Skvarilová B, Povýsil C, Horák M, Kyzlinková K
Hrdlicka Museum of Man, Faculty of Science, Charles University, Prague, Czech Republic.
Acta Chir Plast. 2007;49(4):103-8.
Trephination of the skull is an old surgical procedure practised in both the Old and New Worlds from the Neolithic period 7,000 years ago up to the present. Four methods (scratching, cutting, drilling and circling) were used for therapeutic or ritual (magical) reasons, predominantly in older males. The survival rate was between approximately 25% and 75%, the drilling and especially cutting being most dangerous. Macroscopic, CT and histopathological examination of three trephined skulls from the collection of Hrdlicka's Museum of Man, Charles University, revealed two types of bone defect. In the first type the margin of the defects was covered by the cortical bone of identical structure as the cortical bone on the inner and outer surface of the surrounding skull bones. These cases probably represent defects that healed in living persons for a long time, and consequently new cortical bone developed (skull No. 1). However, congenital origin of defects of this type cannot be excluded. The second type of defects, without cortical bone cover at the hole margin, could be caused by trauma in the post mortem period or may have been performed during the people's lifetimes--if they died shortly after their skull damage, so the healing period was too short for the formation of new cortical bone (skull No. 2 and 3).
颅骨环钻术是一种古老的外科手术，从7000年前的新石器时代至今，在旧世界和新世界均有施行。出于治疗或仪式（魔法）目的，主要针对老年男性，使用了四种方法（刮擦、切割、钻孔和环切）。存活率约在25%至75%之间，钻孔尤其是切割最为危险。对查尔斯大学赫德里卡人类博物馆收藏的三个环钻颅骨进行宏观、CT和组织病理学检查，发现了两种类型的骨缺损。在第一种类型中，缺损边缘被与周围颅骨内外表面皮质骨结构相同的皮质骨覆盖。这些病例可能代表在活人身上长期愈合的缺损，因此形成了新的皮质骨（颅骨1号）。然而，不能排除这种类型缺损的先天性起源。第二种类型的缺损，孔边缘没有皮质骨覆盖，可能是死后创伤所致，也可能是在人们生前施行的——如果他们在颅骨受损后不久死亡，那么愈合期太短，无法形成新的皮质骨（颅骨2号和3号）。
