Researchers in Russia have identified what may be the most advanced skull surgery ever documented from the ancient world, uncovering evidence of complex jaw reconstruction performed about 2,500 years ago on a woman from the Pazyryk culture of southern Siberia.
A team from Novosibirsk State University used high-resolution CT imaging to analyze a skull recovered from the Upper Kaljin-2 burial ground on the Ukok Plateau. The plateau, situated within the Altai Republic, is renowned for its frozen burial sites, which preserve human remains in remarkable condition.
A life-threatening injury
CT scans showed that the woman suffered a severe head injury during her lifetime. A depression fracture measuring about 6 to 8 millimeters (0.24 to 0.31 inches) damaged the right temporal bone and destroyed the temporomandibular joint, or TMJ. The trauma displaced the jaw and tore surrounding ligaments.
Such an injury would have made chewing and speaking extremely difficult. Researchers say survival without medical intervention would have been unlikely.
Evidence of deliberate jaw reconstruction
Instead of leaving the injury untreated, the woman appears to have undergone a carefully planned surgical procedure. Imaging revealed two narrow bone channels drilled into the damaged joint area, each about 1.5 millimeters (0.06 inches) in diameter. One channel passed through the head of the lower jaw. The other cut through the zygomatic process of the temporal bone.
A 2,500-year-old skull from Siberia shows signs of complex jaw reconstruction surgery. Researchers say the woman survived the operation, offering rare evidence of advanced medical knowledge in the ancient world. pic.twitter.com/r4fL8WNhLt
— Tom Marvolo Riddle (@tom_riddle2025) February 17, 2026
The channels intersected at a right angle, a configuration researchers say could only have been achieved through deliberate design and controlled drilling. Around the holes, ring-shaped bone growth showed clear signs of healing, confirming the procedure was performed while the woman was alive.
Primitive ligature suggests prosthetic fixation
Inside the drilled channels, researchers detected traces of elastic organic material, possibly horsehair or animal tendon. The material likely served as a primitive surgical ligature, stabilizing the damaged joint.
Researchers say the method functioned much like an early form of prosthetic fixation, holding the jaw in place after reconstruction. The smooth edges of the drilled channels suggest the use of specialized tools and a steady hand.
CT technology unlocks hidden details
The imaging was carried out at NSU’s Laboratory of Nuclear and Innovative Medicine using a Philips MX 16 CT scanner. According to Vladimir Kanygin, head of the laboratory, the technology allowed scientists to digitally remove preserved soft tissue without damaging the remains.
The scanner produced 551 ultra-thin slices, each just 0.75 millimeters (0.03 inches) thick, which were combined to create a detailed three-dimensional model of the skull.
Radiologist Andrey Letyagin, who led the imaging analysis, said the scanner was operated at maximum settings rarely used in modern medicine because of radiation exposure. Because the subject was an archaeological artifact, researchers were able to obtain exceptionally high-resolution images.
Signs of long-term survival
Additional evidence suggests the woman survived the surgery for a significant period. Dental wear showed heavy use on the left side of her jaw, including chipped molars and inflammation around tooth roots. The injured right side showed much less wear.
Researchers say the pattern indicates the reconstructed joint functioned but remained painful, forcing her to chew mainly on one side for months or possibly years. Specialists estimate she was between 25 and 30 years old at the time of death, considered a mature age in her era.
Burial raises cultural questions
The woman’s burial adds another layer of complexity. The site was discovered in 1994 by archaeologist Vyacheslav Molodin and contains several small kurgans, or burial mounds.
Unlike most Pazyryk graves filled with weapons, ornaments, and textiles, her tomb held almost no grave goods. The only notable item was a traditional wig. Yet the burial chamber was built from massive larch logs, an enormous effort on the largely treeless plateau.
Archaeologist Natalia Polosmak said the contrast suggests the woman was highly valued by her community. The decision to perform complex surgery and invest in an elaborate burial points to strong social care rather than material status.
Rethinking medicine in the Siberian Iron Age
The case fits into a broader pattern of medical knowledge among the Pazyryk people. Earlier research on another Ukok mummy, often called the Ukok Princess, revealed evidence of cranial trepanation. Researchers note that Pazyryk mummification practices would have required familiarity with human anatomy.
Together, the findings are reshaping views of ancient Siberian medicine. Far from primitive, the Pazyryk people appear to have possessed refined technical skill, anatomical understanding, and a willingness to intervene surgically to preserve life.
As advanced imaging continues to be applied to archaeological remains, researchers expect more hidden chapters of early medical history to emerge from beneath the frozen soils of the Altai Mountains.
