Hackensack Meridian School of Medicine at Seton Hall University Faculty Member Publishes Groundbreaking Research Linking Common Childhood Disease with Neanderthal Extinction

Anthony S. Pagano, Ph.D., assistant professor in the Department of Medical Sciences at Hackensack Meridian School of Medicine at Seton Hall University — along with colleagues Samuel Márquez from SUNY Downstate College of Medicine and Jeffrey Laitman from the Icahn School of Medicine — conducted the first-ever reconstruction of the Neanderthal Eustachian tube and published groundbreaking research that implicates Neanderthal ear anatomy and the resulting susceptibility to bacterial middle ear infections as a factor in their extinction.

Advanced Technology and Pioneering Research

Using Neanderthal fossils and advanced 3D digital technology called geometric morphometrics that is commonly used by biologists, paleontologists, and anthropologists, Dr. Pagano and his colleagues reconstructed the Neanderthal Eustachian tube — also called the auditory tube, which connects the middle ear to the upper airway and equalizes pressure within the ear. Then, Dr. Pagano compared the reconstructed Neanderthal Eustachian tube dimensions to those of contemporary humans spanning in age from birth to adulthood in his previous studies of normal Eustachian tube growth changes.

Dr. Pagano’s previous studies found that the Eustachian tubes of human infants and young children are horizontally oriented, which makes them more likely to develop acute bacterial middle ear infections that are common in early childhood and are often treated with modern antibiotics. Dr. Pagano’s previous research demonstrated that the human Eustachian tube becomes more vertically oriented around age six, allowing for better ear drainage that corresponds with today’s clinically observed decline in the rate of acute bacterial middle ear infections in older children.

Setting the Stage for Extinction

In his most recent study, Dr. Pagano and his team found that the Neanderthal Eustachian tube remained horizontally oriented throughout life and did not undergo the vertical re-orientation that humans experience around age six.

As a result, Dr. Pagano’s research suggests that Neanderthals were more susceptible to bacterial middle ear disease beyond childhood, which may have translated to higher mortality rates and lower reproductive rates in a pre-antibiotic world. These factors may have led to a gradual decline in the Neanderthal population over centuries that set the stage for eventual extinction.

“Our research findings suggest that the extinction of the Neanderthal population could have been due, in part, to one of today’s most common childhood diseases,” said Dr. Pagano. “Additionally, our research represents the latest evidence that Neanderthals had anatomical features that point to species-level differences and distinguish them from modern humans.” This new evidence corroborates a previous study by this team (led by Dr. Márquez) in which species-level differences were found in the nasal cavity.

Understanding the Role of Disease in Evolution

Through their research, Dr. Pagano and his team have leveraged advances in digital technology to enhance scientists’ understanding of the relationship between disease, modern humans, and their closest cousins on the family tree of human evolution — the Neanderthals.

“Researchers at Hackensack Meridian School of Medicine are conducting groundbreaking research that helps us understand not only how disease affected extinct populations, but also the role that disease played in the evolution and development of modern humans,” said Bonita Stanton, M.D., founding dean of the School of Medicine.

“Discoveries such as these play an important role in advancing the fields of medical science, biology, archaeology, and anthropology,” said Stanley Terlecky, chair of the Department of Medical Sciences and associate dean of Research and Graduate Studies at the school.

Dr. Pagano’s manuscript was first published online on August 31, 2019, in the Early View section of The Anatomical Record, the peer-reviewed journal of the American Association for Anatomy. The manuscript will also appear in a future print issue of the journal.

For more information, please contact Mary McGeever of the Hackensack University Medical Center Communications and Public Relations Department at 551-996-1730 or Mary.McGeever@HackensackMeridian.org.