RADIOLOGICAL ASSESSMENT OF SINUS MORPHOLOGY FOR FORENSIC IDENTIFICATION
Authors: Anwar Ul Haq  , Naheed Siddiqui  
Published: February 2025

Background: Frontal sinus morphology has been widely recognized as a unique and stable anatomical feature, making it a valuable tool in forensic identification. Due to its highly individualized structure, frontal sinus analysis is increasingly utilized in cases where conventional methods such as DNA analysis and fingerprinting are unavailable. The integration of radiographic imaging techniques has further improved the accuracy of forensic identification, reinforcing the significance of frontal sinus morphology in forensic anthropology and medico-legal investigations.
Objective: This study aimed to evaluate the distinctiveness of frontal sinus configurations using paranasal sinus radiographs and assess their forensic applicability by generating unique identification codes based on specific morphological parameters.
Methods: A total of 30 individuals (15 males and 15 females) between the ages of 20 and 30 years were included in the study. Standardized paranasal sinus radiographs were obtained using a Planmeca OY 2002 CC machine, with controlled exposure parameters (78 kV, 12 mA, 1.2 sec). Morphological assessment included sinus area measurement, bilateral asymmetry analysis using the asymmetry index, unilateral dominance classification, upper border contour categorization, and evaluation of partial septa and supraorbital cells. A unique forensic identification code was generated for each participant based on these parameters. Interobserver agreement was analyzed using Cohen’s kappa and the intraclass correlation coefficient.
Results: The frontal sinus area ranged from 0.6 to 26.27 cm² in females and 1.60 to 23.11 cm² in males. The mean frontal sinus area was larger in males (10.69 cm²) than females (9.09 cm²), though the difference was not statistically significant (t = 0.632, P = 0.533). Bilateral symmetry or near symmetry (asymmetry index 80–100%) was observed in 66.66% of females and 33.33% of males, while varying degrees of asymmetry were found in the remaining participants. Slight asymmetry (80–60%) was present in 26.66% of males and 20% of females, whereas moderate asymmetry (60–40%) was observed only in males (26.66%). Unilateral superiority was more frequently observed on the left side (66.66%) than the right (33.33%). The upper border morphology exhibited six distinct patterns, with scalloped contours with two and three arcades being the most frequent. The presence of partial septa was recorded bilaterally in 46.66% of females and 33.33% of males, while supraorbital cells were absent in 66.66% of males and 33.33% of females. All individuals were assigned a unique forensic identification code, confirming the distinctiveness of frontal sinus morphology.
Conclusion: The findings reinforce the forensic applicability of frontal sinus morphology as a reliable biometric tool. The uniqueness of frontal sinus configurations supports its use in human identification, particularly in forensic investigations where traditional methods are impractical. The integration of advanced imaging techniques and standardized classification systems can further optimize the reliability of frontal sinus-based identification.