Unilateral Congenital Aural Atresia from an Ychsma Group Burial at the Site of Pachacamac, Peruvian Central Coast
Keywords:
Developmental anomaly, Aural pathology, Palaeopathology, Andean archaeology, BioarchaeologyAbstract
Congenital malformations of the human skeleton are a major area of palaeopathological and bioarchaeological interest, although our understanding of such conditions in the ancient world is hampered by their often extreme rarity, and inconsistent reporting in the field. A cranium from a group burial at the Peruvian site of Pachacamac was found to display almost complete absence of the right external auditory meatus, styloid process, vaginal process and tympanic plate of the right temporal bone. Following a differential diagnosis, it was determined that the skeletal pathology likely represents an instance of congenital aural atresia, a developmental anomaly resulting in the partial or complete aplasia of the external acoustic meatus. This condition is often associated with other congenital abnormalities and syndromes. However, as the postcranial remains of this individual could not be distinguished from other remains in the group burial, no further associated skeletal anomalies could be detected. This is the first instance of congenital aural atresia recovered from a defined funerary context in Peru, complementing other bioarchaeological reports of this rare congenital anomaly. The pathology of the condition is described, and compared with clinical and bioarchaeological data. The potential social implications concerning social attitudes of the Pachacamac population towards this individual are also considered, in reference to both historical and archaeological contexts.
References
Acsádi, G., & Nemeskéri, J. (1970). History of human life span and mortality. Budapest: Akadémiai Kiadó.
Ali, K., Mohan, K., & Liu, Y. C. (2017). Otologic and Audiology Concerns of Microtia Repair. Seminars in Plastic Surgery, 31(3), 127–133. https://doi.org/10.1055/s-0037-1603957
Bartel-Friedrich, S., & Wulke, C. (2007). Classification and diagnosis of ear malformations. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 6, Doc05. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22073081
Bass, W. M. (2005). Human Osteology: A Laboratory and Field Manual (5th ed.). Springfield: Missouri Archaeological Society. https://doi.org/9780943414966
Bogusiak, K., Puch, A., & Arkuszewski, P. (2017). Goldenhar syndrome: current perspectives. World Journal of Pediatrics, 13(5), 405–415. https://doi.org/10.1007/s12519-017-0048-z
Boone, B. N., Schuman, T. A., & Eavey, R. D. (2011). Congenital Aural Atresia With Ectopic Tooth. Otology & Neurotology, 32(9), e35. https://doi.org/10.1097/MAO.0b013e318210b8cb
Buikstra, J. E., & Ubelaker, D. H. (1994). Standards for data collection from human skeletal remains. In Fayetteville: Arkansas Archeological Survey. Fayetteville: Arkansas Archaeological Survey.
Cobo, B. (1990). Inca Religion and Customs (First; Roland Hamilton, Ed.). Austin: The University of Texas Press.
Cunningham, C., Scheuer, L., & Black, S. (2017). Developmental Juvenile Osteology (2nd ed.). Amsterdam: Academic Press/Elsevier.
D’Alessandro, L., Kovesi, T., Massoud, S., Lougheed, J., Hunter, A., & Reisman, J. (2006). Horseshoe lung and facio-auriculo-vertebral sequence: A previously unreported association. Pediatric Pulmonology, 41(6), 592–596. https://doi.org/10.1002/ppul.20404
De la Cruz, A., & Teufert, K. B. (2003). Congenital aural atresia surgery: Long-term results. Otolaryngology – Head and Neck Surgery, 129(1), 121–127. https://doi.org/10.1016/S0194-5998(03)00531-X
De Molina, C. (2011). Account of the fables and rites of the Incas (First; B. S. Bauer, V. Smith-Oka, & G. E. Cantarutti, Eds.). Austin: University of Texas Press. https://doi.org/10.5860/CHOICE.49-1046
Ear Community. (2020). Microtia and Atresia. Retrieved April 7, 2020, from https://earcommunity.org/
Eeckhout, P. (2013). Change and permanency on the coast of ancient Peru: the religious site of Pachacamac. World Archaeology, 45(1), 137–160. https://doi.org/10.1080/00438243.2012.759516
Eeckhout, P., & Owens, L. S. (2008). Human Sacrifice at Pachacamac. Latin American Antiquity, 19(4), 375–398. https://doi.org/10.1017/S104566350000434X
Ferembach, D., Schwindezky, I., & Stoukal, M. (1980). Recommendation for Age and Sex Diagnoses of Skeletons. Journal of Human Evolution, (9), 517–549. Retrieved from https://kupdf.net/download/ferembach-et-al-1980recommendations-for-age-and-sex-diagnoses-of-skeletons_599a96e2dc0d60757c53a1ff_pdf
Friedman, E. (2009). U.K. Model’s Surprising Secret. Retrieved April 7, 2020, from Abc News website: https://abcnews.go.com/Health/story?id=4002415&page=1
Gabelmann, O. U., & Owens, L. S. (2019). Good, Bad, or Indifferent? In The Odd, the Unusual, and the Strange (pp. 133–151). University of Florida Press. https://doi.org/10.2307/j.ctvx06wvr.14
Harris, J., Kallen, B., & Robert, E. (1996). The epidemiology of anotia and microtia. Journal of Medical Genetics, 33(10), 809–813. https://doi.org/10.1136/jmg.33.10.809
Hodges, D. C., Harker, L. A., & Schermer, S. J. (1990). Atresia of the external acoustic meatus in prehistoric populations. American Journal of Physical Anthropology, 83(1), 77–81. https://doi.org/10.1002/ajpa.1330830109
Hoffman, S., Sadler, L., Totman, T., & Bagne, L. (2019). A Possible case of Facio-Auriculo-Vertebral sequence (FAVs) in an adult female from medieval Iceland (13th–16th Century). International Journal of Paleopathology, 24(September 2018), 41–47. https://doi.org/10.1016/j.ijpp.2018.08.009
House, J. W., & Wilkinson, E. P. (2008). External auditory exostoses: Evaluation and treatment. Otolaryngology–Head and Neck Surgery, 138(5), 672–678. https://doi.org/10.1016/j.otohns.2008.01.023
Hrdlička, A. (1933). Seven prehistoric American skulls with complete absence of external auditory meatus. American Journal of Physical Anthropology, 17(3), 355–377. https://doi.org/10.1002/ajpa.1330170318
Keenleyside, A. (2011). Congenital aural atresia in an adult female from Apollonia Pontica, Bulgaria. International Journal of Paleopathology, 1(1), 63–67. https://doi.org/10.1016/j.ijpp.2011.01.001
Kelley, P. E., & Scholes, M. A. (2007). Microtia and Congenital Aural Atresia. Otolaryngologic Clinics of North America, 40(1), 61–80. https://doi.org/10.1016/j.otc.2006.10.003
Knüsel, C. J., & Bowman, J. E. (1996). A possible case of neurofibromatosis in an archaeological skeleton. International Journal of Osteoarchaeology, 6(2), 202–210. https://doi.org/10.1002/(SICI)1099-1212(199603)6:2<202::AID-OA263>3.0.CO;2-N
Krogman, W. M., & Iscan, M. Y. (1986). Human Skeleton in Forensic Medicine. Charles C. Thomas Publisher.
Liaw, J., Patel, V. A., & Carr, M. M. (2017). Congenital anomalies of the external ear. Operative Techniques in Otolaryngology-Head and Neck Surgery, 28(2), 72–76. https://doi.org/10.1016/j.otot.2017.03.012
Lipan, M., & Eshraghi, A. (2011). Otologic and Audiology Aspects of Microtia Repair. Seminars in Plastic Surgery, 25(04), 273–278. https://doi.org/10.1055/s-0031-1288919
Lo, J. F. W., Tsang, W. S. S., Yu, J. Y. K., Ho, O. Y. M., Ku, P. K. M., & Tong, M. C. F. (2014). Contemporary Hearing Rehabilitation Options in Patients with Aural Atresia. BioMed Research International, 2014, 1–8. https://doi.org/10.1155/2014/761579
Lovejoy, C. O. (1985). Dental wear in the Libben population: Its functional pattern and role in the determination of adult skeletal age at death. American Journal of Physical Anthropology, 68(1), 47–56. https://doi.org/10.1002/ajpa.1330680105
Martelli-Júnior, H., Miranda, R. T. de, Fernandes, C. M., Bonan, P. R. F., Paranaíba, L. M. R., Graner, E., & Coletta, R. D. (2010). Goldenhar syndrome: clinical features with orofacial emphasis. Journal of Applied Oral Science, 18(6), 646–649. https://doi.org/10.1590/S1678-77572010000600019
Nystrom, K. C., & Tilley, L. (2018). Mummy studies and the bioarchaeology of care. International Journal of Paleopathology, 25(June), 64–71. https://doi.org/10.1016/j.ijpp.2018.06.004
Owens, Lawrence S, & Eeckhout, P. (2015). To the God of Death, Disease, and Healing. Social Bioarchaeology of Cemetery I at Pachacamac. In L. S Owens & P. Eeckhout (Eds.), Funerary Practices and Models in the Ancient Andes : the Return of the Living Dead (1st ed., pp. 158–185). New York: Cambridge University Press. https://doi.org/https://doi.org/10.1017/CBO9781107444928
Roberts, C., & Cox, M. (2003). Health and Disease in Britain: From Prehistory to the Present Day (1st ed.). Sutton Publishing.
Schuknecht, H. F. (1989). Congenital Aural Atresia. The Laryngoscope, 99(9), 908–917. https://doi.org/10.1288/00005537-198909000-00004
Spence, M. W., Williams, L. J., & Wheeler, S. M. (2014). Death and Disability in a Younge Phase Community. American Antiquity, 79(1), 108–127. https://doi.org/10.7183/0002-7316.79.1.108
Stanley, P. (2014). Face the Music: A Life Exposed. HarperOne.
Swanston, T., Carter, Y., Hopkins, C., Walker, E. G., & Cooper, D. M. L. (2011). Developmental Fusion of the Malleus and Incus in a Late 19 th -Century Case of Aural Atresia. International Journal of Osteoarchaeology, 23(5), n/a-n/a. https://doi.org/10.1002/oa.1286
Tassano, E., Jagannathan, V., Drögemüller, C., Leoni, M., Hytönen, M. K., Severino, M., … Gimelli, G. (2015). Congenital aural atresia associated with agenesis of internal carotid artery in a girl with a FOXI3 deletion. American Journal of Medical Genetics Part A, 167(3), 537–544. https://doi.org/10.1002/ajmg.a.36895
Tasse, C., Böhringer, S., Fischer, S., Lüdecke, H.-J., Albrecht, B., Horn, D., … Wieczorek, D. (2005). Oculo-auriculo-vertebral spectrum (OAVS): clinical evaluation and severity scoring of 53 patients and proposal for a new classification. European Journal of Medical Genetics, 48(4), 397–411. https://doi.org/10.1016/j.ejmg.2005.04.015
Tilley, L. (2012). Tilley, L. 2012 The bioarchaeology of care. The Archaeological Record, 12.
Tilley, L., & Oxenham, M. F. (2011). Survival against the odds: Modeling the social implications of care provision to seriously disabled individuals. International Journal of Paleopathology, 1(1), 35–42. https://doi.org/10.1016/j.ijpp.2011.02.003
Todd, N. W. (1994). Mastoid pneumatization in patients with unilateral aural atresia. European Archives of Oto-Rhino-Laryngology, 251(4), 196–198. https://doi.org/10.1007/BF00628422
Trinkaus, E., & Villotte, S. (2017). External auditory exostoses and hearing loss in the Shanidar 1 Neandertal. PLOS ONE, 12(10), e0186684. https://doi.org/10.1371/journal.pone.0186684
Trojanowska, A., Drop, A., Trojanowski, P., Rosińska-Bogusiewicz, K., Klatka, J., & Bobek-Billewicz, B. (2012). External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms. Insights into Imaging, 3(1), 33–48. https://doi.org/10.1007/s13244-011-0126-z
Tsaliki, A. (2008). Unusual Burials and Necrophobia: An Insight into the Burial Archaeology of Fear. In E. M. Murphy (Ed.), Deviant Burial in the Archaeological Record (pp. 1–16). Oxford: Oxbow.
van Duijvenbode, A., Herschensohn, O. J., & Morgan, M. E. (2015). A severe case of congenital aural atresia in pre-Columbian Venezuela. International Journal of Paleopathology, 9, 15–19. https://doi.org/10.1016/j.ijpp.2014.11.002
Vega, G. de la. (2016). Comentarios Reales de los Incas 1609 (1st ed.). Lima: Universidad Inca Garcilaso de la Vega.
Verma, R., Jana, M., Bhalla, A. S., Kumar, A., & Kumar, R. (2016). Diagnosis of osteopetrosis in bilateral congenital aural atresia: Turning point in treatment strategy. World Journal of Clinical Pediatrics, 5(2), 228. https://doi.org/10.5409/wjcp.v5.i2.228
Vyhnanek, L., & Kuzelka, V. (1998). Atresia of the External Auditory Meatus: Two New Cases from Medieval Bone Materials. 1998 12th European PPA Meeting Abstracts August 26-29 Prague and Pilsen, Czech Republic, 23. Detroit: Paleopathology Association. Retrieved from https://paleopathology-association.wildapricot.org/resources/Documents/European PPA Programs/1998 12th European PPA Meeting Abstracts August 26-29 Prague and Pilsen, Czech Republic.pdf
Wells, C. (1962). Three Cases of Aural Pathology of Anglo-Saxon Date. The Journal of Laryngology & Otology, 76(11), 931–933. https://doi.org/10.1017/S002221510006014X
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution 4.0 International Public License
By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.
Section 1 – Definitions.
- Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.
- Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.
- Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.
- Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.
- Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.
- Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.
- Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.
- Licensor means the individual(s) or entity(ies) granting rights under this Public License.
- Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.
- Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.
- You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.
Section 2 – Scope.
- License grant.
- Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:
- reproduce and Share the Licensed Material, in whole or in part; and
- produce, reproduce, and Share Adapted Material.
- Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.
- Term. The term of this Public License is specified in Section 6(a).
- Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a)(4) never produces Adapted Material.
- Downstream recipients.
- Offer from the Licensor – Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.
- No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.
- No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).
- Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:
-
Other rights.
- Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.
- Patent and trademark rights are not licensed under this Public License.
- To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties.
Section 3 – License Conditions.
Your exercise of the Licensed Rights is expressly made subject to the following conditions.
-
Attribution.
-
If You Share the Licensed Material (including in modified form), You must:
- retain the following if it is supplied by the Licensor with the Licensed Material:
- identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);
- a copyright notice;
- a notice that refers to this Public License;
- a notice that refers to the disclaimer of warranties;
- a URI or hyperlink to the Licensed Material to the extent reasonably practicable;
- indicate if You modified the Licensed Material and retain an indication of any previous modifications; and
- indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.
- retain the following if it is supplied by the Licensor with the Licensed Material:
- You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.
- If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.
- If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.
-
Section 4 – Sui Generis Database Rights.
Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:
- for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database;
- if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and
- You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.
For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.
Section 5 – Disclaimer of Warranties and Limitation of Liability.
- Unless otherwise separately undertaken by the Licensor, to the extent possible, the Licensor offers the Licensed Material as-is and as-available, and makes no representations or warranties of any kind concerning the Licensed Material, whether express, implied, statutory, or other. This includes, without limitation, warranties of title, merchantability, fitness for a particular purpose, non-infringement, absence of latent or other defects, accuracy, or the presence or absence of errors, whether or not known or discoverable. Where disclaimers of warranties are not allowed in full or in part, this disclaimer may not apply to You.
- To the extent possible, in no event will the Licensor be liable to You on any legal theory (including, without limitation, negligence) or otherwise for any direct, special, indirect, incidental, consequential, punitive, exemplary, or other losses, costs, expenses, or damages arising out of this Public License or use of the Licensed Material, even if the Licensor has been advised of the possibility of such losses, costs, expenses, or damages. Where a limitation of liability is not allowed in full or in part, this limitation may not apply to You.
- The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.
Section 6 – Term and Termination.
- This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.
-
Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:
- automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or
- upon express reinstatement by the Licensor.
- For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.
- Sections 1, 5, 6, 7, and 8 survive termination of this Public License.
Section 7 – Other Terms and Conditions.
- The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.
- Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.
Section 8 – Interpretation.
- For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.
- To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.
- No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.
- Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.
Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark “Creative Commons” or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.
Creative Commons may be contacted at creativecommons.org.