Possible therapeutic trepanation on a frontal sinus of a skull from the Old Kingdom period of Egypt.

Trepanation has been reported on skulls from major ancient civilizations since the Neolithic period. In this study, on a skull excavated from the Qau village site during the Old Kingdom period of ancient Egypt (7th to 8th dynasties; 2181-2160 BCE), we found a highly probable sign of therapeutic trepanation in the frontal bone. The practice of trepanation was suggested by the healing sign observed at the site on the frontal bone of case QAU-26. Based on our radiological findings, we presume that this ancient Egyptian male likely suffered from frontal sinus pathology, which may have led to the accumulation of exudates inside the cavity. To alleviate the symptoms of sinusitis, the ancient practitioner may have attempted to induce drainage of exudates from the left frontal sinus by therapeutic trepanation. Our findings are significant in medical history, considering that, thus far, trepanation has been reported rarely in ancient Egyptian civilization. This is also the first reported case of trepanation presumed to have been performed to alleviate paranasal sinusitis, which is of paleopathological and clinical significance.