Gender identification from frontal sinus using multi-detector computed tomography
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.
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Frontal sinus index for sex estimation: Is it possible?
2020, Forensic ImagingComparative study of the reliability of frontal and maxillary sinuses in sex identification using multidetector computed tomography among Egyptians
2020, Forensic ImagingCitation Excerpt :In another study conducted in Egypt on 100 individuals, multi detector computed tomography examination of frontal sinus showed statistically significant sex differences regarding antero-posterior length (depth), width and height. Right antero-posterior diameter showed the highest accuracy for sex discrimination (70% in females and 64% in males) [44]. A study on 90 Iraqi subjects using spiral CT examination showed that all measurements of skull and frontal sinus were significantly larger in males.
Morphometric analysis of the frontal sinus: application of industrial digital radiography and virtual endocast
2018, Journal of Forensic Radiology and ImagingCitation Excerpt :Thus, due to its uniqueness, relatively constant morphology and its protected location, the FS is particularly useful for identification of human remains [7–13]. It can also be used as a feature for sex prediction [14–17]. Furthermore, the FS morphology and dimensions are essential in neurosurgical and endoscopic nasal interventions because of its proximity to the orbit and the anterior cranial base so as to avoid its injury during interventions or postoperative complications [4,18].
Evaluation of the paranasal sinuses dimensions in sex estimation among a sample of adult egyptians using multidetector computed tomography
2017, Journal of Forensic Radiology and ImagingCitation Excerpt :Fig. 4) The frontal sinus anteroposterior length (depth) was measured from the axial image. [16,17] ( Fig. 4)
Advances in the use of frontal sinuses for human identification
2017, New Perspectives in Forensic Human Skeletal Identification“Assessment of frontal sinus dimensions using CBCT to determine sexual dimorphism amongst Egyptian population”
2016, Journal of Forensic Radiology and ImagingCitation Excerpt :The investigators had utilized multi-detector computed tomography (MDCT). This percent in comparison with ours (76.7% ) in Table 6 means that examination of frontal sinus using CBCT yield more accurate results for identifying gender than other modalities of computed tomography [24]. Frontal sinus measures and non-metric characteristics are unique for individuals and help for personal identification in forensic practice.