Otopathological indicators in Classic Period Maya: Evidence from the Cueva de Sangre, Dos Pilas

This study evaluates osseous changes suggestive of ear inflammation in three individuals from a Classic Period (250-900 CE) Maya skeletal assemblage.

Isolated left temporal bones from two adults and one juvenile from the Cueva de Sangre, Dos Pilas, Guatemala were examined.

The temporal bones were inspected macroscopically, microscopically, and radiographically.

Each individual presented with pathological bone remodeling on the tympanic part, mastoid region, sigmoid sulcus, and temporomandibular joint, and altered pneumatization in the mastoid process.

The bony modifications observed in each individual are consistent with chronic or recurrent inflammatory processes affecting the temporal bone. Possible etiologies include otitis externa, otitis media, and mastoid involvement. The presence of remodeled bone and the severity and intratemporal extent of osseous changes suggest recurrent infection and inflammation.

Otopathology may have been more common in ancient Maya populations than currently recognized. The individuals described here contribute to our understanding of health challenges faced by the ancient Maya.

Because these conditions primarily affect soft tissues, the osseous changes observed here are not pathognomonic and must be interpreted within a broad differential diagnosis. The commingled and fragmentary nature of the assemblage precluded attempts to estimate a biological profile, assess bilaterality, and identify comorbidities.

Paleo-otopathological investigations have the potential to inform reconstructions of health, sensory impairment, and lived experience. Temporal bones from Maya assemblages should be carefully examined to better understand the health challenges the ancient Maya faced and their resilience to such health stressors.