Trepanation

Tiffany Sanchez, MS2

Angel Chavez, MS2

San Juan Bautista School of Medicine

Two thousand years ago, crainiometries, previously called trepanations, were successfully completed due to the advanced surgical techniques of the Incas, before anesthesia and sanitation methods were well established.

Prehistoric trepanned crania are discovered in the mountains of Peru due to pre-conquest neurosurgeons who practiced a precursor of neurosurgery known as trepanation. In 400 B.C., trepanation was a procedure of drilling a hole into the head for treatment of headaches, bone cysts, trauma, convulsive disorders and expelling demons. The instruments for surgery were made of metal or stones, and were used by Inca surgeons known as sirkaks. In a skull analysis, as many as seven successful trepanations were observed in crania which portrayed repetitive successful trepanations. In the examined skulls, the crania that had remodeled edges around the insertion were deemed as a successful survival with bone healing and the crania that had ragged edges around the insertion were determined as a non survival, without healing. As a result, the crania with remodeling had higher survival rates than those who were examined as no healing/survival. The average survival rate of craniectomy patients ranged from 50% to 70% with low rates of infection and other complications. Despite their limitations, sirkaks had a vast understanding of anatomy and natural medicine.This is impressive because of the many risks of infections that we are made aware of today. Although trepanation disappeared following the Spanish conquest, there is evidence in highland Peru and Bolivia where trepanation is still taking place by healers.

In ancient Peru, the sirkak’s methodology of trepanation, now known as craniometry, had a fairly low mortality rate that may be attributed to the importance of hygiene practices and can nurture the refinement of future surgical techniques.