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Mastoiditis--paleopathological evidence of a rarely reported disease

Stefan Flohr1, Michael Schultz

  • 1Department of Biology, University of Hildesheim, Marienburger Platz 22, Hildesheim, Germany. flohrs@uni-hildesheim.de

American Journal of Physical Anthropology
|September 6, 2008
PubMed

Insights

Mastoiditis, an infection of the mastoid bone, was prevalent in pre-antibiotic eras, affecting 83.4% of examined skeletal samples. This paleopathological study highlights its historical significance and potential underdiagnosis.

Area of Science:

  • Paleopathology
  • Archaeology
  • Infectious Disease Epidemiology

Background:

  • Mastoiditis is rare in modern societies due to antibiotics but remains prevalent in developing countries.
  • Historical and prehistoric mastoiditis prevalence is likely underrepresented in paleopathological literature.
  • Understanding past disease prevalence provides insights into long-term health challenges.

Purpose of the Study:

  • To investigate the frequency and characteristics of mastoiditis in early medieval human skeletal samples.
  • To assess the paleopathological significance of mastoiditis as a historical health threat.
  • To draw epidemiological conclusions about mastoiditis in pre-antibiotic populations.

Main Methods:

  • Macroscopic, endoscopic, and microscopic examination of human skeletal samples (n=223) from two German early medieval cemeteries.
  • Analysis of pathological changes in the pneumatized cells of the mastoid process.
  • Application of light and scanning electron microscopy for detailed analysis.

Main Results:

  • Osseous changes indicative of mastoiditis were diagnosed in 83.4% of examined temporal bones.
  • Higher frequency of mastoiditis observed in the Dirmstein sample compared to the Rhens sample.
  • Males were more frequently affected than females, and older individuals more than younger individuals.

Conclusions:

  • The high observed frequency supports the hypothesis that mastoiditis was a significant health problem in pre-antibiotic times.
  • Mastoiditis likely involved cumulative osseous changes over an individual's lifetime.
  • The study suggests mastoiditis warrants greater consideration in paleopathological investigations, with potential for current underdiagnosis of subclinical forms.

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