Radiological Analysis about Anatomical and Gender Variations of Frontal Sinus Parameters in Adults

Background: Morphological measurements of frontal sinus of human are known to exhibit sexual dimorphism. It was stated by previous workers that frontal sinus of no two individual is alike and as precise as finger print and could be used in personal identification. Radiograph of this sinus is more precise, easier, accurate, reproducible method of knowing the morphological variations in both sexes by linear measurements.

Objective: The present study was attempted to document and evaluate the radiological measurements of adult frontal air sinuses in both sexes and compare them to find out the differences in male and female and of both sides for frontal sinus.

Methods: This study was done in the department of anatomy of Rangpur medical college, Rangpur from January 2018 to December 2018. 100 plain X-ray films (50 male and 50 female) fulfilling the selection criteria were enrolled into this cross sectional, analytical study and these digital X-ray plates were collected from Hypertension and Research center, Rangpur. The X-ray films were collected from adult persons aged 18 to 55yrs. Plain X-ray of both antero-posterior (A/P) and lateral view (right) showing the skull with nasal cavity, orbit and paranasal sinuses were collected. With the help of measuring scale and digital slide calipers the height, width and depth of frontal sinuses were measured carefully and right area, left area and total area of frontal sinuses were calculated.. On the basis of all measurements, different indices (frontal sinus index, asymmetry index of frontal sinus index) were calculated and the data were compared between two sex groups and both sides of frontal sinus. It is noteworthy, the height and width of frontal sinus was measured in A/P view and depth of frontal sinus was measured in lateral view of radiograph.

Results: In this study the mean ± SD of height, width and area of right and left frontal sinus and total frontal sinus area in male was higher than that of female but difference reached on statistically significant level only in right side. Also, the depth of frontal sinus was significantly higher in male than that of female (p value- 0.007).Again the frontal sinus index of both side and asymmetry index of frontal sinus were higher in female than that of male. But the right and left frontal sinus index and asymmetry index did not reach significant level. It was observed that the frontal sinus septum was deviated to the mostly to left side in male (45.65%) but it was mostly in midline in female (56%). There was asymmetry between right and left side of frontal sinus. The height, width and individual frontal sinus area of subjects were found higher in right side than the left side in both sexes but reached significant level in males only. The left frontal sinus index in both sexes had higher value than that of right one but the result was nonsignificant.In this study, bilateral aplasia of frontal sinus was found only in case of male in 4% cases. Unilateral aplasia of frontal sinus was found only in case of female (1% in right side and 2% in left side).

Conclusion: The results of this present study indicate that it is possible to achieve accuracy and precision using a discrete number of morphological features of frontal sinus to determine sex of unknown skeletal remains. This study would help us to know the data of Bangladeshi people about frontal sinuses as well as would provide information for the clinicians (ENT specialists, neurosurgeons), anthropologist, radiologist and forensic experts in home and abroad.