THE PARANASAL AIR SINUSES IN THE HUMAN: An Anatomical Assessment using Helical Multislice Computed Tomography. Applications to Human Forensic Identification.
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Introduction: Forensic pathologists may be asked to identify the race group or
sex of a cranium of unknown origin. Race group refers to geographic ancestry and sex
is biological sex.
An analysis of the volumes and measurements of human paranasal sinuses, namely
maxillary, ethmoid, sphenoid and frontal sinuses, in dried crania of different race and
sex groups (European and Zulu male and female) was undertaken to search for a new
improved approach of classifying crania according to race and sex. This anatomical
assessment of the human paranasal sinuses identifies race and sex variations in the
paranasal sinuses. Variations in paranasal sinus volumes and measurements may mean
a variation in anatomical landmarks. The best combination of sinus measurements was
selected to classify a cranium according to race group and sex making this research
relevant to the field of forensic medicine.
Objectives: To compare the paranasal sinus volumes and measurements of dried
crania of European and Zulu descent with respect to race group and sex and to
develop a method of classifying a cranium according to race group or sex by using
dimensions of the paranasal sinuses.
Methodology: Documented, cadaver derived, dried crania were obtained from the
Raymond A. Dart Collection of Human Skeletons, housed at the School of Anatomical
Sciences at the University of the Witwatersrand, Johannesburg, South Africa. Age, race
and sex were recorded for each cranium within the collection and hence within the
study sample. 26 Adult European crania; 13 male, 13 female. Age range 19-75yrs (mean
49.42yrs) and 27 Adult Zulu crania: 13 male, 14 female. Age range 16-90yrs (mean
40.16yrs) was selected for this study. An additional cranium of unknown origin was
also analysed in the research.
European crania were from descendants of Europe living in South Africa and Zulu
crania were obtained from Zulu patients who were part of the Zulu tribe of South
Africa.
53 crania with intact paranasal sinuses (106 individual sinuses for each of the maxillary,
ethmoid, sphenoid and frontal sinuses) were studied. In addition, 2 sinuses from the
unknown cranium were analysed.
The dried crania of European and Zulu origin were assessed by helical, multislice
computed tomography using 1mm coronal slices. The area for each slice was obtained
by tracing the outline of each slice. A volume was calculated by the CT machine that
totaled the slices for each sinus. Measurements of width, length and height were
also assessed, as were other craniometrical measurements. Statistical analysis was
performed for all European and Zulu male and female sinuses in respect of volumes
and measurements. Further statistical analysis searched for classification patterns.
In addition, forty patients’ scans from the European and Zulu male and female groups
in Southern Africa were also assessed. CT scans of 10 adult European males, 10 adult
European females, 10 adult Zulu males and 10 adult Zulu females provided 40 pairs of
maxillary, ethmoid, sphenoid and frontal sinuses for analysis. Europeans were South
African persons of European descent and Zulus were from the Zulu tribe of Kwa Zulu
Natal in South Africa.
Results: The aim of identifying race and sex differences in this anatomical region is
achieved. Significant race and sex variations were found in the European and Zulu,
male and female groups when analysing the volumes and measurements of the
paranasal sinuses. The very best combinations of classifiable measurements were
described and are being put forward as a new tool in human forensic identification
studies. The significant sex classification figure of 91.8% by combining ethmoid,
sphenoid and frontal paranasal sinus measurements, is a new discovery for using a
combination of the sinuses. The significant race classification figure of 95.9 % is an
excellent classification figure for classification according to race. This was done using
the measurements of maxillary, ethmoid and total distance across the sinuses. All this
was achieved by using the measurements of the paranasal sinuses in a European and
Zulu, male and female population.
Conclusion: Forensic race and sex identification of crania is now possible using a
combination of measurements from the paranasal sinuses. A new approach to
classifying a cranium into an race or sex group is revealed by way of using a
new combination of paranasal sinus measurements. This discovery is of importance
to forensic medicine in the realm of identification as it provides a measurable way of
assigning race or sex to a cranium within a particular region. Other studies based
on other race groups may add further value. What is clear is that the paranasal sinuses
are now of established value when assessing race or sex group of a unknown cranium.
A new tool for forensic race and sex identification is provided to the armamentarium
of the forensic pathologist and associated disciplines.
Authors
Fernandes, Carmen LeeCollections
- Theses [4186]