Sexual Dimorphism of Maxillary Sinus: A Morphometric Analysis using Cone Beam Computed Tomography

Abstract

Introduction: Age and sex determination in forensic sciences are primary components of any skeletal analysis. As most bones used for sex determination are recovered in incomplete state, it is often necessary to use bones that are recovered intact e.g., the maxillary sinus. Cone Beam Computed Tomography (CBCT) can provide precise information about complex anatomical structures, as it is characterized by rapid volumetric image acquisition with high resolution.

Aim: The present study was designed to evaluate the size and volume of Maxillary Sinus (MS) in determining gender by CBCT.

Materials and methods: Bilateral maxillary sinus images (left and right) were acquired for 100 patients (50 females and 50 males) and different parameters (width, length, height, area, perimeter and volume) were measured and evaluated. Mean and standard deviation of both maxillary sinuses measurements were calculated and compared. The data was subjected to discriminative statistical analysis and analysed using unpaired t-test.

Results: Comparison between male and female groups showed statistically insignificant differences on both the right and left sides with respect to the maxillary sinus length, height, area, volume and perimeter. However, the female group showed statistically significant higher values for left side MS width (p=0.041) and left side MS width can be used to determine gender with an overall accuracy of 60%. The final result of discriminative analysis shows that the ability of the maxillary sinus to identify gender was 68% in males and 74% in females with an overall accuracy of 71%.

Conclusion: Maxillary sinus width can be used as an aid in forensic anthropology for gender determination.

Keywords: Forensic sciences; Sex determination; Skeletal analysis.

[Table/Fig-2]:

Measurement of maxillary sinus width in axial section POINT A = Most lateral point on lateral wall of maxillary sinus POINT B = Most medial point on the medial wall of maxillary sinus

[Table/Fig-3]:

Measurement of maxillary sinus length in axial section. POINT A = Most anterior point of the medial wall of the maxillary sinus POINT B = Most posterior point of the medial wall of the maxillary sinus

[Table/Fig-4]:

Mesurement of maxillary sinus height in coronal section. POINT A = Most highest point of the sinus roof POINT B = Most lowest point of the sinus floor