High-resolution imaging of an ancient Egyptian mummified head: new insights into the mummification process.

BACKGROUND AND PURPOSE Systematic facial mutilations during mummification have never been described before. The purpose of this work was to study a wrapped mummified head using high-resolution CT scanning. MATERIALS AND METHODS An isolated mummified head from the Egyptian Middle Kingdom was scanned at 200 mum isotropic resolution. A prototype flat panel CT scanner was used to generate 800 nonoverlapping CT sections at 120 kV and 50 mA. This dataset was analyzed to discern various surgical alterations during mummification. RESULTS There were large defects in the cribriform plate and the posterior fossa. Systematic mutilations of the facial bones and mandible, involving the anterior and inferior walls of the maxillary sinuses, the floor of both orbits, and the zygomatic arches with contiguous segments of the zygomas, were demonstrated. The coronoid processes of both mandibles had been sharply excised and the articular tubercles of the temporomandibular joints fractured. CONCLUSION Defects in the ethmoid and the posterior skull base are consistent with previous descriptions of excerebration. Mutilations of the facial skeleton and jaw, which are unrelated to the process of excerebration, have never been described previously. It is noteworthy that the osteotomies selectively include the insertions of the muscles of mastication. These mutilations apparently were designed for mobilization of lower jaw. The "Opening of the Mouth" ceremony, described in the ancient texts, would be difficult to perform in the presence of rigor mortis; it is probable that the observed osteotomies were performed to facilitate this ceremony. Our research suggests that by the Middle Kingdom, Egyptian embalmers had developed highly sophisticated surgical techniques that have not been appreciated previously.