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

Archaeologists excavated a 5,300-year-old skull from a Spanish tomb and found seven cut marks near the left ear canal, which is strong evidence of a primitive surgical procedure to treat a middle ear infection. The earliest example of ear surgery has been found, according to the authors of a recent paper. A flint blade that may have been used as a cauterizing tool was identified by the Spanish team.

The remains of a megalithic monument dating back to the 4th century BC are located in the Dolmen of El Pend in Burgos, Spain. Archaeologists have been excavating the remains of nearly 100 people since 2016

The team recovered the skull in July of last year. Most of the cranium was intact, but the skull was lying on its right side, facing the entrance of the burial chamber. An elderly woman's skull was indicated by the missing teeth, bone density and fully ossified Thyroid Cartilage.

There was evidence of damage to the skull near the mastoid bones. The authors believed that the two surgical interventions on each ear were the cause of the perforations. There was more bone remodeling on the right ear, which means that the first surgery was likely to treat a life-threatening condition.

The woman underwent two surgeries on her left ear after the first procedure. The authors were not able to determine if the procedures were done back-to-back or months or years between them. It is the earliest documented evidence of a surgery on both temporal bones and is most likely the first known radical mastoidectomy in the history of humankind.

Evidence of a mastoidectomy has been found in Croatia, Italy, and the early 20th century, and it was a common surgical procedure to treat ear infections by the 17th century. Cranial trepanation, the drilling of a hole in the head, is one of the oldest types of skull surgery. Five skulls recovered from a site close to the El Pendón showed evidence of trepanation, and the individuals apparently survived those procedures despite the lack of antibiotics.

What condition might have led to the intervention? Even though a cholesteatoma is one of the most well-known diseases in pathological studies of ancient skulls, the authors ruled it out. The scutum was intact on both sides of the woman's skull. The authors did not rule out a bone tumor or a fast-spreading infections of the ear canal and temporal bone.

Acute otitis media is a middle ear infection that has spread to the mastoid bone, according to the authors. The condition would have been easy to diagnose if the fluid and mucus build up inside the ear caused visible swelling and redness. The mastoid bone would be filled with fluid and mucus if a middle ear infections spread to it. This could have led to hearing loss and possibly a disease. The leading cause of death in children prior to the availability of antibiotics was mastoiditis, which is a rare condition today.

Mastoidectomy is the removal of the cells in the mastoid bone. A radical mastoidectomy involves cutting behind the ear and using a bone drill to open the middle ear. The surgeon will remove the mastoid bone or tissue and bandage the wound. The late Neolithic ear surgeon would have removed the affected bone and connected the mastoid bone with the tympanic cavity to drain the middle ear.