CBCT-BASED MORPHOMETRIC EVALUATION OF MAXILLARY AND SPHENOID SINUSES FOR AGE AND SEX DETERMINATION IN A SOUTH INDIAN POPULATION

Abstract

Among the paranasal sinuses, maxillary and sphenoid sinuses show considerable anatomical variation and sexual dimorphism, making them useful structures in forensic identification. Cone Beam Computed Tomography (CBCT) allows accurate three-dimensional evaluation of these structures with relatively low radiation exposure. The present study aimed to assess the usefulness of linear and volumetric measurements of the maxillary and sphenoid sinuses obtained from CBCT for age and sex estimation in a South Indian population. A retrospective observational study was conducted using 70 archived CBCT scans comprising 35 males and 35 females between 20 and 70 years of age. Linear measurements including height, width, and length, along with volumetric measurements of the bilateral maxillary and sphenoid sinuses, were obtained using RadiAnt DICOM Viewer and ITK-SNAP software. Independent sample t-test was used for sex comparison, while one-way ANOVA and linear regression analysis were used for age estimation. Receiver operating characteristic (ROC) analysis was performed to evaluate predictive accuracy. Males generally exhibited greater linear and volumetric sinus dimensions than females. Statistically significant differences were observed in left maxillary sinus length (p = 0.04), bilateral maxillary sinus volumes (p = 0.01 and p = 0.04), and bilateral sphenoid sinus volumes (p = 0.04 and p = 0.01). Among all evaluated parameters, right sphenoid sinus volume demonstrated the highest predictive accuracy for sex estimation, with an accuracy of 80% for males and 68% for females. Significant associations were also observed between sinus height, sinus volume, and age groups (p < 0.05). Regression analysis demonstrated that selected maxillary and sphenoid sinus parameters contributed significantly to age estimation.