MAXILLARY SINUSITIS IN MEDIEVAL CHICHESTER, ENGLAND

Maxillary sinusitis is a common medical complaint, affecting more than 30 million people per year in the United States alone. Very little pa laeopathological work on this disease has been carried out, probably b ecause of the enclosed nature of the sinuses in intact skulls and the lack of a suitable method for examination. This study tested the hypot hesis that maxillary sinusitis was more common in people with leprosy than in people without it in Medieval England. The prevalence of maxil lary sinusitis by age and sex was recorded in 133 individuals, some di agnosed as being leprous, derived from a later Medieval (12th to 17th centuries AD) urban hospital population at Chichester, Sussex, England using both macroscopic and endoscopic methods of examination. Of the 133 individuals with one or both sinuses available for examination, 54 .9% (73) had evidence of bone change within the sinuses. There was no difference in prevalence between those with leprosy and those without, although clinical studies suggest that over 50% of lepromatous leprou s individuals may develop sinusitis. Comparison with another study on Medieval British sites with a 3.6% prevalence (3 of 83) indicates that the prevalence at Chichester is much greater. The problems with diagn osing sinusitis are addressed and reasons behind the high frequency in this study are discussed. Aetiological factors predisposing to maxill ary sinusitis are considered with reference to possible environmental conditions prevailing in the later Medieval period in Britain. (C) 199 5 Wiley-Liss, Inc.