Professional Documents
Culture Documents
doi: 10.1111/1556-4029.12630
Available online at: onlinelibrary.wiley.com
PAPER
ANTHROPOLOGY
Justin Michel,1,2 M.D., M.Sc.; Arnaud Paganelli,1,2 M.D., M.Sc.; Arthur Varoquaux,3 M.D., M.Sc.;
Marie-Dominique Piercecchi-Marti,2,4 M.D., Ph.D.; Pascal Adalian,2 Ph.D.;
Georges Leonetti,2,4 M.D., Ph.D.; and Patrick Dessi,1,2 M.D., M.Sc.
ABSTRACT: Frontal sinuses (FSs) have been studied in radiology, anthropology, and forensic anthropology. This study aimed to determine
whether it was possible to predict the age and sex of an individual using FS volume. Sixty-nine anonymized CT scans were imported to MIMICS 10.01 software (Materialise N.V.), and each FS volume was calculated in mm3. There was an absence of significant difference between
right and left FS volume (p = 0.173) and an absence of correlation between age and FS volume (Pearsons test; p = 0.705). Sexual dimorphism
was significantly different (p = 0.001). However, the most discriminant datum for determining sex was found to be the total FS volume (sum
of an individuals right and left FS volumes) with linear discriminant Fishers function coefficients of 2.759 for the male group and 1.275
for the female group. With this model, 72.5% of our sample was correctly classified according to sex.
KEYWORDS: forensic science, forensic anthropology, physical anthropology, frontal sinus volume, sexual dimorphism, identification
Although the interest of frontal sinuses (FSs) has been studied
since the 1920s in radiology and anthropology, their usefulness
in forensic anthropology has recently been highlighted for the
positive identification of corpses (1,2). Indeed, it has been scientifically demonstrated that FSs are unique to each individual and
are unaffected by ancestry (3,4). Their anatomical variations are
the bases for forensic identification (3,57). Nowadays, identification of unidentified bodies using the FS is a reliable technique
that is used when antemortem records exist and could be presented as evidence in a court of law (6,810).
The frontal sinus is a paired, irregularly shaped, pneumatized
cavity located in the frontal bone deep to the superciliary arch
(8). FSs develop as diverticula originating from the lateral nasal
wall around the fourth fetal month following the development of
the frontal recess (9). They are noticeable by the end of the first
year but cannot be detected on radiologic plain film until the age
of 3 years (7). They complete their development at the age of
19 or 20 years (6,7,1013). Some authors have reported that
paranasal sinuses become smaller during life perhaps due to
1
Department of Oto-Rhino-Laryngology - Head and Neck Surgery, University Hospital La Timone, 264 rue St. Pierre, 13385 Cedex 5, Marseille,
France.
2
Unite dAnthropologie Bioculturelle, CNRS-EFS, Faculte de Medecine
Nord, UMR 6578, Aix-Marseille Universite, 51 Boulevard Pierre Dramard,
13916, Marseille, France.
3
Department of Radiology, University Hospital La Timone, 264 rue St.
Pierre, 13385 Cedex 5, Marseille, France.
4
Department of Forensic Medicine, University Hospital La Timone, 264
rue St. Pierre, 13385 Cedex 5, Marseille, France.
*Presented at the 117th Congress of the French Oto-Rhino-Laryngology
Society, October 1618, 2010, in Paris, France.
Received 18 Feb. 2013; and in revised form 20 Nov. 2013; accepted 4
Feb. 2014.
Results
Repeatability
Wilcoxons test found no significant difference between
results in the first series of FS volume measurements and results
in the second series. We found an intraclass coefficient of correlation between single measurements of 99.5% (95% confidence
interval ranging from 99.1% to 99.7%) and between mean measurements of 99.7% (95% confidence interval (range: 99.6
99.8%). All statistical calculations were performed using results
from the second series of measurements.
Descriptive Statistics
Table 1 shows the results of our FS volume measurements
according to sex and side.
TABLE 1Minimum, maximum, and mean frontal sinus volumes according to side (right or left) and sex.
Males
Right frontal sinus
Left frontal sinus
Females
Right frontal sinus
Left frontal sinus
Minimum
(mm3)
Maximum
(mm3)
Mean
(mm3)
Confidence Interval
95% (mm3)
Standard
Deviation (mm3)
Mean Standard
Error (mm3)
94.35
188.12
12,935.35
12,737.05
4513.89
5035.09
3415.185612.59
3858.176212
3098.57
3274.6
539.39
561.59
31.05
41.64
6483.47
9407.89
2424.4
2644.48
1833.643015.15
1948.983339.99
1719.76
2024.69
290.69
342.24
MICHEL ET AL.
high feasibility of this technique in addition to the very high reliability of our results. Thus, we were able to demonstrate the
absence of significant differences between right and left FS volume, the absence of correlation between age and FS volume,
and the existence of a sexual dimorphism of FS volume, which
are foreground problems in the fields of physical anthropology
and forensic anthropology aimed at establishing the biological
profile of an individual. We found that there was an absence of
correlation between age and FS volume in our data but that it
was possible to predict sex with 72.5% of accuracy. This study
also opens up new avenues of research which could lead to the
formal identification of an individual by exploiting the very high
degree of morphological variability observed in FS CT-scan 3D
reconstructions used to perform antemortem and postmortem
comparisons.
References
1. Schuller A. Das Rontgenogram der Stirnhohle: ein Hilfsmittel fur die
Identitatsbestimmung von Schadeln. Monatsschr Ohrenheilkd Laryngorhinol 1921;5:161720.
2. Culbert WL, Law FL. Identification by comparison of roentgenograms
of nasal accessory sinuses and mastoid processes. JAMA 1927;88:
16346.
3. Christensen AM. The impact of Daubert: implications for testimony and
research in forensic anthropology (and the use of frontal sinuses in personal identification). J Forensic Sci 2004;49(3):42730.
4. Christensen AM. Assessing the variation in individual frontal sinus outlines. Am J Phys Anthropol 2005;127(3):2915.
5. Christensen AM. Testing the reliability of frontal sinuses in positive
identification. J Forensic Sci 2005;50(1):1822.
6. Quatrehomme G, Fronty P, Sapanet M, Grevin G, Bailet P, Ollier A.
Identification by frontal sinus pattern in forensic anthropology. Forensic
Sci Int 1996;83(2):14753.
7. Wood RE. Forensic aspects of maxillofacial radiology. Forensic Sci Int
2006;159:S4755.
8. Besana JL, Rogers TL. Personal identification using the frontal sinus.
J Forensic Sci 2010;55(3):5849.
9. Lang J. Clinical anatomy of the nose, nasal cavity and paranasal sinuses.
Stuttgart, Germany, New York, NY: Thieme, 1989;629.
10. Tatlisumak E, Ovali GY, Aslan A, Asirdizer M, Zeyfeoglu Y, Tarhan S.
Identification of unknown bodies using CT images of frontal sinus.
Forensic Sci Int 2007;166(1):428.
11. Lawson W, Patel ZM, Lin FY. The development and pathologic processes that influence maxillary sinus pneumatization. Anat Rec (Hoboken) 2008;291(11):155463.
12. Nambiar P, Naidu MDK, Subramaniam K. Anatomical variability of the
frontal sinuses and their application in forensic identification. Clin Anat
1999;12(1):169.
13. Fatu C, Puisoru M, Rotaru M, Truta AM. Morphometric evaluation of
the frontal sinus in relation to age. Ann Anat 2006;188(3):27580.
14. Fleiss JL, Shrout PE. Effects of measurement errors on some multivariate
procedures. Am J Public Health 1977;67(12):118891.
15. Varghese S, Kailasam V, Padmanabhan S, Vikraman B, Chithranjan A.
Evaluation of the accuracy of linear measurements on spiral computed
tomography-derived three-dimensional images and its comparison with
digital cephalometric radiography. Dentomaxillofac Radiol 2010;39
(4):21623.
16. Moerenhout B, Gelaude F, Swennen GRJ, Casselman JW, Van der Sloten J, Mommaerts MY. Accuracy and repeatability of cone-beam computed tomography (CBCT) measurements used in the determination of
facial indices in the laboratory setup. J Craniomaxillofac Surg 2009;37
(1):1823.
17. (HAS) HAdS. Que reste-t-il de la radio standard du massif facial (sinus
et face)? http://www.has-sante.fr/portail/upload/docs/application/pdf/200810/fbutm_radio_facial.pdf (accessed February 18, 2013).
18. Emirzeoglu M, Sahin B, Bilgic S, Celebi M, Uzun A. Volumetric
evaluation of the paranasal sinuses in normal subjects using computer
tomography images: a stereological study. Auris Nasus Larynx 2007;34
(2):1915.
19. Blau S, Robertson S, Johnstone M. Disaster victim identification: new
applications for postmortem computed tomography. J Forensic Sci
2008;53(4):95661.
MICHEL ET AL.
20. Tatlisumak E, Ovali GY, Asirdizer M, Aslan A, Ozyurt B, Bayindir P,
et al. CT study on morphometry of frontal sinus. Clin Anat 2008;21
(4):28793.
21. Uthman AT, Al-Rawi NH, Al-Naaimi AS, Tawfeeq AS, Suhail EH.
Evaluation of frontal sinus and skull measurements using spiral CT scanning: an aid in unknown person identification. Forensic Sci Int 2010;197
(13):124.e17.
22. Jun BC, Song SW, Kim BG, et al. A comparative analysis of intranasal
volume and olfactory function using a three-dimensional reconstruction of
paranasal sinus computed tomography, with a focus on the airway around
the turbinates. Eur Arch Otorhinolaryngol 2010;267(9):138995.
23. Thomas L, Pallanch JF. Three-dimensional CT reconstruction and virtual
endoscopic study of the ostial orientations of the frontal recess. Am
J Rhinol Allergy 2010;24(5):37884.
24. Kawarai Y, Fukushima K, Ogawa T, Nishizaki K, Gunduz M, Fujimoto
M, et al. Volume quantification of healthy paranasal cavity by threedimensional CT imaging. Acta Otolaryngol 1999;540:459.
25. Weber GW, Schaefer K, Prossinger H, Gunz P, Mitteroecker P, Seidler
H. Virtual anthropology: the digital evolution in anthropological sciences.
J Physiol Anthropol Appl Human Sci 2001;20(2):6980.
26. Ponde JM, Andrade RN, Via JM, Metzger P, Teles AC. Anatomical variations of the frontal sinus. Int J Morphol 2008;26(4):8038.
27. Kirk NJ, Wood RE, Goldstein M. Skeletal identification using the frontal
sinus region: a retrospective study of 39 cases. J Forensic Sci 2002;47
(2):31823.
28. Cox M, Malcolm M, Fairgrieve SI. A new digital method for the objective comparison of frontal sinuses for identification. J Forensic Sci
2009;54(4):76172.
29. Goyal M, Acharya AB, Sattur AP, Naikmasur VG. Are frontal sinuses
useful indicators of sex? J Forensic Leg Med 2013;20(2):914.
30. Cameriere R, Ferrante L, Molleson T, Brown B. Frontal sinus accuracy
in identification as measured by false positives in kin groups. J Forensic
Sci 2008;53(6):12802.
31. Danesh-Sani SA, Bavandi R, Esmaili M. Frontal sinus agenesis using
computed tomography. J Craniofac Surg 2011;22(6):E4851.
Additional information and reprint requests:
Justin Michel, M.D., M.Sc.
Department of Oto-Rhino-Laryngology - Head and Neck Surgery
University Hospital La Timone
264 rue St. Pierre
13385 Cedex 5
Marseille
France
E-mail: justin.michel@univ-amu.fr
justin.michel@ap-hm.fr