Document Type : Original Article
Authors
1 Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Undergraduate Student, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
Background: The potential benefit of maxillary sinus measurements for analysis of sexual dimorphism has been proved. Also, it has been shown that maxillary sinus dimensions, as the reliable sex indicators, diminish with age due to physiological and morphological alterations.
Purpose: This study aimed to evaluate the effect of age on the accuracy of maxillary sinus indices for sex determination.
Materials and Method: In this cross-sectional study’s research 240 cone beam computed tomography (CBCT) scans (120 males, 120 females), aged 20-70 years old, were evaluated retrospectively. Subjects were categorized into four age groups: 20-29, 30-39, 40-49, and ≥50 years. Each group consisted of 60 subjects. Maximum sinus height, width, length, and distance between two maxillary sinuses were evaluated.
Results: All the measurements were higher in men than in women. Generally, the strongest sex indicator was maxillary sinus width However, when analyzing different age groups, the most reliable indicators for determining sex were the distance between the sinuses in the 20-29 age group, sinus height in the 40-49 group, and sinus width in both the 30-39 and 50-and-above age groups. The specific sex discriminant formula showed an accuracy of 78.3% for the ages of 20-29 and 40-49 years as well as 71.7% for the 30-39 and ≥50 age groups.
Conclusion: The specific sex discriminant formula presented in this study showed noticeable accuracies for sex determination. Additionally, discriminant analysis revealed that the anthropometric measurements of the maxillary sinus exhibit varying degrees of sexual dimorphism across different age groups.
Keywords
- Velemínská J, Fleischmannová N, Suchá B, Dupej J, Bejdová Š, Kotěrová A, et al. Age-related differences in cranial sexual dimorphism in contemporary Europe. Int J Legal Med. 2021; 135: 2033-2044.
- Spradley MK, Jantz RL. Sex estimation in forensic anthropology: skull versus postcranial elements. J Forensic Sci. 2011; 56: 289-296.
- Akhlaghi M, Bakhtavar K, Kamali A, Maarefdoost J, Sheikhazadi A, Mousavi F, et al. The diagnostic value of anthropometric indices of maxillary sinuses for sex determination using CT-scan images in Iranian adults: A cross-sectional study. J Forensic Leg Med. 2017; 49: 94-100.
- Amin MF, Hassan EI. Sex identification in Egyptian population using Multidetector Computed Tomography of the maxillary sinus. J Forensic Leg Med. 2012; 19: 65-69.
- Teke HY, Duran S, Canturk N, Canturk G. Determination of gender by measuring the size of the maxillary sinuses in computerized tomography scans. Surg Radiol Anat. 2007; 29: 9-13.
- Uthman AT, Al‐Rawi NH, Al‐Naaimi AS, Al‐Timimi JF. Evaluation of maxillary sinus dimensions in gender determination using helical CT scanning. J Forensic Sci. 2011; 56: 403-408.
- Knight B. Forensic pathology. Arnold London; 1996. Knight B, Saukko P. Knight's Forensic Pathology. 4th ed. UK: Arnold; 2016. p. 48-66.
- Ross AH, Williams SE. Craniofacial growth, maturation, and change: teens to midadulthood. J Craniofac Surg. 2010; 21: 458-461.
- Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg. 2020; 44: 1151-1158.
- Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, García-Delgado R, O'Valle F, Catena A, et al. Maxillary sinus dimensions decrease as age and tooth loss increase. Implant Dent. 2017; 26: 288-295.
- Ariji Y, Kuroki T, Moriguchi S, Ariji E, Kanda S. Age changes in the volume of the human maxillary sinus: a study using computed tomography. Dentomaxillofac Radiol. 1994; 23: 163-168.
- Nowak R. Untersuchungen zum Verhalten der Pneumatisation des Sinus maxillaris. Anat Anz.1975;138:143-151.
- Tambawala SS, Karjodkar FR, Sansare K, Prakash N. Sexual dimorphism of maxillary sinus using cone beam computed tomography. Egypt J Forensic Sci. 2016; 6: 120-125.
- Saccucci M, Cipriani F, Carderi S, Di*Carlo G, D'Attilio M, Rodolfino D, et al. Gender assessment through three-dimensional analysis of maxillary sinuses by means of cone beam computed tomography. Eur Rev Med Pharmacol Sci. 2015; 19: 185-193.
- Dangore-Khasbage S, Bhowate R. Utility of the morphometry of the maxillary sinuses for gender determination by using computed tomography. Dent Med Probl. 2018; 55: 411-417.
- Paknahad M, Shahidi S, Zarei Z. Sexual Dimorphism of Maxillary Sinus Dimensions Using Cone‐Beam Computed Tomography. J Forensic Sci. 2017; 62: 395-398.
- Jehan M, Bhadkaria V, Trivedi A, Sharma S. Sexual dimorphism of bizygomatic distance & maxillary sinus using CT scan. IOSR-JDMS. 2014; 13: 91-95.
- Farias*Gomes A, de*Oliveira*Gamba T, Yamasaki MC, Groppo FC, Haiter*Neto F, Possobon RdF. Development and validation of a formula based on maxillary sinus measurements as a tool for sex estimation: a cone beam computed tomography study. Int J Legal Med. 2019; 133: 1241-1249.
- Gulhan O, Harrison K, Kiris A. A new computer-tomography-based method of sex estimation: Development of Turkish population-specific standards. Forensic Sci Int. 2015; 255: 2-8.
- Al*Shehri F, Soliman KE. Determination of sex from radiographic measurements of the humerus by discriminant function analysis in Saudi population, Qassim region, KSA. Forensic Sci Int. 2015; 253: 138.e1-e6.
- De*Oliveira Gamba T, Yamasaki MC, Groppo FC, da*Silveira HLD, de*Almeida*Boscolo SM, Sanderink GC, et al. Validation study of a new method for sexual prediction based on CBCT analysis of maxillary sinus and mandibular canal. Arch Oral Biol. 2017; 83: 118-123.
- Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ. Dosimetry in CBCT with different protocols: emphasis on small FOVs including exams for TMJ. Braz Dent J. 2017; 28: 511-516.
- Khojastepour L, Movahhedian N, Zolghadrpour M, Mahjoori-Ghasrodashti M. Assessment of the relationship between the maxillary sinus and the canine root tip using cone beam computed tomography. BMC Oral Health. 2021; 21: 1-8.
- Pinsky H, Dyda S, Pinsky R, Misch K, Sarment D. Accuracy of three-dimensional measurements using cone-beam CT. Dentomaxillofac Radiol. 2006; 35: 410-416.
- Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH. The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngology-Head Neck Surg. 2005; 132: 429-434.
- Nimigean V, Nimigean VR, Măru N, Sălăvăstru D, Bădiţă D, Tuculină MJ. The maxillary sinus floor in the oral implantology. Rom J Morphol Embryol.2008;49:485-489.
- Sharan A, Madjar D. Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants. 2008; 23: 48-56.
- Singal K. Significance of radiology forensic identification. ARC J Forensic Sci. 2016; 1: 21-24.
- Prabhat M, Rai S, Kaur M, Prabhat K, Bhatnagar P, Panjwani S. Computed tomography based forensic gender determination by measuring the size and volume of the maxillary sinuses. J Forensic Dent Sci. 2016; 8: 40.
- Etemadi S, Seylavi G, Yadegari A. Correlation of the maxillary sinus volume with gender and some of craniofacial indices using cone beam computed tomography. Biosci Biotech Res Comm. 2017; 10: 580-586.
- Przystańska A, Rewekant A, Sroka A, Gedrange T, Ekkert M, Jończyk-Potoczna K, et al. Sexual dimorphism of maxillary sinuses in children and adolescents–A retrospective CT study. Ann Anat. 2020; 229: 151437.
- Fernandes C. Volumetric analysis of maxillary sinuses of Zulu and European crania by helical, multislice computed tomography. J Laryngol Otol. 2004; 118: 877-881.
- Kanthem RK, Guttikonda VR, Yeluri S, Kumari G. Sex determination using maxillary sinus. J Forensic Dent Sci. 2015; 7: 163.
- Urooge A, Patil BA. Sexual dimorphism of maxillary sinus: A morphometric analysis using cone beam computed tomography. J Clin Diag Res. 2017; 11: ZC67.
- Sharma SK, Jehan M, Kumar A. Measurements of maxillary sinus volume and dimensions by computed tomography scan for gender determination. J Anat Soc India. 2014; 63: 36-42.
- Aktuna*Belgin C, Colak M, Adiguzel O, Akkus Z, Orhan K. Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT. Eur Arch Otorhinolaryngol. 2019; 276: 1493-1499.
- Radulesco T, Michel J, Mancini J, Dessi P, Adalian P. Sex estimation from human cranium: forensic and anthropological interest of maxillary sinus volumes. J Forensic Sci. 2018; 63: 805-808.
- Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K. Computed tomography measurements of different dimensions of maxillary and frontal sinuses. BMC Med Imaging. 2011; 11: 1-7.
- Ahmed AG, Gataa IS, Fateh SM, Mohammed GN. CT scan images analysis of maxillary sinus dimensions as a forensic tool for sexual and racial detection in a sample of Kurdish population. Eur Sci J. 2015; 11: 272-281.
- Attia AM, El-Badrawy AM, Shebel HM. Gender identification from maxillary sinus using multi-detector computed tomography. Mansoura J Forensic Med Cli Toxicol. 2012; 20: 17-28.
- Ekizoglu O, Inci E, Hocaoglu E, Sayin I, Kayhan FT, Can IO. The use of maxillary sinus dimensions in gender determination: a thin-slice multidetector computed tomography assisted morphometric study. J Craniofac Surg. 2014; 25: 957-960.
- Hamdy RM. Three-dimensional linear and volumetric analysis of maxillary sinus pneumatization. J Adv Res. 2014; 5: 387-395.
)