Archaeologists have uncovered compelling evidence of the earliest known ear surgery in human history, performed on a woman who lived approximately 5,300 years ago during the Neolithic period. The discovery, detailed in a study recently published in Scientific Reports, highlights remarkable surgical skill and anatomical knowledge in prehistoric times, even as it underscores the excruciating nature of such interventions without modern anesthesia or sterile conditions.
A Neolithic Burial Site Yields Extraordinary Evidence
When archaeologists first excavated the Dolmen of El Pendón in Burgos, Spain, in 2016, they encountered the remains of more than 100 individuals. Radiocarbon dating confirmed the site had served as a funerary chamber since the fourth millennium B.C.E., functioning as a complex symbolic and ritual space for roughly 800 years (approximately 3800 to 3000 B.C.).
Among the finds was a fragmented skull initially set aside for later analysis. In July 2018, closer examination revealed it belonged to a woman estimated to be between 35 and 50 years old—an advanced age for Neolithic society. What made the specimen truly exceptional were two perforations on each side of the skull, positioned around the ear region.
Evidence of a Pioneering Mastoidectomy
According to the international research team from the University of Valladolid in Spain and the Spanish National Research Center in Italy, the bilateral perforations are consistent with a mastoidectomy—a surgical procedure intended to relieve complications from otitis media (middle ear infection) and mastoiditis (infection of the mastoid bone behind the ear).
The presence of bone regrowth around the holes indicates that the patient survived the operation for at least one month, an extraordinary outcome given the technological limitations of the era. Microscopic analysis further revealed seven cut marks near the left ear canal, suggesting the work of a skilled practitioner using precise, controlled techniques.
Lead researcher Manuel Rojo-Guerra of the Department of Prehistory and Archaeology at the University of Valladolid noted: “What we can say is that certain individuals would have attained a degree of anatomical knowledge and experience as ‘healers’ or budding physicians… to succeed in this kind of primitive healing.”
The Brutal Reality of Prehistoric Surgery
The procedure would have been performed using primitive stone tools, most likely a flint blade discovered nearby in the tomb. Traces of cut bone on the blade, combined with evidence that it had been heated to between 300 and 350 degrees Fahrenheit (roughly 149–177°C), suggest the tool was used both for abrasive drilling and cauterization.
Researchers describe the intervention as involving “progressive circular and abrasive drilling,” which would have caused unbearable pain. Multiple individuals were likely required to restrain the patient during the operation, or she may have consumed mood-altering substances to endure it. The surgery bears striking similarities to modern mastoidectomies, which are performed today to clear infected tissue from the inner ear area—though contemporary patients benefit from anesthesia, antibiotics, and precision instruments.
Despite surviving the initial trauma, the woman ultimately succumbed within weeks, likely due to ongoing infection. Her advanced age was confirmed partly through dental evidence, as she had lost several teeth by the time of her death. Skull density analysis also verified her sex.
A Window into Neolithic Medicine and Ritual
The Dolmen of El Pendón represents far more than a simple burial site. Excavated over six years by Rojo-Guerra and colleagues Sonia Díaz-Navarro and Cristina Tejedor-Rodríguez, the monument evolved through multiple phases, serving as a ritual hub before becoming a commemorative landmark.
This groundbreaking find—the oldest documented surgical intervention on the ear—adds significant depth to our understanding of prehistoric medicine. It demonstrates that, even in the Neolithic period, select individuals possessed specialized knowledge capable of performing complex procedures, challenging assumptions about the sophistication of early healing practices.
As the team continues its work at the site, this 5,300-year-old skull may prove to be just the beginning of further revelations about the medical and ritual world of our ancient ancestors. The discovery not only illuminates the resilience of a prehistoric patient but also the ingenuity of those who attempted to heal her under the most challenging conditions imaginable.