[COMPUTED TOMOGRAPHIC EXAMINATION OF CRANIAL LESIONS, A PALEORADIOLOGICAL APPROACH]. / KOPONYACSONT-LAESIÓK KOMPUTERTOMOGRÁFIÁS VIZSGÁLATA ÉS PALEORADIOLÓGIAI ASPEKTUSAI.

BACKGROUND AND PURPOSE: Introducing the multidisciplinary paleoradiology research at the Institute of Diagnostic Imaging and Radiation Oncology of the Kaposvár University, highlighting the cases with potential central nervous system involvement--from the scanning methods to the 3D printing--in order to draw attention to the historical background and clinical aspects of certain pathological conditions. METHODS: The authors developed the examination protocols for three different CT scanners. Among the examined archaeological remains cranial lesions were identified in 26 cases, from which 4 cases with potential central nervous system involvement are demonstrated. The scanning parameters and the advantages of secondary image reconstructions (multiplanar reconstruction, maximum intensity projection, three-dimensional volume rendering technique) are presented with the cases. RESULTS: The authors demonstrate a case with destructive skull lesions due to syphilis from the 15th century AD, a condition rarely seen or even unknown nowadays in the modern world. With the CT images of the skull base fracture from the Iron Age, signs of healing could be verified. Using the CT images a non-invasive approach is presented in the case of the craniofacial osteosarcoma in order to visualize the local status and the direct intracranial propagation. Advantages of the 3D VRT reconstructions are shown in the case of unilateral coronal suture synostosis. CONCLUSION: Paleoradiological CT examinations serve as a non-invasive, non-destructive tool for studying archaeological remains and artifacts. The special applications provided by the imaging modality contribute to the conventional paleopathological investigations.

Middle ear pathology in ancient and modern populations: incudal osteoma.

CONCLUSIONS: Osteomas of the incus were found in surprisingly high numbers in ancient and modern populations. The coexistence of osteoma formation and unique vascularization on the medial surface of the incus alludes to a relationship between the two findings. OBJECTIVE: Osteomas involving the middle ear ossicles are rare. The aim of this study was to compare the incudal pathology of ancient and recent periods using the recent literature. MATERIAL AND METHODS: Pathologies encountered in 1170 human incudes belonging to different populations from ancient and recent periods were studied. Most of the ossicles were found in the middle ear of dry skulls or during dissection. The observations were done with a binocular microscope and a Nikon Profile Projector. RESULTS: A total of 47 incudes (4.01%) presented with a variety of pathologies, osteomas being found in 19 cases (1.62%). The osteomas were noted only on the medial surface of the incus. Other findings, including prominent erosions, multiple nutrient foramina and pitting, were also found on the medial side of the incus. The incidence of osteoma was found to be more common in ancient populations (1.88%) and most prevalent among Bedouins (4.55%).

Human horns: a historical review and clinical correlation.

OBJECTIVE: Accounts of bony human horns originating from the cranium are found peppered throughout the early medical literature. This study reviews the extant literature regarding these entities to elucidate their authenticity. METHODS: We reviewed both historical and current literature as well as osteological material from our anatomy laboratories for accounts or observations of bony outgrowths of the calvaria in humans. RESULTS: Human horns seem to be mentioned more frequently in the historical literature and are documented primarily with drawings. Moreover, from early accounts, it is often difficult to distinguish true large bony outgrowths from scalp excrescences. Only two cadaveric specimens from our laboratory were noted to have small anomalous bony protuberances, one on the occiput and one on the frontal bone. CONCLUSION: With the lack of either photographic or extreme dry specimen evidence of such human horns, we would propose that benign calvarial tumors, such as osteomas, may have initiated speculation that such entities, i.e., horns, exist in humans but that scalp lesions, exaggeration, legend, and religious beliefs have historically propagated these entities to a mythical status. In addition, early surgical intervention and changes in nomenclature may have also decreased the frequency of such sightings. Finally, many early descriptions have not been repeated in recent history, even in third-world countries lacking advanced medical care.

Paragangliomas of the temporal bone.

Recent advances in diagnosis and surgical therapy of glomus tumors of the temporal bone have been made. These advances make it possible for surgeons to benefit patients affected by this locally aggressive and morbid tumor. More sensitive diagnostic modalities and a physician alertness make early surgical cure a possibility. Careful planning and observation of basic surgical principles help to minimize morbidity and improve functional results.

Giant cell lesions of the temporal bone.

Giant cell lesions are rare in the temporal bone. A review of world literature reveals twenty-three reported cases. Histopathologic differentiation has been difficult in the past; several tumors of bone which are characterized by multinucleated giant cells have been grouped together under the term "giant cell tumor." In the temporal bone, true giant cell tumor of bone, osteoclastoma, should be differentiated from the less aggressive reparative granuloma. The clinical course of these two lesions can be greatly different. Two additional cases of giant cell reparative granuloma are added to the literature. In addition, a tabulation is presented of signs, symptoms, treatment, and follow-up in the cases reported in the literature. Surgical excision is recommended when possible.

Tumors in the remains of ancient Egyptians.

A survey of the tumors found in the remains of the Ancient Egyptians shows the occurrence of all the kinds of tumors which would be expected to be preserved in the osteological evidence. On the other hand, findings of tumors in the soft tissues of mummies are only exceptional. The frequency of tumors seems to be lower than in recent years, probably because of the shorter mean duration of life. The pathological lesions preserved in bony sturcture reveal not only osseous tumors, but also the presence of some tumors of soft tissues eroding the bone. To the survey of cases described in the literature, original findings of a calcified myoma uteri and of a probably epipharyngeal carcinoma are added. Because our knowledge on the history of tumors is not yet comprehensive, much more attention should be devoted to the search for them, starting from the moment of excavation of any cemetary.