Dimensions of the sphenoid and ethmoid sinuses on computed tomography: Clinical implications and role in sex determination

Abstract

Background: The measurements of the sphenoid and ethmoid sinuses (ESs) are essential in forensic investigations and during endoscopic sinus and skull base surgeries. This study aimed at assessing the dimensions of these sinuses and elucidating their role in sex determination. Materials and Methods: This retrospective assessment was conducted using brain-computed tomographic images stored in the Department of Radiology in a Tertiary hospital in Delta State, Nigeria. After institutional ethical approval, images of 292 patients (115 females and 177 males) aged >20 years, were used to measure the dimensions of the ethmoid and sphenoid sinuses (SSs) bilaterally. These were analyzed and summarized using descriptive statistics. Their association with gender, side, or age was assessed using inferential statistics and considered statistically significant at P < 0.05. Discriminant function analysis of the sinus measurements was conducted to evaluate their accuracy in correct sex prediction. Results: Both sphenoid and ESs showed significant sexual dimorphism. The ESs showed significant asymmetry (P < 0.05). The anterior width of the left ES (79.8%) was the best sex-discriminating variable. The combination of the left sinus dimensions was more accurate (74.3%, 85.3%) than the right sinuses (72.6%, 81.2%) in sex allocation. Using the bilateral ES dimensions yielded a higher accuracy (89.0%) than using bilateral SS parameters (80.1%). Conclusion: The sphenoid and ESs may be used in predicting the sex of an unknown skull bone recovered within the studied population with acceptable accuracy levels.