Journal of Forensic Dental Sciences
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ORIGINAL ARTICLE
Year : 2010  |  Volume : 2  |  Issue : 2  |  Page : 77-80  

Use of frontal sinus and nasal septum patterns as an aid in personal identification: A digital radiographic pilot study


Department of Oral Medicine and Radiology, M R Ambedkar Dental College, Cooke Town, Bangalore, Karnataka, India

Date of Web Publication20-May-2011

Correspondence Address:
Runjhun Saxena
Department of Oral Medicine and Radiology, M R Ambedkar Dental College,1/36 Cline Road, Cooke Town, Bangalore-05
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-1475.81286

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   Abstract 

Objectives: To examine and classify the variations in the pattern of frontal sinus and nasal septum as observed on the posterior anterior Cephalometric radiographs, and to propose the possible use of the same in personal identification. Materials and Methods: This study was conducted on 50 individuals visiting the department, whose age ranged from 25 to 50 years. The radiographs of 25 males and 25 females were recorded using a Kodak 8000 C and Dental Imaging Software Viewer 6.3.4. Frontal sinus (symmetry and lobulations) and nasal septum patterns (deviations) were observed and classified. Results: Frontal sinus symmetry was observed in 29 (58%) individuals and asymmetry was observed in 16 (32%). Frontal sinuses were absent (bilateral aplasia) in two individuals (4%). Unilateral aplasia was seen in three individuals (6%). Straight nasal septum was seen in 11 (22%), right deviation in 21 (42%), and left deviation in 15 (30%) individuals. Sigmoid was seen in one male (2%), reverse sigmoid in one male (2%), and other pattern type in one female (2%). Both frontal sinus and nasal septum patterns were assessed together for each individual. Out of 50 individuals, 41 unique combinations of frontal sinus and nasal septum were found. However, there were nine individuals whose patterns matched one of the patterns of the 41 individuals. Conclusion: We observed that the frontal sinus and nasal septum patterns had considerable individual variation. A combined use of both the patterns, as observed on the radiographs, could serve as an adjunct to other methods of personal identification.

Keywords: Forensic dentistry, frontal sinus, nasal septum, posteroanterior cephalogram, personal identification


How to cite this article:
David MP, Saxena R. Use of frontal sinus and nasal septum patterns as an aid in personal identification: A digital radiographic pilot study. J Forensic Dent Sci 2010;2:77-80

How to cite this URL:
David MP, Saxena R. Use of frontal sinus and nasal septum patterns as an aid in personal identification: A digital radiographic pilot study. J Forensic Dent Sci [serial online] 2010 [cited 2019 Apr 18];2:77-80. Available from: http://www.jfds.org/text.asp?2010/2/2/77/81286


   Introduction Top


Human identification is a mainstay of civilization and the identification of unknown individuals has always been of paramount importance to the society. Not only it is important to identify the deceased to ensure a proper burial, but there are also issues such as criminal investigations, insurance settlements, and military proceedings that can be resolved only with positive identification. The most reliable means of identification include fingerprints, dental comparison, and biological methods such as DNA profiling. [1] However, when the soft tissue of the human remains became putrid or is burnt, or the DNA is severely degraded, fingerprint identification and DNA analysis cannot be carried out, and the identity of the remains can only be determined by the anthropological method. The radiograph is commonly accepted as a key tool of personal identification. [1],[2],[3]

Frontal sinuses are pneumatic cavities that become radiologically evident at the age of five or six years and develop fully by the age of 20 years. [4] Studies have suggested that the frontal sinuses are slightly bigger in males than in females, and the presence of a metopic suture is associated with the absence of the frontal sinuses. [5],[6] Evaluation of frontal sinuses, even in monozygotic and dizygotic twins, have been found to be different, always. [7],[8] Thus, the reliability of comparing ante- and post-mortem radiographs of the frontal sinus for identification is well founded. [9] They have been found to have individual morphological variations. It has been suggested that frontal sinus patterns have a potential to be used as aids for personal identification, age estimation, and sexual dimorphism. [2],[4],[7],[10],[11],[12]

Similar findings were also observed for the nasal septum. [13],[14],[15]

Also a combined use of different frontal sinus and nasal septum patterns aids in a more precise identification, than by the use of either of them alone. [11]

With this background, this study was undertaken to examine and classify variations in frontal sinus and nasal septum patterns as observed on a posteroanterior (PA) cephalogram, and to propose the possible use of the same in personal identification.


   Materials and Methods Top


PA cephalograms of 50 individuals (25 males and 25 females) between the age group of 25 and 50 years, visiting the Department of Oral Medicine and Radiology, M R Ambedkar Dental College, Bangalore, were recorded. The radiographs were then observed for frontal sinus and nasal septum patterns. The frontal sinus was classified according to symmetry, right or left dominant asymmetry, and unilateral (right or left) and bilateral aplasia. The greatest horizontal dimension was measured from the central septum on either side. The difference in the right and left side dimensions was divided by the greatest dimension and multiplied by 100. If the percentage was more than 20% then it was classified as asymmetrical. They were also assessed for the number of lobulations on each side. The nasal septum was classified according to the deviations in the septa as straight, simple deviation to right or left, sigmoid type, reverse sigmoid type, and others. The combined nasal septum and frontal sinus pattern was recorded for each individual.


   Result Top


Frontal sinus symmetry was observed in 29 individuals (13 males and 16 females) (58%).

Frontal sinus asymmetry was observed in 16 individuals (32%) (10 males and 6 females; 3 right and 13 left).

Frontal sinus was absent (bilateral aplasia) in two individuals (4%) (one male and one female). Unilateral aplasia was seen in three individuals (6%) (one male and two females; two right and one left), [Table 1],[Figure 1].
Table 1: Frontal sinus patterns

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Figure 1: 1-symmetry; 2-asymmetry; 3-unilateral aplasia and 4-bilateral aplasia

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Straight nasal septum was seen in 11 individuals (22%) (three males and eight females).

Right deviation of the nasal septum was seen in 21 individuals (42%) (11 males and 10 females).

Left deviation of the nasal septum was observed in 15 individuals (30%) (nine males and six females).

Sigmoid was seen in one individual (2%) (one male), reverse sigmoid in one individual (2%) (one male), and other types in one individual (2%) (one female), [Table 2],[Figure 2].
Table 2: Nasal septum patt

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Figure 2: 1-straight; 2-right deviation; 3-left deviation; 4-sigmoid; 5-reverse sigmoid and 6-others

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Out of 50 individuals, 41 unique combinations of frontal sinus and nasal septum were found. However, there were nine individuals whose patterns matched one of the patterns of the 41 individuals [Table 3],[Figure 3].
Table 3: Combined pattern of frontal sinus and nasal septum

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Figure 3: 1– 8 similar combinations and 9 unique combination

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   Discussion Top


Ever since Zuckerkandl established the uniqueness of frontal sinus in 1895, many have worked to establish frontal sinus morphology for personal identification, in forensic science. [4] Our study utilized PA cephalograms, as frontal sinus and nasal septum patterns could be assessed with minimal distortion from a single radiograph. [7]

Individuals were selected randomly between the ages 25 and 50 years, owing to the fact that the development of the frontal sinus goes up to 20 years. This was in accordance with the studies done by Libersa and Faber (1957), Krogman (1962), and Porbonikova (1974). [4],[6],[16],[17],[18],[19],[20],[21],[22] Also the growth of the nose increases until the age of 18, as suggested by Antoszewski et al. [13],[14] Quatrehomme et al. suggested that advancing age could lead to changes due to bone resorption, hence, individuals up to the age of 50 years were included in the study. [7]

In our study, symmetry of the frontal sinus was found in 58% of the individuals, whereas, Taniguchi et al. obtained 43.1% symmetry in the Japanese population. Frontal sinus asymmetry was observed in 32% in our sample, whereas, Taniguchi et al. observed 56.6% asymmetry. [11] Unilateral aplasia was seen in 6% of the individuals and bilateral aplasia in 4%. The results were consistent with those of Krogman, who observed frontal sinus absence in 5% of the adults, while Gulisano et al. observed its absence in 4.8% of the cases. [4],[18],[23]

Schuller suggested that the presence of a metopic suture was associated with the absence of the frontal sinus. [4],[5],[24]

Nasal septum patterns revealed various forms in our study. A straight nasal septum was present in 22% of the individuals in contrast to Taniguchi et al., who observed 13.4% straight nasal septum. Right deviation was noticed in 42%, whereas, Taniguchi et al. noticed 35.3%. We observed 30% left deviation of the nasal septum in concordance with Taniguchi et al. who observed 37.6%. A.R. Talaiepour et al. observed 63% nasal deviation (28% to the right, 31.5% to the left, and 3.5% others). [11],[25]

Sigmoid, reverse sigmoid, and other patterns were assessed in 2% of the individuals in our study. On the other hand Taniguchi et al. assessed 6%, 6.3%, and 1.4%, respectively. [11]

When the combined usage of both frontal sinus and nasal septum patterns was assessed, we obtained 41 unique combinations, and nine individuals, whose patterns matched one of the patterns of the 41 individuals.

There are certain limitations, however, for the use of frontal sinus and nasal septum patterns in personal identification. The size of the frontal sinus may be related to environmental and genetic factors. They may be affected by pathology, craniofacial configuration or thickness of the frontal bone. Also, growth hormone levels influence frontal sinus morphology. [7]


   Conclusion Top


We observed that frontal sinus and nasal septum patterns had considerable individual variation. From our study we could conclude that a combined use of frontal sinus and nasal septum patterns, as seen on the PA cephalogram, could be used as one of the aids for personal identification. Moreover, the method used for identification was simple and not time consuming. It could be easily employed by a general dentist, as it did not require expertise. It made use of two patterns, which could be covered in one radiograph. Alternately, the potentially matching frontal sinus images could be examined by a qualified radiologist conversant in the radiographic anatomy of the region. Furthermore, a literature review did not reveal the combined use of frontal sinus and nasal septum patterns for identification in the Indian population, and hence, this study has marked an initial attempt for personal identification based on a combination of the two patterns.

However, to establish the same we suggest further studies, with implementation of newer parameters for the determination of gender, age, and ethnicity, in larger samples.


   Acknowledgments Top


The authors would like to thank Dr. Murali Iyer, Professor, Department of Community and Public Health Dentistry, M. R. Ambedkar Dental College, Bangalore, for his advice and help.

 
   References Top

1.Rothwell BR. Principles of dental identification. Dent Clin North Am 2001;45:253-70.  Back to cited text no. 1
    
2.Tang JP, Hu DY, Jiang FH, Yu XJ. Assessing forensic applications of the frontal sinus in a Chinese Han population. Forensic Sci Int 2009;183:104.e1-3   Back to cited text no. 2
    
3.Wood RE. Forensic aspects of maxillofacial radiology: Review. Forensic Sci Int 2006;159s:s47-55.  Back to cited text no. 3
    
4.Silva RF, Pinto RN, Ferreira GM, Daruge Júnior E. Importance of frontal sinus radiographs for human identification. Braz J Otorhinolaryngol 2008;74:798.  Back to cited text no. 4
    
5.Schuller A. A note on the identification of skull x-ray pictures of the frontal sinus. Med J Aust 1943;25:554-6.  Back to cited text no. 5
    
6.Brown WA, Molleson TI, Chinn S. Enlargement of the frontal sinus. Ann Hum Biol 1984;11:221-6.  Back to cited text no. 6
    
7.Quatrehomme G, Fronty P, Sapanet M, Grévin G, Bailet P, Ollier A. Identification by frontal sinus pattern in forensic anthropology. Forensic Sci Int 1996;83:147-53.   Back to cited text no. 7
    
8.Asherson N. Identification by frontal sinus prints. A forensic medical pilot survey. London: Lewis and Co.; 1965.  Back to cited text no. 8
    
9.Yoshino M, Miyasaka S, Sato H, Seta S. Classification system of frontal sinus patterns by radiography. Its application to identification of unknown skeletal remains. Forensic Sci Int 1987;34:289-99.  Back to cited text no. 9
    
10.Prossinger H. Sexually dimorphic ontogenetic trajectories of frontal sinus cross sections. Coll Antropol 2001;25:1-11.  Back to cited text no. 10
    
11.Taniguchi M, Sakoda S, Kano T, Zhu BL, Kamikodai Y, Fujita MQ, et al. Possible use of nasal septum and frontal sinus patterns to radiographic identification of unknown human remains. Osaka City Med J 2003;49:31-8.  Back to cited text no. 11
    
12.Ruf S, Pancherz H. Can frontal sinus development be used for the prediction of skeletal maturity at puberty? Acta Odontol Scand 1996;54:229-34.  Back to cited text no. 12
    
13.Howie TO. Identical deformities in the nasal septum of a pair of identical twins. Br Med J 1946. p. 760-1.   Back to cited text no. 13
    
14.Grymer LF, Pallisgaard C, Melsen B. The nasal septum in relation to the development of the nasomaxillary complex: A study in identical twins. Laryngoscope 1991;101:863-8.  Back to cited text no. 14
    
15.Grymer LF, Melsen B. The morphology of the nasal septum in identical twins. Laryngoscope 1989;99:642-6.  Back to cited text no. 15
    
16.Pondé JM, Andrade RN, Via JM, Metzger P, Teles AC. Anatomical variations of the frontal sinus. Int J Morphol 2008;26:803-8.  Back to cited text no. 16
    
17.Porbonikova S. An x-ray investigation of the development of the frontal sinus in children. Folia Med (Plovdiv) 1974;16:213-20.  Back to cited text no. 17
    
18.Gulisano M, Pacini P, Orlandini GE. Frontal sinus dimensions in relation to the cranial index: Anatomoradilogic findings. Boll Soc Ital Biol Sper 1978;54:66-9.   Back to cited text no. 18
    
19.Blaney SP. Scaling properties of the frontal sinus in the African great apes: A clue to the role of the human paranasal sinuses. Ver Laryngol Otol Rhinol 2000;121:99-102.   Back to cited text no. 19
    
20.Phrabhakaran N, Naidu M, Subramanian K. Anatomical variability of the frontal sinus and their application in Forensic identification. Clin Anat 1999;12:16-9.  Back to cited text no. 20
    
21.Ponde JM, Metzger P, Amaral G, Machado M, Prandini M. Anatomic variations of the frontal sinus. Minim Invasive Neurosurg 2003;46:29-32.  Back to cited text no. 21
    
22.Szilvassy J. Development of the frontal sinuses. Anthropol Anz 1981;39:138-49.  Back to cited text no. 22
    
23.Krogman WM. The human skeleton in forensic medicine. Thomas, Springfield, 1962.  Back to cited text no. 23
    
24.Aydinlioðlu A, Kavakli A, Erdem S. Absence of frontal sinus in Turkish individuals. Yonsei Med J 2003;44:215-8.  Back to cited text no. 24
    
25.Talaiepour AR, Sazgar AA, Bagheri A. Anatomic variations of the paranasal sinuses on CT scan images. J Dent 2005;2:142-6.  Back to cited text no. 25
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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