Contribution of Morphology of Frontal Sinuses (Linear and Volumetric Measurements) to Gender Identification Based on Cone Beam Computed Tomography Images (CBCT): A Systematic Review

Human identification is considered as an important step in the reconstruction of biological profiles, especially of unknown individuals. Frontal sinuses (FS) have been regarded as an ideal anatomical structure for individualisation because few pathological conditions can potentially alter their shape. Aim: The aim of this review was to evaluate scientific evidence published since January 2010 and determine whether the dimensions and volume of FS might be useful parameters for gender determination and human identification, based only on cone beam computed tomography images (CBCT). Methods: This review was performed in accordance with the PRISMA statement. Four databases were searched for articles published between January 2010 and June 2022. Results: A total of 195 records were initially identified, and 90 remained after a manual duplicate check. Eight articles were selected for a full review according to the inclusion and exclusion criteria after title and abstract screening. A total of 718 participants (359 males and 359 females) were identified from the included studies. Frontal sinus volume (FSV) was significantly higher in male individuals. Frontal sinus height (FSH) and volume were the superior discriminating parameters for forensic identification. Conclusions: This review demonstrates that assessment of FS based on CBCT images could be beneficial for gender identification in forensic science. According to the obtained studies, frontal sinus volume (FSV) and frontal sinus height (FSH) are significant greater in males than in females, providing an additional complementary method. Larger sample size and common measurement protocols are needed to verify their usefulness.