Sex estimation by maxillary sinus using computed tomography: a systematic review

Area of Science:

• Forensic Anthropology
• Human Identification
• Radiology

Background:

• Sex estimation is crucial in forensic identification, especially when primary methods are unavailable.
• The maxillary sinus offers a potential identification marker due to its resilience even in severely damaged skulls.
• Forensic anthropology provides auxiliary identification methods when standard techniques are not applicable.

Purpose of the Study:

• To evaluate the efficacy of maxillary sinus measurements using computed tomography for sex estimation.
• To synthesize current research on maxillary sinus analysis in forensic contexts.
• To determine the reliability of the maxillary sinus as an auxiliary tool for sex determination.

Main Methods:

• Systematic literature search of PubMed, Web of Science, Scopus, and Cochrane databases (past 10 years).
• Inclusion of studies using computed tomography for maxillary sinus measurements; exclusion of studies using radiographs.
• Evaluation of methodological quality and data from 18 selected studies across diverse populations.

Main Results:

• Maxillary sinus dimensions (height, width, length, volume) were analyzed across various ethnic groups (Indian, Iraqi, Iranian, Egyptian, Brazilian, French, Dutch, Turkish).
• The maxillary sinus demonstrated potential as a viable metric for sex estimation.
• Computed tomography provided the necessary three-dimensional analysis for accurate measurements.

Conclusions:

• The maxillary sinus serves as a valuable auxiliary indicator for sex estimation in forensic investigations.
• Computed tomography-based measurements of the maxillary sinus contribute to robust human identification protocols.
• Further research can refine the application of maxillary sinus analysis in diverse forensic scenarios.