Point and shoot: a radiographic analysis of mastoiditis in archaeological populations from England’s North-East

Despite how common, severe, and impactful mastoiditis is, it is understudied archaeologically. When it is, it requires destructive methods or access to large imaging equipment. This project developed and tested a new method of imaging the mastoid process using a hand-held X-ray system and diagnosing mastoiditis in human skeletal remains. The method was grounded in modern clinical practices, non-destructive, and accessible. Adult individuals from two archaeological populations were studied: the Anglo-Saxon/Saxo-Norman population from Black Gate, Newcastle-upon-Tyne (7th–12th centuries CE) (n=263) and the Industrial Period population from St. Hilda’s Church, Coronation Street, South Shields (c. 1750–1855 CE) (n=123). A preliminary analysis of Black Gate adults and non-adults (n=40) developed and refined the method. The prevalence of maxillary sinusitis (MS) and lower respiratory infection (LRI) was also studied. A slight increase in adult mastoiditis amongst young adults (8/15, 53.3%; 8/13, 61.5%) compared to other age groups (0.0%–50.0%), and a significant difference in MS between senior adults (8/35, 22.9%) compared to young (8/13, 61.5%) and mature adults (19/40, 47.5%), likely reflected age-specific exposure to risk factors in the Black Gate population. Additionally, significant differences in the prevalence of LRI amongst those buried in plain (12/152, 7.9%) and coffin graves (7/28, 25.0%) may have reflected lifeway differences amongst the social classes. In the Coronation Street population, a significant difference in the prevalence of MS and LRI between females (17/22, 77.3%) and males (5/13, 38.5%) likely reflected gendered occupations and habits. In general, the Coronation Street population appeared frailer than the Black Gate population, likely reflecting the ubiquity and severity of some risk factors and the embodied effects of classism and sexism. The project achieved its aim: expanding the understanding of the epidemiology and etiology of mastoiditis and the lifeways of those living with mastoiditis in the context of public health.