Ecco una curiosità, che potrebbe anche essere vera, vista la fonte autorevole (www.thelancet.com Vol 384, October 11, 2014 – pag. 1348), anche se le vicende del cranio di Cartesio (Descartes) sono note e complicate.
Mi piace anche il fatto che il titolo sia in forma interrogativa (le verità assolute ed indiscutibili instillano sempre il dubbio di trovarsi di fronte a ciarlatani).
"René Descartes aveva un osteoma gigante del seno etmoidale?"
Si tratta - di fatto - di un articolo medico, documentato e circostanziato, su studi con CT Scan effettuati sul cranio di Cartesio (secondo le ultime certificazioni, riportate, del 2008).
Vi si cita l'aspetto dell'etmoide del cranio di Cartesio (che presenta una massa radio-opaca nel seno etmoidale destro di circa 3 cm per 0.8 cm) e si formula la possibile diagnosi di osteoma etmoidale.
- Questo tipo di tumore è il più benigno dei tumori sinusali, più frequente nei maschi, con incidenza maggiore tra i 30 - 50 anni. La sede etmoidale è la seconda sede più frequente: occorre statisticamente nel 14% dei casi.
- La sintomatologia, presente nel 10% dei casi, consiste in: ostruzione nasale, affezione sinusale( congestione, pressione, rinorrea, modifiche dell'olfatto), disfunzioni lacrimali (epifora, dacriocistite), epistassi, dolore facciale, cefalea, disturbi visivi (diplopia: visione doppia).
- I biografi di Cartesio non riportano sintomi simili, ove si eccettui un singolo episodio di emicrania accompagnato da un'aura ed improvvise allucinazioni visive, avvenuto la sera del 10 novembre 1619.
La patologia sopra ipotizzata non fu tra le cause di morte: Cartesio morì per una polmonite acuta a Stoccolma, il giorno 11 febbraio 1650, all'età di 54 anni.
Did René Descartes have a giant ethmoidal
sinus osteoma?
The skull of the French philosopher René
Descartes has been held in the National Museum of Natural History (Paris,
France) since 1821.
Its authenticity has been confirmed by
anthropological and historical investigations.(1)
We did a CT scan of the skull, which showed
a dense radio-opaque mass in the right ethmoidal sinus of 3·0 cm × 1·8 cm and 1440–1840
Hounsfield units.
This formation did not extend to the frontal
sinus or the right orbit.
After a comparison with modern radioanatomical and
forensic cases, we propose a diagnosis of osteoma.
Osteomas are the most benign tumour of the
paranasal sinuses with a point prevalence of 3%, a male preponderance, a peak
incidence at age 30–50 years, and an average age at presentation of 50 years of
age.(2)
The most frequent
site is the frontal sinus (75% of cases), followed by the ethmoidal sinus
(14%), the maxillary sinus (8·5%), and the sphenoid sinus (2·5%).(3)
Two variants have
been described: ortical osteomas (which are round or lobuted with ivory-like
density; as with Descartes), and cancellous osteomas (much less dense and
consisting of lamellar trabeculation of cancellous bone and an abundant
fibrofatty marrow).(3)
Various causes have been proposed including embryonic
malformation, post-trauma formation, calcifying polyposis, and response to a
chronic inflammation.(2)
Due to the radiological presentation and gross morphology of the
CT scan of Descartes, we excluded other diagnoses such as fibrous dysplasia of
the right ethmoid, ossifying fibroma, and osteoblastoma.
If symptomatic (10% of cases) (4), osteoma presents
with nasal obstruction, sinus dysfunction (congestion, pressure, excess of
mucus, and change in sense of smell), lacrymal dysfunction (epiphora and
dacryocystitis), epistaxis, facial pain, and headache; visual disturbance
(diplopia) has been reported in a few cases.(4)
Biographers have not described such symptoms
in René Descartes (1) apart from one possible isolated episode of migraine with aura on the night
of Nov 10, 1619 (characterised by sudden visual and auditory hallucinations) (5); however, simple
benign masses do not usually cause such phenomenon, especially in the first 24
h as seen in vascular headache.
Such an organic lesion probably had no role
in the cause and circumstances of death of René Descartes, who died due to an
acute pneumonia in Stockholm, Sweden, on Feb 11, 1650, at the age of 54 years.
We declare no competing interests.
*Philippe Charlier, Philippe Froesch,
Nadia Benmoussa , Alain Froment, Russell Shorto, Isabelle Huynh-Charlier philippe.charlier@uvsq.fr
Section of Medical and Forensic
Anthropology, Faculty of Health Sciences, Montigny-Le-Bretonneux 78180, France
(PC, IH-C); National Museum of Natural History, Department of Anthropology,
Paris, France (PC, AF); Visual Forensic, Parc Audiovisual de Catalunya,
Barcelona, Spain (PF); Department of Otolaryngology—Head and Neck Surgery,
Rouen University Hospital, Rouen, France (NB); John Adams Institute, Amsterdam,
Netherlands (RS); and Department of Radiology, University Hospital
Pitié-Salpétrière, Paris, France (IH-C)
1) Shorto R. Descartes’ bones. A skeletal
history of the conflict between faith and reason. New York: Doubleday, 2008.
2) Erdogan N, Demir U, Songu M, et al. A
prospective study of paranasal sinus osteomas in 1889 cases: changing patterns
of localization. Laryngoscope 2009; 119: 2355–59.
3) Sayan NB, Ucok C, Karasu HA, Gunhan O.
Peripheral osteoma of the oral and maxillofacial region: a study of 35 new
cases.
J Oral Maxillofac Surg 2002; 60: 1299–301.
4) Cokkeser Y, Bayarogullari H, Kahraman SS.
Our experience with the surgical management of paranasal sinus
osteomas. Eur Arch Otorhinolaryngol 2013; 270: 123–28.
5) Baillet A. La Vie de Monsieur Descartes. Paris: Daniel
Horthemels, 1691.
