwent a second operation on her left ear shortly after. The authors were unable to determine whether the procedures were performed sequentially or whether months or even years had passed. Regardless, “thus the oldest documented evidence of surgery on both temporal bones, and thus, perhaps, the first known evidence” Mastoidektomi radikal in human history. ”

This was a fairly common surgical procedure for treating acute ear infections in the 17th century, according to the authors, and skulls showing evidence of mastoidectomy have been found in Croatia (11th century), Italy (18th-19th centuries) and Copenhagen ( 19th century). ) or early twentieth century). Perhaps the oldest type of skull surgery is skull surgery disassembleHeadhole drilling – well documented along the Iberian Peninsula. Five skulls recovered from the site near the Dolmen El Pendón show evidence of trepanation, and it appears the individual survived the procedure, despite the lack of antibiotics and the high risk of complications.

What situations might encourage such an intervention? The authors exclude cholesteatomaInjury to the temporal bone can cause hearing loss, dizziness, and other complications – although it is one of the most documented diseases in pathological studies of ancient skulls. But the cholesteatoma tends to erode the bony wall (shield) that separates the ear canal from the mastoid, and the shield was intact on both sides of the woman’s skull. The authors also excluded the presence of osteosarcoma or Otitis external malignancy (rapidly spreading infection of the ear canal and temporal bone).

The authors conclude that the most likely case is acute otitis mediaalso known as a middle ear infection, which has spread to the underlying bone, specifically the mastoid bone (mastoiditis). This condition is easy to diagnose, as the infection causes swelling and redness that is visible with the buildup of fluid and mucus inside the ear. If the middle ear infection spreads to the mastoid bone, the honeycomb-like structure of the bone will also fill with fluid and mucus. If left untreated, it can lead to hearing loss and possibly meningitis. Mastoiditis due to middle ear infection was the leading cause of death in children before antibiotics were widely available (luckily a rare condition today).

Modern mastoidectomy involves the removal of cells in the air-filled cavity of the mastoid bone. In radical mastoidectomy, the surgeon first makes an incision behind the ear and then uses a bone drill to open access to the middle ear cavity. Then the surgeon removes the infected bone or mastoid tissue, sutures the wound and bandages the wound. According to the authors, a late Neolithic ear surgeon followed a similar (albeit more horrible) procedure, removing the affected bone to dry out the middle ear and then gluing the mastoid bone to the mastoid bone. tympanic cavity around the inner ear.

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