Maxillary sinusitis as a respiratory health indicator: a bioarchaeological investigation into medieval central Italy.

OBJECTIVE: This study aims to assess chronic maxillary sinusitis in an osteoarchaeological sample from the medieval rural site of Pieve di Pava (central Italy), to investigate triggers responsible for sinus inflammation, and to compare prevalence rates with coeval European rural sites. MATERIALS: The analysis focused on 145 10th-12th-century adults with at least one preserved maxillary sinus. METHODS: Sinusitis-related lesions were observed macroscopically and microscopically. Alveolar pathologies of the maxillary posterior dentition were recorded to investigate the impact of odontogenic sinusitis. RESULTS: Maxillary sinusitis was observed in 23.4% of the individuals (n = 34), with similar frequencies in both sexes and bilateral sinusitis appearing more frequently than unilateral sinusitis. An association of alveolar lesions with sinusitis was found in 38.2% of cases. CONCLUSIONS: Compared to coeval rural sites in Northern Europe, Pieve di Pava shows the lowest prevalence of maxillary sinusitis, likely reflecting a greater amount of time spent outdoors. Despite the small size of the sample, odontogenic sinusitis cannot be ruled out. SIGNIFICANCE: This is the first Italian study to investigate maxillary sinusitis and to focus on the Mediterranean area, contributing to the understanding of this condition as a health indicator in ancient populations. LIMITATIONS: Research limitations include preservation issues affecting the number of observable sinuses, the non-homogenous age distribution of the sample, and the impact of inclusion and methodological criteria on the comparability of results. SUGGESTIONS FOR FURTHER RESEARCH: Further investigations into odontogenic sinusitis and the microscopic examination of dental calculus may provide new data on the pathogenesis of sinusitis.

Multiple osteomata from medieval Tuscany, Italy (ca. 10th-12th AD).

OBJECTIVE: To explore the possible etiology of multiple osteomata on a skull and long bones from an individual from a medieval site in Tuscany, Italy. MATERIALS: Human skeletal remains dating to the 10th-12th century AD from the parish church of S. Pietro in Pava, in the province of Siena (Tuscany, Central Italy). METHODS: Macroscopic and imaging analyses (Cone Beam Computed Tomography). RESULTS: Nine round-shaped new bone formations are observed on a female individual aged 40-50 years. The lesions have a smooth surface and range from 2.2-6 mm in diameter. CONCLUSIONS: Cone Beam Computed Tomography confirmed that the lesions were composed of compact bone. Macroscopic and radiological features suggest the presence of nonsyndromic multiple osteomata. SIGNIFICANCE: Single cranial osteomata are commonly observed in osteoarchaeological remains, but multiple osteomata are rare and might assist in our understanding of neoplastic conditions in the past. LIMITATIONS: The lack of soft tissues prevents the diagnosis of complex disorders, such as the Gardner syndrome, which is characterised by multiple osteomata and polyposis of the colon. SUGGESTIONS FOR FURTHER RESEARCH: Careful investigation and reporting of all neoplastic lesions in ancient human remains in order to increase our knowledge about the etiology in past human populations.