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Abstract Mastoiditis is a disease that follows otitis media and may lead to severe endocranial complications. Most studies on mastoiditis and middle ear diseases in archaeological skeletal remains are based on radiological investigations. The following study describes the morphological changes in the pneumatised cells of the mastoid process due to mastoiditis in archaeological skeletal remains, based on macroscopic, endoscopic, light and scanning‐electron microscopic investigations. For the purposes of this study, we used an early medieval Frankish population from Dirmstein, State of Rhineland‐Palatinate, Germany. Copyright © 2008 John Wiley & Sons, Ltd.
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