UMR 5199 PACEA, CNRS, Université de Bordeaux, Ministère de la Culture et de la Communication, Pessac, France.
Muséum National d'Histoire Naturelle, CNRS, Eco-Anthropologie UMR 7206, Musée de l'Homme, Université de Paris, Paris, France.
J Anat. 2020 Dec;237(6):1049-1061. doi: 10.1111/joa.13266. Epub 2020 Jun 25.
The diagnosis of cranial trepanation in the archaeological record has always been a big challenge for archaeologists. The identification is first and foremost based on the shape and edges of the opening, and in cases where the individual survived, the shape and edges resulted from both the surgical procedure and the healing process. Because of the lack of reliable data on the osseous remodelling process of the skull, it is difficult to distinguish true trepanations from some pathological or physiological defects called pseudotrepanations. Furthermore, it is challenging to investigate the post-operative survival time. The purpose of this paper was to summarize observations made on a total of 90 archaeological samples of cranial lesions interpreted as 'partially' or 'completely' healed trepanations, and compare them with 14 modern case studies. Observations made on monitoring post-operative scans of modern patients, at varying times after craniotomy, provided a preliminary timetable for the successive post-surgery bony changes in the skull, and confirmed that the process of osseous remodelling does lead to smooth and rounded edges of the profile of the opening. However, contrary to what has been observed in several archaeological case studies, none of the cases shows a complete closure of the cranial vault. The sharp vertical edges of the opening become bevelled at late stages of healing, which has to be taken into consideration when interpreting the procedures and methods in past population. By bridging bioarchaeology and medical sciences, this study adds to previous discussions on the diagnosis of healed trepanation in the archaeological record, by providing detailed descriptions of morphological changes at various healing stages, that may help archaeologists to identify ancient trepanations more accurately.
在考古记录中，对颅骨穿孔的诊断一直是考古学家面临的一大挑战。这种识别首先基于开口的形状和边缘，而且在个体存活的情况下，形状和边缘是手术过程和愈合过程共同作用的结果。由于颅骨骨质重塑过程缺乏可靠的数据，因此很难将真正的穿孔与一些被称为假穿孔的病理性或生理性缺陷区分开来。此外，调查术后存活时间也具有挑战性。本文的目的是总结对总共 90 个被解释为“部分”或“完全”愈合的颅骨病变的考古样本的观察结果，并将其与 14 个现代案例研究进行比较。对现代患者术后扫描的监测观察结果，在开颅手术后的不同时间进行，为颅骨随后的手术后骨质变化提供了初步时间表，并证实了骨质重塑过程确实会导致开口轮廓的边缘变得光滑和圆形。然而，与一些考古案例研究中观察到的情况相反，没有一个案例显示颅骨穹窿完全闭合。在愈合的晚期，开口的锐利垂直边缘会变圆钝，这在解释过去人群中的程序和方法时必须加以考虑。通过将生物考古学和医学科学联系起来，本研究通过详细描述各种愈合阶段的形态变化，为考古记录中愈合穿孔的诊断提供了更多的讨论，这可能有助于考古学家更准确地识别古代穿孔。
