Histomorphological study on hypocellularity in mastoid processes from archaeological human skeletons

Is the promontory a promising site to diagnose otitis media in paleopathology? A search for evidence

OBJECTIVE

The promontory of the middle ear was recently suggested to be an appropriate site for diagnosing otitis media (OM) in archaeological bones by endoscopic inspection. The present study scrutinized the underlying assumption that a bulgy, irregular promontorial surface represents a pathological condition.

MATERIALS

We compared an allegedly healthy individual and an allegedly diseased individual in skeletal remains of two human individuals from the early Medieval period in Germany.

METHODS

The specimens were studied using microscopic analyses of thin ground sections.

RESULTS

The osseous architecture of the three-layered promontorial wall was the same in both specimens. Both the contour of the resorption front of the middle layer and the thickness of the overlying outer periosteal layer showed some variation, resulting in an either smooth or a bulgy promontorial surface, while signs of resorptive or proliferative changes at the periosteal surface were missing in both cases.

CONCLUSIONS

Our results suggest that an irregular promontorial surface represents normal variation in the development of the otic capsule rather than a pathological condition. We therefore conclude that the promontory is not an appropriate site for diagnosing OM in archaeological bone.

SIGNIFICANCE

The study contributes to evidence-based diagnoses in paleo-otological studies. Our assumption is in line with clinical and experimental findings indicating that the otic capsule is protected against bone remodeling.

LIMITATIONS

Only two specimens were studied.

SUGGESTIONS FOR FURTHER RESEARCH

SEM-studies to detect more subtle changes to the promontorial surface.

Evidence of otitis media and mastoiditis in a Medieval Islamic skeleton from Spain and possible implications for ancient surgical treatment of the condition

OBJECTIVE

To evaluate lesions on a cranium from the Iberian Peninsula and assess its medico-historical and paleopathological significance.

MATERIALS

The skeletal remains of a juvenile individual found in a Medieval Islamic grave (10th -16th century) in Eastern Spain.

METHODS

Macroscopic examination of the left and right temporal bones, binocular microscopy, X-ray, and Scanning Electron Microscopy - Energy Dispersive X-ray Spectroscopy (SEM-EDS) were performed.

RESULTS

A sub-oval perforation superior to the right mastoid process and pathological changes on the right temporal bone were identified. SEM-EDS confirmed the presence of copper in the surrounding area of the perforation.

CONCLUSIONS

The observed pathological changes are most likely compatible with otitis media and subsequent mastoiditis. The sub-oval perforation could be interpreted either as an abscess or as evidence of a surgical procedure (mastoidectomy) or a combination of both; and the Cu traces may be the result of an associated object or, possibly, the application of a plaster with copper acetate used as medical treatment.

SIGNIFICANCE

This case contributes to the paleopathological record and the interpretation of similar cases, and also helps in the understanding of medical care and treatment in Medieval Islam.

LIMITATIONS

The lack of similar pre-modern cases of surgical intervention limits comparability to clinical cases. Suggestion for further research: Exploration into indicators of health care in past populations.

Two probable cases of mastoiditis in a cemetery from the Warring States to Han Dynasty (475 BCE-220 CE) in Qufu, Shandong Province, China

In modern clinical medical practice, middle-ear infection is a frequently reported condition. If untreated, persistent inflammation caused by infection may lead to perforation of the mastoid process or other portions of the temporal bone. When the middle-ear abscess penetrates the surrounding bone and invades the mastoid process, it causes mastoiditis. Abnormal osseous fistulae were observed on the temporal bones of individuals M137 and M199, which were unearthed in Qufu Olympic Sports Center Cemetery in Qufu City, Shandong Province, and date to the Warring States to the Han Dynasty (475 BCE-220 CE). Microscopic observation and CBCT were used to examine the lesions. A differential diagnosis suggests that the lesions were related to mastoiditis, and based on reference studies, burial information, and paleopathological observation, pollution in the living environment and poor living conditions may be potential factors that caused individuals M137 and M199 to suffer from mastoiditis. The two examples from Qufu are the earliest reported cases of mastoiditis from China; however, infections in the middle ear often go unnoticed in archaeological samples.

Localization of DLL1- and NICD-positive osteoblasts in cortical bone during postnatal growth in rats

The long bone midshaft expands by forming primary osteons at the periosteal surface of cortical bone in humans and rodents. Osteoblastic bone formation in the vascular cavity in the center of primary osteons is delayed during cortical bone development. The mechanisms of the formation of primary osteons is not fully understood, however. Focusing on NOTCH1 signaling, an inhibitory signaling on osteoblastic bone formation, our immunohistochemical analysis revealed Delta like1 (DLL1), a ligand of NOTCH1, and the NOTCH1 intracellular domain (NICD, an activated form of NOTCH1) immunoreactivity, in the cuboidal osteoblasts lining the bone surface in the vascular cavity of primary osteons during postnatal growth in rats. Interestingly, five days after treatment of primary osteoblasts with ascorbic acid and β glycerophosphate, protein levels of both DLL1 and NICD increased transiently, indicating that DLL1 activates NOTCH1 in primary cultured osteoblasts. Thus, the results imply that DLL1-NOTCH1 signaling in osteoblasts is associated with primary osteonal bone formation.