For more than 5,300 years, it has lain undisturbed beneath a Stone Age grave in northern Spain, hidden among the remains of nearly 100 people. When archaeologists finally discovered the ancient skull, they expected another glimpse of prehistoric life.
Instead, they found evidence of something far more extraordinary. Close examination revealed that the woman underwent not one, but two complex ear surgeries thousands of years before the advent of modern medicine. Even more surprising, signs of new bone growth showed that they had survived both procedures, making the discovery the world’s first known physical evidence of ear surgery and rewriting what scientists know about prehistoric healthcare.The skull was discovered in 2018 from the Dolmen of El Pendón, a large Neolithic burial monument near Reynoso in the Spanish province of Burgos. The tomb, dating between 3800 BC and 3000 BC, served as a mass burial site for about 100 individuals. Among them was the skull of an elderly woman, believed to be around 65 years old, whose remains would become the focus of an extraordinary scientific investigation.
How a 5,300-year-old skull revealed the world’s first ear surgery
The researchers found two carefully made holes behind the woman’s ears, indicating that she had undergone two separate surgeries. One operation was performed on the right side of her skull, while the other targeted the left side. Scientists believe that the surgeries may have taken place months or even years later. The accuracy of the wounds ruled out accidental injury or ritual modification, indicating instead intentional medical treatment.According to the study published in the journal Scientific Reports, the woman most likely suffered from mastoiditis, a serious bacterial infection that affects the mastoid bone behind the ear. If left untreated, the condition can spread to the brain, causing meningitis, blood clots or even death. Researchers believe that prehistoric healers located the source of the infection and removed the diseased bone in an attempt to save her life.The most convincing evidence that the procedures worked came from the skull itself. New bone had formed around the surgical incisions, proving that the woman remained alive for at least several weeks after each operation and perhaps longer. Without this bone regeneration, archaeologists may have dismissed the holes as post-mortem damage rather than evidence of surgery.
Stone Age surgeons relied on flint tools rather than modern medicine
Unlike modern operations which are performed using surgical drills and anesthesia, the prehistoric procedure was performed using sharp flint tools.
Researchers believe the surgeon gradually scraped and drilled the mastoid bone using slow, circular motions until the affected area was reached. Microscopic analysis of the skull revealed cutting marks consistent with stone tools, indicating that the process required a great deal of skill, precision, and anatomical knowledge.Archaeologists also recovered a flint blade from the burial site that showed microscopic marks of bone cutting.
The tool was repeatedly heated to around 350 degrees Celsius, leading researchers to suggest that it may have been sterilized or used to cauterize tissue during the procedure. Although its exact purpose cannot be confirmed, the blade offers a rare glimpse into the medical practices of Neolithic societies.
The surgery was incredibly painful
The procedure was performed thousands of years before the advent of antibiotics, anesthesia, or metal surgical instruments.
Researchers believe the woman may have been physically restrained during the procedure or given natural pain-relieving plants such as poppies or other psychoactive herbs to ease her suffering. Despite intense pain and the constant risk of infection, she survived both procedures, highlighting the amazing effectiveness of the treatment and the expertise of the prehistoric healer.Prior to this discovery, the first physical evidence of mastoid surgery dates back to the Proto-Byzantine period between the 4th and 9th centuries AD, while the first written descriptions of the procedure did not appear until the 17th century.
The Spanish skull pushes direct archaeological evidence of ear surgery back by more than 4,000 years, making it the oldest known example ever discovered.
What this discovery tells us about prehistoric medicine
This discovery challenges the long-held belief that Stone Age societies relied solely on primitive remedies. Instead, the study suggests that they were able to diagnose serious diseases, identify their source, and perform complex surgeries that gave patients a real chance of survival. Together with other archaeological evidence of trepanation, early amputations, and ancient dental treatments, the Spanish skull paints a picture of prehistoric societies that possessed far more advanced medical knowledge than previously thought.
