Brickley Megan B
Department of Anthropology, McMaster University, Hamilton, Ontario, Canada.
Am J Phys Anthropol. 2018 Dec;167(4):896-902. doi: 10.1002/ajpa.23701. Epub 2018 Sep 27.
Porotic lesions of the skull (cribra orbitalia and porotic hyperostosis) are one of the most common types of lesion identified in archaeological human bone and have also been found in hominins and non-human primates. Because of the frequency with which such lesions are found there has been extensive debate on the possible causes and whether they are linked, with much of the debate centering on anemia. The biological approach to diagnosis in paleopathology used by Don Ortner and recently proposed more formally as a technique to facilitate diagnosis in paleopathology by Simon Mays may offer a means of answering some of the questions surrounding these lesions.
A review was undertaken of biomedical information on changes in the distribution of marrow type and pattern of conversion of red and mixed marrow, and the potential for re-conversion of yellow marrow with age. The range and type of other conditions that might result in the development of porous lesions were also considered.
Combining information from the biomedical literature on marrow type and patterns of conversion with age, with careful evaluation of the type and location of porous lesions in the skull and across the rest of the skeleton will assist in suggesting a diagnosis.
A wide range of conditions can produce porous lesions in the cranial vault and the orbital roof, but due to anatomical structures and physiological factors such lesions are more likely to occur in the orbital roof. Anemia can produce lesions in both locations, but evidence of marrow expansion is required to confirm it as a cause.
颅骨的多孔性病变（眶筛孔和多孔性骨质增生）是在考古发现的人类骨骼中最常见的病变类型之一，在人类及非人类灵长类动物中也有发现。由于此类病变的发现频率较高，人们对其可能的病因以及它们是否存在关联展开了广泛的讨论，其中大部分讨论集中在贫血方面。唐·奥尔特纳在古病理学中采用的生物学诊断方法，以及西蒙·梅斯最近更正式提出的作为促进古病理学诊断的一项技术，可能为解答围绕这些病变的一些问题提供一种途径。
对有关骨髓类型分布变化、红骨髓和混合骨髓转化模式以及黄骨髓随年龄再转化可能性的生物医学信息进行了综述。还考虑了可能导致多孔性病变发生的其他病症的范围和类型。
将生物医学文献中关于骨髓类型和随年龄转化模式的信息，与对头骨及骨骼其他部位多孔性病变的类型和位置进行仔细评估相结合，将有助于提出诊断建议。
多种病症可在颅顶和眶顶产生多孔性病变，但由于解剖结构和生理因素，此类病变更易发生在眶顶。贫血可在这两个部位产生病变，但需要骨髓扩张的证据来证实其为病因。
