Abstract: Objective: To encourage the use of different methodological approaches for the identification of paleopathological lesions and to evaluate osteolytic lesions found on a temporal bone from La Llana cave (Spain). Materials: Cranial remains recovered from from La Llana cave (Spain) dated to the Bronze Age, 3300 ± 25 BP (1631?1509 cal BC). Methods: The cranium underwent macroscopic, microscopic and computed tomography scan examinations. Results: The Tegmen tympani of the left temporal bone is present but is missing on the right. Both cochleae are intact. Both the right and left temporal bones display osteolytic lesions, with the left Tegmen tympani displaying deep and profuse pits on the endocranial surface, exposing the ear channel. Conclusions: The lesions are compatible with otitis media (atticitis). By using different methods of analysis, the presence and effects of infection were identified. Significance: This systematically described case contributes to our understanding of disease in the past and describes otitis-related lesions in archeological contexts for comparative purposes. Limitations: The fragmentary and damaged cranial remains rendered evaluation difficult and diagnosis tentative. Suggestions for Further Research: The use of different approaches to diagnose otitis media in archeological skeletal collections is recommended to improve the knowledge of health status and lifestyle of past

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