Gender identification from frontal sinus using multi-detector computed tomography

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Highlights

  • Right and left frontal sinus (FS) dimensions were measured using computed tomography.

  • FS dimensions measured were maximum transverse, height and anteroposterior lengths.

  • Lower values were detected in female in comparison to the male group.

  • FS dimensions are valuable in gender identification.

Abstract

The determination of gender of unknown persons is of vital importance in forensic investigations. The present study aimed to evaluate the accuracy and reliability of frontal sinus (FS) dimensions measurement in gender identification. One hundred people (50 males and 50 females) with age range from 20 to 70 years were selected in this study. FS dimensions for both right and left sinuses (transverse, height & anteroposterior lengths) were measured from axial and coronal sections (4-mm slice thickness) using multi-detector computed tomography (MDCT) scanner. Statistically significant lower values for the maximum transverse length of both right and left FS in female group were detected in comparison to the male group (p=0.002). In addition, the maximum height of right and left FS in females showed statistically highly significant lower values for in comparison to males (p=0.001). Also, the maximum anteroposterior length of the frontal sinus for right and left sides in female group had statistically significant lower values (p=0.001and 0.01 respectively) in comparison to the male group. Multiple regression equations revealed that among all FS measurements, the right FS anteroposterior length was the best discriminate variable between genders with overall accuracy 67.0% (70.0% for women and 64.0% for men). It can be concluded that FS dimensions measurement especially the right anteroposterior length are valuable in studying sexual dimorphism using MDCT image.

Introduction

Identification of human remains is one of the most essential aspects of forensic medicine. The determination of gender of unknown people is also of vital importance in forensic investigations [1].

Skeletal remains have been used for sexing the individual as bones of the body are last to perish after death, next to enamel of teeth. However, when extreme post-mortem changes have developed as in explosions, warfare and other mass disasters like aircraft crashes, identification and sex determination are not easy tasks [2].

Radiological identification of humans still has a very important place in forensic medicine especially in difficult cases of DNA analysis, or in cases where the body is putrefied, fragmented, carbonized or skeletonized [3].

The skull is useful in sex assessment of skeletonized remains; however, its fragmentation precludes the use of all conventional craniofacial markers. The frontal bone may be recovered intact in fragmented remains and the sinuses therein may be useful in sex differentiation [4].

The frontal sinuses are a part of paranasal sinuses and they are located in the frontal bone above each eye. They consist of paired, loculated cavities, which communicate with the nasal fossa via the infundibulum [5].

Frontal sinus has great variability due to its irregular shape and because of individual characteristics which make the frontal bone unique for every individual, just as with fingerprints even for monozygotic twins [6].

Also, the Frontal sinus has very strong walls and its structure does not change after the age of 20 years except for very rare occurrences as fractures, tumors or severe infections [7].

Gender estimation can be accomplished using either morphological or metric methodologies. Statistical methods utilizing metric traits are becoming more popular; with most of the bones have been subjected to linear discriminant classification [8].

Computerized tomography (CT) is an excellent imaging modality in the identification of unknown human remains and could be used to evaluate the paranasal sinuses and craniofacial bones. It can provide valuable and precise measurement for frontal sinus dimensions [10].

CT presents a lot of advantages as compared with conventional radiographs. First, it provides the opportunity of avoiding the superimposition of structures beyond the plane of interest and allowing the visualization of small differences of density [9]. Second, the images can be easily manipulated and internal points that should be evaluated can be shown by images segmentation. Third, Craniometric points can be precisely located and measurements can be more accurately performed than on conventional radiographs. Volumes and areas can be determined. Fourth, the film includes a description of the technical details and knowledge about the patient which can be very useful for the identification process [3].

CT measurements of frontal sinus may be a useful method in differentiating gender [11]. This study was designed to determine the reliability and accuracy of frontal sinus dimensions measurement using CT as a method for gender identification.

Section snippets

Study design

Total number of patients referred to radiology department, Mansoura University Hospital for performing CT scanning of paranasal sinuses from January to December 2012 was 280. 38 patients were excluded because they were too young for a complete maturation of frontal sinuses, 135 patients were excluded because of history of trauma, surgery or pathological lesions in the frontal region, further 7 patients were then excluded, because of the detection of frontal sinus aplasia. Thus, the final study

Results

As shown in Table 1, the mean value for the maximum transverse length of the right frontal sinus in males was 23.72±9.21 mm and 26.74±10.15 mm for the left side. Female group had statistically significant lower values for both right and left sides (17.8±9.85 and 20.17±10.14 mm, respectively) in comparison to the male group (p=0.002).

The mean value for the maximum height of the right frontal sinus in males was 11.46±4.49 mm and 12.46±5.29 mm for the left side (Table 1). Females had highly significant

Discussion

This work was conducted to determine the reliability and accuracy of FS dimensions measurement by using MDCT scanner as a method for gender identification. FS dimensions for both right and left sinuses (transverse, height & anteroposterior lengths) were measured from axial and coronal section (4-mm slice thickness) using multi-detector computed tomography (MDCT) scanner.

Subjects included in the present study were above 20 years old to exclude the possibility of incomplete growth which may lead

Conclusion

From the current work, it could be concluded that the frontal sinus measurements (especially right anteroposterior length) are valuable in differentiating gender and CT images that could provide adequate measurements for frontal sinuses.

Ethical approval

This study followed the ethical guidelines of ethical committee of Mansoura University.

Conflict of interest

Neither the author nor any of the coauthors have any potential conflict of interest related to the publication of this paper.

Funding

None.

Contributors

Sameera Sh. Hamed: Conception and design, analysis and interpretation of data, manuscript writing and approval of final article.

Adel M. El-Badrawy: Conception and design and data collection.

Sherif Abdel Fattah: Data collection.

Acknowledgment

We would like to thank Prof. Dr. Saleh El-Essawy for his assistance in reviewing this study and his help for inter-examiner calibration.

References (15)

There are more references available in the full text version of this article.

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