Maxillary sinus in gender determination: a morphometric analysis using cone beam computed tomography

Gender determination of skeletal remains is an important forensic procedure in the identification process. Maxillary sinus remains intact even when the skull and other bones may be badly disfigured. Cone beam computed tomography (CBCT) can provide precise information about complex anatomical structures, as it is characterized by rapid volumetric image acquisition with high resolution. The present study aimed to assess the accuracy of maxillary sinus measurements using cone beam computed tomography in gender determination and to develop a formula using discriminate function analysis. Bilateral maxillary sinus images (left and right) were acquired for 200 patients (100 females and 100 males) and different parameters (width, length, height, area, perimeter, and volume) were measured and evaluated. Mean and standard deviation of both maxillary sinuses measurements were calculated and compared. The data was subjected to discriminative statistical analysis and analyzed using an unpaired t-test. The difference between all these variables was statistically significant between males and females. Based on discriminant analysis, the most pronounced variable in the differentiation of gender groups was maxillary sinus height. Gender assessment was established correctly with an accuracy of 75% for females and 64% for males with an overall accuracy of 69.5%. Adding other independent variables to the model did not result in an improvement in overall accuracy. Cone beam computed tomography measurement of maxillary sinus can be used as an aid in forensic anthropology for gender determination.