Distribution of frontal sinus pattern amongst Malaysian population: a skull radiograph study (original) (raw)
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Forensic Imaging, 2022
Sex identification is vital in establishing biological identity of unknown remains. In cases of fragmented skeletons, the resiliency of the frontal sinus suggests its potential in establishing biological identity. The traditionally used linear measurement has low reliability and is size-oriented, whereas geometric morphometrics is efficient as being reliable in characterising the shape. However, the frontal sinus approach for sex identification among Malaysians is yet to be explored. Objective: This study aims to evaluate sexual dimorphism of frontal sinus among Malaysians using the twodimensional (2D) geometric morphometrics method. Methods: Lateral skull radiographs of 453 adult Malaysian, comprising 228 males and 225 females, were retrieved retrospectively. Eight 2D landmarks were applied to the lateral skull radiographs using TPSDig2 software. 2D geometric morphometric analysis was performed by MorphoJ software. Results: The Principal Component Analysis (PCA) showed that the first three Principal Component (PCs) exhibit 83.0% of the total variance of the frontal sinus shape. Procrustes analysis of variance (ANOVA) revealed significant differences in centroid size and shape (p-value < 0.05) of frontal sinus between sexes. Discriminant Function Analysis (DFA) after cross-validation demonstrated a classification accuracy of 78.5% in males and 82.7% in females, with an average of 80.6%. Conclusion: High classification accuracy suggests that frontal sinus is a valuable tool for sex identification using 2D geometric morphometrics. The significant sexual dimorphism of the frontal sinus shape indicates its capability to aid in forensic investigation. To the best of our knowledge, this is the first study which showed such findings among Malaysian population.
Morphometry of frontal sinus in correlation to age and gender by computed tomography
IP Innovative Publication Pvt. Ltd, 2019
Introduction: The frontal sinus is funnel-shaped cavity separated by septum. The frontal sinus is unique to individual and often thought as a more symptomatic sinus because of the difficulties encountered in treatment of frontal rhino sinusitis. It requires the clinician to have precise knowledge of nasal sinus anatomy in the surgical treatment of sinusitis in recent years, particularly in endonasal endoscopic surgery. Materials and Methods: 100 patients (72 males and 28 females) undergoing coronal and axial sections of computed tomography scan of frontal sinus of head and neck aged between 1year to 90 years at the radiology department, Vydehi institute of medical science & research centre, Bangalore for reasons other than due to craniofacial abnormalities or sinus problem were taken for the study. Volume and dimensions of the frontal sinuses with its anatomical variations were obtained. Mean, SD, significant difference between age & gender was calculated. Results: Mean value of all the parameters of frontal sinus of both right & left were more in males compared to females. Compared between sides, all the parameters of both sides in males were more in right sinus than left side, in females right depth & volume were more on right side & height & width were more on left side. There is a significant difference in height of right frontal sinus, width & volume of left frontal sinus between male & female. The maximum height was observed in the age group in males on right side was in 51-60 yrs & on left side was 71-80yrs, in females on right & left side was 61-70 yrs. The Maximum width, depth & volume of sinus in males & females on right & left side were in age group 51-60 yrs. There is a significant difference both side in males & females and in right & left sinus in depth was in age group 11-20 yrs & on right side in 21-30 yrs age group. Conclusion: These results will be helpful in understanding normal and pathological conditions of the frontal sinuses & useful in clinical planning of medical or surgical interventions of the frontal sinuses.
Computerized tomographic study of frontal sinus patterns in skulls of South Indian Population
The frontal sinuses are a part of paranasal sinuses and they are located in the frontal bone above each orbits. The structure of frontal sinus can be variable from person to person and its sizes might be different in different populations. 50 macerated skulls(Males=28, Females=22) of age group 40-60 yrs are cleaned and subjected to 3D axial multislider CT scan. Axial and coronal images of slice thickness of 4mm were obtained. Frontal sinus ( symmetry and lobulations) were observed and classified. Frontal sinus symmetry was observed in 34 (68%) individuals, asymmetry in 15 (30%) individuals and frontal sinus was absent in 1(2%). The features of frontal sinus morphology make it most convenient part of the skeleton for forensic identification. Variations seen in the anatomy of frontal sinus will help otolaryngologists during surgical procedures involving frontal sinus and skull base.
Background and Aims: There is no study in the literature that investigates an asymmetric morphological feature of the frontal sinus (FS). Materials and Methods: Four hundred and sixty‑nine consecutive direct X‑rays of FSs were analyzed for the asymmetry between the right and left sides. When an asymmetry in the height and contour of the FS existed, this difference was quantified. Results: Of the 469 patients, X‑rays of 402 patients (85.7%), there was an asymmetry between right and left sides of the FS. Of these 235 (50.1%) were dominant on the left side, whereas 167 (35.6%) were dominant on the right, the sinuses of remaining 67 patients (14.3%) was symmetric. Statistical Analysis: The comparisons between parameters were performed using Wilkinson signed rank test. The relationship between handedness and sinus asymmetry was also examined by two proportions test. There is statistically significant difference between the dominance of left and right FS. Conclusions: Hemispheric dominance may have some effect (s) of on sinus asymmetry of the human cranium. Surgeons sometimes enter the cranium through the FS and knowledge of asymmetric FS is important to minimize surgical complications.
World Neurosurgery, 2021
Background: Knowledge of frontal sinus morphometry is important in bifrontal, pterional, orbitozygomatic, and supraorbital craniotomies. Inadvertent frontal sinus violation can lead to infection, cerebrospinal fluid fistula, and mucocele formation. In particular, knowledge of anatomy in relation to surgically relevant landmarks can help surgeons perform these procedures more precisely and safely. We performed a descriptive radiographic analysis to better understand variations in frontal sinus anatomy. Methods: Using 3D reconstructive software, we analyzed 162 normal cranial computerized tomographic angiograms (from 80 males and 82 females). A line between the supraorbital notches (SONs) was used as a horizontal reference line (HRL). We recorded the maximum sinus height and width from the HRL and midline, respectively. Additionally, sinus width was measured in relation to the SON at 0, 1, and 2 cm above the HRL. Results: The mean maximal sinus height from the HRL was 1.8 cm. The mean maximum sinus width was 2.6 cm (right and left) from midline and 0.46 cm (right) and 0.49 cm (left) from the SON. Less than 11% of sinuses were lateral to the SON at 2.0 cm above the HRL and less than 6% of sinuses were >1.5 cm lateral to the SON at 1.0 cm above the HRL. Conclusions: Planned surgical corridors >1.5 cm lateral to the SON and/or >3.0 cm above the HRL are most likely to avoid the frontal sinus based on our radiographic measurements of normal sinus anatomy. Careful radiographic study and appropriate planning for more medial and/or inferior corridors is suggested.
CT study on morphometry of frontal sinus
Clinical Anatomy, 2008
The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 ± 13.34 (range 20–83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31–40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity. Clin. Anat. 21:287–293, 2008. © 2008 Wiley-Liss, Inc.
Frontal Sinus Morphological and Dimensional Variation as Seen on Computed Tomography Scans
Biology
Frontal sinus variation has been used in forensic anthropology to aid in positive identification since the 1920s. As imaging technology has evolved, so has the quality and quantity of data that practitioners can collect. This study examined frontal sinus morphological and dimensional variation on computed tomography (CT) scans in 325 individuals for assigned sex females and males from African-, Asian-, European-, and Latin American-derived groups. Full coronal sinus outlines from medically derived CT images were transferred into SHAPE v1.3 for elliptical Fourier analysis (EFA). The dimensional data were measured directly from the images using the MicroDicom viewer. Statistical analyses—Pearson’s chi-square, ANOVA, and Tukey post hoc tests—were run in R Studio. Results indicated that 3.7% lacked a frontal sinus and 12.0% had a unilateral sinus, usually on the left (74.3%). Additionally, no statistically significant morphological clustering using EFA was found based on assigned sex an...
Configuration of frontal sinuses A forensic prespective
Background: Identification of an individual whether living or deceased is of paramount importance in maintaining the integrity of the society. A simple, reliable, and efficacious method always finds a way for easier acceptance and inclusion in any discipline. Likewise, identification of an individual using the radiographic frontal sinus patterns is a simple technique which emphasized to conduct the study with a proven result. Objective: The objective of the study is to evaluate the radiographic configurations of frontal sinuses for their uniqueness based on different parameters. Study Group and Methods: Study group consisted of thirty individuals (15 males and 15 females) of age between 20 and 30. Individuals with the history of sinusitis, surgery, or any trauma were not included in the study. Paranasal sinus views were taken using standard exposure parameters, and the radiographs were assessed for their uniqueness. Results: The radiographs were assessed for area size, area asymmetry, superiority of the upper border, outline of the upper border, presence or absence of partial septa and supraorbital cells, and based on these results, a unique code number was assigned to each individual to prove the uniqueness. Conclusion: A frontal sinus comparison is particularly useful when no other means of an individual identification are available. Caution must be taken regarding the physiological and pathological changes (trauma, infection, old age, surgery, etc.) and postmortem changes and about the technical issues while taking a radiograph (distance, angle, orientation of the skull). In spite of all these issues, the configuration of frontal sinus is an excellent individualizing feature.
Journal of Forensic Science & Criminology, 2016
Background: Frontal sinuses are pneumatic cavities that radiologically revealed in 5 or 6 years old and completed in 20 years old. Comparison of the frontal sinus has significant value to establish identification. The purpose of this study was to comparison of frontal sinus and assessment of right and left frontal sinus volume according to gender by using Multi Detector CT scan (MDCT). With this background, this study was undertaken to examine and classify variations in frontal sinus and assessment of right and left frontal sinus volume according to sex by using CT scan. Materials and Methods: Sixty five consecutive men's and women's patients who underwent paranasal CT scans from September 2014 to April 2016 were identified from our institutional imaging database. Height, depth, and width of frontal sinuses were measured and a cubical approximation of volume determined by using Digimizer Image Analyzer. Result: Right and left frontal sinus were observed in 44 individuals (67.8%). Right frontal sinus was absent in 6 individuals (9.2%) and left frontal sinus was absent in 3 individuals (4.6%). Both of frontal sinus were absent in 9 individuals (13.8%). Right and left frontal sinus were not separate (integration) in 3 individuals (4.6%). Lack of frontal sinus frequency was higher in men and sinus integration was seen only in women .The average volume in left sinus was significantly higher than the right (P=0.02). Average volume of both the right (P=0.04) and the left (P=0.02) frontal sinus in males were significantly more than females. Conclusion: We found that the frontal sinus patterns had considerable individual variation. Right and left frontal sinus volumes were variable according to gender by using CT scan.
World Neurosurgery, 2016
Background: Knowledge of frontal sinus morphometry is important in bifrontal, pterional, orbitozygomatic, and supraorbital craniotomies. Inadvertent frontal sinus violation can lead to infection, cerebrospinal fluid fistula, and mucocele formation. In particular, knowledge of anatomy in relation to surgically relevant landmarks can help surgeons perform these procedures more precisely and safely. We performed a descriptive radiographic analysis to better understand variations in frontal sinus anatomy. Methods: Using 3D reconstructive software, we analyzed 162 normal cranial computerized tomographic angiograms (from 80 males and 82 females). A line between the supraorbital notches (SONs) was used as a horizontal reference line (HRL). We recorded the maximum sinus height and width from the HRL and midline, respectively. Additionally, sinus width was measured in relation to the SON at 0, 1, and 2 cm above the HRL. Results: The mean maximal sinus height from the HRL was 1.8 cm. The mean maximum sinus width was 2.6 cm (right and left) from midline and 0.46 cm (right) and 0.49 cm (left) from the SON. Less than 11% of sinuses were lateral to the SON at 2.0 cm above the HRL and less than 6% of sinuses were >1.5 cm lateral to the SON at 1.0 cm above the HRL. Conclusions: Planned surgical corridors >1.5 cm lateral to the SON and/or >3.0 cm above the HRL are most likely to avoid the frontal sinus based on our radiographic measurements of normal sinus anatomy. Careful radiographic study and appropriate planning for more medial and/or inferior corridors is suggested.