Abstract
Concha bullosa is a variant of the sinonasal anatomy in which the middle nasal turbinate contains pneumatized cells, which leads to turbinate enlargement. The reason for concha bullosa formation is unclear, but the variant is seen in up to half the modern population and it may predispose to paranasal sinusitis. The variant has hitherto featured little in paleopathology. Therefore, in the present study we seek to determine the presence of concha bullosa, with the coexisting hypertrophy of the middle turbinate and signs of sinusitis or other pathology of the paranasal complex, in a population living in Tomersdorf-Toporow in the Upper Lausatia, a historical region in Germany and Poland, presently Zgorzelec County in the Lower Silesian voivodeship, at the turn of the nineteenth and twentieth century. The material consisted of 32 skeletons (24 males, 8 females). The gender, age, and stress indicators and the presence of pathological signs were assessed, followed by CT of the skulls. We found 2 skulls (6.3 %) with concha bullosa. In one case septal nasal deviation was present. We conclude that the incidence of concha bullosa could be lower in the past times than at present. Wider research is necessary to settle whether concha bullosa is indeed a rare respiratory paleopathology or a missed, and thus underreported observation.
A genetic component is suggested since differences in the presence of concha bullosa are observed between populations from different regions of the world and different climatic conditions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Acsádi G, Nemeskéri J (1970) History of human life span and mortality. Akademiai Kiado, Budapest
Alkire BC, Bhattacharyya N (2010) An assessment of sinonasal anatomic variants potentially associated with recurrent acute rhinosinusitis. Laryngoscope 120:631–634
Badia L, Lund VJ, Wei W, Ho WK (2005) Ethnic variation in sinonasal anatomy on CT-scanning. Rhinology 3:210–214
Bolger WE, Butzin CA, Parson DS (1991) Paranasal sinus anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64
Buikstra JE, Ubelaker DH (1994) Standards for data collection from human skeletal remains, Arkansas Archeological Survey research series no. 44. Arkansas Archeological Survey, Fayetteville
Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic patients. Otolaryngol Head Neck Surg 104:480–483
Chaiyasate S, Baron J, Clement P (2007) Analysis of paranasal sinus development and anatomical variations: a CT genetic study in twins. Clin Otolaryngol 32:93–97
Cho JH, Park MS, Chung YS, Hong SC, Kwon KH, Kim JK (2011) Do anatomic variations of the middle turbinate have an effect on nasal septal deviation or paranasal sinusitis? Ann Otol Rhinol Laryngol 120:569–574
Clark ST, Babin RW, Salazar J (1989) The incidence of concha bullosa and its relationship to chronic sinonasal disease. Am J Rhinol 3:11–12
Derums V (1978) Changes in skeletal bones in residents of the Baltic area studied on the paleoanthropological material. Arkh Patol 40:65–69 (Article in Russian)
Earwaker J (1993) Anatomic variants in sinonasal CT. RadioGraphics 13:381–415
Gawlikowska-Sroka A, Kwiatkowska B, Dąbrowski P, Dzięciołowska-Baran E, Szczurowski J, Nowakowski D (2013) Respiratory diseases in the late middle ages. Respir Physiol Neurobiol 187:123–127
Hatipoğlu HG, Cetin MA, Yüksel E (2005) Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol 11:145–149
Koertvelyessy T (1972) Relationships between the frontal sinus and climatic conditions: a skeletal approach to cold adaptation. Am J Phys Anthropol 37:161–172
Kwiatkowska B, Gawlikowska-Sroka A, Szczurowski J, Nowakowskai D, Dzięciołowska-Baran E (2011) A case of concha bullosa mucopyocele in a medieval human skull. Int J Osteoarchaeol 21:367–370
Lloyd GA (1990) CT study of paranasal sinuses: study of coronal series in relation to endoscopic sinus surgery. J Laryngol Otol 104:477–481
Loth SR, Henneberg M (1996) Mandibular ramus flexure: a new morphic indicator of sexual dimorphism in human skeleton. Am J Phys Anthropol 99:473–485
Mays S, Vincent S, Snow M, Robson-Brown K (2011) Concha bullosa, a neglected condition in palaeopathology. Int J Paleopathol 1:184–187
Mays SA, Mavrogordato M, Lambert J, Sofaer JR (2014) The prevalence and health implications of concha bullosa in a population from mediaeval England. Int J Osteoarchaeol 24:614–622
Ortner DJ (2011) What skeletons tell us. The story of human palepathology. Virchows Arch 459:247–253
Pospísilová B, Procházková O, Kracík M, Stojanov R, Slízová D, Krs O (2001) Findings of massive pneumatization of the middle nasal turbinate in a collection of skulls from the 13th–18th centuries. Acta Medica (Hradec Kralove) Suppl 44, 53–58 (Article in Chech)
Roberts CA (2007) A bioarcheological study of maxillary sinusitis. Am J Phys Anthropol 133:792–807
Skinner MF, Goodman AH (1992) Anthropological uses of developmental defects of enamel. In: Saunders SR, Katzenberg MA (eds) Skeletal biology of past peoples: research methods. Wiley-Liss, New York
Subramanian S, Lekhraj Rampal GR, Wong EF, Mastura S, Razi A (2005) Concha bullosa in chronic sinusitis. Med J Malaysia 60:535–539
Tonai A, Baba S (1996) Anatomic variations of the bone in sinonasal CT. Acta Otolaryngol Suppl 525:9–13
Acknowledgments
Project financed by the National Center of Science, grant. DEC-2013/10/E/HS3/00368.
Conflict of Interest
The authors declare no conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Gawlikowska-Sroka, A. et al. (2016). Concha Bullosa in Paleoanthropological Material. In: Pokorski, M. (eds) Advancements in Clinical Research. Advances in Experimental Medicine and Biology(), vol 952. Springer, Cham. https://doi.org/10.1007/5584_2016_62
Download citation
DOI: https://doi.org/10.1007/5584_2016_62
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-48032-9
Online ISBN: 978-3-319-48033-6
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)