Are coding systems of frontal sinuses anatomically reliable? A study of correlation among morphological and metrical features

Frontal sinuses are of special interest for personal identification thanks to their high variability. A common procedure for comparing ante-mortem and post-mortem material is based on coding systems classifying frontal sinuses according to their morphological and metrical characteristics. However, the calculation of possible combinations is performed on the hypothesis that all the classified features are independent one from each other. This study aims at analysing the correlation among morphological and metrical characteristics of frontal sinuses. Two hundred CT scans of patients equally divided between males and females were segmented through the ITK-SNAP software. Number of accessory septations, scalloping and supra-orbital cells, side asymmetry and superiority, breadth, height, length and volume were extracted from the frontal sinuses of each subject. A possible relationship among morphological and metrical features was analysed through Pearson's correlation test, Mann-Whitney test or chi-square test according to the type of compared data (p < 0.05). In general, a positive correlation was found for all comparisons among metrical measurements (breadth, height, depth and volume) and number of septations, scalloping and supra-orbital cells (p < 0.05), but not between the number of scalloping and supra-orbital cells. In addition, side of asymmetry was positively related with side of superiority of the upper profile of frontal sinuses (p < 0.05). This study proved that morphological and metrical characteristics of frontal sinuses are strictly related one with each other: therefore, the coding systems based on these features should be applied with caution for personal identification, as the number of possible combinations is lower than reported by literature.