Fibro-osseous processes of the craniofacial skeleton: What human skeletal remains from archaeological contexts can contribute to clinical research

Introduction Small, roundish lesions of localized porous bone, particularly of the craniofacial skeleton of so far unknown etiology are, to our knowledge, twice reported as incidental discoveries in clinical studies (Yang et al., 2011; Park et al., 2016) and slightly more frequently mentioned in paleopathological reports (e.g. Mann and Hunt, 2005). Such lesions are very discreet and most probably do not represent severe pathological changes. Their etiology is still discussed, including cancer, or processes of inflammatory or fibro-osseous origin. Taking biopsies of these mainly benign lesions in patients for microscopic research is not recommendable and therefore information about their microscopic structure is limited. In skeletons from archaeological contexts, these restrictions do not apply and therefore, a larger sample of fibro-osseous lesions of the craniofacial skeleton could be investigated by micro-CT and microscopic analyses.

Methods 145 skeletons from the Neolithic to modern times showed at least one lesions being visible in macroscopic investigation. 30 of the lesions were further subjected to digital, scanning electron and plain light microscopy. Limitations of research on archaeological bones are foremost the lack of soft tissue but possible taphonomic changes (inclusion of soil, erosion of lesion surfaces) also can restrict diagnosing.

Results The preferred location of fibro-osseous processes was in the maxillary and frontal bones. Only few were located in other regions of the craniofacial skeleton or in the postcranium. Radiography and micro-CT predominantly showed a ground glass appearance. Microscopic investigations showed relatively uniform pattern of the lesions, containing woven bone but no further calcified components.

Discussion The lesions in the skeletons from all investigated archaeological sites show a similar distribution in the craniofacial area with the region around the nasal cavity being most affected. The lesions are predominantly single and but can also occur multiple. Radiographic and microscopic evidence points to fibro-osseous origin of the processes, mainly being present in bones originating from the desmal ossification process. A lack of these changes in subadults and adolescents might suggest an age-related process. These lesions seem to be quite common in craniofacial skeletons from all time periods and should not be confused with malign processes or inflammatory changes.

Keywords fibro-osseous process, paleopathology, woven bone, microscopy

Korrespondenzadresse Julia Gresky, Deutsches Archäologisches Institut, Referat Naturwissenschaften, Im Dol 2-6, 14195 Berlin, Deutschland, E-Mail: [e-mail]

 

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Publication History

Article published online:
16 June 2023