Using computed tomography to diagnose chronic frontal sinusitis in the skeletal remains of a post-medieval Dutch rural community (AD 1829–1866)

Chronic frontal sinusitis (CFS) has afflicted humanity throughout history and continues to be a significant global health issue today. In bioarchaeology, sinusitis is often diagnosed through the identification of bone alterations within the maxillary sinus cavities by macroscopic and/or endoscopic examination. However, due to the inaccessible nature of frontal sinuses, CFS specifically has not been studied extensively archaeologically yet. This paper aims to demonstrate the effectiveness of diagnosing CFS through computed tomography (CT), highlighting the potential of radiographical imaging for future advancements in paleopathological research.

We conducted a CT examination of 41 crania from the rural community of Middenbeemster, the Netherlands (AD 1829–1866) to assess the presence of CFS. Criteria for identifying CFS included bone formation and/or thickening of the sinus walls. Our analysis revealed that 14 individuals (34.1%) exhibited signs of CFS in one or both frontal sinuses. We found that males exhibited a slightly higher CFS prevalence (38%) than females (32%), although no significant correlation between sex and sinusitis occurrence was found. This lack of correlation suggests equal exposure to risk factors (e.g., indoor air quality, environmental pollution, allergens, and cold weather) among both sexes.

To our knowledge, this study is the first of its kind to confirm the presence of CFS through CT scanning in an archaeological skeletal collection. It demonstrates that computed tomography allows for a straightforward and non-destructive detection of sinusitis in archaeological assemblages. Considering the currently limited bioarchaeological research on frontal sinusitis, our findings should be considered relevant and promising for future osteoarcheological studies on upper respiratory diseases.