Osseous changes due to mastoiditis in human skeletal remains

Flohr, Stefan; Schultz, Michael

doi:10.1002/oa.961

Cited by 26 publications

(19 citation statements)

References 15 publications

(16 reference statements)

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“…In our study, mastoid pneumatisation pattern was evaluated on X‐rays. However, according to Flohr and Schultz (, ), a diagnosis of mastoiditis on the basis of a conventional X‐ray study might be inconclusive. They recommend a method based on longitudinal section of the mastoid.…”

Section: Discussionmentioning

confidence: 99%

“…Mastoiditis has been repeatedly examined in archaeological populations as a sequela of OM (Rathbun and Mallin, ; Titche et al ., ; Gregg and Steele, ; Mann et al ., ; Homøe and Lynnerup, ; Flohr and Schultz, , ; Flohr et al ., ; Cullen Doyle and Judd, ). It most commonly results from AOM, but can develop also in consequence of COM (Flohr and Schultz, ; Casselbrant and Mandel, ; Qureishi et al ., ).…”

Section: Introductionmentioning

confidence: 99%

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Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Krenz‐Niedbała

Łukasik

2016

Intl J of Osteoarchaeology

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In palaeopathological research, otitis media (OM) is a rarely reported disease, although it is one of the most common diseases of childhood, with potentially severe consequences resulting in physical and social impairment, or even death. The episodes of OM are often preceded by upper respiratory tract infections, though the aetiology of OM is multifactorial, with significant role of environmental factors. In archaeological skeletons, middle ear inflammation is identified as erosive lesions and new bone formation of auditory ossicles. The aim of this study was to examine the skeletal signs of OM in children from a mediaeval early urban site (Cedynia) and a post‐mediaeval rural site (Słaboszewo) located on the territory of Poland. Among the entire sample (N = 435), ear bones were present in 99 skeletons. The total of 168 ossicles were examined. The general frequency of individuals with eroded ossicles was 47.5% (53.4% in Cedynia and 39.0% in Słaboszewo). In the total sample, 33.9% of ear bones showed pathological changes, with the incudes being most frequently affected. The frequency of altered ossicles was significantly higher in the early urban site than in the rural settlement (42.2% vs 25.9%, respectively; Fisher exact test, p = 0.0339). The children aged 0–3 years old tend to have a higher frequency of altered ear bones than the children aged 4–11 years old. The majority of the mastoid processes of the subadults with ear bone erosion show abnormal pneumatisation pattern. The results indicate that the environmental and socio‐cultural conditions in the stronghold likely made their inhabitants more prone to upper respiratory tract infections than the inhabitants of the village. A variety of factors may be responsible for this pattern, such as exposure to dust, environmental pollution, indoor pollution, wood smoke, occupation, population density, sanitation and quality of housing. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Krenz‐Niedbała

Łukasik

2016

Intl J of Osteoarchaeology

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“…Minor bone proliferations due to mastoiditis that extend into the air-cell lumen can be diagnosed in sectioned bones (Flohr and Schultz, 2009a). More extensive bone proliferation can lead to a more or less-complete obliteration of air cells.…”

Section: Discussionmentioning

confidence: 99%

“…However, the Type 3 condition constitutes an advanced stage of bone proliferation that has led to extensive filling of the air cell lumen. Earlier stages of this proliferation process in the form of frequently observed pin or platelike structures extending from the air-cell wall into the air-cell lumen would not be diagnosed as Type 3 hypocellularity although they are also attributable to mastoiditis (Flohr and Schultz, 2009a).…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of mastoid hypocellularity in human skeletal remains

Flohr

Kierdorf

Schultz

2009

American J Phys Anthropol

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Mastoid hypocellularity is frequently used as an indicator of chronic otits media in paleopathological investigations. The condition can be caused by a poor development of air cells during infancy and early childhood (primary hypocellularity) or by obliteration of air cells with bone during later life (secondary hypocellularity). We performed a macroscopic, radiographic, and microscopic study of pneumatization patterns in 151 mastoid processes of individuals from an early-medieval cemetery in Germany, with emphasis on the architecture of the nonpneumatized portion of hypocellular mastoid processes. Two types of primary mastoid hypocellularity were distinguished. The first was characterized by a poorly defined boundary between the pneumatized portion and the nonpneumatized portion and a trabecular thickening in the spongy bone of the latter. The second showed a well-defined boundary between the pneumatized portion and the nonpneumatized portion and normal spongy bone architecture in the latter. The key feature for the diagnosis of secondary hypocellularity was the recognition of the walls of former air cells. Our observations closely match the histopathological findings by Wittmaack (Wittmaack: Uber die normale und die pathologische Pneumatisation des Schläfenbeins. Jena: Gustav Fischer [1918]), who developed a concept of the normal pneumatization process of the temporal bone and the pathogenesis of aberrant pneumatization. We agree with Wittmaack's view that two types of primary mastoid hypocellularity can be distinguished morphologically. Regarding the pathogenesis of these types, we, however, conclude that Wittmaack's concept needs to be revised and updated. Further studies are required to establish the relationship between morphological findings in cases of mastoid hypocellularity and the health status of individuals.

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“…7) and reactive bone formation. Although essentially non-specific, these features have been used as diagnostic hallmarks in various paleopathological reports (Blondiaux et al, 1994;Schultz and Roberts, 2002;Wapler et al, 2004;von Hunnius et al, 2006;Flohr and Schultz, 2009;Nicklisch et al, 2012;Schultz and Schmidt-Schultz, 2015). In most of these cases histology did not provide a definitive diagnosis, but rather narrowed down the differential diagnosis.…”

Section: Infectious Diseasesmentioning

confidence: 99%

Diagnostic dry bone histology in human paleopathology

Boer

Merwe

2016

Clinical Anatomy

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Paleopathology is the study of trauma and disease as may be observed in ancient (human) remains. In contrast to its central role in current medical practice, microscopy plays a rather modest role in paleopathology. This is at least partially due to the differences between fresh and decomposed (i.e., skeletonized or "dry bone") tissue samples. This review discusses these differences and describes how they affect the histological analysis of paleopathological specimens. First, we provide a summary of some general challenges related to the histological analysis of palaeopathological specimens. Second, the reader is introduced in bone tissue histology and bone tissue dynamics. The remainder of the paper is dedicated to the diagnostic value of dry bone histology. Its value and limitations are illustrated by comparing several well-studied paleopathological cases with similar contemporary, clinical cases. This review illustrates that due to post-mortem loss of soft tissue, a limited number of disorders display pathognomonic features during histological analysis of skeletonized human remains. In the remainder of cases, histology may help to narrow down the differential diagnosis or is diagnostically unspecific. A comprehensive, multidisciplinary diagnostic approach therefore remains essential. Clin. Anat. 29:831-843, 2016. © 2016 Wiley Periodicals, Inc.

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Osseous changes due to mastoiditis in human skeletal remains

Cited by 26 publications

References 15 publications

Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Skeletal Evidence for Otitis Media in Mediaeval and Post‐Mediaeval Children from Poland, Central Europe

Differential diagnosis of mastoid hypocellularity in human skeletal remains

Diagnostic dry bone histology in human paleopathology

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