Abstract
This study examines the occurrence of skull osteomyelitis/osteitis using four samples from modern Floridian contexts. The aim of this research was to develop a new method of identification for skull osteomyelitis/osteitis as well as, identify its etiology and demographics. For etiology purposes, I examined the co-occurrence between of skull osteomyelitis/osteitis and eight additional cranial pathologies: otitis media, cribra orbitalia, auditory exostoses, cholesteatoma, porotic hyperostosis, linear enamel hypoplasia, periodontal disease, and dental abscesses. I evaluated the location, depth, and extent of granulation erosion and scored the lesions as present or absent. Overall, the most common bone with evidence of skull osteomyelitis/osteitis lesions was the frontal bone followed by (in descending rate of occurrence) the temporal, parietal and sphenoid bone. This condition favored males over females which was consistent with previous clinical studies. However, this analysis diverged from the previous research with the age of individuals with the condition tending to be less than 60 years (median age range = 32–62 years). Periodontal disease was the most common disease to co-occur skull osteomyelitis/osteitis which was contrary to previous research in which otitis media held that distinction. A total of 40 (33%) individuals exhibited skull osteomyelitis/osteitis. This result illustrates that skull osteomyelitis/osteitis might not be a rare condition as published by other researchers. Furthermore, this sample comprises individuals from all ancestry groups, both biological sexes and different ages unlike previous research that comprised mostly geriatric European males. The etiology of skull osteomyelitis or osteitis is inconclusive although, this study supports the designation as a nonspecific bone infection. This study, however, shows the condition can be triggered by six different disease processes that originate in the venous or sinus systems. Skull osteomyelitis is an infection within the bone marrow whereas osteitis is a generalized bone inflammation that can affect and/or destroy any compact bone structure Therefore, instead of labeling this condition as skull osteomyelitis I concluded that the lytic lesions were mostly related to osteitis rather than osteomyelitis.