Cranial Vault Suture Obliteration in Relation to Age: An Autopsy-Based Observational Study

Age is one of the most critical identifiers for both living and dead. Forensic professionals in medical and legal matters are often presented with dismembered, disfigured, putrefied, or skeletal remains for analysis. In such situations, it is essential to identify individuals and estimate their ages. The skull is typically the well-preserved part of the body in such situations. If an aged person needs their age officially established for employment, superannuation, pension settlements, senior citizen benefits, etc., they may turn to medical professionals for help in making that determination. It has always been controversial to use cranial suture obliteration as a reference for age. Different geographical locations have been shown to have vastly different patterns of cranial suture closure. Therefore, this study was conceptualized to assess cranial vault suture obliteration in relation to age in the Meo population. This study was conducted to determine whether obliteration of cranial sutures can be taken into account for the estimation of age in elderly in this region and its reliability along with the influence of other factors such as sex and right and left side differences.

A total of 100 cases of more than 20 years of age brought for medicolegal autopsy were analyzed. The coronal, sagittal, and lambdoid sutures were studied ectocranially and endocranially. The degree of obliteration of sutures was scored ectocranially as well as endocranially. Data were analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Descriptive statistics were evaluated for continuous data in terms of mean and standard deviation, and categorical data were presented by frequency and percentages. An independent t-test was applied to find out the mean difference between the right and left sides of suture closure for ectocranial and endocranial surfaces. The Spearman rank correlation test was carried out to find out the relationship between the age and score of suture closure both ectocranially and endocranially.

Ectocranially and endocranially, the overall sagittal suture obliterates early followed by coronal sutures and then lambdoid sutures. On comparing the mean ectocranial and mean endocranial scores of 100 subjects by applying an independent t-test, a highly significant difference was observed in all three sutures. On correlating ectocranial sutures and endocranial sutures and age at death in all the cases through sagittal, right and left coronal, and lambdoid by applying the Spearman rank correlation coefficient, a highly significant correlation was found in all the subjects combined (p-value 0.000). However, no significant correlation (p-value >0.05) was found in ectocranial and endocranial sagittal sutures in individual age groups.

We concluded that obliteration on the endocranial surface is more reliable than on the ectocranial surface. No statistically significant difference exists on the obliteration of sutures on the right and left sides of coronal and lambdoid sutures. The lapsed union was evident in all three sutures ectocranially. Endocranial suture obliteration can be used as a corroborative tool for age estimation.