The effect of otitis media on the human mastoid process in a common milieu over a millennium was evaluated by comparing two present and four ancient populations. Temporal bone pneumatization patterns indicate that otitis media and mastoiditis existed in antiquity, and there were more altered pneumatization patterns in skulls from the era following European contact than from eras before European contact. Pneumatization patterns were similar in ancient skulls and in a preponderantly white male population mostly born before antibacterial availability. Both ancient and modern pre-antibacterial era temporal bones show more effect of otitis media during childhood than is found in present day schoolchildren. Reasons for differences are explored. It is inferred that upper respiratory tract infections were prevalent in the Upper Missouri River Basin during the past millennium. Furthermore, microbiological agents with virulence similar to today's flora were prevalent in this region more than 1,000 years ago.
Gregg JB, Steele JP. Mastoid Development in Ancient and Modern Populations: A Longitudinal Radiological Study. JAMA. 1982;248(4):459–464. doi:10.1001/jama.1982.03330040047030
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