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Journal of Advanced Zoology A Comparative Analysis of Frontal, Maxillary

Sinus and Pyriform Aperture as Gender Identification Tool Using Radiographic
Morphometric Parameters

Article in Journal Of Advanced Zoology · October 2023

DOI: 10.17762/jaz.v44i3.574

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 Journal of Advanced Zoology
ISSN: 0253-7214
Volume 44 Issue 03 Year 2023 Page 156:160

_______________________________________________________________________________________________________________________________

A Comparative Analysis of Frontal, Maxillary Sinus and

Pyriform Aperture as Gender Identification Tool Using
Radiographic Morphometric Parameters
Dwivedy Shweta1*, Kulkarni Tejas M1, Tayde Nivedita1, Sulgante Pooja
Chandrashekhar2, Divekar Rohini S3, Turkar Aboli1

1
Department of oral medicine and Radiology, SMBT IDSR, Nashik, Maharastra, India
2
Department of Oral and Maxillofacial Suregery, SMBT IDSR, Nashik, Maharastra, India
3
Department of oral medicine and Radiology, MIDSR Dental college, Latur, Maharastra, India
*Corresponding author’s E-mail: [email protected]
Article History Abstract

Received: 06 June 2023 Aim: The study was done with the aim to check for the reliability of
Revised: 05 Sept 2023 morphometric parameters of frontal and maxillary sinuses along with
Accepted:11Sept 2023 pyriform aperture for sexual dimorphism on posteroanterior skull radiograph
in young adults. Material and method: 30 individuals with equal distribution
of females and males were selected considering inclusion and exclusion
criteria and PA skull view of same were analyzed for frontal sinus, maxillary
sinus and pyriform aperture parameters using Carestream Dental imaging
software 6.14.7 CS 3D. Statistics and Result: Statistical analysis establishes
frontal and maxillary sinus parameters in comparison to pyriform aperture
parameters as reliable tool for gender assessment.

CC License Keywords: Frontal sinus, sex determination, radiograph, Maxillary sinus,

CC-BY-NC-SA 4.0 pyriform aperture
1. Introduction
Human identification is the prime aspect of forensic science. Human skull plays a major role in
human identification as it contains various gender-based features which an contribute for forensic
importance (1). Based on these specific features researchers have conducted and established various
parameters of identification through numerous methods such as, cheiloscopy, various tooth index,
mandibular morphological characteristics and paranasal sinuses morphometry are of prime
importance.
Anatomical uniqueness of frontal sinus was first studied and established by Schuller in 1921 (2).
Since then, several aspects of facial sinuses have been studied by researcher for establishing the
human identification status in varied population of world. Similarly maxillary sinus which is the first
paranasal sinus to complete its development (3) also serves the purpose for victim identification as it
remains intact even when skull is badly mutilated. So, frontal and maxillary sinuses have been
established as a tool for human identification in various races of human.
Radiographs can serve as retrospective tool for identification of deceased as these are stored form of
medical data which can be utilized during the process of forensic credentials. Radiographic data is
generally used to confirm identification of human remains that are highly decomposed, incinerated or
mutilated. Several structures like sella turcica, mastoid air cells, paranasal sinuses and particularly the
frontal sinuses have been utilized for this purpose due to its irregular shape and unique nature with
respect to every individual just like finger prints.

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 Similarly, pyriform aperture has been established dimorphic section of bone by Krogmann and Iscan
in 1986 (4). Sexual dimorphic characteristics of pyriform aperture have been established in various
human races. The sexual dimorphism in the size of the pyriform aperture can be influenced by racial
issues, especially in populations where there is miscegenation.
So, the current study was conducted to comparatively evaluate the radiographic morphometric
characteristics of frontal sinus, maxillary sinus and pyriform aperture in western Maharashtra
population, which is one of its kind as literature search has not put forward any conducted
comparative study on these parameters for this population.
2. Materials And Methods
After obtaining institutional ethical clearance which is in accordance with Helsinki Declaration
present study was conducted in an institutional setup on western Maharashtra population. 30 random
samples were selected including 15 males and 15 females. Samples were selected keeping in
consideration inclusion criteria of age between 20 -45 years, considering the stable period between
growth and regressive geriatric changes. Also, it is an established fact that maxillary sinus continues
to pneumatize into the developing alveolar ridge as the permanent teeth erupt. At the age of 20, with
the completion of the eruption, the pneumatization of the sinus ends, and it continues after the
exfoliation of the teeth. (5) Hence, we excluded the patients with edentulous ridge at any age. Also,
sample with no history of traumatic episode, developmental faults or medical conditions involving
head and neck region were included. Written informed consent was obtained from each subject after
explaining the purpose and method of the study and confirming the age by aid of supportive official
document a proper case history was recorded on a prescribed format.
In the present study, Posterior anterior (PA) Skull view of patient was recorded in Kodak 9000 Digital
Panoramic and Cephalometric system at standard exposure parameters (80 kVp, 10 mA, and 13.9 s),
and under adequate radiation protection measures by single operator. PA view was used for analysis
as image of sinuses could be obtained unmagnified and reproducible for each patient without
operator’s error for adjusting patient at angle for paranasal sinus view (PNS). The position of patient’s
head was standardized according to manufacturer’s instructions. All radiographs were assessed so that
only high-quality and correctly positioned radiographs were included for the study. Carestream Dental
imaging software 6.14.7 CS 3D was used and the images were analysed through same.
Following metrics were assessed for: (Figure 1)
FRONTAL SINUS right and left frontal sinus was measured for
• Length – right (Rt length FS) and left side (Lf width FS) (largest dimension)
• Width – right (Rt width FS) and left side (Lf length FS) (largest dimension)
• Area – right (Rt area FS) and left side (Lf area FS) (Length X Width)
MAXILLARY SINUS right and left maxillary sinus was measured for
• Length – right (Rt length MXS) and left side (largest dimension)
• Width – right (Rt width MXS) and left side (largest dimension)
• Area (Length X Width) – right (Rt area MXS) and left side (Lf area MXS)
PYRIFORM APERTURE right and left pyriform aperture was measured for
• Length (largest dimension) (Length pYfa)
• Width (largest dimension) (width pYfa)
The reliability and reproducibility of these measurements were assessed twice by investigator within
one-month interval, where the data of first session was masked at the second session to avoid bias. By
this method, a general consensus was reached. The obtained measurements which showed no
statistically significant differences were considered for study
3. Results and Discussion
A The obtained metrics was compiled on a MS Office Excel Sheet (v 2019, Microsoft Redmond
Campus, Redmond, Washington, United States). Data was subjected to statistical analysis using
Statistical package for social sciences (SPSS v 26.0, IBM). All the measured parameters data was then

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 A Gender Identification Tool: Frontal Sinus, Maxillary Sinus or Pyriform Aperture?

subjected to discriminative statistical analysis and analysed using unpaired t-test. Statistical analysis
was done by calculating the mean and standard deviation of all above mentioned parameters.
Table 1: Inter group comparison of values
Sex N Mean (mm) Std. Deviation Std. Error Mean T value p value of t test
M 15 34.93 8.565 2.211 1.857 .074#
Age(years)
F 15 29.53 7.318 1.889
M 15 26.427 5.6383 1.4558 .949 .350#
Rt width FS
F 15 24.120 7.5325 1.9449
M 15 24.1600 5.39442 1.39283 .694 .493#
Rt length FS
F 15 22.7600 5.65203 1.45935
M 15 660.30 247.437 63.888 1.021 .316#
Rt area FS
F 15 571.76 226.941 58.596
M 15 31.440 7.1234 1.8392 2.406 .023*
Lf width FS
F 15 25.933 5.2756 1.3622
M 15 27.287 7.5820 1.9577 1.521 .140#
Lf length FS
F 15 23.967 3.7445 .9668
M 15 891.7253 366.55532 94.64418 2.427 .022*
Lf area FS
F 15 631.0900 196.50437 50.73721
M 15 26.933 5.6558 1.4603 2.015 .054#
Rt width MXS
F 15 23.167 4.5201 1.1671
M 15 27.85 3.934 1.016 1.358 .185#
Rt length MXS
F 15 25.87 4.077 1.053
M 15 761.799 242.1429 62.5210 2.112 .044*
Rt area MXS
F 15 603.931 158.6642 40.9669
M 15 26.067 5.2139 1.3462 1.417 .167#
Lf width MXS
F 15 23.513 4.6383 1.1976
M 15 28.360 4.4912 1.1596 1.812 .081#
Lf length MXS
F 15 25.727 3.3904 .8754
M 15 752.2820 235.33631 60.76357 2.056 .049*
Lf area MXS
F 15 606.2733 142.46331 36.78387
M 15 43.513 4.4659 1.1531 .685 .499#
Length pYfa
F 15 42.380 4.5943 1.1862
M 15 28.527 2.5725 .6642 1.199 .241#
width pYfa
F 15 26.600 5.6672 1.4633

All the mentioned metric parameters were having higher mean values for males as compared to
female subjects but statistically significance difference between the groups (p<0.05) was present only
for, (Table 1).
• Left width of Frontal Sinus,
• Left area of Frontal sinus
• Right area Maxillary Sinus
• Left area Maxillary sinus
Human identification in forensics is through a series of methods, among them finger prints been most
widely adopted but in cases when soft tissue is preserved. However, when body is incinerated or is in
skeletal form, forensic dental and anthropologic analysis becomes the necessity for identification.
Radiographs of an individual may serve as a retrospective tool for identifying corpses that are deemed
unrecognizable. (6). Radiographs play an important role in human identification and establishing the
gender of deceased, which is known to be the first and foremost important step for human

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 identification. Radiographic details in form of retrospective data can serve as important tool for
establishing one’s identity. Present study was conducted to comparative assessment of frontal sinus,
maxillary sinus and pyriform aperture for the determining gender of an individual. No such
comparative assessment has been done before for same purpose. Various studies have been done to
look for diagnostic accuracy individually for frontal, maxillary sinus and pyriform aperture. Hence no
comparative data is available in literature for same. Present study establishes that pyriform aperture
shows no statistically significant sexual dimorphism in age group of 20 to 45 years which is not in
accordance to various anthropometric studies done on human skull (7) which has established
dimorphic characteristics of pyriform aperture. Present study establishes mean length of pyriform
aperture (Length pYfa) for males as 43.5mm were as for females as 42.5mm i.e., higher for males.
Similarly mean width of aperture (width pYfa) was calculated to be 28.5mm for males and 26.6mm
for females, i.e., higher for males. But both these values prove to be statistically insignificant for
gender determination which was in accordance to study conducted by DE ARAÚJO et al (8) in 2018
on human skull of Brazilian population. Similar study done by Moreddu E et al (9) on CT image of
French population establishes gender diversity within a wide age group of 15 – 97 years. Another
anthropological study done on North Indian human skull of unknown age and gender by Adil Asghar
et al (7) establishes pyriform Length and width as statistically significant parameter for sexual
dimorphism. Other study done on south Indian skull (10) establishes pyriform aperture height as
statistically significant parameter for gender establishment.
Frontal sinus in present study was studied for length, width and area of sinus separately for right and
left side out of which left width and left area of frontal sinus establishes a statistically significant
difference between males and females. Mean values of length, width and area on right side came to be
24.2mm, 26.4 mm and 660.3 mm2 for males and 22.7mm, 24.1mm and 571.7mm2 for females.
Similarly on left side mean length, width and area for males was 27.3mm, 31.4mm and 891.7 mm2
and for females it was 23.9mm, 25.9mm and 631.1 mm2. Similar study done on PA view for frontal
sinus by Belaldavar et al. (2), done on Indian origin population of age 25- 30 years, establishes all
these above mentioned parameters significant for establishing gender. Present study draws a similar
conclusion of higher parameters of left frontal sinus in both males and females, which was also
concluded by Schuller in (1943), Dr. Uppe, Anu Netharaa et al. and Vrushali P Karadkhelkar (1,11)
Similarly, Maxillary sinus parameters in present study show significant values for gender
determination. All the studied parameters were higher in males compared to females, these results
were consistent with similar studies done by Deshpande et al (5) on western Maharashtra population
and Kandel S, et al (12).
4. Conclusion
Present study reestablishes that sinuses are gender specific and are predictable parameters of forensic
importance. However, pyriform aperture is an established parameter for gender determination in
several anthropological studies but this study could not generate the same. Also, very fewer studies
have been conducted on radiographs to establish pyriform aperture as identification tool. However
present study was done on a limited sample size, so greater sample strength may draw a different
conclusion. Present study however reestablishes frontal and maxillary sinus parameters as more
powerful tool for gender identification in comparison to pyriform aperture.

5. Acknowledgement
We would like to extend our heartfelt gratitude to Department of Oral Medicine and Radiology SMBT
IDSR, Nashik, for helping us with resources to conduct the study. Also we are in debt by the help
provided by Dr. Dhiraj Kalra sir, Department of Public Health Dentistry, SMBT IDSR, Nashik for
statistical analysis for the study.

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 A Gender Identification Tool: Frontal Sinus, Maxillary Sinus or Pyriform Aperture?

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