Assessment of paranasal sinus parameters according to ancient skulls’ gender and age by using cone-beam computed tomography

Background: The aim of this study was to determine whether paranasal sinus dimensions and volume can be useful to identify gender and age estimation for ancient skulls using cone-beam computed tomography (CBCT) images. Materials and methods: CBCT scans of 32 ancient skulls of approximately 1000 years of age were included in this retrospective study. The gender and age estimation of the skulls were made by an independent anthropologist, which was considered as the gold standard. Paranasal sinuses’ dimensions (width and height) and volumes of each sinus were measured from the CBCT data set that was linked to the three-dimensional rendering software (Anatomage, Invivo 5.2). All measurements were performed by an independent observer. Intra-observer analysis was made. Mann-Whitney and Kruskal-Wallis tests were used to compare paranasal sinus parameters in terms of age estimation and gender (p < 0.05). Results: The results demonstrated no statistically significant difference between measurements (p < 0.05). The measurements were found to be highly reprodu- cible. The mean volumes of frontal and sphenoid sinus were found to be higher in males. The distance from anterior-posterior wall of sphenoid sinus in axial sec- tions is larger in males (p > 0.05). The frontal sinus width and volume increased statistically with age above 60 years of age (p > 0.05). Conclusions: The paranasal volume and dimensions’ measurements from CBCT data can be a promising technique to determine gender and age of ancient skulls because of its lower voxel sizes and higher resolution.