Inflammatory bone reaction is one of the most common pathological alterations observed in ancient human skeletal remains. However, such finding is usually detected in connection to the external cranial surface and postcranial bones, while the inner structures of the sinuses are rarely encountered due to difficult access to their observation. The aim of this study is to present an uncommon location of chronic sinusitis observed thanks to appropriate recovery of osteological remains during archaeological excavations and to careful laboratory procedures. The macroscopical skeletal analysis of a mature male individual (US 289) from the site of ‘Volterra Le Colombaie’, in Tuscany (central Italy, second half of the 3rd-4th centuries AD), allowed us to appreciate deposits of grey porous woven bone adhering to the underlying cortex of numerous fragments of the left sphenoid sinus. This pathological alteration was diagnosed as a case of isolated chronic sphenoid sinusitis in active stage at the time of death of this individual. Different organisms are responsible for the inflammation of the sphenoid sinuses, with the Staphylococcus aureus being the most common pathogen, followed by the Aspergillus species among the fungal organisms. Bone remodeling and bone sclerosis, as seen in the present case, are signs of important long-standing inflammation of the sinuses, usually associated with fungal infection in individuals with compromised immune systems (e.g., old people or those affected by serious pre-existing conditions). Sphenoid sinusitis is a rare entity in clinical practice and, to our knowledge, no cases have been detected so far in paleopathology.
Common inflammatory reaction for uncommon place: a case of sphenoid sinusitis from Late Roman Etruria (Tuscany, second half of the 3rd-4th centuries AD)
Bareggi A.;Tocco G.;Rosselli L;Giuffra V.;Riccomi G.
2023-01-01
Abstract
Inflammatory bone reaction is one of the most common pathological alterations observed in ancient human skeletal remains. However, such finding is usually detected in connection to the external cranial surface and postcranial bones, while the inner structures of the sinuses are rarely encountered due to difficult access to their observation. The aim of this study is to present an uncommon location of chronic sinusitis observed thanks to appropriate recovery of osteological remains during archaeological excavations and to careful laboratory procedures. The macroscopical skeletal analysis of a mature male individual (US 289) from the site of ‘Volterra Le Colombaie’, in Tuscany (central Italy, second half of the 3rd-4th centuries AD), allowed us to appreciate deposits of grey porous woven bone adhering to the underlying cortex of numerous fragments of the left sphenoid sinus. This pathological alteration was diagnosed as a case of isolated chronic sphenoid sinusitis in active stage at the time of death of this individual. Different organisms are responsible for the inflammation of the sphenoid sinuses, with the Staphylococcus aureus being the most common pathogen, followed by the Aspergillus species among the fungal organisms. Bone remodeling and bone sclerosis, as seen in the present case, are signs of important long-standing inflammation of the sinuses, usually associated with fungal infection in individuals with compromised immune systems (e.g., old people or those affected by serious pre-existing conditions). Sphenoid sinusitis is a rare entity in clinical practice and, to our knowledge, no cases have been detected so far in paleopathology.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
