Sex Determination Using Frontal Sinus Diameters on Direct Radiography

Background and aim: The shape and developmental stages of the frontal sinus (FS) differ in each individual, it can be used to determine sex and identity. This study aimed to assess the morphological structure of the FS diameters in sex determination using posterioanterior (AP) skull radiography. This data can be valuable for identifying and characterizing human features. Methods: The study included 350 patients (171 females, 179 males) aged between 20 and 55 years who underwent AP skull radiography. FSs were classified as symmetrical, asymmetrical, unilateral, or bilateral aplasic. The right and left FS height and width measurements were made based on the largest diameters. Results: The mean age was 32.8±11.45 years for the whole sample. The mean age of the males was 31.23±11.9 (20-51) years and that of the females was 34.45±10.75 (20-55) years. When classified anatomically, 20 patients had bilateral aplasia (12 males, eight females), 19 patients had right aplasia (10 males, nine females), and 11 patients had left aplasia (seven males, four females). FS was symmetrical in 206 (72.1%) patients while right dominance was observed in 33 (9.43%) patients and left dominance in 61 (17.43%) patients. The FS height and width values on both sides ​​were statistically significantly higher in males than in females (p<0.001 for each parameter). The females were accurately classified at a rate of 71.2% and the males at 68.2%. Conclusion: Notably, our research has revealed that frontal sinus diameters are consistently larger in males than in females, and that direct radiography can be employed for gender determination with an accuracy rate of 69.7%. This information underscores the utility of morphometric evaluation of the frontal sinus diameters on direct radiography for gender and identity determination, potentially in conjunction with other parameters. In conclusion, our study has demonstrated the potential of the morphological structure of the frontal sinuses as a valuable tool for identifying and characterizing human individuals.