Morphometric Evaluation of Frontal Sinus and Investigating the Role of Gender in Anatomical Variations in Cone-beam Computed Tomography Images of an Iranian Population
Journal of "Regeneration, Reconstruction & Restoration" (Triple R),
Vol. 6 (2021),
Introduction: The frontal sinus has been of great interest to surgical and forensic specialists for human identification due to anatomical variations. The purpose of this study was to investigate the role of gender in the dimensions and anatomical variations of frontal sinus in cone-beam computed tomography (CBCT) images.
Materials and Methods: In this historical cohort study, CBCT images of 40 patients i.e, 20 males and 20 females, older than 18 years of age were reviewed. CBCT images with 1-mm-thick sections and NNT Viewer software for image analysis were used to measure frontal sinus height. The mean width, depth, thickness of the anterior cortex of the frontal bone, and the number of septa were measured in the axial sections, and the height was measured in the coronal sections of the CBCT images in both sexes. The data were analyzed by Student's t-test.
Results: The mean frontal sinus height was 20.5 mm in women and 25.9 mm in men; this difference was statistically significant (P<0.05). The mean frontal sinus width was 48.3 mm in women and 57.1 mm in men (P<0.002). The mean frontal sinus depth was 16.5 mm for women and 22.1 mm for men (P<0.05). The mean number of frontal sinus septa was 2.1 in females and 3.1 in males (P<0.05).
Conclusion: The results of this study showed the higher height, width, depth, and number of septa in males than in females, but the difference in the number of the frontal sinuses and the thickness of the anterior cortex of the frontal sinus was not sufficient to accurately determine gender.
- Anatomical Variation
- Cone-Beam Computed Tomography
- Forensic Identification
- Frontal Sinus
How to Cite
2. Wanzeler AMV, Alves-Júnior SM, Ayres L, da Costa Prestes MC, Gomes JT, Tuji FM. Sex estimation using paranasal sinus discriminant analysis: a new approach via cone beam computerized tomography volume analysis. Int J Legal Med. 2019 Nov; 133(6):1977-1984.
3. Yun IS, Kim YO, Lee SK, Rah DK. Three-dimensional computed tomographic analysis of frontal sinus in Asians. J Craniofac Surg. 2011 Mar; 22(2):462-7.
4. Almeida Prado PS, Adams K, Fernandes LC, Kranioti E. Frontal sinus as an identity and sex indicator. Morphologie. 2021 Jan 16:S1286-0115(20)30126-0.
5. Gadekar NB, Kotrashetti VS, Hosmani J, Nayak R. Forensic application of frontal sinus measurement among the Indian population. J Oral Maxillofac Pathol. 2019 Jan-Apr; 23(1):147-151
6-Sommer F, Hoffmann TK, Harter L, Döscher J, Kleiner S, Lindemann J, Leunig A. Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological signs of opacification. Eur Arch Otorhinolaryngol. 2019 Nov; 276(11):3139-3146
7-Dassi CS, Demarco FR, Mangussi-Gomes J, Weber R, Balsalobre L, Stamm AC. The Frontal Sinus and Frontal Recess: Anatomical, Radiological and Surgical Concepts. Int Arch Otorhinolaryngol. 2020 Jul; 24(3):e364-e375.
8-Ekşi MŞ, Güdük M, Usseli MI. Frontal Bone is Thicker in Women and Frontal Sinus is Larger in Men: A Morphometric Analysis. J Craniofac Surg. 2020 Nov 19.
9) Nagare SP, Chaudhari RS, Birangane RS, Parkarwar PC. Sex determination in forensic identification, a review. J Forensic Dent Sci. 2018; 10(2):61-66. doi:10.4103/jfo.jfds_55_17
10) Ekizoglu O, Hocaoglu E, Inci E, Can IO, Solmaz D, Aksoy S, Buran CF, Sayin I. Assessment of sex in a modern Turkish population using cranial anthropometric parameters. Leg Med (Tokyo). 2016 Jul; 21:45-52. doi: 10.1016
11) Wu W, Li Y, Fan F, Zhang K, Deng ZH. Research Progress on Individual Identification by Frontal Sinus Imaging. Fa Yi Xue Za Zhi. 2021 Feb; 37(1):81-86.
12) Nautiyal A, Narayanan A, Mitra D, Honnegowda TM, Sivakumar. Computed Tomographic Study of Remarkable Anatomic Variations in Paranasal Sinus Region and their Clinical Importance - A Retrospective Study. Ann Maxillofac Surg. 2020 Jul-Dec; 10(2):422-428
13. Akhlaghi M, Bakhtavar K, Moarefdoost J, Kamali A, Rafeifar S. Frontal sinus parameters in computed tomography and sex determination. Leg Med (Tokyo). 2016 Mar; 19:22-7
14. Cossellu G, De Luca S, Biagi R, Farronato G, Cingolani M, Ferrante L, et al. Reliability of frontal sinus by cone beam-computed tomography (CBCT) for individual identification. Radiol Med. 2015 Dec; 120(12):1130-6.
15. Zhao H, Li Y, Xue H, Deng ZH, Liang WB, Zhang L. Morphological analysis of three-dimensionally reconstructed frontal sinuses from Chinese Han population using computed tomography. Int J Legal Med. 2021 May; 135(3):1015-1023.
16. Scendoni R, Kelmendi J, Cossellu G, Canturk N, Celik Arslan B, Peker E, Ferrante L, Cameriere R. Comparison of Frontal Sinuses for Personal Identification in 3 Populations Using Cameriere's Code Number. Am J Forensic Med Pathol. 2021 Mar 1; 42(1):42-45
17. Benghiac AG, Thiel BA, Haba D. Reliability of the frontal sinus index for sex determination using CBCT. Rom J Leg Med. 2015 Dec; 23(4):275-278.
18. Benghiac AG, Constantin Budacu C, Moscalu M, Ioan B, Moldovanu A, Haba D. CBCT assessment of the frontal sinus volume and anatomical variations for sex determination. Rom J Leg Med. 2017 Jun; 25(2):174-179.
19. Luo H, Wang J, Zhang S, Mi C. The application of frontal sinus index and frontal sinus area in sex estimation based on lateral cephalograms among Han nationality adults in Xinjiang. J Forensic Leg Med. 2018 May;56:1-4.
20. Tatlisumak E, Asirdizer M, Bora A, Hekimoglu Y, Etli Y, Gumus O, et al. The effects of gender and age on forensic personal identification from frontal sinus in a Turkish population. Saudi Med J. 2017 Jan; 38(1):41-7.
21) 1. Lee MK, Sakai O, Spiegel JH. CT measurement of the frontal sinus - gender differences and implications for frontal cranioplasty. J Craniomaxillofac Surg. 2010 Oct; 38(7):494-500.
22) Sarment DP, Christensen AM. The use of cone beam computed tomography in forensic radiology. J Forensic Rad Imaging. 2014 Oct;2(4):173-181
23. Choi IGG, Duailibi-Neto EF, Beaini TL, da Silva RLB, Chilvarquer I. The Frontal Sinus Cavity Exhibits Sexual Dimorphism in 3D Cone-beam CT Images and can be used for Sex Determination. J Forensic Sci. 2018 May; 63(3):692-698.
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