Craniotomy through the ages.

Today, the Specialist in Otorhinolaryngology often has to perform surgery requiring an endocranial approach, as, for instance, in the case of neoplastic or inflammatory disorders, or even in malformations. These specialists should, therefore, not forget one of the most important Chapters in the History of Medicine and Ethnology: that related to the evolution of craniotomy over thousands of years, probably the surgical procedure that has been practiced longer than any other and certainly that for which we have, by far, the oldest tangible evidence. In fact, the first findings related to perforation of the skull date back to the neolithic period (8000-5000 BC) and were found in France already in 1685 1. But the foramen, round or oval, present primarily in the parietal or occipital bone, had, for a long time, been attributed to trauma, until, in 1783, the anthropologist Prunieres 2, having observed the regularity in the loss of substance and the marks on the edges due to repeated action of sharp instruments, showed the French Association for Progress in Science that the origin of these marks could be attributed, without any doubt whatsoever, to a purposeful human procedure, in a broad sense, to some type of surgical intervention. Thanks, in particular, to Paul Broca 3, the father of Neurology, who later dedicated a large number of publications to this topic, interest rapidly grew in the scientific world and as a result there was an enormous increase in new findings.