Cephalometric Analysis of Sphenoid Sinus Dimensions for Sex Identification: A Radiologic Study

Abstract

Background: Post-mortem identification of human remains with severe crushing and mutilating skeletal injuries from mass burials and natural disasters, is a challenging forensic procedure. Gender determination from skeletal remains requires a comparison between established ante-mortem data and post-mortem findings from mostly intact, easily recoverable parts of the skeleton, like the skull base sphenoid bone. Computed tomography, being the gold standard for radiological assessment of the paranasal sinuses, offers accurate and precise information about skeletal tissues. The aim of the study was to determine the sex of subjects from measurements of the sphenoid sinus using computerized tomography. Materials and Methods: Computerised tomography images of 323 adult sphenoid sinuses, obtained over a six-year period, from individuals whose ages ranged from 18 to 80 years were recruited, and the study was conducted at the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, following ethical approval. Images were taken with a GE Brightspeed Multidetector Helical CT Scanner, the anteroposterior, craniocaudal and transverse dimensions were measured on sagittal reformatted, axial and coronal reconstructed CT images respectively, and the volumes were determined. Measurements were taken in millimetres, between the widest points at the middle of the sinus walls from three-dimensional reconstructed images using the RadiAnt Version 4.2 (Medixant, 2017), powered by the Digital Imaging and Communication in Medicine (DICOM) viewer software. These images were viewed on bone windows. Results: Sinus volume and the transverse diameter, each correctly classified the sexes of subjects, in 60.4% of cases. However, when all the measured parameters of the sinus were analysed together as a single factor for sex determination, an overall value of 57.6% was obtained. Conclusion: Computerized Tomography measurements of sphenoid sinus dimensions could be useful in support of gender identification in unknown severely damaged human remains with speared sphenoid bone. Keywords: Sex, Sphenoid, CT, Forensic Anthropology