A skull from a millennia-old burial mound has two holes on the left and right that, according to Spanish archaeologists, indicate an ear operation. Others are not convinced.

It must have been quite a painful affair: the operations a woman from present-day Spain is said to have undergone 5,300 years ago. A hole was drilled through her skull on both the right and left. Others may have restrained her while she was undergoing that treatment, or she may have been given some sort of pain reliever, archaeologist Sonia Díaz-Navarro and colleagues speculate in the scientific journal. Scientific Reports†

But that horrific operation did take place for a good reason, write Díaz-Navarro and her team. According to them, this would be the earliest known mastoidectomy† In doing so, a surgeon — or, in this case, someone with some stone tool — makes a hole in the skull to remove an inflammation behind the ear caused by a serious ear infection.

small scratches

The skull with the two holes was already found in 2018 at the dolmen of El Pendón, an archaeological site in northern Spain. Díaz-Navarro and her team have now subjected that skull to further examination, including with a CT scanner.

According to the team, that research shows that the holes were made deliberately. For example, there are small scratches around the left hole, which indicate that someone has been working with tools. There also appears to be a cure. This indicates that the patient must have lived for at least a few months after the operation.

Strange locations

Rachel Schats, an archaeologist specializing in bones at Leiden University, however, has doubts about the conclusion that the holes indicate a mastoidectomy. “The locations of the holes are strange,” she says. “To get holes in those places, you would have to cut right through the ear – and that seems illogical. It is an inflammation behind the ear, and swelling is usually visible there. Then why not cut it right away?”

Furthermore, Schats let her PhD student Maia Casnan look at the photos accompanying the article. “She indicated that the inside of the right ear looks normal. And that doesn’t fit with a dramatic ear infection – but it may be that it was already healed at the time of death.”

There is clearly something strange going on with the skull and its holes as far as Schats is concerned; something that demands an explanation. But whether that statement includes a very early ear surgery, according to her, is open to question.