A comparative approach to bony changes in maxillary and frontal sinuses as indicators of upper respiratory health

Objective: The central aspect of this study is to provide a detailed comparison of bony changes in the maxillary and frontal sinuses in human skeletal remains in an effort to assist researchers record lesions and assist with potential diagnoses. Materials: 198 adult human remains from a medieval Avar population from Vienna, Austria. Methods: Analysis of bony changes using an endoscopic multifunctional camera with an ultra-small lens and adjustable LED lights. Results: Most common findings in both the maxillary and frontal sinuses are “pitting” and “white pitted bone”. However, significant differences between the maxillary and frontal sinuses regarding the frequency and variation of bony lesions exist. Conclusion: The maxillary sinuses exhibited significantly greater prevalence of bony changes compared to the frontal sinuses but frontal sinuses, which generally are less frequently affected by inflammatory, malignant, or benign lesions, may ultimately provide more informative insights in paleopathological studies concerning the health of the upper airways than the maxillary sinuses. Significance: Considering that most paleopathological studies on paranasal sinuses focus primarily on the maxillary sinuses, this study provides comparative data on the diversity of bony changes found in the frontal sinuses as a means to assist paleopathological recording and potentially eventual diagnosis. Limitations: The lack of knowledge about the pathophysiological mechanisms underlying individual bony features complicates interpretation, particularly in paleopathological studies. Suggestions for further research: A further examination of all paranasal sinuses (including the sphenoid sinuses and ethmoidal cells) is recommended.